Birth
and Physical Development
during the First Three Years
Learning Outcomes
4.1 Specify how childbirth has childbirth has changed in developed countries
4.2 Describe the birth process
4.3 Describe the adjustment of a healthy newborn and the techniques for assessing its health
4.4 Explain potential complications of childbirth and the prospects for infants with complicated births
4.5 Identify the factors affecting infants’ chances for survival and health
4.6 Discuss the patterns of physical growth and development in infancy
Childbirth and Culture:
How Birthing Has Changed
Pre 20th Century:
Birthing was a modest “female only” ritual Use of midwives was predominant
Death rates high for mother and baby One out of four babies died in first year
Modern Generations:
Dramatic reductions in death rate due to:
“Humanizing” Childbirth:
A Social Trend
Home births have brought back
intimacy of event
Birthing centers and hospitals
Soft lights
Father or partner as coach
Birth Process
Parturition
– brings on labor
Two weeks before delivery
Uterine contractions
Cervix becomes flexible
Stimulated by rising estrogen
Stages of Childbirth
First: Longest, typically 12–14 hours
for first child, cervix dilates
Second: 1–2 hours, contractions
stronger and closer together, baby’s
head moves through birth canal; Stage 2 ends with baby emerging from
mother’s body
Third: 10–60 minutes, placenta and
Fetal Monitoring
Electronic monitoring can track
the fetus’s heart rate during delivery
Used in 89% of live births in the
U.S. in 2004
Sometimes can have false
Cesarean Delivery
Cesarean delivery: Surgically removing baby from uterus through abdomen
Over 30% of all U.S. births
Often used when labor progresses slowly
Changing preferences among women and some
physicians
Common with:
First and/or large babies Older moms
Unmedicated Delivery
Natural Childbirth
Mother receives training in fitness, breathing and
relaxation
Traditional cultures - Use of doula
Experienced helper provides emotional support to
mother
Prepared Childbirth
Lamaze
Mother learns to substitute other responses for feelings
Medicated Deliveries
Local or regional anesthesia
Blocks pain receptors in brain
Relaxing analgesic
Approximately 60% of
Size and Appearance
of the Newborn
Average neonate is:
20 inches long
7.5 pounds
Fontanels – soft plates of head Lanugo – fuzzy prenatal hair
Vernix caseosa – oily protection
Body Systems
of the Newborn
Breathing: Anoxia or hypoxia can lead to birth
trauma
Meconium
Stringy waste in fetal intestinal tract
Neonatal Jaundice
Yellowing of skin and eyeballs
Caused by immaturity of the liver Half of all babies experience
Assessments: Apgar Scale
Sign 0 1 2
Appearance Blue and pale Body pink, limbs blue All pink
Pulse Absent Slow (< 100) Rapid
Grimace None Grimace Coughing and crying
Activity Limp Weak Strong
Assessments:
Brazelton NBAS
Tests responses to physical and
social environment
Motor organization
Reflexes
Attention and interactive capacity
Neonatal Screening Tests
Help detect correctable
disorders
PKU
Galactosemia
Infant Arousal States
State Eyes Breathing Movement
Regular Sleep Closed Regular, slow None
Irregular Sleep Closed Irregular Twitching
Drowsiness Open or closed Irregular Some activity
Alert Inactivity Open Even Quiet
Wakeful and
Childbirth Complications
Birth trauma
Postmaturity
Prematurity
Low Birthweight
Prematurity and low birth weight are
Maternal Traits That Increase
Risk of Low Birth Weight
Underage or overage
Uneducated and poor
Poor nutrition
Smoking and drinking
Stress
Immediate Treatment for
Prematurity
Intravenous feeding
Surfactant
Isolette
–
controlled
environment,
like an incubator
Long-Term Outcomes of
Low Birth Weight
Greater risk of:
Neurological and cognitive
impairment
Lower academic achievement
Social, behavioral, and attention
Postmaturity & Stillbirth
Postmature:
42 weeks or more
Stillbirth:
Death of fetus at or
after 20th week of gestation
Reduction may be due to fetalmonitoring
Death during Infancy
Primary causes worldwide:
Preterm delivery
Sepsis or pneumonia
Asphyxiation at birth
Birth defects are leading cause in the
U.S.
Improvement in U.S. infant mortality
SIDS
Sudden Infant Death Syndrome
“Crib death”
Sudden death of infant under 1 year of age
Cause of death unexplained
May have underlying biological defect (heart
gene mutations)
Deaths from Injuries
90% of injury deaths in
infancy due to:
Suffocation
Motor vehicle accidents
Drowning
Immunizations
About 90% all children today are
vaccinated
Some regions are better
vaccinated than others
No causal connection between
Nutrition: Breast Feeding
Breast milk almost always the best food
More digestible
Reduces allergic reactions
Minimizes numerous infections
May reduce risk of SIDS
Better cognitive performance
Recommendation is babies exclusively
Bottle Feeding
Formula should be
iron-fortified
Necessary for women with
infectious illnesses
Does NOT reduce emotional
Other Nutritional Concerns
Solid food introduced second half of
first year
Malnutrition
Overweight
6% of U.S. infants classified as overweight
Research in Action:
Lessons from Neuroscience
Brains develop over time
Social environment is factor in
brain development
Brains are capable of change
Complex, integrated dynamic
organ
Parts of Brain
Cerebrum
Corpus callosum joins two halves
Four lobes
Brain Cells
Neurons:
Send and receive
information
Glia:
Nourish and protect
neurons
Neurotransmitters:
Chemical
messengers
Myelination:
Fatty substance
Reflexes:
Unlearned & Protective Behaviors
Postural
Reactions to changes in posture or
balance
Locomotor
Resemble later-appearing voluntary
movements
Research in Action
:
The Autism “Epidemic”
Autism disorders are brain disorders
characterized by a lack of normal social interactions, impaired communications,
repetitive movements, and a highly restricted range of activities and interests
Asperger syndrome
Genetic factors
Environmental factors
Role of Experience
in Brain Development
Postnatal brain is molded by development
Plasticity
Threats
Sensory impoverishment
Malnutrition
Corrective experiences can relieve past
Early Human Reflexes
Moro
Darwinian
Tonic neck
Rooting
Babkin and Babinski
Early Senses of Touch & Pain
Touch
First sense to
develop
Rooting reflex
Able to experience
Early Senses of Smell & Taste
Begins to develop in womb
Newborns prefer sweet tastes
Fluids and odors may be
Nature vs. Nurture?
Odor preference requires experience
6-day-olds prefer mother’s breast pad to
another nursing mother’s
Certain tastes are innate
Sweetened water calms crying newborns,
Sense of Hearing
Functional before birth
3-day-olds can tell new speech
Sense of Sight
The sense least developed at
birth
20/20 reached by about 6 months
Binocular vision (depth) develops
Milestones of Motor Development
Skill Age 90% of Children Master
Rolling over 5.4 months Grasping rattle 3.9 months Standing alone 13.7 months
Walking well 14.9 months Building tower of cubes 20.6 months
Denver Developmental
Screening Test
Gross motor skills
Fine motor skills
“Average”
Head control
Hand control
Walk & Gibson: The Visual
Cliff
Do infants perceive depth?
6-month-old babies would
approach “ledge,” but
avoided “drop”
Demonstrated depth
Thelen’s Dynamic Systems
Theory
Learning occurs through detecting the
many features of an environment
With experience, babies learn to
gauge their environment
Is that ball moving away from me? Is that ground too
Cultural Influences on
Motor Development
Depends on the pace of the culture African and West Indian cultures
actively encourage early motor strength
Bouncing and stepping exercises
Other cultures discourage …
Ache mothers pull infants
