Care of Mother, Child, Adolescence Reviewer
HEALTH PROMOTION OF THE TERM NEWBORN
Assessment
 Pregnancy History
 Physical exam of a Newborn
 Lab results like HCT, bilirubin and blood type
 Teach new mother to make assessments to their infants TPR
Nursing Diagnosis
 Ineffective-out way clearance related to heat loss from exposure in the birthing room
 Ineffective thermoregulation related to heat loss from exposure in the birthing room
 Imbalanced nutrition, less than body requirements, related to poor sucking reflex
 Readiness for enhanced family coping related to birth of infant
Outcome Identification and Planning
 The parent must now about the newborn care
Implementation- conserving newborn warmth and energy to help patient hypoglycemia and
respiratory distress, should be an important consideration
Outcome Evaluation- infants long – term health needs are met.
The Profit of a Newborn- all newborns look “alike” from people viewing a nursery full of babies
Birthmarks- small reddened areas are sometimes present on the eyelids, mid – forehead and nape of
the neck.
Hemangioma- blood vessel tumor
Stork Bites- salmon patch telangiectasia
Strawberry mark- grouping of red dots that eventually coalesce, forming the clean – cut raised lesion
Head- two fontanel, on soft spots, where sutures cross on meets, can be felt and identified
1. Caput Succedaneum or Caput- is the result from the continued pressure of the
undelivered head organs the partially dilated cervix
-It is the abnormal collection of fluid under the scalp that may or may not
cross suture lines, depending on the size
2. Cephalhematoma- caused by collection of bloody fluid between a flat canal bone and
the periosteal membrane
Face- assess for the symmetry when the new born is at rest and when crying. Eyes should be at the
same level, nostrils equal size, cheek full and chin reciding
Eyes- may not track properly and may cross (strabismus) on twitch (nystagmus)
-Irises of the neonates are slate blue, grey or dark brown
-True eye color is seldom established until 3 to 6 months of age
-Assess for whiteness and visualize the red reflex
Red Reflex- red – orange flash of color observed when the opthalmoscope light reflects off the vascular
retina
White pupil- absence of the red reflex may indicate congenital cataracts.
Opthalmia Neonatorum- it is the results from a gonorrheal infection if the mother.
Edema- in the eyelids caused by irritation and trauma
Ears-the ears may be folded and crossed and may seem out of shape initially because of positioning
while in the uterus
-a line drawn from the inner to outer canthus of the eye to the occiput bone should
intersect the top of the ear
-low set of ears are characteristics of several chromosomal abnormalities or internal
organ abnormalities
Nose- asses for patency, discharged and septal deviation
Mouth - early visualized while crying
-lips and mucus membrane should be pink
-tongue should freely movable and midline
-small white cysts is called Epstein’s pearl on the hard palate are normal and gradually
disappear
Trush- Oral infection
-It is caused by fungus called Candida (monilia) albicans that acquired from infected vaginal
tract during birth
-Cleft palate is present in the cleft lip
-If tooth is present at birth which has little root
-The lose is called “rice teeth” are pulled to prevent aspiration.
Neck- short and creased
-muscle is not well developed the neck muscles are unable to support full weight of head
-neck should palpate for masses and inspected for weighing.
-clavicle should palpate for fracture
-moro reflex should be elicited to evaluate equal movement of arms
-more response is absent, if clavicle is fractured
Thorax- chest is cylindrical and ribs are flexible
-33cm normal chest circumference
-Xiphoid cartilage is visible in newborn
-Breast are frequently enlarge in both male and female, a result of maternal hormonal influence
may persist for 2 weeks
-Witch’s milk – breast secrete small amount. Heart and circulatory system serve as respiratory
system
-O2 is not obtained through lungs but in umbilical cord vein
-Through 2 umbilical arteries is elimination of CO2
-Foramen ovale- opens of the arteries of the heart
-Ductus arteriosus- fetal vessels between pulmonary artery and aorta
-When the cord is clamped the 2 umbilical arteries, umbilical vein, and ductus venosus close
and become ligaments
Lungs and respiratory system- surfactant and phospholipid which coats the lining of the alveoli in the
lungs, reduces the surfaces tension of the lungs allowing expiration without lung collapse
Abdomen- the newborn’s abdomen is cylindrical and protrudes slightly.
-the nurse should listen for bowel sounds before palpating the abdomen because palpation
may temporarily decrease bowel sounds
-bowel sounds should be present
-bowel sounds should be present in 4 quadrants to determine the softness, tenderness and
masses
-Palpate the:
 Liver- between 1 – 2 cm below the right coastal margin
 Spleen- lateral upper left quadrant
 Kidneys- Difficult to feel but felt before the intestines become filled with and
fluid from the 1st feeding
Umbilical Cord- look for 1 vein, 2 arteries and presence of Wharton’s Jelly.
Elimination- stools which is called meconium the 1st stool of the infant greenish black, tarry, odorless,
but very tenacious material
-the meconium should appear in 24 – 48 hours for 2 days
-Transitional stools- yellow green and more in consistency
-Breast – fed babies are yellow in color called “Cottage cheese” curds, noisy when passed, with
a sweet odor
Urine- the first voiding is usually occurs within 24 hours
External Genitalia
Female Infants
- The labia minora and majora clitoris, and vaginal opening should be visualize
-Smegma- a white cheese – like substance, is often present under the labia
-Pseudomenstruation- few blood spots are seen in the labia and in the diaper (it is not
profuse)
Male infants
-The penis should be inspected to determine the urinary meatus.
-Hypospadias- refers to condition in which the meatus is located in the ventral or lower
surface.
-Epispadias- placement of the urinary meatus in the dorsal or upper surface. (both can
be surgically repaired)
-Phimosis- Inability to retract the foreskin at all.
Anus- should be inspected for the patency and have no fissure
-The passage of meconium is the best indicator that there is no obstruction.
Extremities
-Polydactyly - (Extra Digits)
-Syndactyly – (Webbing)
-Creases- a single crease called Simian Line- it is something indicative of Down syndrome.
-The full term infant has multiple plantar creases, down to and including the heel, whereas the
preterm infant has fewer creases
-Ortolani’s Maneuver – The nurse place thumbs on the inner thigh and fingers on the outer
aspects of the infant’s leg.
Back -The sacrum and base of the spine should be inspected for tufts of hair or indentation that
may indicate complete closure of the spinal column (spina bifida occulta)
Neurological Assessment
 Assess the state of – alertness, posture, cry, quality of muscle tone movement.
 The healthy infant has full alertness.
 Lusty cry
 Strong muscle tone
 Symmetrical movements of extremities.
Reflexes
 Rotting, Sucking and Swallowing
Rooting- is by touching the side of the newborn’s mouth and cheeks
Sucking- after rooting the infant’s turns toward and opens the lips
Swallowing- observed during feeding
 Moro reflex- head is brought forward (about 30 degrees) and then allowed to fall back
suddenly, abduction of the upper extremities at the shoulder, extension of the elbows
and opening of the hands follow
 Care of Mother, Child, Adolescence Reviewer
 Starter reflex- initiated by a loud noise or sudden movement or jarring may be Significant Characteristics: Peer group increasingly influences behavior physical,
considered part of moro reflex cognitive, and social development increases, communication improved
 Grasp reflex- palmar grasp reflex is elicited by placing the nurses finger in the newborn’s Nursing Implications: Allow time and energy or the school-age child to pursue hobbies
palm and school activities. Recognize and support child’s achievements. Physical growth
-the newborn should grasp the fingers firmly increases
 Babinski reflex- the nurse strokes the sole of the foot from the heel upward and across 6. Adolescence (12-20 years old)
the ball of the foot, the newborn responds by dorsi flexing the big toe and faring all Significant Characteristics: Self-concept changes with biologic development values are
toes. tested. Physical growth accelerates. Stress increases especially in face of conflicts
 Tonic Neck (Fencer Position)- in supine position the Newborn turned the head to one Nursing Implications: Assist adolescents to develop coping behaviors. Help adolescents
side, the arm and leg on the same side of the body will extend and the opposing arm develop strategies for resolving conflicts
and leg flex GROWTH AND DEVELOPMENT
 Neonates and Infants (Birth to 1 year)
Newborn Behavior State A neonate’s basic task is adjustment to the environment outside the uterus, which
 Deep Sleep requires breathing, sleeping, sucking, eating, swallowing, digesting, and eliminating.
- Eyes closed, no eye movement under lids, Infants continue to grow and develop rapidly during the first year, learning more skills as
- Respiration regular they interact with their world.
- Occasional jerky movements at regular intervals A. Physical Development
 Light Sleep  Weight- most babies weigh 2.7 – 3.8kg (6.0 to 8.5lbs)
- Eyes closed, rapid movements under lids -Babies gain their weight at a rate of 150 -210g weekly for
- Respirations irregular 6 months
- Occasional sucking reflex movement -Infants double their weight at 5 months of age
- Random but smoother movements -Triple their birth weight at 12 months
 Drowsy -Just after birth, most infants lose 5% to 10% of their birth
- Eyes open or closed, eyelids fluttering weight because of fluid loss. It is normal and infants regain that weight in
- Activity level variable, movements are smooth about 1 week.
 Active -Studies have shown that increased weight gain in early
- Eyes wide open, considerable activity infancy leads to an increased risk of obesity later in life.
- Thrusting movements of arms and legs -Exclusive breast-feeding in the first 4 to 6 months may be
 Alert helpful in preventing excessive weight gain.
- Eyes open, bright look, attention focused on source of stimulations  Length- measure horizontally
- Minimal Activity Height- measured vertically
 Crown to Rump- head to sacral (during ultrasound)
Growth- pertains to physical increase in size, measured quantitatively, enlargement  Head to heel length- 18inches to 20 inches (average for
Examples: growth of bones, height Western races)
Development- increase in complexity of function and skill progression -15 inches to 18 inches (average for
Examples: walking, crawling, running Filipinos)
It is important to know the growth and development so that you can distinguish the normal and -By 6 months infants gains 13.75cm
abnormalities (5.5inches)
Learning can hinder the growth and development based on: -By 12 months they add another 7.5cm (3
 Learning styles inches)
 Ability of an individual on how to cope up  Head and Chest Circumference
 Maturation At birth- head circumference:
 Grow old -35cm (14 inches) and varies only 1 or 2 cm.
FACTORS THAT AFFECT GROWTH AND DEVELOPMENT -assessment of head circumference is particularly
 Genetics- characteristics from both parents important in infants and children to determine the growth rate of the
-the gender is confirmed through conception skull and the brain
-growth of penis/vagina -the head’s circumference is measured around the skull
-first meet of sperm and egg above the eyebrows, and around the occiput
 Temperament- way on how individual respond to their internal and external At birth- Chest circumference:
environment -less than 2.5cm (1 inch) from the head circumference
Example: hereditary (traits) -9-10 months head and chest circumferences are about
 Family- they are involved in their children physical and psychological well-being and the same.
development -After 1 yr. the chest circumference is larger
-children are socialized through family dynamics  Head molding
-parents set the appropriate behavior  SFontanels - are unossified (i.e., without bone formation)
 Nutrition- adequate nutrition is essential for growth and development membranous gaps in the bone structure of the skull.
Example: malnourished prone to infection -Within a week, a newborn’s head usually regains its
 Environment- environmental factors can influence growth and development including symmetry.
living condition of the child a. Anterior fontanel (4 to 6 cm [1.6 to 2.4 in.] in diameter
 Health- illness, injury or congenital conditions can affect the growth and development and diamond shaped) can increase in size for several
Example: hospitalized can affect the coping mechanism months after birth; closes between 9 to 18 months
 Culture- cultural customs can influence the child growth and development b. Posterior Fontanel closes between 2 to 3 months after
Example: In Middle East, man is superior in any race birth.
STAGES OF GROWTH AND DEVELOPMENT  Sutures - are junction lines of the skull bones that override to
1. Neonatal Stage (birth to 28 days) provide flexibility for molding of the head.
Significant Characteristics: Behavior is largely reflexive and develops to more purposeful The heads of many newborn babies are misshapen because of the
behavior molding of the head that occurs during vaginal deliveries. Molding of the
Nursing Implications: Assist parents to identify and meet and unmet needs head is possible because of fontanels and sutures in the skull.
2. Infancy Stage (1 month to 1 year old)  Vision- The newborn can follow large moving objects and blinks in
Significant Characteristics: Physical growth is rapid (change in weight and height) response to bright light and sound.
Nursing Implications: Control the infant’s environment so that physical and -The pupils of the newborn respond slowly.
psychological needs are met -1 month - Infant can focus his or her gaze on objects and
3. Toddlerhood (1-3 years old) follow moving ones.
Significant Characteristics: Motor Development permits increased physical autonomy. -2 months social smile
Psychosocial skills increase -4 months – recognizes parents smile; has almost
Nursing Implications: Safety and risk taking strategies must be balance to permit growth complete color vision and follows objects through a 180-degree arc.
4. Preschoolers (3-6 years old) -5 months - infant reaches for objects.
Significant Characteristics: Their word is expanding, new experience and the -6 – 10 months - infant can fix on an object and follow it in
preschooler’s social role are tried during play; Physical growth is slower all directions.
Nursing Implications: Provide opportunities for play and social activities -12 months – depth perception has fully developed, and
5. School Age (6-12 years old) the infant will consistently be able to recognize where a change in level
Pre-adolescence period 10-12 years old occurs, such as at the edge of the bed
 Hearing
 Care of Mother, Child, Adolescence Reviewer
 Smell and Taste- the senses of smell and taste are functional shortly after Demonstrates emotions such s
birth anger and affection
-Newborns prefer sweet tastes and tend to decrease their
sucking in response to liquids with a salty content. GROSS MOTOR DEVELOPMENT
-they are able to recognize the smell of their mother’s milk Gross motor skills- refers to the child’s development of skills that require the use of
and respond to this smell by turning toward the mother. large muscle groups. They include: posture, head control, sitting, creeping, standing and
 Touch- the sense of touch is well developed at birth walking.
-skin-to-skin touching is important for an infant’s FINE MOTOR DEVELOPMENT
development Fine motor skills- refers to the infant’s ability to use his hands and fingers to grasp an
-the infant responds positively to the warmth, love, and object. As the infant grows, he begins to refine his motor skills to grab small objects and
security it perceives when touched, held, and cuddled feed himself.
-the newborn is sensitive to temperature extremes and One Month
has poor self-regulation of body temperature Motor Development:
-in response to pain, young babies react diffusely, with a  Can hold head parallel momentarily but still has marked head lag
whole-body reaction, and cannot isolate the source of discomfort  Back is rounded in sitting position, with no head control
 Reflexes- reflexes of the newborn are unconscious, involuntary responses  Able to follow object to midline
of the nervous system to external and internal stimuli.  Strong grasp reflex
-reflexes normally present at birth are the sucking, rooting,  Hands remain mostly closed in a fist
Moro, palmar grasp, plantar, tonic neck, stepping, and Babinski reflex.  Distinguishes mother’s voice after 1 week, father’s by 2 weeks
-the abilities to yawn, stretch, sneeze, burp, and hiccup are  Listens to voices; quiets to soft music, singing, or talking
all present at birth.  Utters small, throaty sounds
INFANT REFLEXES Solitary (plays alone)- Small enough to grasp but big enough to safety
Sucking Reflex Feeding reflex occurs when the infants’ lips are -At birth to 2 months- Crib mobiles with contrasting colors.
touched -2-4 months – Rattles, Teething toys, small blocks
Persists throughout infancy -4-6 months – Brightly colored toys, squeeze toys, plastic keys, rubber ducks,
Rooting Reflex Feeding reflex elicited by touching the baby’s cheek, plastic boats
causing the baby’s head to turn to the side that was -6-9 months – Large toys with bright colors, movable arts and noise makers
touched -9 to 12 months – Books with large pictures, push- pull toys, cuddly toys, pats
Disappears after 4 months and pans, peek – a- boo, tickling and swinging.
Moro Reflex Estimate the maturity of the central nervous system C. Psychosocial Development
A loud noise, a sudden change in position Trust vs. Mistrust
Disappears after 4 months -From birth to 12 months of age, infants must learn that adults can be trusted.
Palmar Grasp Occurs when small object is placed against the palm -Infants are dependent upon their caregivers, so caregivers who are responsive
Reflex of the hand, causing the fingers to curl around it and sensitive to their infant’s needs help their baby to develop a sense of trust;
Disappears after 3 to 6 months their baby will see the world as a safe, predictable place.
Plantar Reflex Similar to palmar grasp reflex; an object placed just -Unresponsive caregivers who do not meet their baby’s need can engender
beneath the toes causes them to curl around it feelings of anxiety, fear, and mistrust; their baby may see the world as
Disappears after 8 to 10 months unpredictable.
Tonic Neck Reflex A postural reflex. When a baby who is lying on its -If infants are treated cruelly or their needs are not met appropriately, they will
(TNR) or Fencing back turns its head to the right side, the left side of likely grow up with a sense of mistrust for people in the world.
Reflex the body shows a flexing of the left arm and leg Sleep and Rest- all infants are positioned on their backs for sleep until they can roll over
Disappears after 4 to 6 months and determine their own sleeping
Stepping Reflex Can be elicited by holding the baby upright so that Expectations for sleeping through the night
(Walking or the feet touch a flat surface. The legs move up and - Birth to 4 months – an infant will wake to feed at night from 0 to 3 times.
Dancing Reflex) down as if the baby were walking - Breast fed- infants feed frequently than bottle –fed infants because
Disappears about 2 months breast milk is digested faster than the formula.
Babinski Reflex When the sole of the foot is stroked, the big toe rises
- Ages 4 to 6 months- infants are capable of sleeping( without feeding) for
and the other toes fan out. A newborn baby has a
6 to 8 hours at night.
positive Babinski. After age 1, the infant exhibits a
Napping
negative Babinski; that is, the toes curl downward. A
- Birth to 3 months – infants may take many naps per day. An infant
positive Babinski after age 1 can indicate possible
shouldn’t be allowed to sleep longer than 4 hours at a time during a day,
upper motor neuron damage
because this will lead to more night time awakenings to feed.
- Ages 4 to 9 months – the infant will have transitioned to two naps per
B.Motor Development- motor development is the development of the baby’s
day( one in the morning and one in the afternoon.
abilities to move and control the body. Initially, body movement is
- Total naptime should add up to about 2 to 3 hours.
uncoordinated
- Ages 9 to 12 months – most infants will have transitioned to only one
-1 month - infant lifts the head momentarily when prone, turns the head
nap in the afternoon
when prone, and has a head lag when pulled to a sitting position. Head lag
- Total of 1 to 2 hours of napping time
should be minimal by 4 months of age
SLEEP REQUIREMENTS FOR INFANTS
-After 6 months -infants may sit without support.
Age Hours of Sleep
-9 months - they can reach, grasp a rattle, and transfer it from hand to
1 week 16%
hand.
1 month 15%
-12 months - they can turn the pages of a book, put objects into a 3 months 15%
container, walk with some assistance, and help to dress themselves. 6 months 14%
EXAMPLES OF MOTOR AND SOCIAL DEVELOPMENT (INFANCY) 9 months 14%
AGE MOTOR DEVELOPMENT SOCIAL DEVELOPMENT 12 months 13%
Newborn Turns head from side to side Displays displeasure by crying
when in prone position and satisfaction by soft Nutrition
Grasps by reflex when object is vocalizations - Breast milk or iron fortified formula is recommended for the first 12 months of
placed in palm of hand Attends to adult face and voice life.
by eye contact and quieting - Human milk consumed through breastfeeding is considered optimal for the
4 months Rolls over. Sits with support, Babbles, laughs, and exhibits neonates.
holds head steady when sitting increased response to verbal - Iron supplements by 4 months
play - Fluoride supplementation may be needed at about 6 months depending on the
6 months Lift chest and shoulders off Starts to initiate sounds infant’s intake of fluoridated tap water.
table when prone, bearing Vocalize one-syllable sounds: - Vitamin D supplementation if not frequency exposed to sunlight.
weight on hands “ma, ma” “da, da” - Skim milk and low – fat milk should be avoided. Whole milk should not be
Manipulates small objects introduced until 1 year.
9 months Creeps and crawls. Uses pincer Complies with simple verbal Breastfeeding
grasp with thumb and commands Displays fear of - A neonate should nurse on demand, approximately 8 to 10 per day for at least
forefinger being left alone 10 to 15 minutes at each breast.
Waves “bye-bye” - The after duration of feeding may increase and the frequency may decrease as
12 months Walks alone with help Clings to mother in unfamiliar the infant gets older and after solid foods are introduced.
Uses spoon to feed self situations Formula feeding
 Care of Mother, Child, Adolescence Reviewer
- Formula feeding can provide adequate nutrition when the mother shouldn’t or To prevent falls:
can’t breast her infant.  Never leave the child unattended, especially on a changing table, bed, sofa, or
- Infant formulas are constituted to provide the proper variety and amount of counter.
carbohydrates, proteins, fats and micronutrients needed for healthy growth and  Place gates at the top to bottom of Staircases.
development.  Put up window guards, if needed
Introduction of Solid Foods  Avoid placing infants in walkers because they can tumble over an uneven surface
- The age at which solid foods are introduced into an infant’s diet depends on such or the leg of a chair or table, or fall down stairs.
factors : Nutritional need for iron, the infant’s physiologic capability to digest  Toddlers (1 to 3 years)
starch, and his physical ability to chew and swallow. A. Physical Development- two-year-old children lose the baby look. Toddlers are
- Introduction at 5 to 6 months of age because of developmental readiness and usually chubby, with relatively short legs and a large head.
infant can assume upright position, extrusion reflex lessens and mature digestive -The face appears small when compared to the skull, but as the toddler
tract. grows, the face seems to grow from under the skull and appears better
SEQUENCE OF INTRODUCTION OF FOODS proportioned.
Age Type of food Rationale -Toddlers have a pronounced lumbar lordosis and a protruding abdomen.
4 month Rice cereal mixed with Less likely than wheat to The abdominal muscles develop gradually with growth, and the abdomen
breast milk or formula cause allergic reaction flattens.
5 to 6 months Strained vegetables Vegetable offered first  Weight- two-year-olds can be expected to weigh approximately four
(offered first) and fruits because they may be times their birth weight.
more readily accepted  Height- a toddler’s height can be measured as height or length.
tan if introduced -Between ages 1 and 2 years, the average growth in height
aftersweet fruits is 10 to 12 cm (4 to 5 in.); between 2 and 3 years it slows to 6 to 8 cm (2
7 to 8 months Strained meat, cheese, Provide important 1/2 to 3 1/2 in.).
yogurt, rice, noodle, source of iron and add  Head Circumference- the head circumference of the toddler increases
and pudding variety to the diet about 2.5 cm (1 in.) each year.
8 to 9 months Finger foods (bananas, Promote self-feeding -by 24 months the head is 80% of the average adult size
crackers) and the brain is 70% of its adult size.
10 months Mashed egg yolk (no Use of bite-size pieces B. Motor Abilities
whites until age of 1) to decrease the risk of -18 months - babies can pick up raisins or cereal pieces and place them in
bite-size cooked foods choking a receptacle. They can also hold a spoon and a cup and can walk upstairs with
(no foods that may assistance. They will probably crawl down the stairs.
cause choking) -2 years old - toddlers can hold a spoon and put it into the mouth
12 months Foods from the adult Provides a nutritious
correctly. They are able to run, their gait is steady, and they can balance on one
table (chopped or and varied diet that
foot and ride a tricycle.
mashed according to should meet the infant’s
-3 years old - most children are toilet trained, although they still may
the infant’s ability to nutritional needs
have the occasional accident when playing or during the night.
chew foods)
C. Psychosocial Development
Autonomy vs. Shame/Doubt
Rules when introducing supplementary foods
-As toddlers (ages 1–3 years) begin to explore their world, they learn that they
 Watch for behaviors that indicate feeding preferences. If the infant rejects a food
can control their actions and act on their environment to get results.
initially, offer it again later.
-They begin to show clear preferences for certain elements of the environment,
 Keep the infant in an upright feeding position
such as food, toys, and clothing.
 Initially, offer iron- fortified rice cereal. Avoid wheat- based cereal for the first year
-A toddler’s main task is to resolve the issue of autonomy vs. shame and
 Introduce new foods one at a time, waiting 5 to 7 days between them.
doubt by working to establish independence. This is the “me do it” stage.
 Avoid grapes and grape halves, nuts food with seeds, raisins, popcorn, Jell-O. and cut up
 Preschoolers (4 to 5 years) (longer extremities)
hotdogs until infant has adequate chewing and swallowing skills.
A. Physical Development- preschool-age children tend to grow more in height than
 Give regular, not sweetened juices.
in weight, so by the time children are 4 or 5 years old, they appear taller and
 If an infant has history of allergies, delay offering eggs, wheat – based products, and
thinner than toddlers.
citrus fruits.
-the posture of preschoolers gradually becomes more erect as the pelvis
 Avoid honey, corn syrup and other unpasteurized products.
is straightened and the abdominal muscles become stronger
 Avoid microwaving baby foods.
-the extremities of the body grow more quickly than the body trunk,
Weaning
making the child’s body appear somewhat out of proportion.
Timing:
-the preschooler’s brain almost reaches its adult size by 5 years.
- 6 months- from breast to bottle
 Weight- weight gain in preschool children is generally slow.
- 12 months – from bottles to cup
-by 5 years they should have added only another 3 to 5 kg
Sequence:
(7 to 12 lb) to their 3-year-old weight, increasing it to somewhere
- Weaning should be gradual. One breast feeding session per day is placed with a bottle
between 18 and 20 kg (40 and 45 lb)
feeding until over period of days to weeks. Eliminate breast (one) or bottle feeding at a
 Height-by 4 years of age they have doubled their birth length and
time of one complete feeding.
measure about 102 cm (41 in.).
- Gradual weaning helps prevent engorgement in the mother and decreases the risk of
B. Motor Abilities- by 5 years of age, children are able to wash their hands and face
mastitis.
and brush their teeth.
Dental Hygiene
-hey are self-conscious about exposing their bodies and go
1. Wiping the teeth and gums with a soft washcloth and water alone provides adequate
to the bathroom without telling others.
cleaning when infant has only few teeth.
-preschoolers can balance on their toes (tiptoe) and dress
2. Once 7 to 8 teeth have erupted, they can be cleaned with a small, soft bristled
themselves without assistance.
toothbrush and water.
C. Psychosocial Development
3. Toothpaste shouldn’t be used, because the infant would swallow it. Ingesting
Initiative vs. Guilt
fluoridated toothpaste can cause nausea and Fluorosis (a gray discoloration of the
-The preschool stage (ages 3–6 years), they are capable of initiating activities and
permanent teeth).
asserting control over their world through social interactions and play.
4. Dental visits can begin at ages 1 to 6 months.
-Preschool children must resolve the task of initiative vs. guilt. By learning to plan
5. Fluoride supplements maybe needed in areas where the water supply contains
and achieve goals while interacting with others, preschool children can master
inadequate fluoride or none at all. Fluoride supplements can be given in infants 6
this task.
months old.
-Initiative, a sense of ambition and responsibility, occurs when parents allow a
Injury Prevention
child to explore within limits and then support the child’s choice. These children
 Aspiration - Because infants become adopt at placing objects in their mouths for
will develop self-confidence and feel a sense of purpose.
exploration, they’re risk for aspiration.
-Those who are unsuccessful at this stage—with their initiative misfiring or
To prevent aspiration:
stifled by over-controlling parents—may develop feelings of guilt.
 Feed the infant in slightly upright position.
 Burp infants in an upright or prone position
 Cut solid foods into very small pieces when the infant starts eating solids.
 Avoid foods and other things that can be choking hazards like hotdogs, nuts,
popcorn, hard candy, ice cubes, grapes, uncooked vegetables chunks, and lumps
of peanut butter.
 Keep small toys and other small items off the floor.
 Falls- as the child becomes mobile, the risk of falls increases.