Growth and development of infant for B.Sc Nursing students

1. Prof. Dr. G. Maheswari, Ph.D (N),
Dhanvantri College of Nursing
Namakkal District

2. Introduction
Definition:
From birth to first 28 days (4 weeks) period
is called as newborn period.
The newborn immediately after birth started to
adapt with the external environment.

3. APGAR scores
The neonatal well being will be evaluated with
the use of APGAR scoring system. The score 7 at
1 minute and 10 at 5 minutes after birth is
considered as normal.

4. Systematic study of Growth and development
includes
 Physical growth
Physiological growth
Organ system maturation
Sensory and motor development
Emotional and social development (includes psycho-
social and psycho-sexual)
Cognitive development
Language development
Interpersonal development
Moral development
Spiritual development

5. Physical growth
Weight
The average birth weight of Indian newborn is
2,500 grams – 3,500 grams.
3 - 4 days after birth the newborn lose up to 10%
of birth weight, due to
withdrawal of maternal hormones
lose of urine and feces.
But this 10% of weight can be regained within 10
days after birth. The newborn gains 110 grams to
220 grams per week.

6. Physical growth
Length
The length varies from 46 – 56 cms.
The newborn grows about 2.5 cms to 3.5 cms
with in the first month of life.

7. Physical growth
Head circumference
The average head circumference varies from
33 – 35 cms

8. Physical growth
Chest circumference
The average chest circumference varies from
30.5 – 33 cms. In newborn the chest
circumference is 1- 1.5 cm less than the head
circumference.

9. Physiological growth
The vital signs of newborn
 Heart rate: ranges from 120 – 140 beats per
minute
 Respiration: ranges from 50 – 60 breaths per
minute
 Blood pressure: average is 60/40 mmHg

10. Organ system maturation
The newborn infant’s organ system undergoes lot
of changes after birth.
The major, significant changes occur in cardio-
vascular, respiratory, neurological, integumentary,
gastro-intestinal, renal and hematological system.

11. Organ system maturation
Cardiovascular system
Immediately after birth the temporary
structures of fetal circulation closes
The normal circulation started to establish.
The blood circulated through the lungs for
oxygenation.
The peripheral capillaries are very close to the
skin leads to excessive heat loss.

12. Organ system maturation
Respiratory system
The average respiratory rate ranges from 50 – 60
breaths per minute.
The alveoli remain opens for gas exchange.
The breathing pattern is irregular with periodic
pause.
The newborn are abdominal breathers, respiration
rates can be counted with abdominal movements
not with chest movements.

13. Organ system maturation
Neurological system
By birth the newborn has certain reflexes, is
called as primitive reflexes.
The primitive reflexes are involuntary, automatic
response to stimuli from the external
environment.
The primitive reflex disappears when newborn
progress to grow.

14. Organ system maturation
Primitive Reflexes
Primitive
reflex
Stimuli Response of
newborn
Appears Disappears
Moro
reflex
Change in
equilibrium
by jarring
the crib
Drawing legs up with
sudden extension of
the head, The arms
fan out and forms ‘C’
position, then moves
toward midline
Birth 3–4 months

15. Organ system maturation
Primitiv
e reflex
Stimuli Response of
newborn
Appea
rs
Disappear
s
Rooting
reflex
The cheek
is stroked
Turns the head
towards that
direction of stroke,
searching with
mouth with
anticipation of
food.
Birth 3-4 months
when
awake
7-8 months
when in
sleep

16. Organ system maturation
Primitive
reflex
Stimuli Response
of newborn
Appears Disappears
Sucking
reflex
Keeps the
nipple or
finger in
infants
mouth
Started to
suck
Birth 5-12 months

17. Organ system maturation
Primitive
reflex
Stimuli Response of
newborn
Appears Disappear
s
Tonic neck
reflex
The head is
turned to
one side
The same side arm
and leg are
extended, the
opposite side arm,
leg are flexed in a
fencing position.
Birth 4-6 months

18. Organ system maturation
Primitive
reflex
Stimuli Response
of
newborn
Appears Disappear
s
Palmar
grasp
reflex
Touch the
palm with
fingers
Grasping
the fingers
with palm
Birth 4-5 months

19. Organ system maturation
Primitiv
e reflex
Stimuli Response
of newborn
Appears Disappear
Plantar
grasp
Apply pressure
with the use of
finger in the
plantar surface
Grasp the
finger with
bottom of
foot
Birth 9 months

20. Organ system maturation
Primitiv
e reflex
Stimuli Response
of newborn
Appears Disappear
Babinski
reflex
Stroking along
the lateral
aspect of the
sole
Fanning and
hyperextensi
on of the toes
Birth Variable at
12 months

21. Organ system maturation
Primitiv
e reflex
Stimuli Response of
newborn
Appea
r
Disappear
Step
reflex
Keep the baby
in upright
position wth
one foot on a
flat surface
The newborn
puts the other
foot down in
order to step
Birth 1-2 months

22. Integumentary system
 Lanugo – fine, downy hair in the scapular region,
anterior aspect of the upper and lower
extremities, the newborn lost lanugo within a
week but not replaced.

23. Integumentary system
 Vernix caseosa – white cheese like substance
covers the newborn skin in order to protect fetal
skin from irritation and infection due to amniotic
fluid.

24. Integumentary system
 Milia – white pin point pimples in nose and chin is
because of obstruction of sebaceous glands,
disappears by week

25. Integumentary system
 Mongolian spot – greenish blue discoloration of
the skin mostly in sacral and gluteal areas,
disappeared by few years

26. Integumentary system
 Acrocyanosis – peripheral blueness of hands and
feet, disappears within few days after birth.

27. Organ Gastro-intestinal
The capacity of stomach is 20 – 30 ml. Small
amounts of saliva presents during birth. Digestive
enzymes are insufficient. The liver is immature,
failure to conjugate excessive bilirubin causes
physiological jaundice. The ability to conjugate
bilirubin is developed within two weeks after
birth.

28. Organ Gastro-intestinal
 A meconium, is a first stool,
mixture of intestinal
secretions, dead cells,
lanugo, amniotic fluid.
 The meconium is dark,
sticky, greenish black, is
passed within 8 -24 hours
after birth. In the next
few days the tool become
yellowish. The newborn
passes 8- 10 stools per day.

29. Renal system
 Renal structures are immature, cannot
concentrate the urine, so the newborn passes
frequent and low specific gravity urine.
 The newborn is more prone to get dehydration is
because of composition of intra cellular fluid
(40%) is more than adult (20%).

30. Hematological system
 After birth the significant changes occur in
hematological system.
 At birth the fetal hemoglobin is present in large
amounts, and then the fetal hemoglobin
production ceases, adult hemoglobin production
starts.
 The excessive RBC destruction and immature
lungs, insufficient glucronyl – 6 transferase
enzymes causes increased uncongucated biliruin in
blood, causes physiological jaundice.

31. Sensory and motor skills development
 The newborn has all five senses, can recognizes
care giver’s face, voice, smell of breast milk, and
can taste sweet, bitter, sour, salt.
 Uncoordinated motor movements (reflexes),
gradually develops toward coordinated motor
movements during infant period.

32. Emotional and social development
 The newborn express their discomfort by crying
 Will response to soothing talk by parents or care
givers
 Seeks interaction with facial expression and
different sounds.

33.  Psycho social development
- Trust Vs Mistrust
 Psycho-sexual Development
– Oral stage

34. Cognitive development
The newborn brain grows very rapidly; the
positive interaction with newborn promotes
healthy brain growth

35. Language development
 The newborn observe and listens the sounds of
language which gives the foundation of speech in
later life.

36. Interpersonal theory - Sullivan
Activities
Birth to 1½ yrs Depends the care giver for meeting
their needs, tries to satisfy the care
giver timely to get benefits.

37. Moral development theory – Lawrence
Kohlberg
Age Stage Activities
Birth to 2
years
Stage 0 Think what he likes and want
is good, others are bad

38. Fowler’s Spiritual development
Age Stage and Activities
Birth
to 2yrs
Stage 0 – Primal or
Undifferentiated faith: Wants to be
in a safe and secure environment. If
they are nurtured with the sense of
safety the trust on the universe and
the Divine develops

39. Conclusion
The newborn exposed to gentle touch,
comfortable stimulation, simple hug, kiss, tender
loving care shows marked changes in their late life
of growth and development.

40. REFERENCES
Wong’s Essential of Pediatric Nursing, 10th edition; Elsevier
publication.
Principles of Pediatric Nursing; “caring for children” ;author,
Jane Ball et all., sixth edition.
Text book of Pediatric Nursing; author, Dorothy R Marlow; 6th
edition
Lippincott, Pediatric Nursing; 5th edition.
https//www.ncbi.nlm.nih. gov/pmc/artices/PMC 5006399