GROWTH & DEVELOPMENT OF THE

EMBRYONIC AND FETAL STAGE

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN Pdiatric
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Dr AWAYI G. ABDULKAREEM
MSC ,PhD IN PEDIATRIC NURSING
Fetal growth and development (Conception to Birth)

Each human begins life as a single cell (fertilized ovum

or zygote)

Fertilization: is the process by which a sperm fuses

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN Pdiatric
with an ovum to form a new diploid cell or zaygot in
the fallopian tube.

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Stages of fetal development includes

1. Pre-embryonic period ( The first 14 days

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
of development )
2. Embryonic period (the beginning of 3 rd
week
until approximately 8 week)

3. Fetal period (end of 8 week until birth)

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
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Embryonic and fetal development
Developmental milestones at:
0-4 weeks:
 Head accounts 1/3 of embryo

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
 Heart appears as bulge on anterior
surface
 Eyes, ears, nose appear
 Extremities appear as buds
 Nervous system begins to form

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4-8 weeks:
 Organ formation is complete
 Heart beats and has a septum and valves
 Abdomen is large with evidence of

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
intestine
 Gestational sac is visible on ultrasound

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12 weeks:
Heartbeat can be heard using a Doppler
ultrasound stethoscope
Kidney function begins

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
Placenta formation complete (fetal
circulation established)
Sex is distinguishable with external
genital as outward appearance

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16-24 weeks
Mother feels spontaneous movement of
fetus
Hair begin to form

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
Lungs produce surfactant
Passive immunity begins to transfer from
the mother

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24-32 weeks
Alveoli in lung begin to mature
Moro reflex active
Vernix caseosa becomes thick

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
Hearing is developing and fetus begin
able to respond to a sudden sound

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32-40 weeks
Subcutaneous fat continues to deposited
Vernix caseosa fully formed
Soles have creases

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
Fetus begins kick activity ,causing maternal
discomfort

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GROWTH AND DEVELOPMENT OF THE
NEWBORN AND INFANT

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN Pdiatric
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Dr AWAYI G. ABDULKAREEM
MSC & PhD IN PEDIATRIC NURSING
Physical growth: Infants grow very rapidly over
the first 12 months of life; weight, height, head
and chest circumference are all indicators of
physical growth in the newborn and infant

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
 The average a new born weight (3.400gm) at
birth, lose up to10%of their body weight over
the first 5 days of life and regains his or her
birth weight by 10-14 days
 Most infants double their birth weight by 4-6
months of age and triple their birth weight at
1years old. 12
 Height, the average newborn is (48-53cm)long at birth,
during first six months length increases by 2.5cm /month,
then by about 1.25cm /month in second six months (1inch =
2.5cm)
 Head and chest circumferences are relatively equal, but

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
average (HC) of the full term newborn is 33-35cm, and the
HC is about 2-3cm greater than chest circumference. HC
increases rapidly during the first 6 months by about
1.5cm /month, and from 6-12 months it increases by 0.5 cm
 averages of the chest circumference CC is about 30.5-
33cm,CC is not measured after 6 months

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Neuralgic system:
 Involuntary movement progress to voluntary movement
 Posterior fontanel closed at 8 weeks of age ,but anterior fontanel
remain open until 12-18 months of age
 Immature vocalization and crying progress to the ability to speak

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
 Reflexes: includes primitive and protective

 Primitive reflexes: present at birth, except for the babinski they

are diminish over the first few months of life and given way to
protective reflexes
 Protective reflexes: (also termed postural responses or reflexes)
are motor responses related to maintenance of equilibrium
 
 
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 Respiratory system: continues to mature over first
year of life and it reaches adult levels at about 7 years
of age.
 R R =30-60 breaths/minute in newborn

 R R = 20-30 breaths /minute in 12 month-old

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
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Cardiovascular system
 Heart become doubles in size over the first
year of life
 PR in newborn = 120-140 beats/minute

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
 PR in 1-years old =100 beats/minutes
 BP in newborn=60/40 mm Hg
 BP in 1-years old = 100/50 mm Hg

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Gastrointestinal system
 Teeth:
 Some infant is born with one or more teeth (termed
natal teeth)
 First primary teeth (deciduous teeth) erupt between

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
the ages of 6-8 months, which is the lower central
incisors usually the first to appear then followed by
upper central incisors
 At age 1 years infants has 4-8teeth
 Meconium is the newborn first stools, result in
digestion of amniotic fluid swallowed in uterus,
which is dark green to black and sticky 17
Genitourinary system: renal structures are
immature and renal functions are reduced
compared with adult
 Integumentary system:

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
 infant may covered by vernix caseosa
 lanugo; fine hair cover the body of
newborn ,often this hair lost over the time
 Temperature regulation is altered because of
poor thermoregulation.

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 Motor skill development
 Gross motor skill development: (refers to use
of large muscle, e.g., head control, rolling,
sitting, and walking).gross skill develop in a

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
cephalocaudal (learning lifts head before roll
and roll before sit)
 Fine motor skill development: (refer to
maturation of hand and finger use) develops in
a proximodistal (from center to periphery)
palmar grasp before pincer grasp.
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 Gross motor skill in infancy
1. Lifts and turn head to side in prone position
(1 month)
2. Improving head control (2 months)

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
3. Rolls from prone to supine (4 months)
4. Rolls from supine to prone and back again (5
months)
5. The infant transfers toy from one hand to
the another hand (5-6)
6. The infant sits with support (5-6)
7. The infant sits alone without assistance (7-9 20
months)
8. The infant stands and stays up by grasping for
support
9. The infant develops a pincer grasp, place
every thing in his mouth, and is therefore at high
risk for aspirating objects (7-9 months)

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
10.The infant self feeds (7-9 months)
11.Walks with support (10 months)
12.Stands alone (11 months)
13.Takes his first steps (12 months)

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Fine motor skill in infancy
1. Strong grasp reflex, hands remain mostly closed in a
first (1 month)
2. Hands open more often, diminishing grasping reflex (2
months)

Pdiatric nursing
Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
3. Hands remain open and grasp reflex absent, can hold a
rattle (3 months)
4. Grasp objects with both hands, can move objects
towards mouth (4 months)
5. Transfer objects from hand to hand (7 months)
6. Has beginning pincer grasp (8 months)
7. May attempt to build a two-block tower, can crudely
turn pages of book, and feed self with cup and spoon 22
Sensory development
 Vision : newborn is nearsighted and preferring view
objects at a distance of 8-15 inch, vision is poor, at
age of 1 month can recognize his/her parents face .
 

Pdiatric nursing
Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
 Hearing: newborn birth hearing well developed
 Smell: develops rapidly at 7 days of age infant can
recognize smell of his/her mothers milk

 Taste: newborn at the beginning prefer sweet tastes to

all others
 Touch: well developed
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Communication and language development: crying is first speech
of child
0-2 months:
Listen to voices, quotes to soft music, singing, talking
Distinguishes mothers voice after 1 week, fathers voice by 2 weeks
Produce vowel sounds ah, eh, oh

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
3-4 months:
Coos and gurgles
Laugh
Says da, ba, ma, pa, ga
Respond to caregiver with social smile by 3 months
5-6 months
Talks to toy and self in mirror
Recognize names and familiar sounds
Notices how his speech influences actions of others
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7-9 months
Tries to imitate more sounds; makes several sounds in
one breath
Begin learning to meaning of No by tone of voice and

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
actions
10-12 months
May have a few word approximations, such as bye-bye,
hi
Follow one step instructions such as go to daddy
Recognize words as symbols of objects
 
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 Social and emotional development:
 Infant exhibit real smile at age 2 months, and
first thought process in this age
 Stranger anxiety: around the age of 8 months

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
the infant may develop stranger anxiety, the
infant become more aware of new people and
new places.
 Separation anxiety: start in the last few
months of infancy, the infant becomes
distressed when the parent leaves.
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Common developmental concerns for newborn and infancy
period
 Colic is defined as inconsolable(impossible to comfort because
of great sadness or unhappiness) crying that lasts 3 hours or
larger per day and for which theirs no physical cause .it resolve

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Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
by age 3 months
 Spitting up regurgitating small amounts of stomach contents,
occurs in all infants
 Thumb sucking, pacifiers and security items is a healthy self-
comforting activity
 Teething

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 Safety guidelines for newborn
 Always support an infants head

 Never leave the infant on high place

Pdiatric nursing
Dr AWAYI G. ABDULKAREEM/MSc,PhD IN
 Use car seats properly

 Check the temperature of formula and food, we should feel lukewarm

when a few drops are placed on the caregiver's skin, especially inner
wrist area
 Do not worm formula, breast milk in microwave

 Remove harm full items (pins, small object,…)from infant

environment to avoid aspiration
 Insert safety plugs in wall outlet

 Use gates across stairways and other dangerous area

 Place infants in supine for sleep to decrease the risk of sudden infant 28
death syndrome