Health Promotion of Infant and Family

Created by JDRN14 

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Define infancy

Period of birth to 12 months

Which Erikson phase applies to infancy?

Trust vs. Mistrust (birth to 1 yr)

Which Piaget phase applies to infancy?

Sensorimotor phase (birth to 24 mths)

When does solitary or one-sided play emerge?

6-12 months

At what age does child start imitating sounds?

8 months

At what age does child associate meaning to sounds?

9-10 months

Interventions for difficult temperament

routine and structure

Interventions for highly distractible temperament

soothing measures, swing

Interventions for high activity temperament

extra safety precautions

interventions for easy child temperament

reminders to be vigilant with feeding schedules

when should head lag disappear by?

6 months

when does teething begin?

6 months

when does object permanence begin?

6 months

when can child stand with furniture support?

9 months

when does crude pincer grasp emerge?

9 months

when can child sit without support?

9 months

how many words can 12 month old say?

5

when can child walk with one-handed support?

12 months

What does the Denver II (DDST-II) assess?

four sectors of development:
- personal/social
- fine motor/adaptive
- language
- gross motor

What does the Bayley Scale of Infant Development test?

-gross motor
- fine motor
- language
-cognitive development
accomplished through play tasks

when is Bayley Scale used?

0-3 yrs

What is the Ages and Stages tool?

a survey for parents to fill out (lengthy)

What supplements does an infant receiving breastmilk need?

-Vitamin D
-Iron

What does iron supplement cause in infants?

dark stool

How much Vit D should infants take?

400 IU

What may happen if infants receive water in addition to breastmilk?

water intoxication
FTT
hyponatremia

how long does refrigerated breast milk last?

5 days

how long does frozen breast milk last?

12 months

What supplement is needed for formula-fed babies?

fluoride

What can too much fluoride cause?

tooth discoloration in children

Fruit juice is not recommended before:

6 months

Cows milk is not recommended before:

12 months

How many bottles does a formula-fed baby need?

1 month - 6
6 months - 4-5

Average volume of feed for formula-fed babies

32 ounces

introducing cow's milk too early can cause:

an allergy

Why wait until 6 months to introduce solids?

-GI tract able to handle more complex nutrients
- teeth start to erupt
- extrusion reflex disappears
- swallowing is more coordinated
-head control present
-pincer grasp present
-improved hand/eye coordination

Foods that should not be introduced too early due to risk of allergy:

peanuts
eggs
fish
seafood

What is the first food that should be introduced to infants?

Iron-fortified cereal or rice cereal

Describe how new foods should be introduced

one at a time, wait 4-5 days between foods

How long should infant cereal be continued?

until 18 months

how much fruit juice should babies receive?

not more than 4-6 ounces a day

benefit of fruit juice

vitamine C helps absorb iron

serving size of infant cereal

3 Tbsp

S&Sxs of teething

drooling
swollen gums
increase in finger sucking
biting hard objects

What symptoms require medical examination?

fever >100.4
vomiting
diarrhea

what may happen if pacifier usage is continued after 4-6 yrs?

malocclusion

when does oral hygiene begin?

with first tooth

what type of oral hygiene can be used before six months?

damp washcloth

when should baby get first dental exam?

at 6 months

Infant FOC is how much greater than chest circumference?

2-3 cm

Signs of a food sensitivity in an infant

systemic: anaphylaxis
GI: abd pain, vomiting, diarrhea, cramping
Rsp: cough, wheezing, rhinitis, infiltrates
Cutaneous: urticaria, rash
infants: restlessness, irritability, listlessness, unresponsiveness, urticaria

if high risk of hereditary food allergy, exclusively breast feed until:

12 months

Colic affects what percent of infants?

5-30%

S&Sxs of colic

loud crying, drawing legs up to abd
last longer than 3 hrs, 3 days a week at more than 3 months of age

Causes of colic

too rapid feeding
overeating
swallowing excessive air
improper feeding technique
emotional stress
milk allergy

Paroxysmal Abdominal Pain

Colic

drugs that may assist with colic

antihistimines
zimethicone drops
sedatives

Failure to Thrive (FTT)

inadequate growth/inability to obtain or use calories required for growth (less than 5th percentile)

organic FTT

physical causes with absorption, cardiac issues, GERD, lead, anemia, occult blood, parasite

non-organic FTT

environmental, psychosocial

S&Sxs of FTT

withdrawn
no fear of strangers
avoidance of eye contact
stiff or flaccid
minimal smiling
(poor attachment)

nursing care for FTT

set up a consistent, soothing feeding routine
consistent caregiver
unstimulating environment
be persistent

Erythema Toxicum Neonatorum

Newborn Rash

Describe Newborn Rash

benign
begins in first 2 days of life
firm lesions 1-2mm, pale yellow or white papules or pustules on an erythematous base
no systemic manifestations
lasts 5-7 days

How is candidiasis contracted in infancy?

vaginal delivery
poor handwashing
contaminated source (hands, bottle, nipple)

Types of candidiasis

diaper dermatitis
oral (thrush)

normal sleep in 3-4 months

9-11 hours at night, 15 hrs a day

Sudden Infant Death Syndrome

under 1 yr
(95% before 6 months)

risk factors with SIDS

maternal smoking
male sex
pacifier usage
bedding
overheating
co-bedding

positional plagiocephaly

oblique or nonsymmetrical head shape from cranial molding

management of positional plagiocephaly

tummy time, alternate head position when lying
helmut can be used if necessary

normal number of diapers in an infant

6-8 in a 24 hour period

meconium

black tarry first stools (4-5 days)

differentiate breastfeeding and formula stool

formula stool -- less frequent
breastfed - yellow, seedy

S&Sxs of dehydration in infants

dry mucous membranes
fewer wet diapers
lack of tears
dry skin
sunken fontanels
vital changes indicate late-stage

S&Sx of constipation in infants

pellet-like stool
infant strains with stooling

Causes of diarrhea in infants

intestinal infection
food allergy

pain relief for infants and immunizations

sucrose on a pacifier (or breastfeeding)
EMLA (requires 60 mins)
distraction

IM injections in infants: equipment

1" needle
25 gauge
90 degrees

SubQ injections in infants: equipment

5/8" needly
25-30 gauge
injected at 45 degrees

sites for injections in infants

vastus lateralis or ventrogluteal

written information for immunization documentation

completed consent
expiration date
lot number
manufacturer
site, route, tolerance of patient
name/address/title of person administering
VIS date (vaccine information statement)

leading cause of death in infants

injury

most common injuries in infants

suffocation, MVAs, drownings

trauma and falls is more common in which age group and why?

under 7-9months due to poor depth perception

how long should rear-facing seat be used?

until 1 year and 20 lbs

Water heater should be set at what temp to prevent burns?

120 degrees

When does Moro reflex disappear?

5-6 months

When does rooting reflex disappear?

3-4 months

When does suck reflex develop?

Around 36th week of pregnancy

when does palmar grasp reflex disappear?

2-3 months

when does stepping reflex disappear?

2-3 months

when does Babinski reflex disappear?

2 years

Tonic Neck reflex

When baby's head is turned to one side while lying on her back, the same arm will extend and the opposite arm will bend (fencing reflex)

when does the tonic neck reflex disappear?

6-7 months

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