Growth and Development Growth an increase in physical size (height, length, or weight); peaks during infancy and adolescence

e Development an increase in function; occurs in a cephalocaudal sequence Motor skills progress a in proximal to distal manner I N F A N CY Age 1 month to 1 year Accdg. Erikson, the infant is in the critical stage of TRUST vs. MISTRUST. It is important for the child to develop a trusting relationship with a consistent primary caregiver. Interference may cause failure to thrive. Things to expect: Birth weight doubles in 6 months. Birth weight triples in a year. Posterior fontanel closes by 2-3 months. Anterior fontanel remains open until 18 months. Height increases by 50% in 1 year (length X 1.5) Head circumference > than chest circumference until 1 year. Tooth eruption starts at 4 mos. (1 tooth per month) Play is solitary; think SAFETY At 3 months, expect: Social smile Infant knows primary caregiver Follows object with eyes. Lifts head and chest when in prone position Appropriate toys: music box, mobile, mirror At 6 months:

Stranger anxiety Rolling from side to side NO HEAD LAG Sits with support Can transfer object from hand to hand Uses palmar grasp Appropriate toys :bright toys, soft toys, rattle At 9 months: Stranger anxiety escalates Can wave bye,bye Exhibits objext permanency Cries when reprimanded Utters mama, dada Can sit well without assistance Pulls self to stand Uses pincer grasp Appropriate play/toys: peek-a-boo, cloth books At 12 months: Imitative behaviors Cooperates when dressed Mama,dada and two syllable words has meaning Shows jealousy Recognizes meaning of NO Can walk and stand without assistance Turns pages in book Scribbles with crayons Appropriate toys: push toys, large ball, large blocks Nutrition:

Breast milk or iron-fortified formula should be given Think safety when bottle feeding Breast milk may be refrigerated for 48 hours Infant cereal may be started in 4-6 months Fruits and vegetables may be introduced starting 6 months Meats and egg yolks may be started at 9 months Introduce food at 4 day intervals Give finger foods starting 9 months Weaning may be started at 8 months (gradually) Hospitalization: Rooming-in with caregiver TODDLER 1 to 3 years ols Accdg. To Erikson, this is the critical stage of AUTONOMY vs. SHAME and DOUBT. The child develops sense of independence and should be allowed to explore the environment with the encourage of the primary caregiver. The child should be taught to tolerate frustration through socialization and proper toilet training. Things to expect: Sphincter control begins at age 2 All deciduous teeth erupt by 21/2 years Pot-bellied appearance At 18 months: my Vocabulary of 25 words Walks independently Can use spoon Climbs Appropriate toys: push/pull toys, blocks

 At 24 months: Negativistic Temper tantrums Transitional object 2-4 word sentences Walks up and down stairs Turns door knobs Builds tower of six blocks Removes clothes Appropriate play: parallel play,sand, riding toys, water play, finger paints Manage Temper Tantrums: ignore behavior, monitor for safety Nutrition: Offer nutritious snacks May experience food jags Give 6 small meals esp. iron-rich food Avoid giving hotdog,peanuts, and grapes Toilet-training: consider readiness, never punish Hospitalization: rooming-in, transitional object, offer choices Consider water safety and injury prevention