Chapter 4 Infancy from the Newborn Baby to the Toddler Newborn s First Minutes o Apgar Scale o An assessment of risk taken 1 and 5 minutes after birth o Measures of the 5 vital signs each scored 0 1 or 2 Appearance typical to have blue hands and feet Pulse is there a heart beat Grimace muscle reactions in the face Activity are they moving around Respiration are they breathing o Score of 7 or higher infant is fine o Score below 7 infant needs help breathing o Score below 4 infant needs critical care Anoxia o Oxygen deprivation at birth o Can lead to brain damage and or later cognitive language problems o Cerebral palsy Causes include Squeezing by umbilical cord Placenta abruption premature separation in utero placenta previa placenta covers cervical opening while baby is being born Failing to breathe after birth Respiratory distress syndrome in preterm infants o Often because the lungs are the last organ to fully develop o Preventing Brain Cell Death From Anoxia Researchers are experimenting with ways to prevent this secondary damage Anoxic newborns placed in a head cooling device shortly after birth for 72 hours substantially reduced brain injury and increased their assessment scores Precooled water blankets are also being used to reduce the rates of death and severe disabilities brain damage Preterm and Small for Date Babies o Preterm Born weeks before their due date May be appropriate weight for length of pregnancy o Small for Date o Preterm Infants May be born at the due date or preterm Below expected weight for length of pregnancy Some small for date babies have weakened abilities to manage stress 7 days in the womb from 34 to 35 weeks can contribute greatly to infant health Babies born at 35 weeks show substantially reduced rates of illness and lengthy hospital stays compared to those born at 34 weeks o Interventions for Preterm Infants Isolette controls temperature breathing prevents germs Respirator controls breathing Feeding tube monitors nutrients IV medication Kangaroo skin to skin contact Parent training in care giving monitors infant CPR etc Precious Moments After Birth o Oxytocin causes the breasts to let down milk and heightens the mother s response to the baby Newborn Reflexes o First time fathers also show hormonal changes including an increase in prolactin and a decrease in androgens that are associated with positive emotional reactions to infants o Reflexes involuntary simple responses to certain stimuli o Most reflexes that develop before birth are present for 4 to 8 months after birth and then suddenly disappear Highly canalized cortical function o The disappearance reflects normal brain development and the emergence of higher o Reflexes present at birth in the healthy infant are Rooting touch the side of the face the baby will turn its head and begin to suck Sucking whenever anything is placed in the mouth Swallowing whenever anything wet is put in the mouth Stepping Grasping whenever anything is put in its hands Moro reflexes startled arms and legs flail whenever the baby experience the Babinski feet spread and tows curl whenever the bottom of the feet are stroked Newborn States sensation of falling or being thrown o Developmentalists have identified six primary states of arousal in newborns which occur throughout the day and night o Each state is associated with its own pattern of activity gross muscle movements eye movements breathing patterns and brain states o Across a 24 hour period a typical newborn in the United States will experience about 7 sleep intervals and 7 waking intervals each lasting from a few minutes to a few hours o Taken together the sleep intervals occupy about 16 hours of each day half spent in active REM sleep and half in deep sleep o Over the first few years total sleep decreases and sleep bouts consolidate into fewer more long lasting intervals of sleep Infant States of Arousal o Active Irregular REM Sleep The active sleep state is characterized by increased muscle tone and motor activity facial grimaces and smiles occasional eye movements under closed lids and irregular breathing o Active sleep occurs at the beginning of a period of sleep in newborns o After two or three months the sequence of active sleep and quiet sleep will reverse quiet sleep will occur before active sleep as it does in adults Newborns spend about 8 hours a day 50 percent of their total sleeping time in REM sleep The proportion of REM sleep declines rapidly in the months after birth
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