Nursing Care of a Family

with an INFANT
Presented by:
Maydilyn M. Gultiano, RN, MAN
 Within 4 hours of SLA, student nurses should be
able to:
01 Describe the physical characteristics of
an infant;
02 Describe the normal infant growth and
development;

Objectives: 03 Formulate nursing diagnoses related to infant

growth and associated parental concerns; and

04 Integrate knowledge of infant growth and

development in providing nursing care.

https://www.youtube.com/watch? v=oI9WE1spJ Fs
• Triples
• Increases length by 50
• First social relationship attachment to primary
caregiver
• Use a calm, unhurried approach to help an
infant feel safe enough to accept interventions
• Teach new parents about normal growth and
development milestones.
• Schedule of healthcare visits – 2 week, 2 month,
4-month, -month, 9-month, and 12 month
• Provide time for immunizations and health
assessments.
• Provide opportunity for parents to ask questions
about their child’s growth pattern and
developmental progress.
• Provide opportunities for healthcare providers to
assess for potential problems.
 PHYSICAL G ROWTH
Weight – doubles by 6 months
- triple by 1 year.
- 1 lb weight gain after 6 months
Height - gains 50% during 1st years
- lengthening of legs on 2nd half of 1st
year.
Head circumference
- brain: 2/3 of adult size at the end of
the year
- asymmetric
 BODY PROPORTION
• Lower jaw is definitely prominent
• Abdomen remains protuberant
• Cervical, thoracic, and lumbar vertebral curves
develop as infants hold up their head, sit, and walk.
• Lengthening of the lower extremities during the
last months of infancy readies the child for
walking.
 BODY SYSTEMS
• HR = 100 – 120 bpm
• Prone to develop physiologic anemia at 2 to 3
months of age.
• RR = 20 – 30 cpm
• Prone to URTI because the lumens of the
respiratory tract remains small and mucus
production is still inefficient.
• Liver kidneys are immature.
• Immune system becomes functional by at least
2 months of age.
• Can actively produce IgG and IgM by 1 year.
• Ability to adjust to cold is MATURE by months.
– Can shiver
– Has developed additional adipose tissue to serve
as insulation.
 TEETH

• 1st tooth- central incisor, 6 months

• Natal teeth- 1/2,000
• Neonatal teeth - erupts in 1st 4 weeks.
• Deciduous teeth - essential for allowing the
growth of dental arch.
 MOTOR DEVELOPMENT
• G ross motor development
– Ability to accomplish large body movements
– Ventral suspension, prone, sitting, standing
• Fine motor development
– Testing prehensile ability or the ability to
coordinate hand movements.
 VENTRAL SUSPENSION
POSITION
• Landau reflex – 3 months
• Parachute reaction – to 9 months
 PRONE POSITION
• 1 month – lift their head and turn it easily to the
side
• 2 months – raise their head
• 3 months – lift the head and shoulders well off the
table and looks around when prone.
• 4 months – lift their chests off the bed and look
around actively, turning their head from side to
side.
• NECK RIG HTING REFLEX
• 9 months – can creep from prone
Head lag
 SITTING POSITION
• Head lag is present until about 1 month
• 4 months – important milestone no more head
lag
• 6 months – can sit momentarily without support
• 7 months – can sit alone but only when hands are
held forward for balance
• 8 months – sit securely without any additional
support
• 9 months – sit steadily that they can lean forward
and regain their balance
 STANDING POSITION
• Newborn – stepping reflex
• 3 months- begin to try to support part of their
weight
• 4th month- support their weight on their legs,
stepping reflex disappear.
• th month - ability to sustain a portion on their
weight
• month - bounces with enjoyment in standing
position
• 9 month - can stand holding on coffee table.
• 11 month - cruising
• 12 months - can stand alone
 FINE MOTOR DEVELOPMENT

• 3 months - reach for attractive objects n front of

them.
• 4 months - bring hands together and pull at their
clothes.
Thumb opposition - e.g. shaking of rattles
• 5 months - can accept object with whole hand
fisting- more than 5 months is abnormal .
• 6 months - can hold objects in both hands.
( alternate holding)
- can hold spoon
• 7 months - can transfer one toy from 1 hand
to another
• 10 months - pincer grasp (major milestone)
• 12 months - can draw semi straight line with
crayon.
- can hold spoon and cup, remove socks.
Pincer G rasp Reflex
 LANG UAG E DEVELOPMENT

• 3 months – will squeal with pleasure or laugh out

loud
• 4 months – very talkative, cooing, babbling,
gurgling when spoken to
• 5 months – says simple vowel sounds eg. G oo goo
gah gah
• 6 months – learn the art of imitating
• 9 months – usually speaks the first word “da-da”
“ba-ba”
• 10 months – “bye bye” “no”
• 12 months – can generally say 2 words in addition
to “ma-ma” and “da-da”, and they use those
words with meaning.
PLAY
• 1 month old – mobiles
• 2 months – light, small rattles
• 3 months – small blocks or rattles
• 4 months – playpen or sheet spread on the floor
• 5 months – plastic rings, blocks, squeeze toys,
rattles, plastic keys
• 6 – 7 months – bathtub toys eg. rubber ducks,
plastic boats
 VISION
• 1 month – fixed stare
• 2 months – can focus well and able to follow
moving objects with the eyes (not past midline)
• Ability to follow and focus – major milestone
indicating the infant has achieved BINOCULAR
VISION (ability to fuse two images into one
• Teach parents to initiate eye to eye contact
• 3 months – can follow object across their midline
hand regard
• 4 months – able to recognize familiar objects;
eagerly follow their parents’ movements with their
eyes.
• 7 months – pat their own image in a mirror
transferring toys from hand to hand
• 10 months – object permanence
 HEARING
• 2 months – will stop an activity at the sound
of spoken words
• 3 months – turn their head to attempt to locate a
sound
• 5 months – can localize sounds downward and to
the side
• 10 months – can recognize their name and listen
acutely when spoken to
• 12 months – can easily locate sounds in any
directions and turn toward them.
 EMOTIONAL DEVELOPMENT

• 6 week old – social smile

• 3 months – smiling at the sight of a
parent’s face; laugh out loud at the sight
of a funny face
• 4 months – likely to cry when a person
who has been playing with and
entertaining the infant leaves
• 5 months – show displeasure when an
object is taken away from them.
• 6 months – begin to draw back from unfamiliar
people
• 7 months – show obvious fear of strangers
• 8 months - eight month anxiety or stranger
anxiety
• 9 months – aware of changes in tone of voice
• 12 months - they overcome their fear of
strangers; like to play interactive nursery rhymes
 COG NITIVE DEVELOPMENT

• 1st month of life – uses simple reflex activity

• Primary circular reaction – explores object by
grasping them with the hands or by
mouthing them
• months – secondary circular reaction
• 10 months – object permanence – peek-a-
boo
• 1 year of age – capable of reproducing new
events
Promoting Infant Safety
• Aspiration Prevention
• Fall Prevention
• Car Safety
• Safety with Siblings
• Bathing and Swimming
Safety
• Childproofing
 TECHNIQUES for FEEDING
SOLID FOOD
• Offer new foods one at a time and allow the
child to eat that item for 3 to 7 days before
introducing another new food.
• Introduce food before formula or
breastfeeding when the infant is hungry.
• Instruct parent to hold infant for the first
solid food feeding to minimize stress.
• Avoid spinach carrots, beets, green beans,
squash
• Fruit is usually offered 1 week after
beginning vegetables (after 6
months of age)
• Meat – 9 months; part of the
evening meal in place of cereal
• Egg yolks are offered after 6
months
 Promoting Infant
Development in Daily
Activities
 BATHING

• Infant does not need a bath everyday.

• Seborrhea or cradle cap
 DIAPER-AREA CARE
• Change diaper every 2 to 4 hours.
• Diaper rash from sleeping – air drying or
sleeping without a diaper
• Wash the skin with clear water or a commercial
alcohol free diaper wipe and then pat or allow
the skin to air dry.
• Ointment – with zinc oxide or petroleum
ointment
• Do not use baby powder – source of aspiration
 DENTAL CARE

• Initial dental check up should be made

before 2 years old; should continue at 6
month intervals.
• Oral fluoride supplement starting at 6
months of age
• Rubbing a soft washcloth over the gum pads
even before teeth erupt.
• Toothbrushing
DRESSING
 SLEEP

• Most require 10 to 12 hours of sleep at night

• Not to place pillows in an infant’s crib.
• Supine position.
• Use a firm sleep surface.
 EXERCISE

• Sun exposure: 3 to 5 minutes initially up to

10 to 15 minutes
• Provide opportunity to move.
PARENTAL CONCERNS
• Teething
• Thumb-sucking
– Sucking reflex peaks at 6 to 8 months
– Thumb-sucking is normal; peaks at about 18
months
– Best approach is to be certain an infant has
adequate sucking pleasure and then ignore thumb-
sucking.
• Use of pacifier – parents should attempt to
wean a child after 3 months and 6 to 9 months
when sucking reflex is fading
• Head banging
• Sleep concerns
• Constipation
• Loose stools
• Colic
• Spitting up
• Diaper dermatitis
• Miliaria
• Baby-bottle tooth decay
syndrome
• Obesity in infants
THANK YOU
1ST SEMESTER 2023