CHILD CARE

DEVELOPMENTAL MILESTONES-

NEW BORN AND TODDLER

• The newborn • An infant or baby is the very

young offspring of humans. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth. The term "newborn" includes premature infants, post mature infants and full term newborns. It is typically applied to children between the ages of 1 month and 12 months.

• Physical characteristics of newborn

• A newborn's shoulders and hips are narrow, the abdomen protrudes slightly, and the arms and legs are relatively short. The average birth weight of a full-term newborn is approximately 3.2 kg, but is typically in the range of 2.7–4.6 kg. The average total body length is 14–20 inches (35.6–50.8 cm), although premature newborns may be much smaller.

• At birth, many regions of the newborn's skull have not yet been converted to bone, leaving "soft spots" known as fontanels. The two largest are the diamond-shaped anterior fontanel, located at the top front portion of the head, and the smaller triangular-shaped posterior fontanel, which lies at the back of the head. Later in the child's life, these bones will fuse together in a natural process. A protein called noggin is responsible for the delay in an infant's skull fusion.

• Some newborns have a fine, downy body hair called lanugo. It may be particularly noticeable on the back, shoulders, forehead, ears and face of premature infants. Lanugo disappears within a few weeks.

• Newborns' digestive tracts, are filled with a greenish-black, sticky material called meconium. This has the function of standing in for fecal material and allows the intestines to develop to the point where they can process milk immediately on birth. This material is passed by the child in the first few days.

• Immediately after birth, a newborn's skin is often grayish to dusky blue in color. Newborns are wet, covered in streaks of blood, and coated with a white substance known as vernix caseosa, which is act as an antibacterial barrier. The newborn may also have Mongolian spots, various other birthmarks, or peeling skin, particularly on the wrists, hands, ankles, and feet.

• A newborn's genitals are enlarged and reddened. This is caused by naturally occurring maternal hormones and is a temporary condition.

• The umbilical cord of a newborn is bluish-white in color. After birth, the umbilical cord is normally cut, leaving a 1–2 inch stub . Occasionally, hospitals may apply triple dye to the umbilical stub to prevent infection, which may temporarily color the stub and surrounding skin purple.

• Newborns can respond to different tastes, including sweet, sour, bitter, and salty substances, with a preference toward sweets. It has been shown that neonates show a preference for the smell of foods that their mother ate regularly.

• Care of the Newborn

• 1. Immunizations.

• 1. BCG vaccine to prevent tuberculosis; and

• 2. oral polio vaccine to prevent polio soon after birth. In some places, hepatitis B vaccine is also given in the first few days.

• The newborn should also get DPT to protect against diphtheria, pertussis (whooping cough) and tetanus. The first DPT shot should be given at 6 to 8 weeks of age and the second DPT shot should be given 4 to 8 weeks later. The third DPT shot is given 4 to 8 weeks after the second. The measles vaccine is usually given at 9 to 12 months of age.

• 2. Monitor growth.

• Growth monitoring is the measuring of the height and weight of children. Growth

• monitoring is an important way to see if a baby is healthy and well nourished. Healthy babies get heavier every month, and babies who lose weight are sick. Newborns should be weighed soon after birth, and should be weighed every month for the first year of life..

• 3. Vitamin A for nutrition and to fight infections-

• Yellow fruits and vegetables, green leafy vegetables, eggs, liver and fish

• Vitamin A helps the skin and tissues heal after infections and prevents blindness.

• 4.Bathe the newborn. • To bathe the newborn, the new mother

should:• 1. wash her hands before bathing the

baby;• 2. use clean, warm water for the bath;• 3. clean the umbilical cord stump with

antiseptic and let it dry in the air. • 4. dry the newborn with clean cloths after

the bath and wrap or dress the newborn warmly.

• 5. Allow the newborn to sleep.

• For about two weeks after birth, a newborn sleeps most of the time.

• Slowly a baby starts to stay awake more between feedings.

• 6. Breastfeed the newborn.

• The baby should breastfeed at least every 2 to 4 hours. The baby should wet at least 6 to 8 times a day. The baby should be sucking well.

• 7.Congestion:

• Mild nasal congestion can be due to normal mucous secretions.. Salt water (or tap water) nose drops and a bulb syringe can be used to clear the infant’s nose. 8.Crying: Crying is the baby’s only way of communicating.. Hunger, cold, soggy diapers, intestinal discomfort, and the need for physical contact are common causes of an infant crying.

• 9.Dehydration:

• Signs of dehydration include – decreased urine output (less than 4 wet diapers in a 24 hour period), dry mouth and lips, sunken anterior fontanel, and decreased activity. Usually there is a reason for dehydration such as vomiting or diarrhea or refusing to eat.

• 10.Eyes: The eyelids are often puffy in newborns. If there is significant discharge, redness, or swelling, the baby should be seen by her healthcare provider. In the beginning, a baby may have occasional uncoordinated eye movements and look cross-eyed (exotropia or esotropia). The colors babies see best are red, black, and white. Clear color and binocular vision is usually established by 6 months of age.

• Reassuring signs after the first 24 hours are:• the baby is eager to nurse• the baby nurses at least 8 times every 24 hours• mom can hear the baby swallowing during

nursing• mom may notice milk dripping from the opposite

breast• the breasts may be softer after nursing• the baby wets 6 or more times every 24 hours• the baby’s urine is pale yellow, not deep yellow

or orange• the baby is gaining weight

• warning signs of serious newborn problems1. Newborns who have a birth weight less than

2.5 kg, or newborns who do not gain any weight in the first month.

2. Newborns who have a rectal temperature of less than 36 degrees centigrade or more than 38 degrees centigrade.

3. Newborns who do not suck well at all or who vomit a lot with every feeding. (Most babies spit up some after feedings.)

4. Newborns who are very irritable, or who are listless.

5. Newborns who take quick and shallow breaths or who are struggling to breathe.

6. Newborns who have a sunken fontanelle (soft spot); dry, cracked or loose skin; do not urinate often; or who otherwise look dehydrated.

7. Newborns with bleeding or signs of infection (discharge, redness, and foul smell) around the umbilical cord stump.

8. Newborns with signs of a tetanus infection, including fits or seizures, stiffness, or difficulty breathing and eating.

9. Newborns who must be woken up to eat after four or more hours on a regular basis (some newborns will sleep four to six hours at night).

• BCG vaccine– vaccination to prevent tuberculosis, BCG stands for bacillus Calmette-Guerin

• DPT vaccine– vaccination to prevent diphtheria, pertussis (whooping cough) and tetanus

• OPV vaccine– drops given by mouth to prevent polio; OPV stands for oral polio vaccine

• Tetanus– an infection caused by bacteria which enters the body through a wound or the

• umbilical cord and causes stiffness, seizures and difficulty eating due to lockjaw

• Tuberculosis– a serious and communicable infection of the lungs. It causes fever, coughing, poor appetite and loss of weight, and it can spread to the bones, skin and other organs.

Toddler• A toddler is a young child, usually defined as

being between the ages of one and three.• Toddler development• The toddler years are a time of great cognitive,

emotional and social development. Toddler development refers to the changes that occur in children aged between 1 and 3 years. Change may occur as a result of genetic processes known as maturation, or may be due to environmental factors and learning. Usually it involves an interaction between the two.

Developmental milestones at 1 year of age

• At one year of age, the typical toddler will be able to display the following skills:

physical and motor skills• Triple the birth weight • Grow to a height of 50% over birth length • Have a head circumference equal to that

of the chest • Have one to eight teeth • Pull to stand

• Walk with help or alone

• Sit down without help

• Bang two blocks together

• Turn through the pages of a book by flipping many pages at a time

• Have a pincer grasp

• Sleep 8 - 10 hours a night and take one to two naps

• sensory and cognitive development

• Follows a fast moving object

• Can respond to sounds

• Responds to his or her name

• Understands several words

• Can say mamma, papa, and at least one or two other words

• Understands simple commands

• Tries to imitate animal sounds

• Connects names with objects • Understands that objects continue to exist,

even when they are not seen (object constancy)

• Points to objects with index finger • Waves bye bye • May develop attachment to a toy or object • Experiences separation anxiety and may

cling to parents • May make brief journeys away from

parents to explore in familiar settings

• 2 years

• Weight: about 11–13 kg

• Height: about 80–82 cm

• Teeth: 12 temporary

• 2½ years

• Teeth: full set of 20 temporary

• Decreased need for naps

• Motor development

• 14 months

• Walks well alone with wide based gait

• Creeps upstairs

• Builds of two blocks

• Drinks from a cup, uses spoon

• Enjoys throwing objects and picking them up

• 18 months

• Walks sideways and backwards, runs well, falls easily

• Climbs stairs or up on furnitures

• Scribbles vigorously, attempting a straight line

• Drinks well from a cup, still spills with a spoon

•

• 2 years

• Gross motor skills quite well refined, can walk up and down stairs on both feet, one step at a time while holding on to a rail

• Builds tower of five cubes

• Control of spoon well-developed

• Toilet trained during day time

• Vocalization and socialization• 15 months• Can use 10-15 words • Says "no" • Indicates when diaper is wet • 18 months• Uses phrases composed of adjectives and

nouns • Begins to have temper tantrums • Very ritualistic, has favorite toy or blanket,

thumb-sucking may be at peak

• 2 years• Vocabulary of about 350 words • Obey simple commands • Helps undress self and put on simple clothes • Shows sign of increased autonomy and

individuality • Does not share possessions, everything "mine" • 2½ years• Begins to see self as separate individual; still

sees other children as "objects"

THANK YOU