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Prenatal and Neonatal
Prenatal Development
• Prenatal development lasts approximately 38 weeks from conception to birth.
• Three periods of development:
▫ Zygote
▫ Embryo
▫ Fetus
Zygote Period
• The zygote is formed at conception and continues to develop for the first two weeks.
• The zygote travels from the fallopian tube to the uterus and implants itself in the uterine wall.
• After 2 weeks, the placenta begins to grow and is attaches to the zygote via the umbilical cord.
Embryo Period
• The embryo period begins at the end of the second week and ends at the end of the eighth week.
• First half of this period:
▫ The ectoderm, mesoderm, and endoderm layers develop.
▫ The heart begins to pump.
• Second half of this period:
▫ Facial features, arms, legs, fingers, and toes form.
▫ Can respond to touch.
Fetus Period
• The fetus period begins in the ninth week and continues through birth.
• At the beginning of this period:
▫ Organs, muscles, and the nervous system organize.
▫ The lungs expand and contract.
▫ The external genitals are distinguishable.
▫ The fingernails, toenails, tooth buds, and eyelids develop.
Fetus Period (continued)
• 18 Weeks - Fetal movements are felt by the mother.
• 20 Weeks - The fetus can hear sounds and react to them.
• 24 Weeks - All the brain neurons are developed.
• 25 to 38 Weeks – The fetus has a chance for survival outside the womb. This is called the age of viability.
Prenatal Health Issues
• Teratogens - environmental substances that cause damage during prenatal development
▫ Medications
▫ Drugs, cigarettes, and alcohol
▫ Radiation and pollution
▫ Infectious disease
• Other health issues can include:
▫ The mother’s nutrition and stress level
▫ Rh blood incompatibility
▫ The mother’s age and previous pregnancy experiences
Medications
• Almost all medications that are taken by the mother can reach the embryo or fetus through the bloodstream.
• Medications can cause:
▫ Low birth weight
▫ Lower intelligence later in life
▫ Death
• Mothers must consult doctors before taking any medications.
Illegal Drugs
• Fetuses exposed to illegal drugs in
the womb are at risk of: ▫ Low birth weight
▫ Numerous defects
▫ Death
• If the fetus manages to survive through birth, the baby is likely born with a drug addiction.
Cigarettes
• Cigarette smoking while pregnant can cause:
▫ Low birth weight
▫ Cancer in childhood
▫ Miscarriage
▫ Death
• Second-hand smoke can also put children at risk
Alcohol
• Fetal alcohol syndrome (FAS) is a serious effect caused by the mother consuming alcohol during pregnancy.
• Children with FAS may have:
▫ Mental retardation
▫ Poor attention
▫ Hyperactivity,
▫ Facial abnormalities
▫ Slow growth
Radiation
• Pregnant women should avoid exposure to radiation, including medical X-rays.
• Exposure to radiation can cause:
▫ Miscarriage
▫ Poor physical growth
▫ Brain damage
▫ Cancer
Pollution
• Some environmental pollution dangers include mercury, lead, and PCBs.
• Exposure to pollutants can cause:
▫ Brain damage
▫ Mental retardation
▫ Low birth weight
Infectious Disease
• Infectious disease can be difficult for pregnant mothers to evade.
• Common illnesses such as the cold and flu are essentially harmless to the fetus as long as the mother is well-rested and continues to get nutrients.
• Serious infectious disease can cause:
▫ Birth defects
▫ Low birth weight
▫ Miscarriages
Non-Teratogen Prenatal Health Issues
• Pregnant women must be certain to get proper nutrition. The level of malnutrition of the mother is directly linked to brain weight in the child.
• Pregnant women should also try to remain stress-free. Anxiety can have harmful effects on the fetus.
Non-Teratogen Prenatal Health Issues (continued)
• Rh blood incompatibility between the mother and fetus can cause: ▫ Mental retardation
▫ Heart damage
▫ Death
• Blood tests and vaccines are given to prevent illness or injury resulting from Rh incompatibility.
Neonatal Development
• The first four weeks of life are called the neonatal, or newborn, stage.
• In this stage, special attention is given to:
▫ Parent-child bonding
▫ Reflexes
▫ Temperament
▫ States of arousal
▫ Sensory capabilities
The Apgar Scale
• The Apgar scale rates newborns in the following areas: ▫ Appearance
▫ Pulse
▫ Grimace
▫ Activity
▫ Respiration
• Apgar scores: ▫ 7 to 10 – Healthiest
▫ 4 and 6 – Need assistance with breathing or other vital signs
▫ 0 and 3 – Need serious emergency medical attention
Bonding
• Bonding is a parent’s deep affection and concern for the newborn.
• Parents and children develop a special bond that allows the infant to grow and develop with confidence.
• Some parents instantly bond, while other parents bond over the first few weeks.
Reflexes
• Reflexes are expected, automatic responses to specific stimulants.
• Newborn reflexes include:
▫ Rooting reflex
▫ Sucking reflex
▫ Palmer reflex
• Most of these reflexes should disappear as the baby grows and develops.
Sensory Capabilities
• Touch – most important sense for newborns
• Taste – prefer sweet over salty
• Smell – respond to good and bad smells
• Sound – special interest in the human voice
• Vision – least developed sense in a newborn
Newborn States of Arousal
• Newborns continually cycle through five states of arousal:
▫ Regular sleep – deep sleep with little movement
▫ Irregular sleep – light sleep with body movement
▫ Drowsiness – waking up or falling asleep
▫ Quiet alertness – awake and attentive
▫ Waking activity and crying – uncoordinated movements and irregular breathing
Neonatal Health Issues
• The transition from the womb into the world does not occur smoothly.
• Neonatal health issues include:
▫ Premature birth
▫ Respiratory issues
▫ Sudden Infant Death Syndrome
Premature Birth
• Premature birth is used to describe infants that are preterm or small-for-date.
▫ Preterm babies are born 3 weeks or more before the 38-week due date.
▫ Small-for-date babies weigh less than expected compared to their length of time in the womb.
• With proper care and special attention, many premature babies go on to lead normal, healthy lives.
Respiratory Issues
• In respiratory distress syndrome, a baby’s air sacs collapse, which makes breathing very strenuous
• Respiratory distress syndrome can occur in premature or full-term babies.
• Babies with respiratory distress syndrome are attached to respirators until they can breathe comfortably on their own.
SIDS
• Sudden Infant Death Syndrome (SIDS) occurs when an infant dies during sleep.
• Death occurs with no trauma to the child and no indication from the child, such as crying, prior to death.
• No cause, cure, or prevention has been found for SIDS.