
| Development in Infants and Toddlers |


| BODY GROWTH proximodistal and cephalocaudal (below) Developmental milestones: ONE YEAR 12 -- 18 months 18 -- 24 months TWO YEARS IMMUNIZATIONS also HERE NEWBORN REFLEXES (below) SHAKEN BABY SYNDROME SUDDEN INFANT DEATH SYNDROME FONTANELLES (below) FEEDING/ NUTRITION TEETH FINE MOTOR/GROSS MOTOR LANGUAGE DEVELOPMENT TOILET TRAINING |



| Fontanelles. The "sutures" or anatomical lines where the bony plates of the skull join together can be easily felt in the newborn infant. The diamond shaped space on the top of the skull and the smaller space further to the back are often referred to as the "soft spot" in young infants. The posterior fontanelle is often quite difficult to feel and it usually closes by six weeks of age, as the bones of the head grow. The anterior fontanelle is more obvious and can easily be felt as a slightly soft area of skin on the top of the head. This does not close until well after your baby's first birthday, usually by eighteen months. In human anatomy, a fontanelle (or fontanel) is one of two "soft spots" on a newborn human's skull; although there are six fontanels in the infant's skull: the anterior fontanel, the posterior fontanel, the sphenoidal fontanel, the mastoid fontanel, and two others that no one seems to know about, but the text mentions. The skull of a newborn consists of five main bones: two frontal bones, two parietal bones, and one occipital bone. These are joined by fibrous "sutures" which allow movement that facilitates childbirth and brain growth. The posterior fontanelle ossifies and closes by the time the newborn is only one or two months old. The anterior fontanelle usually closes within the range of 7 to 19 months old. |



| ceinfo.unh.edu/Family/ graphics/firststsm.jpg www.countrywidepromotions.com/.../ KA140t_med.jpg www.bbc.co.uk/health/ images/300/baby_three.jpg malondashots.com/albums/ infants/Payton_248a.jpg www.phfocus.com/photos/ infants/infants-(1).jpg www.fpnotebook.com/NIC27.htm www.fpnotebook.com/NIC27.htm www.nlm.nih.gov/medlineplus/ency/article/003310.htm http://en.wikipedia.org/wiki/Fontanelle upload.wikimedia.org/ wikipedia/en/thumb/4/4c/... www.geocities.com/.../ albie.jpg |
| NEWBORN REFLEXES As a newborn and young infant, most of your baby's development and physical reactions will be determined by primitive reflexes. For example, if you brush your newborn's cheek, he will likely turns his head (rooting reflex), which helps him to find a breast or bottle for a feeding. Or if you place a nipple in his mouth, as it touches the roof of his mouth, it will cause him to begin sucking (sucking reflex). There are many of other types of reflexes, most of which are present at birth, including the moro or startle reflex, walking or stepping, tonic neck reflex and the palmar and plantar grasp. Foot Stroke Inner Sole Toes curl around ("grasp") examiner's finger Stroke Outer Sole (Babinski) Toes spread, great toe dorsiflexion Doll's Eyes Give one forefinger to each hand - baby grasps both Pull baby to sitting with each forefinger Eyes open on coming to sitting (Like a Doll's) Head initially lags Baby uses shoulders to right head position SteppingWalking Reflex Most parents are surprised by this reflex. If you hold your baby under his arms, support his head, and allow his feet to touch a flat surface, he will appear to take steps and walk. This reflex usually disappears by 2-3 months, until it reappears as he learns to walk at around 10-15 months. Hold baby up with one hand across chest As feet touch ground, baby makes walking motion Protective Reflex Soft cloth is placed over the babies eyes and nose Baby arches head and turns head side to side Brings both hands to face to swipe cloth away Rooting Reflex Touch newborn on either side of cheek Baby turns to find breast Sucking mechanism on finger is divided into 3 steps Front of Tongue laps on finger Back of Tongue massages middle of the finger Esophagus pulls on tip of finger Tonic Neck (Fencing) Reflex A postural reaction, the asymmetric tonic neck reflex, or fencer response, is present at birth. To elicit this reflex, while your baby is lying on his back, turn his head to one side, which should cause the arm and leg on the side that he is looking toward to extend or straighten, while his other arm and leg will flex. This reflex usually disappears by 4-9 months. If the Babies' head is rotated leftward The left arm (face side) stretches into extension The right arm flexes up above head Opposite reaction if head is rotated rightward Moro Reflex (Startle Reflex) Also called the startle reflex, the moro is usually triggered if your baby is startled by a loud noise or if his head falls backward or quickly changes position. Your baby's response to the moro will include spreading his arms and legs out widely and extending his neck. He will then quickly bring his arms back together and cry. The moro reflex is usually present at birth and disappears by 3-6 months. Hold supine infant by arms a few inches above bed Gently drop infant back to elicit startle Baby throws Arms out in extension and baby grimaces Babinski Reflex Stroke sole of foot from toe toward heel Toes fan out and curl as foot twists in. Disappears about 8 -- 12 months. |
| EXAMPLE OF CEPHALOCAUDAL AND PROXIMODISTAL PRINCIPLES OF DEVELOPMENT Cephalocaudal Principle of Development: The upper portion of the body develops quicker than the lower part of the body Proximodistal Principle of Development: The middle part of the body develops quicker than the outer part of the body. In this photo, the one month old infant's head and trunk are larger in proportion to her legs and arms. |
| Grasp This reflex is shown by placing your finger or an object into your baby's open palm, which will cause a reflex grasp or grip. If you try to pull away, the grip will get even stronger. In addition to the palmar grasp, there is also a plantar grasp, which is elicited by stroking the bottom of his foot, which will cause it to flex and his toes to curl. The palmar and plantar grasp usually disappear by 5-6 months and 9-12 months respectively. Positive Support Reflex Like the stepping reflex, if you hold your baby under his arms, support his head, and allow his feet to bounce on a flat surface, he will extend (straighten) his legs for about 20-30 seconds to support himself, before he flexes his legs again and goes to a sitting position. This reflex usually disappears by 2-4 months, until it becomes a more mature reflex in which there is a sustained extension of the legs and support of his body by about 6 months. Galant Reflex If your baby is on his stomach and you stroke neck to the spinal cord (paravertebral area) on his middle to lower back, it will cause his back to curve towards the side that you are stroking. This reflex is present at birth and disappears by 3-6 months. Swimming If you were to put a baby under six months of age in water, they would move their arms and legs while holding their breath. This is why some families believe in swim training for very little babies. Hand-to-Mouth (Babkin) Reflex Stroke newborns cheek or put finger in babies palm Baby will bring his fist to mouth and suck a finger Swimmer's (Gallant) Response Hold baby prone while supporting belly with hand Stroke along one side of babies' spine Baby flexes whole body toward the stroked side Crawling Reflex Newborn placed on abdomen Baby flexes legs under him and starts to crawl Eye Blink Shine bright light at eyes or clap hands near head Baby quickly closes eyelids. This reflex remains throughout life. Sucking Place finger in infant's mouth. Infant sucks finger rhythmically. Replaced by voluntary sucking after 4 months. This reflex is still present during sleep even in older infants -- opinion of Dr. Shafer. |


| BRAIN DEVELOPMENT **100 to 200 billion NEURONS in the human brain -- store and transmit information. **Gaps between neurons SYNAPSES across which the messages are sent from neuron to neuron. **Neurons send out messages to each other by releasing chemicals called NEUROTRANSMITTERS. **The prenatal brain produces far more neurons than the brain will ever need. **Neurons that are not stimulated lose their synapses, a process called SYNAPTIC PRUNING. **The CEREBRAL CORTEX surrounds the rest of the brain, and is the largest, most complex brain structure. **The cortex has two HEMISPHERES, left and right, that differ in their functions. For most of us, the left hemisphere is largely responsible for verbal abilities, and the right for spatial abilities. **When the two hemispheres of the brain become specialized, it is called LATERALIZATION. **BRAIN PLASTICITY refers to the ability of the brain sections to take over if another part is damaged. A brain that is not yet lateralized is more PLASTIC. Later, after lateralization, brain damage cannot be recovered by other brain regions. **By birth, the brain hemispheres have already begun to lateralize. GO HERE IF YOU WANT TO READ A LITTLE BIT ABOUT BEING RIGHT OR LEFT BRAINED ... interesting. True? You decide. |



| The fontanelles should feel firm and very slightly concave (curved inward) to the touch. A tense or bulging fontanelle occurs when fluid accumulates in the skull cavity or when pressure increases in the brain. When the infant is crying, lying down, or vomiting, the fontanelles may look like they are bulging, but they should return to normal when the infant is in a calm, head-up position. |




