The period of infancy infancy. Infancy The infancy period lasts
How long does infancy last?
From the 29th day of a child’s life after birth until the end of the first year of life, this period lasts, characterized by an intensive increase in body weight and height, intense physical, neuropsychic, and intellectual development. The name itself speaks of close contact child with mother during this period when the foundation of human health is laid. An infant has an innate need for active knowledge of the world around him.
Features of growth and development of an infant
Intensive increase in body weight. By 4.5 months. Body weight doubles at birth; by the end of the year, body weight is 10–11 kg. Significant growth rates are noted: body length increases by 50% of the length at birth and reaches 75–77 cm by the year. The head circumference by the year is 46–47 cm, the chest circumference is 48 cm. The child’s motor skills and motor skills are rapidly developing.
There are three “peaks” of motor activity:
peak – at the age of 3 – 4 months. – associated with significant morphofunctional changes in the visual area; he is characterized by a complex of excitement and joy at the first communication with adults.
peak – at the age of 7 – 8 months. – activation of crawling, formation of binocular vision and mastery of space.
peak – 11 – 12 months. – start of walking.
These types of motor activity are determined by sensory-motor connections, and determined by the processes of growth and development of the child’s skeletal muscles and his motor activity.
Child development in the first year of life
The first year of a child’s life is characterized by rapid growth and development and is very important for the development of his physical and mental health. The age period has characteristic anatomical and physiological features, taking into account which treatment and preventive measures should be carried out. Unfavorable ecology, maternal illnesses during pregnancy, pathology during childbirth, not always rational nutrition. Here is an incomplete list of the reasons that can provoke various diseases in a baby.
Diseases of children in the first year of life
The most gentle approach to treating diseases in early age is one of the main criteria for treatment and prevention. Therefore, pharmaceuticals used to treat newborns and infants are subject to the highest safety requirements (absence of toxic effects, allergic reactions and other side effects on the child’s body). A convenient release form and pleasant organoleptic properties are also important.
Among the most common conditions and diseases that pediatricians encounter in children during infancy, especially in outpatient settings, are: ARVI, acute gastrointestinal diseases, states of agitation and anxiety of various etiologies, sleep disorders, functional dyspepsia, severe teething, intestinal colic, flatulence, diaper rash, diathesis, dysbiosis, neonatal hyperbilirubinemia, post-vaccination reactions. Low reactivity of the body and the formation of allergic diseases, including bronchial asthma, are becoming increasingly common.
Teething in infants
Even if the child grows up healthy, parents have to endure difficulties associated with teething, periodic regurgitation, functional dyspepsia, diathesis, etc. For teething, accompanied by local inflammation and soreness of the gums, local anesthetics are used. However, in case of severe teething (with fever, anxiety, stool upset), additional medications are required. As for dyspepsia and regurgitation, there is a shortage of safe and effective means.
Vaccinations for infants
Add to this the problem of vaccinations during infancy. It’s no joke, from the first days of life until one year, get 10 vaccinations, especially considering that DTP is the most allergenic vaccine with a high risk of developing severe complications and reactions. But this artificial antigenic load is layered on top of “acquaintance” with ordinary, ubiquitous microbes of the surrounding world. It is almost impossible to prepare the body for this load with chemotherapy, since the chemotherapy drugs themselves load the body.
Constipation and diarrhea in children
Infants are often prone to constipation or diarrhea. If for constipation it is possible to use mild herbal preparations, then for diarrhea or stool upset, more stringent therapy with chemicals is used.
Diathesis in children
From 3 to 5 months, allergic diathesis most often debuts, realizing in the worst case into eczema. The use of antihistamines and hormonal agents (externally and internally) during diathesis only drives the problem deeper, and then transforms or manifests itself as eczema.
ARVI in children
The natural epidemiological situation, that is, several uncomplicated acute respiratory viral infections combined with the inability to breathe through the mouth and the unwanted use of vasoconstrictor drugs, also causes a lot of trouble. Irrational use of antipyretic drugs for ARVI is fraught with a weakening of the immune response and the development of complications. If ARVI is complicated by otitis media, pneumonia, meningitis, etc., then antibiotic therapy is inevitable, which quickly leads to diarrhea due to lactase deficiency and intestinal dysbiosis.
How to care for a newborn in the first year of life?
During infancy, the baby's sleep and wakefulness do not depend on the time of day; patterns corresponding to day and night begin to appear in the child by 2–3 months. life.
The newborn needs to create a calm environment, provide access to fresh air, perform hygiene procedures, free swaddling, since the position with bent legs is protective, reduces the heat transfer surface and ensures the proper level of heat production.
For normal neuropsychic development, the emotional connection between mother and child during breastfeeding is important. It is necessary to stimulate the newborn's interest in visual scenes; do not let him cry for a long time so that the baby does not cry out at the umbilical hernia. In addition, a quick reaction to a baby’s cry and affectionate intonations contribute to the establishment of a strong attachment between mother and baby.
You should pay attention to the depth of sleep of the newborn, his reaction to sound, sucking activity, and cry features. Prolonged “whining” crying, especially at night, for no apparent reason, indicates a high nervous excitability of the child, monotonous crying without emotional coloring indicates a disorder of the central nervous system.
Caring for an Infant
Daily care for a healthy baby, especially a newborn, involves: washing, eye drops when they become sour, and the need to cleanse the nasal passages 1-2 times a day. Taking into account the especially thin, vulnerable and densely vascularized mucosa of these organs, the safest drugs in terms of traumatization, sensitization and drying out are the following drugs:
- "Okuloheel" - for the eyes,
- "Euphorbium compositum C" - for the nose.
These drugs are as close in composition as possible to the physiological fluids of the body and promote gentle cleansing of the mucous membranes. They have moderate anti-edematous, anti-inflammatory and anti-allergic effects.
For diaper rash, Traumeel S ointment is used, which is applied in a thin layer to the affected area 2 - 3 times a day. The duration of use depends on the dynamics of improvement in skin condition.
Send your good work in the knowledge base is simple. Use the form below
Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.
Posted on http://www.allbest.ru/
Department of Health of the Voronezh Region BOU vocational education institution Buturlinovsky Medical College
Infancy period. Physical education of an infant
Prepared by: student of group 107 f/o Chuvenkova D
Checked by: T.A. Dernovaya
Buturlinovka 2014
1. Brief description of the infancy period
1.1 Features of growth and development
1.2 Features of the central nervous system
1.3 Features of the endocrine system
1.4 Features of immunity
1.5 Nonspecific resistance factors
1.6 Physical education of an infant
1.7 Massage and gymnastics at an early age
1.8 An approximate set of exercises and massage for children from 1.5 to 3 months
2. Complexes of physical exercises
2.1 For children from 1.5 to 3 months
2.2 For children 3-4 months
2.3 For children 4-6 months
2.4 For children 6-10 months
Used Books
1. Brief characteristic period breast age
The period of infancy is from the 29th day of a child’s life after birth until the end of the first year of life. This period is characterized by an intensive increase in the child’s body weight and height, intense physical, neuropsychic, and intellectual development. The name itself speaks of the close contact of the child with the mother during this period. During infancy, the foundation of human health is laid. An infant has an innate need for active knowledge of the world around him.
1.1 Peculiarities growth And development
Intensive increase in body weight. By 4½ months, birth weight doubles; by the end of the year, body weight is 10-10½ kg. Significant growth rates are noted: body length increases by 50% of the length at birth and reaches 75-77 cm by the year. By the age of one year, the head circumference is 46-47 cm, the chest circumference is 48 cm. The child’s motor skills and motor skills are rapidly developing. Three “peaks” of motor activity are observed. The first - at the age of 3-4 months - is associated with significant morphofunctional changes in the projection visual zone; it is characterized by a complex of excitement and joy during the first communication with adults. The second - at the age of 7-8 months - activation of crawling, formation of binocular vision and mastery of space. The third peak is 11-12 months - the beginning of walking. These types of motor activity are determined by sensory-motor connections, and the processes of growth and development are determined by the child’s skeletal muscles and his motor activity.
1.2 Peculiarities CNS
By the age of one year, brain mass increases by 2-2½ times. Intensive differentiation of nerve cells in the brain is noted in the first 5-6 months of a child’s life. The orienting reflex is of great importance in development, reflecting the child’s innate need for movement and activity of the senses. Nervous connections between the child and the people around him are established through facial expressions, gestures, and vocal intonations. Developing fine finger movements promotes brain and speech development. The emergence of a connection between words and the child’s motor responses is of great importance, then the baby’s connection of the visual and auditory perception of objects with words, the names of objects when they are shown, connections with individual actions (“give”, “show”) - this is the optimal course of development necessary as a basis for subsequent periods of childhood. The need for contact with adults determines the child’s mental development.
Features of the EEG: at 2-3 months a stable rhythm is observed, at 4-6 months the changes are unidirectional, and at 8-10 months progressive individualization is observed.
1.3 Peculiarities endocrine systems
During the infancy period, children experience increased function of the pituitary gland and thyroid gland. Levels of thyroxine and triiodothyronine are higher than in adults. They stimulate the metabolism, growth and development of the child, ensure normal differentiation of the brain and intellectual development, but at the same time, the pituitary-thyroid system is the most vulnerable and sensitive to adverse effects, especially to environmental and environmental factors. Clinically, this is characterized by a decrease in the rate of increase in body weight, the development of anemia and an increase in ARVI. In the breast period, there is an increase in adrenal function and the biological activity of corticosteroids. Partial involution of the fetal zone of the adrenal cortex occurs.
1.4 Peculiarities immunity
Compared to the neonatal period, there is a slight decrease in the number of T- and B-lymphocytes, a decrease in maternal IgG, starting from 2-3 months. At 4-6 months the first critical period immunity, which is characterized by a weakening of passive humoral immunity received from the mother, and the lowest level of specific antibodies is noted - physiological hypoimmunoglobulinemia. The child begins to synthesize his own IgG from 2-3 months of life; its constant level is established after 8 months - 1 year.
By the end of the year of life, the IgM level reaches 50% of the adult level. The increase in secretory IgA occurs slowly. The IgE content in a healthy child throughout the year is insignificant, but with manifestations of atopic dermatitis it increases significantly. The infancy period is characterized by the synthesis of IgM, which leaves no immunological memory. In connection with the above, there is a high sensitivity to respiratory syncytial viruses, parainfluenza viruses and adenoviruses; Measles and whooping cough occur atypically, leaving no immunity.
1.5 Nonspecific factors resistance
In infants, high levels of lysozyme and properdin are observed, the level of complement in the blood serum increases rapidly, and from the first month of life its content does not differ from the level of an adult. From 2-6 months, the final phase of phagocytosis to pathogenic microorganisms is formed, with the exception of pneumococcus, staphylococcus, Klebsiella, and Haemophilus influenzae.
1.6 Physical upbringing breast baby
The physical development of an infant and the development of speech occurs so quickly that it is assessed by quarters of the year.
Physical education is a holistic system that combines the protection and promotion of health, improvement of the functions of the child’s body, and his full physical development. Physical education is aimed at the timely formation in children of motor skills, abilities, physical qualities: development of interest in various types of motor activity accessible to the child and positive moral and volitional personality traits. To carry out these tasks, the following conditions are necessary:
Appropriate cultural environment (child's living conditions);
Compliance with hygiene rules;
Regular, sufficient and nutritious meals;
A stable, correct regime that creates opportunities for a child’s normal life and a variety of active activities, outdoor games and activities with him.
When these conditions are met, the unity and consistency of health and educational work should be observed. A child cannot develop well physically if he moves little or cries frequently. Health-improving activities, such as dousing with water and gymnastics, have a positive effect on the child’s health when he willingly participates in the water procedure and does gymnastics with pleasure. Properly organized physical education creates the basis for complete mental, moral and aesthetic education and the development of work skills.
One of the means of physical education for children preschool age is Physical Culture. It includes massage and gymnastics, physical education, outdoor games, sports entertainment, and hardening.
Physiological effects of special physical exercises, various kinds There is a huge amount of movement. Movements increase blood flow to muscles and oxygen to tissues, help improve metabolism, increase the body's reactivity, improve blood composition, are biological growth stimulants, and contribute to the harmonious development of the child.
From 1.5-2 months of age, healthy children begin to receive massage and gymnastics during one of the periods of wakefulness before feeding.
1.7 M assage And gymnastics V early age
Massage is a mechanical effect using special techniques (stroking, effleurage, rubbing, kneading, etc.) on the skin with a certain force and in a certain sequence. It has a variety of effects on the child’s body. Massage is prescribed depending on the physiological characteristics of the child.
General massage predominates in classes with children up to 6 months; after 6 months, massage of the back, abdomen and feet begins, i.e., the muscle groups that most need it. Gradually, after 6 months of a child’s life, massage is replaced by gymnastic exercises.
Massage has a positive effect on a child's development. Its effect is manifested in improving blood supply and protective properties of the skin, increasing its firmness and elasticity, and improving muscle contractility. Systematic massage helps to improve the function of receptors, pathways, strengthening reflex connections of the cerebral cortex with muscles, blood vessels, and internal organs, which contributes to more coordinated activity of all body systems. This is one of the types of passive gymnastics and is of great importance for the subsequent development of static and motor functions - the ability to maintain body position in space, for example, the ability to sit, stand, and coordinate movements when crawling, walking, grasping, standing, etc.
The adult performing the massage should have clean, warm hands, healthy, soft skin; It is not recommended to use any ointments, talc or other emollients to avoid irritation of the child’s skin.
The table is covered with a four-fold flannelette blanket, oilcloth and sheet. The child is undressed and placed on his back. Taking into account that in children up to 3 months of age, the predominance of the tone of the flexor muscles over the tone of the extensor muscles of the upper and lower extremities remains (the child keeps his arms bent at the elbows and legs bent at the hip and knee joints), this position should not be forcibly corrected, They only use a stroking massage, as it helps relax the muscles. Other types of massage (rubbing, kneading, light tapping) are not indicated at this age, as they increase physiological muscle hypertension. For the same reason, children under 3 months of age are not given passive exercises, but only reflex movements. The entire complex lasts 4-5 minutes at the beginning, and 5-6 minutes after 2 months. During the massage, the child receives a general air bath. At the end of the exercises, it is put on.
1.8 ExemplarycomplexexercisesAndmassageForchildrenfrom1,5 before3 months
1.Hand massage - stroking. The palm of the hand is drawn in the direction from the hand to the shoulder along the inner surface of the child’s forearm and shoulder. The movement is repeated 4-5 times for each hand.
2. Abdominal massage - stroking. Using the palm of your hand, make a circular stroking of the abdomen in a clockwise direction, bypassing the area of the right hypochondrium (location of the liver). The circular motion is repeated 6-8 times.
3. Foot massage - stroking. Holding the child’s leg by the foot with one hand, with the palm of the other hand they stroke it along the outer and back side of the lower leg and thigh (without touching the inner side) in the direction from the foot to the hip joint. The movement is repeated 4-6 times for each leg. massage gymnastics infant
4. Reflex extension of the spine. Exercise strengthens the back muscles. The child is turned on his side and, touching the skin of the back on both sides of the spine with two fingers, a movement is made in the direction from the buttocks to the shoulder girdle. Tactile irritation of the skin of the back causes reflex extension of the spine. The exercise is performed once with the child positioned on the right and left sides.
Starting from 2 months of age, the complex of massage and gymnastics is supplemented with the following exercises that help strengthen the muscles of the back, neck, and foot.
5.Laying on the stomach. The child is placed on his stomach, and his arms bent at the elbows are placed under his chest.
6. Reflex crawling on the stomach. The child, lying on his stomach with his arms bent at the elbows, has his feet lightly supported by the palm of his hand. This causes a reflex extension of the child's legs, as a result of which he moves forward and bends his legs again. The exercise is repeated 2-3 times.
7.Back massage. The child is placed on his stomach and his back is stroked in the direction from the buttocks to the neck with the back of both hands and back from the neck to the buttocks with the palms. The movement is repeated 4-6 times.
8. Reflex extension of the back and legs (imitation of a swimmer’s position). The child lying on his stomach is lifted on the right palm, while at the same time the left hand holds him by the feet and the lower parts of both legs. In this case, a reflexive deviation of the head back, extension of the spine and legs in the hip joints occurs. The exercise is carried out 1-2 times.
In addition to the above special exercises that strengthen the back muscles, it is recommended, starting from 2 months, to place the child on his stomach for 1-2 minutes during all periods of wakefulness.
9.Foot massage. The child lies on his back.
a) Stroking. The leg rests with the Achilles tendon on the index fingers of both hands of an adult. Using his thumbs, he strokes the back of the child's foot from the toes to and around the ankle joint. The movement is repeated 4-6 times.
b) Rubbing the toes. The adult performing the massage places the child's foot between the palms of his hands and makes 4-6 light rubbing movements for each foot in turn.
10. Reflex flexion and extension of the toes (plantar reflex). The child lies on his back. With one hand, slightly lift the child’s leg, holding the shin in the palm of your hand. With the index finger of the other hand, lightly press on the skin of the plantar surface of the child’s foot at the base of the fingers, thereby causing a reflex flexion of the toes. Then they run their finger along the outer edge of the foot to the heel and press lightly again - a reflex of fan-shaped extension of the toes appears. The exercise is repeated 3-4 times for each leg.
11.Dancing (leg reflex). The child is held under the armpits with both hands and, having given him a vertical position, momentarily touches his feet to the table. When touching a dense surface, the child’s half-bent legs reflexively straighten at the knees and hips. The exercise is repeated 4-6 times.
Gymnastic exercises are divided into active, reflex and passive. Active exercises are voluntary exercises that the child does independently. Reflex reactions occur directly in response to irritations of the musculocutaneous system. Passive exercises are performed by a nurse. These are movements in which the active participation of the child himself is not necessary (for example, crossing the arms or bending and straightening the legs).
2.Kcomplexesphysicalexercises
2.1 Forchildrenfrom1,5 before3 months
Physiological prerequisites: increased tone of muscles, arms and legs, the presence of some innate reflexes - plantar, leg, dorsal, etc.
Elements of massage at this age include stroking and reflex movements.
1.Hand massage (stroking).
2. Abdominal massage (stroking).
3. Foot massage (stroking).
4.Laying on the stomach.
5. Reflex extension of the spine (dorsal reflex).
6.Back massage (stroking).
7.Foot massage (stroking).
8. Flexion and extension of the toes (plantar reflex).
9. Reflex crawling.
2.2 Forchildren3-4 months
Physiological prerequisites: disappearance of physiological hypertension of the hands; Establishing balance between the flexors and extensors of the upper limbs. (Therefore, passive exercises for the hands, as well as rubbing, kneading, and stroking are introduced into this age group.)
1.Hand massage (stroking).
2. Crossing your arms over your chest and moving them to the sides (passive exercise).
3. Abdominal massage (stroking - rubbing).
4.Turn onto your stomach in both directions (reflex exercise).
5.Back massage (stroking, kneading).
6. Foot massage (stroking, rubbing, kneading, ring rubbing of the shin).
7.Foot massage (stroking, rubbing fingers, patting).
8. Abduction and adduction of feet (reflex exercise).
9. “Dancing” (reflex exercise).
10. Flexion of the spine and legs (position reflex).
2.3 Forchildren4-6 months
Physiological prerequisites: complete balancing of the flexor and extensor muscles of the lower extremities; strengthening of the anterior cervical muscles, as a result of which some more innate position reflexes appear; an increase in the child’s activity aimed at changing the body position from lying to sitting; formation of the activity of the auditory analyzer, which makes it possible to cultivate motor conditioned reflexes in response to sound signals, performing exercises on the count: “one, two, three, four.”
1.Hand massage.
2. Crossing your arms over your chest and moving them to the sides.
3. Abdominal massage.
4.Turn from back to stomach in both directions.
5. “Hovering” on the stomach (position reflex).
6.Back massage.
7. Raising the upper body from a position on the back with support from both arms extended to the sides.
8,9,10. Foot massage and exercise for the feet.
11.Bending and extending the legs together and alternately (passive exercise).
12. “Hovering” on your back.
13. Sitting down.
14.Massage chest.
15. Raising the child to his feet with support.
16. Sitting down.
2.4 Forchildren6-10 months
Physiological prerequisites: increasing number active movements; expansion of conditional connections with the environment; development of speech understanding, the emergence of the ability to contract large muscles for a longer period of time and hold the body in a certain position.
1. Circular movements with your hands.
2. “Sliding steps” - bending and straightening the legs together or alternately with verbal instructions.
3. Abdominal massage.
4.Turn from back to stomach to the right.
5.Back massage.
6. Exercise to stimulate crawling.
7.Foot massage.
8. Sitting down.
9.Turn from back to stomach to the left.
10. Raising the child to his feet.
11. Raising the torso from a position on the stomach.
12. Raising straight legs.
13.Stepping over.
14. Chest massage.
Massage and gymnastics are prescribed for everyone healthy child, starting from 1.5-2 months. For children in the first year of life, exercises should be simple and easy to do.
Before performing gymnastics and massage, the room is well ventilated, the room temperature should be optimal (20-22°). Massage and gymnastics are carried out only at the child’s normal body temperature, before feeding, the duration of the session should not exceed 5-10 minutes.
While performing the exercises, they maintain a positive emotional tone, a joyful mood, and prevent overwork. Gymnastics classes are accompanied by a gentle conversation with the child, which helps create positive emotions, develop sound skills and subsequently speech.
During the first year of life, children are prescribed 5 sets of physical exercises (massage and gymnastics). In this case, the physiological age-related characteristics of the child’s central nervous system and musculoskeletal system must be taken into account in order to ensure his correct physical development.
Usedliterature
1. Beniaminova M.V. “Raising Children” p. 67;
2. Spirina V.P. “Hardening Children” p. 81;
3. Tonkova-Yampolskaya R.V., Chertok T.Ya., Alferova I.N. “Fundamentals of medical knowledge” p. 72.
Posted on Allbest.ru
Similar documents
Rules and requirements for the nutrition of an infant, ways to meet his needs for vitamins and minerals. Determining the need breastfeeding to improve the health and immunity of the child. Development of motor activity.
abstract, added 01/16/2011
Physical and neuropsychic development of infants. Features of feeding infants. The main tasks of prenatal care. Requirements for clothes and shoes for pregnant women. Recommendations for daily routine for infants.
course work, added 05/26/2010
Considering the benefits of breastfeeding. Study of composition breast milk. Description of the basic rules for successful breastfeeding. Analysis of problems arising from incorrect application. Consideration of the nutritional characteristics of a nursing mother.
presentation, added 04/20/2019
The value of breast milk for a baby. Lactose is one of the components of breast milk and the most important source of energy for the baby. Analysis possible problems with the absorption of lactose. Causes of lactase deficiency, its main types, symptoms and signs.
presentation, added 12/20/2015
Benefits of breastfeeding for mother and baby. Composition and the nutritional value human milk. Early attachment of the newborn to the mother's breast. Feeding process. Psychological support. WHO/UNICEF methodology for supporting breastfeeding.
course work, added 11/30/2014
Nervous system of a child. Periods of development of the thymus gland. Morphological and physiological features of the skin of a newborn and infant. Reorganization of the child’s body activity at birth. Indicators of mental development of a child.
abstract, added 06/23/2010
The period of newborns and infancy. Psychological characteristics of preschool age. Adolescence period of mental formation. The essence of the concept of "acceleration". Characteristics of periods mature age. Mental changes in old age.
course work, added 04/20/2010
The benefits and necessity of breastfeeding a baby. Comparative composition of human milk and milk of animal origin. Features of colostrum. Vitamin content. Expressing breast milk. Principles of breastfeeding. Dairy products.
presentation, added 02/01/2017
The role of nutrition in ensuring normal physical development child. Balanced diet and a friendly attitude towards the child from the moment of birth. Basic nutrients and their importance for the child’s body. Principles for successful breastfeeding.
presentation, added 10/01/2016
The importance of breastfeeding in a child’s life. Current recommendations and WHO/UNICEF breastfeeding initiative. Promotion of breastfeeding as one of the areas of work of a local nurse at a children's clinic.
The period of infancy lasts from the 29th day of life to 1 year. The name itself emphasizes that during this period of life the mother and child have the closest contact. Mother feeds her child. The basic processes of adaptation to extrauterine life have already been completed, the mechanism of breastfeeding is sufficiently formed and the child is undergoing very intensive physical, neuropsychic, motor and intellectual development. During this period, at the same time, a number of problems arise to ensure optimal development and prevent diseases of the child. This is primarily a problem rational feeding, since feeding a child older than 5 months only with human milk does not satisfy the child’s needs. Therefore, he needs to promptly introduce corrective products or components. Infant after 2 - 3 months, he loses passive immunity, transmitted to him transplacentally from the mother, and the formation of his own immune systems occurs relatively slowly, and as a result, the morbidity of infants turns out to be quite high. Against the background of the anatomical and physiological characteristics of the respiratory system (narrowness of the respiratory tract, immaturity of the acini, etc.), infants often experience lesions of the respiratory system, the course of which is particularly severe. To prevent morbidity, the versatile use of means and hardening methods. This includes massage, gymnastics and water procedures carried out according to specially developed schemes.
During infancy there is intense preventive vaccination, aimed at developing immunity to various diseases. (Appendix 2)
Growth rate, increase in body weight, maturation of various organs and systems on each age stage, are mainly programmed by hereditary mechanisms and, under optimal living conditions, follow a certain plan, in which, under the influence of unfavorable factors (environmental factors, i.e., nutritional conditions, education, diseases, social, etc.), not only violations of the sequence of child development are possible , but also sometimes irreversible changes. And therefore, knowledge of the characteristics of the growth and development of an infant is important for recommending adequate lifestyle, nutrition, education, disease prevention, etc.
Physical development of infants
The most clear and simple way to assess a child’s development is by various anthropometric indicators.
Physical development- this is a dynamic process of growth (increase in body length and weight, development of individual parts of the body, etc.) and biological maturation of a child in one or another period of childhood, and in children of the first year of life - the formation of statistical and motor functions, which generally determines the performance or reserve of physical strength.
BODY LENGTH (HEIGHT). After birth, the intensity of growth gradually slows down, only occasionally giving way to short-term acceleration, with the lower segments of the body growing faster than the upper ones. For example, the foot grows faster than the lower leg, and the lower leg faster than the thigh, etc., which affects the proportions of the body. In the postnatal period, sex-specific growth rates increase, with boys growing faster than girls. At the same time, the rate of maturation of girls is higher.
Body length is of particular importance, as it reflects the complex processes occurring in the body, to some extent the level of maturity of the organism. And the younger the child, the faster his growth.
Child's body length first year of life can be calculated based on monthly and quarterly growth changes. In the first 3 months of life, growth increases by approximately 3 cm monthly or by 9 cm per quarter, in the second quarter - by 2.5 cm, i.e. by 7.5 cm per quarter, in the third quarter - by 1.5 - 2.0 cm, in the fourth quarter - by 1 cm per month, i.e. by 3 cm. The total increase in body length for the first year is 25 cm. You can also use the following formula: a 6-month-old child has a body length of 66 cm, for each missing month 2.5 cm is subtracted from this value, for each month after 6, 1 is added. 5 cm.
BODY WEIGHT AFTER BIRTH. Unlike growth, body weight is a rather labile indicator that reacts relatively quickly and changes under the influence of various reasons - both endo- and exogenous.
The rate of mass growth in the first year is higher (except for the first month of life) the younger the age. To roughly calculate body weight in the first year of life, you can use a number of formulas.
1. Formula of Mazurin and Vorontsov.
For the first half of the year, body weight can be determined as the sum: body weight at birth + 800 x n, where n- the number of months during the first half of the year, and 800 g is the average monthly increase in body weight during the first half of the year.
For the second half of life, body weight is equal to: body weight at birth + body weight gain for the first half of the year (800 x 6) + 400 x (n-6), where P is age in months, and 400 g is the average monthly weight gain for the second half of the year.
2. The body weight of a 6-month-old child is 8200 g, 800 g is subtracted for each missing month, and 400 g is added for each subsequent month.
A more accurate assessment of the increase in body weight in children of the first year of life is made in centile terms.
CHANGES IN HEAD CIRCUMSTANCE. Monitoring changes in head circumference is an integral component of monitoring physical development. This is due to the fact that head circumference also reflects the general patterns of biological development of the child, namely the first (cerebral) type of growth; in addition, disturbances in the growth of skull bones can be a reflection or even a cause of the development of pathological conditions (micro- and hydrocephalus). At birth, the head circumference is on average 34 - 36 cm. Subsequently, it grows quite quickly in the first months and years of life and slows down its growth after 5 years.
Approximately, the head circumference for children under 1 year of age can be estimated using the following formulas: the head circumference of a 6-month-old child is 43 cm, for each missing month from 43 cm one must subtract 1.5 cm, for each subsequent month add 0.5 cm.
CHANGE IN CHEST CIRCUMSTANCE. Chest circumference is one of the main anthropometric parameters for analyzing changes in transverse body dimensions. Chest circumference reflects both the degree of development of the chest, closely correlating with the functional indicators of the respiratory system, and the development of the muscular apparatus of the chest and the subcutaneous fat layer on the chest. The chest circumference at birth is on average 32 - 34 cm. It is slightly smaller than the head circumference; at 4 months these circumferences are compared, and then the rate of growth of the chest outstrips the growth of the head.
To approximate the rate of chest development for children under 1 year of age, you can use the following formula: the chest circumference of a 6-month-old child is 45 cm, for each missing month up to 6 you need to subtract 2 cm from 45 cm, for each subsequent month after 6 add 0.5 cm.
CHANGE IN BODY PROPORTIONS. Changes in body length with age are characterized by varying degrees of elongation of different body segments.
Approximate ideas about the harmonious physique and nutritional status of the child can be obtained using the Erisman and Chulitskaya indices.
Erisman index- the difference between chest circumference and half the body length (height). It is often used to monitor the physical development of schoolchildren.
Body condition index (Chulitskaya) is the following ratio: 3 shoulder circumference + thigh circumference + lower leg circumference - body length. In well-nourished children in the first year of life, the value of this index is 20 - 25. A decrease in the index confirms the child's malnutrition.
Chest age lasts from the 29th day after birth until the end of the 1st year of life. The weight of the brain in relation to the body weight of the newborn is 1:8 (in higher primates - 1:80–100). Infancy is characterized by:
- close contact of the child with the mother. The mother feeds her milk to the child;
- high rate of growth, morphological and functional improvement of all organs and systems. During the 1st year of life, the newborn’s body length increases by 50%, body weight triples;
- high growth rate is ensured by intensive metabolism and the predominance of anabolic processes, which explains the high need for basic nutrients and calories per kilogram of body weight. The relative energy requirement of children of this age is 3 times higher than that of an adult;
- the morphological structure and functions of the child’s nervous system are improved. As the central nervous system differentiates, the child’s neuropsychic development occurs at a rapid pace. From the first weeks of life, conditioned reflexes are formed, motor skills and complex locomotor acts (hand function, independent walking, etc.) develop. By the end of the year, speech appears;
- after 3–4 months of life, the child loses transplacentally acquired immunity, the formation of its own immune systems occurs relatively slowly. The rare incidence of viral childhood infections in children in family settings is mainly due to the lack of uncontrolled contact with other children; in children's institutions the situation is often the opposite.
Typical pathologies in infancy are:
- unbalanced nutrition can cause delays in physical, neuropsychic and intellectual development. Under conditions of intensive growth, nutrition inadequate to the needs of a growing organism can lead to the development of deficiency conditions (rickets, anemia, dystrophy);
- constitutional anomalies: exudative-catarrhal and lymphatic-hypoplastic diathesis;
- tendency to generalization remains inflammatory process, general response to any impact. Infectious diseases may cause convulsions (as with high core temperature), meningeal phenomena, toxicosis, and dehydration. The body is sensitive to pyogenic bacteria and especially to pathogens of intestinal infections (including viruses and conditionally pathogenic flora). High sensitivity to RS virus, parainfluenza viruses, adenoviruses;
- Gastrointestinal dysfunctions often develop, which is associated with the characteristics of the digestive organs and the need for their intensive functioning (high need for plastic substances and energy);
- anatomical and physiological features of the respiratory organs: narrowness of the respiratory tract, immaturity of the acini, etc. contribute to the development of bronchiolitis and pneumonia, the course of which is particularly severe;
- childhood infections (measles, whooping cough) occur atypically, leaving no immunity behind;
- high incidence of sudden death syndrome;
- manifestation of congenital psychiatric pathology (mental retardation, early childhood autism, etc.).
In children with a neuropathic constitution (neuropathy), these somatovegetative pathologies reach a clinically significant degree.
The development of speech in infants perhaps best characterizes the formation of the child’s consciousness and his social relationships.
Early vocalization (booming) is observed at the age of 1–4 months. Vowels and consonants are produced in the back of the mouth and are similar to the cooing and gurgling of water. From the 1st month the baby smiles, at 4 months he turns towards the voice and laughs loudly.
In the period from 3–4 to 15 months, he babbles (deaf babies also babble, but less actively and without the intonations of the speech of surrounding adults). Babbling consists of pure vowels and consonants of different tones pronounced by the child, including those that are not in native speech (up to 80 different speech sounds are pronounced). At 5 months the baby turns towards sounds, at 6 months he imitates the melody of adults’ speech, at 8 months he understands the word “no”, and unconsciously pronounces “dad” and “mama”. At 9 months he gestures, at 10 he consciously says “dad”, “mom”, at 11 months he pronounces another word, at 12 he pronounces words meaningfully, but his speech is incomprehensible.
At 2–3 months, the baby becomes able to distinguish between living and inanimate objects and treat them differently. Seeing his mother’s face, he smiles at her, vocalizes, and tries to imitate something like communicating with her. He examines inanimate objects, tries to drag them into his mouth or throw them out of his playpen. At 3 months he clearly distinguishes different faces in photographs; unfamiliar faces give rise to his heartbeat and orientation reaction. More than others at this age and much later, he prefers his mother's face. If up to 2.5 months the child pays attention to the edges and corners of the face, then by 3 months his attention is attracted mainly by the eyes, he already looks directly into the eyes of another person ("eye contact" appears). At the same time, he confidently recognizes the faces of familiar people, but still does not show signs of attachment to them, and does not get bored without them. By 6 months, the child acquires the ability to remember objects that are absent, and begins to realize separation from a familiar person.
At 9 months, the child crawls, stands on his feet, and walks with support; at 12 months, he walks without support.
At the age of about one year, the child recognizes his image in the mirror. This means that he clearly distinguishes between himself, his inner world, on the one hand, and everything outside it, on the other. In other words, by the age of one year the baby recognizes himself as a human being, expresses his desires to another person in an unambiguous way, and demonstrates his independence. A little later, children will become “harmful”, capable of vigorously defending their interests, being stubborn, capricious, and manipulating adults (“those harmful two-year-old children”). Very early, presumably between 1 and 2 years, a stable awareness of gender also arises. Based on behavior and interests in toys, one can unmistakably determine which gender a child identifies with. This may mean that disturbances in self-awareness may arise at a very early age; the clinical problem is how they can be identified.
Infancy lasts from the 29th day of life to 1 year. The name itself emphasizes that during this period of life the contact between mother and child is the closest; the mother breastfeeds her child. The basic processes of adaptation to extrauterine life have already been completed, the mechanism of breastfeeding is sufficiently formed and very intensive physical and neuropsychic development is taking place, motor skills are established, and intelligence begins to form.
Features of the infancy period can be considered:
1. A pronounced anabolic orientation of metabolism, as there is very intensive growth - body length increases by 50% (from 50-52 cm to 75-77 cm), body weight triples (from 3-3.5 kg to 10-10, 5 kg). The energy need of a child exceeds the need of an adult by 3 times (per 1 kg of weight). If an adult had the same energy needs as a child, then an adult would need to receive 10-12 liters of food per day. The high intensity of metabolism explains its frequent disorders in infancy:
Diathesis (exudative-catarrhal, lymphatic-hypoplastic);
Hypovitaminosis;
Hypotrophy and paratrophy
2. The relatively large volume of food (per kg of body weight) received by the child places increased demands on the functioning of the child’s gastrointestinal tract. However, at this age, the nervous regulation and enzyme system of the gastrointestinal tract are not yet mature enough. The combination of these factors quite often leads to gastrointestinal disorders.
3. The child’s intestines are abundantly supplied with blood, its mucous membrane has increased permeability, so it can be easier for harmful agents to enter the body and cause a general reaction of the body (disease-causing bacteria, toxins, allergens, etc.).
4. Unstable immune status. The newborn has passive immunity (received antibodies from the mother in utero). At 4-6 months, passive immunity decreases, there are no active ones yet, so in infancy children are prone to infectious diseases (ARVI, streptoderma, etc.)
5. In infancy, the child lies down a lot, so the parts of the lungs are poorly ventilated. The child's airways are narrow, and the protective properties of the mucous membrane are reduced. These factors explain the frequent pathology of the respiratory system in infants.
6. Skin and mucous membranes infant rich in blood and lymphatic vessels, easily vulnerable, and have increased penetration for harmful agents (viruses, microbes, toxins, allergens).
7. In infancy, preventive vaccination is actively carried out.
Knowledge of the characteristics of the infancy period will allow the average medical worker competently organize care for a child of this age and protect him from possible complications associated with these characteristics.
The main areas of care are:
Control over physical and neuropsychic development;
Rational feeding;
Hygienic care;
Physical education and hardening;
Aesthetic education.
Under physical development is understood as a set of morphological and functional characteristics of an organism, determined by hereditary factors and specific environmental conditions.
Physical development– a complex of genetically determined traits, the implementation of which depends on environmental conditions.
For example: if the parents of a child are tall, then the child’s genotype suggests him high growth, but if a child is often sick, eats poorly, lives in poor conditions, then he will have a much shorter height than determined by the genotype.
The role of hereditary factors And environmental conditions in physical development is clearly visible in the phenomenon called acceleration (earlier puberty, physical and mental development).
Acceleration caused by a change in genotype as a consequence of large population migration. The average height of children in cities with all-Russian construction projects is higher than in cities with a stable population. The role of social conditions cannot be excluded - the rate of acceleration in developed countries is higher than in underdeveloped ones. The term “Physical development” in clinical pediatrics is understood as a dynamic process of growth (increase in body length and weight) and biological maturation.
It is most clear and simple to assess the physical development of a child by its anthropometric indicators.
Anthropometric measurements were introduced into medical practice in the 30s of the 19th century. The main anthropometric indicators are:
Body mass;
Body length;
Head circumference;
Chest circumference.
To assess physical development it is necessary:
1. Determine age
2. Conduct anthropometry
3. Determine the somatotype (hyposomia-low stature, normosomia-normal height, hypersomia-high stature) using tables of growth series at different ages
4. Determine the harmony of development (correspondence between weight and height) using tables of weight values at different lengths
5. Determine the option of physical development using tables of options
6. Make a final record of the anthropometric study.
Body mass
The minimum body weight of a full-term newborn baby is 2500 g; average – 3500 + 200 g.