02/03/2015Male TeratogensGulf war syndrome: children no arms, no legs, sometimes awful skin disordersNo contact with:x-rays (dentist office)radiationlead, mercury, gasolinecocaine (hitchhike or sperm)Older men sperm decrease in quantity and quality- oldest known male parent 94Fetal Stage 3m-9months (40 weeks)Visually would start to look more like a babyStart adding on weight and is a more safe timePoor maternal nutrition could lead to stillbornVitamin B1 Folic Acid prevents spina bifidaWomen should expect to gain 22-40 lbsExercise can happen moderate low impactPremature birth: overworked, stress, strenuous laborAge of viability: 6 months when baby can liveLast month add a pound a week (overdue a problem)Prenatal AssessmentUltrasound: noninvasive uses sound waves to produce a picture: often tell sex and down syndromeAmniocentesis- go through the mother’s stomach and pierce amniotic sac and get a fluid sampleProblem: have to wait until 14-17 weeks, may be too late to do Anything; also caused miscarriage if the amniotic sac brokeChorionic Villius Sampling (CVS)- vaginal go into the placenta and take out cells there can be done 8-12 weeks and less likely to cause miscarriage Ch. 4 Childbirth and 1st yearTypes of childbirth Medicated/hospital epidural- baby often gets some of the medicine, drowsy, slowed relationship with momLamaze- natural breath, decrease fear, coach or partner, relaxation helps deliveryC-sections- taken through the abdomen- increased recovery time (6 weeks), more expensive (Doctor visits, more time in hospital) other birth higher % C-sectionMidwife- goal to have baby in home. Lamaze + doctorStages of ChildbirthHospital time: water breaks/ contractions regularly intenseDilation and effacement- cervix opening dilates 10 cm it is time to go. Effacement baby’s head drops to the spot. 12-14 hour 1st pregnancy4-6 2nd Delivery of baby- pushing time 1st and 50 minutes and 2nd 20 minutesPlacenta is delivered (after birth) 10 minutesBaby/mother rest and monitoredAverage baby is 20 inches and 7 ½ pounds02/05/15***Exam TUES. 02/10—look over text- sections we didn’t cover***APGAR Scale10 point scale (total)Appearance 0 blue; 1 pink w/ blue; 2 pinkPulse 0 0-60; 1 60-100; 2 100-140Grimace 0 placid; 1 movement; 2 agitatedActivity 0 still; 1 some movement; 2 kick/screamRespiration 0 none; 1 irregular; 2 cryingBelow 7 a concernAnoxia (lack of oxygen) biggest concern. Breech or umbilical cord issuesNeonatal Period- 1 st 4 weeksMom did everything that the baby now needs to do.Circulatory, respiration, GI, and temperature regulation systems need to come onlineBabies can lose up to 10% of weight; jaundice- take baby to doctor- liver and kidney problem- whites of eyes and skin turn yellowBrain development significant in the first year. At birth, the baby’s brain weighs 25% of adult; atthe end of the year it is 75%. Baby adds weight through axon development (Iranian orphan and premature baby stories- massaging/touching baby with skin-to-skin contact developed better)Reflexes will eventually begin to disappear. Child born with about 27 reflexes and at the end of the year about 17 left.Sucking is one of the reflexes the child is born withSleep and Sudden Infant Death Babies will sleep a great deal of time (16 hrs/day)For the first month (great deal of REM sleep) takes about 3 months before child sleeps through the night. Mom and dad’s sleep cycles troubledSudden Infant Death Syndrome (worse 2-4 months)Increase risk : 1) winter-lots of blankets 2) smoking in the house 3) baby sleeping on belly 4) poorInfant Mortality RatesNumber of children who die per thousand in US = 6-7 now—was 7-8USA has one of the highest infant mortality rates in 1st world countries¾ of infant mortality in neonatal periodPoor prenatal and neonatal care particularly for minoritiesRecent decrease in numbers attributed to SIDS educationNourishment and Growth Breast milk or formula the only food needed up to 6 months After 6 months, need iron supplementsBreast milk the best food. Helps: 1) teeth and bones 2) prevents diarrhea 3) decrease infections 4) gains some antibodiesAvoid giving JUICE, sweeter than milk- don’t introduce juice because that is all they will wantBabies’ weight will triple 7 to 21 lbs in first yearBabies will grow 10 inches or so to about 30 inchesMost amount of growth you will do in that amount of time in your life5 Sense and Early DevelopmentHearing- most developed. Babies will feed more to a recording of mother’s voice vs. another womanSmell seems to quick to develop. Babies feed more to mother’s breast pad than another woman’sTaste- babies prefer sweet over sour and breast milk is sweetPain- once though that babies did not feel pain. Circumcisions and even surgeries were not done with anesthetics. Protected animals can be imperviousVision- poorly developed. No depth perception till about 6 months. Gain vision right at the time they can crawl and the visual cliffDevelopmental MilestonesGen principles head to toe and near to farDenver Developmental Screening Test gives schedules when 25%, 50%, and 90% of children areable to do certain tasks 25%; 50%; 90%Rolling over 2.1; 3.2 ; 5.4Grasping 7.2; 8.2; 10.2Walking 11; 12.3; 15child considered developmentally delayed if they have 2 things when 90% of other children can do