GROWTH AND DEVELOPMENT OF

INFANT
 INTRODUCTION
The period of growth and development extends
throughout the life cycle; however, the period in which
the principal changes occur is from conception to end of
adolescence. This most important period of growth and
development is a complex one, in which two cells joined
as one normally become thinking, feeling person who
eventually take the responsibility of the society. It is
important for a nurse to understand this early period as
well as the total life cycle of an individual to better
under stands the behavior of parent and other adults who
provide care for the child.
 PHYSICAL GROWTH AND
DEVELOPMENT
 
BIOLOGICAL GROWTH
Biological growth during infancy includes
changes in weight length, head and chest
circumference, vital signs, reflexes dentition
and physiological functioning.
  
MOTOR DEVELOPMENT

Motor development depends on the maturation of

the muscular, skeletal and the nervous system.
Motor development is usually termed as gross motor
and fine motor.
Gross motor development describes the
acquisition of increasing mobility and independent
locomotion. Gross motor activities include turning,
reaching, sitting, standing, and walking.
Cont….
Fine motor development evolves as the
reflexes gives way to the acquisition of motor
dexterity. As the neural tract matures, reflexes
disappear and are replaced by purposeful
activities. The child learns to use the hands
and fingers for thumb apposition palmar grasp,
releases, pincer grasp.
 
 Principles of motor development

 Muscular development occurs in a cephalocaudal

manner.
 The development of muscular control is also from

proximal to distal.
 The two preceding principles operate in conjunction

with development from general to specific

movement
 SENSORY DEVELOPMENT
 All the senses develop gradually; those of vision,
hearing, and taste develop especially during the period
of infancy.
 Visual acuity, binocularity, depth perception and visual

preference continue to develop during the first 12

months of life.
 The new born baby can see larger objects, the older

infant becomes interested in their details and is able to

see and pick up much smaller objects.
 Deep perception is dependent on binocular vision, it

may be present early in life but generally begin to

develop at about 7months of age.
 The young infant shows a visual preference
for the human face and by 6 month of age can
respond to facial expression and can recognize
stranger. This ability to recognize stranger
leads to separation anxiety.
 Maturation of system

 All the system change and grow during infancy. Respiratory

rate slows; respiratory movements continue to be
abdominal.
 The lumen of the trachea and bronchi enlarges during

infancy. As the infant grows the heart rate slower

 The digestive process is relatively immature at birth.

Although full term new born infant have some limitations in

digestive functions.
 Digestion takes place in duodenum, where pancreatic

enzyme and bile begin to break down protein and fat.

 Cont….
 The immunologic system under goes numerous
changes during the first year. Immaturity of the
renal structure also predisposes the infant in
dehydration. Complete maturity of kidney occurs
during the latter half of the second year.
 The endocrine system is adequately developed at
birth, but their functions are immature.
 PSYCHO SOCIAL DEVELOPMENT OR EMOTIONAL
DEVELOPMENT
 
 Social development means training g a child in the culture
of the group.
 Children’s are prepared for their adult role through a
process of socialization that takes place from birth to
adulthood.
  According to Erikson, the first and probably the most
important of these is the development of the sense of trust
 If this sense of trust in others is not learned, the reverse a

sense of mistrust, is acquired a tendency hat become

increasingly difficult to change as the infant enters
childhood.
 PSYCHO SEXUAL DEVELOPMENT
 
 Human sexuality is expressed in every day life. Sexuality
refers to the total quality of a human being from the time of
birth, not just to the genitals and their functions.
 According to Sigmund Freud theory of psychosexual

development, the infancy is termed as the oral stage.

 During this period, the oral region, or the sensory area of

the mouth, provides the greatest sexual satisfaction for the

infant.
 SPIRITUAL DEVELOPMENT
 
 According to Fowler the spiritual development in
infancy is stage1 Primal faith.
 Paralinguistic and preconceptual, this stage embodies

that trust between parent and infant.

 Parent and child from a mutual attachment and progress

through a period of give and take.

 The primary caregiver provides the infant and young

child with a variety of experience that encourages the

development of mutuality, trust, love and dependence
progressing to autonomy.
 INTELLECTUAL DEVELOPMENT OR
COGNITIVE DEVELOPMENT

The theory of Piaget concerning intellectual or cognitive

development in the infant as Sensori motor (0-2years).
When infant or children have attained a new level of
cognitive functioning, they consolidate and progressively
organize it while the same time begins to learn yet a newer
level of functioning.
 
 Piaget’s theory
 

Describes four major cognitive processes

 Schema is a category of thought or a classification fir a
behaviors or an action
 Assimilation is the process during which stimuli are
recognized, absorbed and incorporated into an already
existing schema
Cont….
 Accommodation is the creation of new schemas
the modification of an old one
 Equilibration or the achievement of a balance
between two elements is the balance an individual
attempts to maintain between assimilation and
accommodation.
Equilibration is used for coping with
discrepancies which lead to growth.
 Cont…
Three important events take place during sensorimotor
stage are:
 Separation of infants self from other persons such as
mother or object in the environment
 Perceiving the concept of object permanency or
constancy.
 Using symbols to think of a situation or a object
such as toy, with out its being present in the
immediate environment
 Four sub stages during the first year of life
 

 
 Sub stage 1 (birth - 1 month)
 Sub stage 2 (1- 4months)
 Sub stage 3 (4-8months)
 Sub stage 4 (8-12months)
 MORAL DEVELOPMENT

According to Piaget and Kohlberg the moral

development in infancy is preconventional morality-
egocentricity.
Children make moral judgment only on the basis of what
will bring them a reward or punishment.
Stage 0
“The good is what I like and want” (0-2years)
Infant and young toddlers are ego centric, liking or
loving that which help them and disliking or hating that
which hurts them.
 LANGUAGE AND SPEECH DEVELOPMENT

 The infants biophysical, cognitive, affective and the

social development of the ability to understand and
use language.
 For optimal development to occur the infant must be

healthy and with out problem, i.e., blindness,

deafness, cleft palate, or mental retardation.
 Prevention of language disorder begins prior to

conception and continues during the period of

gestation.
 Before words can be used the infants communicates

in other available ways; a cry to indicate discomfort ,

a smile to indicate pleasure.
 Attachment
 The importance of human physical contact cannot be
overemphasized. Parenting is not an instinctual ability but
a learned acquired process.
 The attachment of parent and child, which begins before

birth and assume even more importance at birth continue

during first year.
 In attachment, the word mother is used in the broad

context of the consistence caregiver with whom the child

relate more than anyone else.
Cont…
Infant acquire other development behavior that
influences the attachment process. These include:
 Differential crying, smiling and vocalization
 Visual –motor orientation
 Crying when mother leaves the room
 Approaching through locomotion (crawling,

creeping, walking)
 Cling(especially in presence of a stranger)
 Exploring away from mother while using her as a

secure base
 Personal social behavior
 Personal –social behavior include the child personal
response to the environment.
 Personal social behavior implies communication with

one’s self wit others.

 It provides the foundation for the successful mastery

of skills such as feeding control of bodily activities

independence and cooperativeness in play.
 PLAY
 Play enhances the infants maturation and provide an
opportunity to practice newly acquired motor skills as well
as learn about the environment and the people around
them.
 play for the infant moves rapidly from accidental pleasure
producing activities with an increasing awareness of the
surrounding environment.
 By 6month -1year the infant engages in repetitive activities
involving voices, sounds, music’s, and a variety of toys
which enhances the development of language and
sonsorimotor skills.
 Safety precautions with infant toys
 Select toys that are smooth and rounded made of wood or
plastic.
 Plastic toys should be made of through resident plastic

rather than the thin rigid kind that will crack

 Avoid fuzzy and furry stuffed animals
 Inspect toys for small removable parts
 Make sure toys are not painted with toxic substances
 Keep the infant under supervision who playing with string

paper or cloth
 selection of play materials
Birth -6weeks:
 Hang colorful toys , objects, shapes 8-10 inches from the

face to face and midline

 Music box
 Rattles

2-3months
 Bright colored toys of different shapes
 Large soft washable toys
 Mobile
 Rattles
 Squeeze toys
 Rubber toys, music
Cont…..
4months 5-6 months
 Small bright colored  Squeeze toys

toys which can be held  Rattles

 Rattles  Mirror toys

 Soft different texture,  Teething rings

 Infant swing
stuffed animals ,
 Large plastic beads
 Colored plastic rings
 Music
Cont……
7-9months
10-12 months
 Large bright colored
 Toys to fill and spill,
toys with movable parts String of big beads and
 Plastic toys
sharp beads
 Sponge toys  Walker
 Measuring cups, Bowls,  Crayons

Cup and spoon  Rhythmic music

 Teething toys  Toys to stimulate

 Rhythmic music curiosity

Suggestion to aid the care giver in being involved in
infant play
 Be sure toys are developmentally appropriate and safe
 Provide toys that use all five senses
 Place the infant in a variety of position throughout the

day (e.g. stomach, side ,back)

 Encourage the use of hand and feet in play
 Offer a new experience each day
 Encourage banging toys together
 Praise often
 Over all growth and development of
infant And development Psycho social& Intellectual Language
Physical growth Psychosexual& & and speech
Spiritual Moral
Biologic Motor and sensory

HEIGHT cm
53
GROSS MOTOR SKILL: Psycho social: Sensory motor Receptive
Lies in flexed position (0-2years).
WEIGHT Kg Language
4.4 - Head lags when baby pulled Trust versus mistrust -Responds to
SUB STAGE 1
HEADCIRCUMFERENCE & from supine to sitting position
CHEST CIRCUMFERENCE - Head sag forward when baby Psycho sexual:
(BIRTH - 1 human voice
cm
MONTH)
HC-37
is held in sitting position
PULSE & RESPIPATON - Turns head to side when Oral stage(0-1year) SUB STAGE 2 Expressive
Beats/mt prone (1- 4MONTHS) Language
Breaths/mt Fine motor: Spiritual: Moral
P-130 development: -Opens and
R-36 -hold hands in tight fists close mouth
BLOOD PRESSURE Mm of Can grasp an object placed in Undifferentiated Pre conventional when adult
hg 80/50 hand stage1 morality
Sensory development: primal faith. Stage 0 speaks
REFLEXES
-startled by sound -Cry pattern
-Sucking -attentive to speech of others developing
-Rooting -blinking in response to bright -Begins to coo
-Swallowing light
-Extrusion
-Moro
-Tonic neck reflex
-Dance and dolls eye fades
 2 months
Physical And development Psycho Intellectual Language and
growth social& & speech
Motor and Psychosexual Moral
Biologic sensory &
Spiritual
Posterior GROSS MOTOR SKILL: Psycho social: Sensory motor Receptive Language
-less fixed prone position (0-2years). -Alert expression
fontanel -less head lag when listening
Trust versus
-lifts head almost 45
closed at 6 mistrust SUB STAGE 2 -Soothed by
degree
caregivers , mother
to 8weeks of -holds head erect in (1- 4MONTHS)
voice
midposition Psycho sexual:
age Expressive Language
-hold head erect when Moral
Cry pattern develops
held upright Oral stage(0- development:
-turns from side to back -Crying becomes
1year) differentiated ,
Pre varying with reasons
Fine motor:
-hands may be open Spiritual: conventional for crying eg hunger ,
-holds rattle briefly when morality sleepiness or pain
placed in hand Undifferentiated Stage 0 -Pitch and intensity
stage1 vary
Sensory development: -Respond vocally to
primal faith.
-turns head to side when a caregivers voice :”ah”
 3 months
Physical And development Psycho Intellectual Language
growth social& & and speech
Psychosexual Moral
Biologic Motor and sensory &
Spiritual
HEIGHT cm GROSS MOTOR SKILL: Psycho social: Sensory
60 Receptive
-Symmetric posture of head
WEIGHT motor (0-
5.7kg and body Trust versus Language
-very slight head lag
2years).
PULSE & mistrust
RESPIPATON -sits , back rounded, knees -Looks in
Beats/mt
Breaths/mt
flexed when supported in
Psycho sexual: SUB STAGE 2 direction of
sitting position speaker
P-130 (1-
R-36 -holds head erect and steady
Oral stage(0- 4MONTHS) Expressive
BLOOD PRESSURE Fine motor:
Mm of hg 80/50 -hands open or closed loosely 1year) Language
-holds hand in front of face Moral
REFLEXES Spiritual: -cries less
-holds object put in hand with developmen -shows pleasure
active grasp in making many
-grasping(palmar) t: sounds
-carries objects or hands to Undifferentiated
reflex absent -may laugh
--landau reflex mouth stage1
aloud
appear Sensory development: primal faith. Pre -coos and
-turns head and looks in same conventional chuckles
 4 months
Physical And development Psycho Intellectua Language
growth social& l& and speech
Psychosexual Moral
Biologic Motor and sensory &
Spiritual
Drooling between GROSS MOTOR SKILL: Psycho social: Sensory Receptive
3and 4months of -sit with adequate support motor (0- Language
age indicating -hold head erect and steady Trust versus 2years).
increased Lift head and shoulder at -respond
production of mistrust
90degree differently to
saliva . Unable to SUB STAGE 2
-attempt to roll over from pleasant or anger
swallow Psycho sexual: (1-
front to back voice
it ,therefore , it 4MONTHS) - don’t cry when
runs from mouth Fine motor:
Oral stage(0- scolded
-holds hand open
1year) Sub stage 3 Expressive
REFLEXES -Bring hands together in
Secondary Language
midline
-Tonic neck
-grasp object held near hand Spiritual: circular
reflex, moro, -object are carried to mouth reaction(4-8
-laugh aloud
-very talkative to
sucking, and Sensory development: Undifferentiated months) self, people or toys
rooting reflex -follow moving object well stage1 -coos and gurgle
absent -good binocular vision primal faith. when spoken
Moral -talking and crying
-looks briefly to toys that
 5 months
Physical And development Psycho social& Intellectual Language
growth Psychosexual& & and speech
Spiritual Moral
Biologic Motor and
sensory
GROSS MOTOR SKILL: Psycho social: Sensory Receptive
Weight at least -sit with slight support
motor (0-
twice the birth -balance head well when Language
2years).
weight sitting Trust versus respond
-physical growth -hold back straight when
mistrust when own
pulled to sitting position
slowing down Sub stage 3
-can breath -roll from back to front name is
-pull feet to mouth when secondary
through mouth Psycho sexual: spoken
supine circular
when nose
Fine motor: reaction (4-8
obstructed -tries to obtain objects
-beginning signs beyond reach
Oral stage(0- months) -Expressive
of tooth -able to grasp object 1year) Language
eruption voluntary Moral
-uses palmer grasp
development:
-play with toes Spiritual: Squeals when
-take object directly to
mouth happy
Pre
Sensory development Undifferentiat
6 months
Physical And development Psycho Intellectual Language
Growth social& & and speech
Psychosexual Moral
Biologic Motor and sensory &
Spiritual
HEIGHT cm GROSS MOTOR SKILL:
65.5
Psycho social: Sensory motor Receptive
-sit alone (0-2years).
WEIGHT Kg Language
7.4 -pulls to sitting
Sub stage 3
HEADCIRCUMFEREN position Trust versus -recognizes
CE Secondary
cm -lift chest and upper mistrust familiar
HC-43 abdomen when prone circular
PULSE & words
RESPIPATON position , putting reaction
Beats/mt
weight in arms
Psycho Moral
Breaths/mt
P-120 --hitches – moves back sexual: development: -Expressive
R-32 ward when sitting
Language
BLOOD PRESSURE position
Mm of hg 90/60 Oral stage(0- Pre -Actively
Fine motor:
1year) conventional vocalizes
Teething -rescue a dropped
-2 central incisor object morality cooing,
erupts -drops one cube when Spiritual: Stage 0
-begins to bite and crowing
another is given
 7 months
Physical And development Psycho Intellectual & Language
growth social& Moral and speech
Psychosexua
Biologic Motor and sensory l&
Spiritual
REFLEXES GROSS MOTOR SKILL: Psycho Sensory motor Receptive
-sit alone in hard surface (0-2years).
-sit, lean forward on both
social: Language
-Sucking hands -recognizes
And Rooting -when prone bear weight in Sub stage 3
Trust versus own name
reflex disappear 1 hand Secondary
-bears full weight on feet mistrust -respond with
at 7-8 months circular
Fine motor: gestures to
when asleep reaction (4-8
-holds two toys at once words such as
Parachute reflex -transfer toys from hand to
Psycho months)
come
appear hand sexual: Moral
-Imitate simple act of others
-Expressive
Teething development:
--holds cup Language
-upper central Sensory Oral
Pre -vocalizes “m-
incisor erupt development: stage(0-
--depth perception 1year) conventional m-m”when
crying
beginning to develop morality
Physical
8 months
And development Psycho Intellectual & Language
growth social& Moral and speech
Psychosexual
biologic Motor and sensory &
Spiritual
Beginning of GROSS MOTOR SKILL: Psycho Sensory motor Receptive
-Sit steadily unsupported (0-2years).
a pattern in social: Language
-readily bear weight on Sub stage 3
bowel and stops activity
leg when supported Secondary when name is
bladder -adjust posture to react Trust versus circular reaction spoken
object
elimination mistrust (4-8 months) -beginning to
-hand eye coordination
understand
is perfect Sub stage 4 meaning of “no”
Fine motor: Psycho coordination of
Expressive
Has pincer grasp with sexual: schema (8-12
index and 4th ,5th finger months) Language
-release object at will Moral
-retain 2 cubes while Oral stage(0-
development: -shouts for
looking to 3rd cube 1year)
-secure object by pulling attention
Pre conventional -imitate sound
on string
Spiritual: morality sequence
-eat finger foods
 9 months
Physical And development Psycho social& Intellectual & Language
growth Psychosexual& Moral and speech
Spiritual
Biologic Motor and sensory
GROSS MOTOR SKILL: Psycho social: Sensory motor Receptive
-creeps on hands and
(0-2years). Language
knees
REFLEXES -sits steadily on floor for Trust versus Stop activity in
Plantar prolonged time Sub stage 4 response to no
mistrust
-pulls self to standing coordination -beginning to
grasp
position and stands holding of secondary respond to
absent on to furniture's Psycho sexual: simple
schema(8-12
Fine motor: commands
months)
Teething -uses thump and index
Oral stage(0- Moral
given verbally
finger in early pincer grasp -respond to
Upper lateral
-holds own bottle with 1year) development: adult anger
incisor erupt
good mouth coordination Expressive
-drink from cup with some
Spiritual: Pre Language
spilling
-attempts to use a spoon conventional cries when
but spill
Undifferentiate morality scolded
Sensory development: -echolalia
d Stage 0
 10 months
Physical Growth Psycho social& Intellectu Language and
and development Psychosexual& al & speech
Spiritual Moral
biologic Motor and sensory
Macula is well GROSS MOTOR SKILL: Psycho social: Sensory Receptive
developed so -can change prone to
motor (0-
that fine visual sitting position
Language
2years).
discrimination -stands while holding on t Trust versus Understand
can be made furniture , sit by falling
mistrust simple
down Sub stage
-recovers balance easily commands
4
while sitting Psycho sexual: Coordinati
-while standing lift one foot
to take step on of Expressive
Fine motor: Oral stage(0- secondary Language
-picks objects up with 1year) schema(8-
index and thumb (pincer
12 months)
grasp) -may speak one
Moral
-release objects after Spiritual: word beside “ma-
holding it developme ma” and “da-da”
-bring hands together nt: such as” no’, ”hi’
Sensory development: Undifferentiate -understand the
d meaning of “bye-
 11 months
Physical And development Psycho social& Intellectual Language
growth Psychosexual& & and speech
Spiritual Moral
biologic Motor and sensory
Eruption of GROSS MOTOR SKILL: Psycho social: Sensory motor Receptive
lower lateral Stand erect with minimal (0-2years).
incisor may Language
support
begin Trust versus respond to
-cruises: walks holding
Sub stage 4 simple
on to furniture mistrust
coordination question:
Fine motor:
of secondary where is the
-explores toys and other
Psycho sexual: schema
objects more carefully kitty? By
-removes cover from pointing and
boxes Oral stage(0- Moral looking
-takes toys out of box 1year) development: towards the
or cup
object
-put toys inside cup
Spiritual: Pre Expressive
-begins to hold a crayon
Sensory conventional Language
development: Undifferentiate morality
-imitate
d Stage 0 specific speech
 12 months
Physical Growth Psycho social& Intellectual Language and
and development Psychosexual & speech
& Moral
biologic Motor and Spiritual
sensory
HEIGHT cm
GROSS MOTOR Psycho social: Sensory Receptive
74.5
WEIGHT Kg SKILL: motor (0- Language
10 -walk in few steps with 2years). respond with gesture
HC-46 cm help or alone Trust versus
or action to more
Head and chest are -stand alone mistrust complex verbal
equal in - Can sit down from Sub stage 4
request, such as
circumference standing position with out
PULSE &
Coordination “please give it to me”
RESPIPATON
help Psycho sexual: of secondary Expressive
Beats/mt Fine motor:
Breaths/mt schema (8-12 Language
P-110 -good pincer grasp
R-30
Oral stage(0- months) may speak more
-pick up small amount of
BLOOD PRESSURE food and transfer it to 1year) Moral words beside “ma-
Mm of hg 90/60 ma”
mouth development:
-understand meaning
-can turn page in book
Birth weight tripled -Drink from cup and eat Spiritual: of many more words
Reflexes food Pre spoken
-knows names of
-babinski reflex dis -hold crayon adaptively
conventiona increasing number of
 NEEDS OF INFANT

Love and security

Nutrition
Sleep and activity
Dental care
Immunization
Injury prevention
Anticipatory guidance
 LOVE AND SECURITY
 The most important emotional need of infants and
children of all ages is to be loved and to feel secure
that love. Love is communicated to them through
actions and words. They eventually learn that they are
loved just because they exist and not because of what
they do
 A sense of security and a beginning sense of self –

esteem develop from such unconditional love.

Because of this love they can learn to cope with the
minor problems of growing up as the major problems
of illness and separation
 INFANT NUTRITION

Whether a newborn is to be fed by breast or bottle

should be decided before birth .The feeding of infants
Birth to six months
If the infant gain 1ounce of weight daily during the
first 6 months of life , an intake of about 120kcal per
kg per day is necessary. As the infant grow older, the
number of feeding per day decreases
Cont….
Six to 1 year
During this year the infant should gain a little over
0.5 ounce daily. This requires the intake of
approximately 100 kcal per kg per day. Either human
milk or formula continues to be the main source of
nutrition during the second 6 months of life
 SLEEP AND ACTIVITY
 The infants have variable sleep pattern that are
influenced by temperament, satisfaction with
feedings care giver responds to periodic awakenings,
and environment condition.
 There is a transition from neonatal sleeping which is

shorter with multiple sleep periods to the more

organized central nervous system maturation after the
third month .
 As the child matures the sleep way cycle evolves in

to a pattern of being awake during the day and asleep

at night.
Cont…
 The nurse should suggest measures that will faster
healthy sleep pattern includes
 Establishing bedtime routine such as giving bath,

reading a book, telling a story, singing, holding,

rocking.
 Provide a quiet relaxed environment in a safe in to.
 Maintain a comfortable room temperature
 Using low level lighting in the room.
 Place in the bed when drowsy but not asleep.
 Place a supine or side lying position or side lying a

sleep.
 Don’t feed during night.
 DENTAL CARE
Tooth development and eruption are affected by
genetic gender race and growth patterns. Deciduous
teeth also referred to as primary or baby teeth and the
first teeth to develop and erupt.
The eruption of teeth varies among children but
teething process typically begins around 3-4 months
of age. First erupt are the lower central incisor
 IMMUNIZATION

 Prior to administering any immunization the nurse

assess for contraindication to administration.
Immunization is usually not contraindicated.
 When mild illness such as allergic rhinitis, mild

diarrhea, mild respiratory infections is present. The

nurse also provide the information about the benefits
and risk of immunization
 INJURY PREVENTION
 
 Infant are in a state of perpetual development and
reinforcement of motor skills. In addition infants
have an insatiable curiosity about the environment.
When perpetual changes and curiosity combines the
infant is at risk for accidental injury the leading cause
of death especially between 6-12 months
 The nurse and the care giver should discuss the

environmental hazards associated with specific motor

development
 
 ANTICIPATORY GUIDANCE
 Child rearing is not a easy task. At present challenges
to both new parent and seasoned parents with a
highly mobile population there is a little stability for
traditional role model and time honored methods
raising children.
 As result parents look to professional guidance.

Nurses are in a advantageous position to render

assistance and suggestion. For parents of an infant
some challenges center around dependency discipline
increased mobility and safety
 PROBLEMS OF INFANT

 Separation anxiety
 Spoiled child syndrome
 Limit setting and discipline
 Alternate child care arrangement
 Thump sucking
 Teething
 Infant shoes
 Colic
 SEPARATION ANXIETY

 Stranger and separation anxiety emerge at

approximately 8-12 months of age.
 stranger and separation anxiety usually peaks at 15-

18 months and disappear by 2 years of age.

Separation anxiety behavior are demonstrated when
an infant is separated from care giver.
Family teaching regarding reliving separation
anxiety
 Leave the child in a familiar place or with a familiar
person
 Encourage friends and relatives to visit often
 Encourage the care giver to talk to the child before

leaving
 Don’t leave the child without saying good bye
 Leave a security objects with the child a familiarity

or an object belonging to the care giver

 Encourage the child to explore at his / her own place
 THUMB SUCKING
 Sucking is the infant’s chief pleasure and may not be
satisfied by breast or bottle feeding. It is strong need
that infant who is deprived of sucking such as those
with a cleft lip repair will suck on their tongues.
Some new borns are born with sucking blisters on
their hands from in utero sucking activity.
 During infancy and early childhood there appear to

be no need to restrain non nutritive sucking of the

finger unless the habit extend into the late preschool
years
 Thumb sucking reaches its peak at the age of 18-20

months.
 TEETHING
 During infancy the period of eruption of deciduous
teeth is called teething and occurs over several
months.
 During eruption the periodontal membrane become

slightly swollen red and linear.

 The infant may have increased drooling of secretion

and fussiness, mild anorexia and an increased desire

to bite other symptoms such as low grade fever,
vomiting and diarrhea have also been attributed to
teething
 Colic
 It is one of the most common health problem seen in
infants younger than 3 months of age, describes
recurrent episode unexplained crying and the inability
to be consoled. The onset varies but it is usually occurs
around 1-2 weeks of age and subside spontaneously by
approximately 16 weeks of age.
 Excessive air swallowing improper feeding techniques,

food allergies, infant behavior and parental factors

have been implicated as cause of colic.
 The colic episode is characterized by persistent crying

and flexing of hips towards abdomen.