developmental milestones and complications
Developmental Stages
Week 7
Christina Sierra
1
Subjects
Developmental Management in Pediatric Primary Care
Developmental Management of Infants
Developmental Management of Early Childhood
Developmental Management of School Age Children
Developmental Management of Adolescents
2
Developmental Management in Pediatric Primary Care
Assessing development
Height weight head circumference
Interviewing parents
Knowing appropriate milestones
Educating families on normal vs abnormal
Educating on developmental expectations
We all grow at different rates so never compare yourself to someone else’s situation, doing so, can only bring disappointment.
– Massy Arias
3
Growth Chart
In child development nothing is set in stone. There is a grey area in timing.
Development has a variation in time- it maybe a few weeks or months.
Developmental Management of Infants
Birth to one month:
Babies lose 5-8% of body weight in their first few days and then regain within 10-14 days
They should gain about 2 lbs per month
Nutritional needs should meet 110 kcal/kg/day
Sleep about 16 hours
Sucking, rooting, tonic neck, moro, grasp- present and symmetric
Moving hand to mouth, sucking, or grasp clothing- self console
May turn to parents voice
Visual space is about 8 -12 in from face, vision is foggy
Hearing and smell is developed- but especially smell
Four ways of being awake: 1. Drowsy 2. Quiet but alert 3. Crying 4. Alert and active
What does a baby’s cry mean?
Normal
Hunger- rhythmic intense
They want to be cuddled-slow, low tone
Pain- high pitch screetchy
Tired- slow rhythmic, intensifies
Cries should be distinctive and vary on needs or feels.
This begins articulation
What does a baby’s cry mean?
Usually colics
Crying for over 30 minutes even after being fed, cleaned, consoled.
High-pitched, shrieking
Abnormal central nervous system
Cornelia de Lange syndrome – like a bleating lamb
Cri-du-chat syndrome- like a cat
Cerebral irritability (i.e. meningitis, hydrocephalus, kernicterus)
Malnutrition especially marasmus
Grunting
Pneumonia
Sepsis
Hoarseness
Hypothyroidism
Trauma to the hypopharynx
Vocal cord paralysis
Muffled
Epiglottis
Stridorous
Foreign body
Infection – abscesses, croup, epiglottitis
Laryngeal abnormalities
Oropharynx abnormalities
Tracheal abnormalities
Neoplasm
Weak or whimperyMuscle weakness
Muscular dystrophy
Myasthenia gravis
Infection
1 month to 3 months
Growth in height is approximately 1.4in per month
Growth in head circumference is approximately 0.8 in
Weight gain is approximately 420 g= about 1 lb a month
Growth spurts are expected and baby will eat more in a quicker time frame
Baby becomes more routined with sleeping, passing stool and eating schedule
Body movement is symmetric
Attempts to grasp objects
Cooing and babbling should be expected
Response to conversations- acknowledgment, turning head, focused with communication with body language
They may show smiles, imitation, tracking objects
By two months you should expect to see:
Social and Emotional
Begins to smile at people
Can briefly calm herself (may bring hands to mouth and suck on hand)
Tries to look at parent
Language/Communication
Coos, makes gurgling sounds
Turns head toward sounds Baby raising head and chest when lying on stomach
Cognitive (learning, thinking, problem-solving)
Pays attention to faces
Begins to follow things with eyes and recognize people at a distance
Begins to act bored (cries, fussy) if activity doesn’t change
Movement/Physical Development
Can hold head up and begins to push up when lying on tummy
Makes smoother movements with arms and legs
4 months to 5 months
Sleep approximately 12 hours and through the night
By 5 months baby DOUBLE BIRTH weight
Weight gain, height and head circumference growth slows down
Begin to grab objects, hold bottles
You now see the Landau reflex
Baby rolls
Tummy time is important- they should start to see slight holding of the head while on their belly
Beginning to show signs of progression to sit
You may begin
Landau’s Reflex
Begins at 3-4 months
Seen until 12-24 months
Lay prone supported in air
You want to see the “superman”
Is your baby ready for solids?
At 4 months you can introduce solids such as cereals.
`Can your baby hold his or her head in a steady, upright position?
Can your baby sit with support?
Is your baby mouthing his or her hands or toys?
Is your baby showing a desire for food by leaning forward and opening his or her mouth?
Foods are introduced one at a time for three days straight to assure there are no food allergies
6 months to 8 months
Teething symptoms begin
Crawling begins, infant may stand, scooting, sitting longer
Rake and pincer grasp, transfer ball to ball, reach and grab, pointing, tugging throwing
Led weaning begins at this time
Single sound- oh, ah, da, ba, ma. Cooing and babbling
Imitation of sounds such as coughing
They learn parents tone and can understand no
Social play, separation anxiety
Cause and effect- gravity, peek a boo
9 months to 12 months
Bowel and bladder are more regular
Food preferences with structured meals- breakfast snacks lunch snack dinner
Hold cups and sips
They should put objects in box, stack objects,
Add a Slide Title – 4
Resource through the CDC
Developmental check list
References
American Academy of Pediatrics, healthychildren.org website. Responding to your baby’s cries. www.healthychildren.org/English/ages-stages/baby/crying-colic/Pages/Responding-to-Your-Babys-Cries.aspx. Updated November 21, 2015. Accessed November 20, 2018.
Pomeranz AJ, Sabnis S, Busey SL, Kliegman RM. Irritable infant (fussy or excessively crying infant). In: Pomeranz AJ, Sabnis S, Busey SL, Kliegman RM, eds. Pediatric Decision-Making Strategies. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.
Illingworth RS. Common Symptoms of Disease in Children. Blackwell Scientific Publications: Oxford. 1988:296.
Jonathan Juett, and Benjamin Kuipers, “Learning to reach by building a representation of peri-personal space,” 2016 IEEE-RAS 16th International Conference on Humanoid Robots (Humanoids), pp. 1141–1148, .
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