Tajuk 3:

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Tajuk 3

• PERKEMBANGAN BAYI

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Post natal Development
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The Babys Adaptation to Labor and
DeliveryNewborns appearance
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The Newborn Baby

• Newborn are called Neonate.
• First four weeks of life (neonatal period)
• A time of transition from the uterus, where a
  fetus is supported entirely by the mother ? to
  an independent existence.
• When neonate are first born
• Covered by fluid from amniotic sac
• Blood from placenta
• Brownish fluid from own faeces.
• Covered with lanugo (fuzzy prenatal hair)
• Covered with vernix caseosa (cheesy varnish)

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The Newborn Baby

• Size and Appearance
• New babies have distinctive feature? a large head
  and a receding chin
• On the head ? Fontanels (the soft spots)
• Newborns have a pinkish cast ? skin so thin that
  it barely covers the capillaries through which
  blood flows.
• Boys tend to be slightly longer and heavier than
  girls, and a firstborn child is likely to weigh
  less at birth than laterborns
• Weight 2.8 -3.2 kg
• Length 51-53 cm (Boy gt girl)
• Head Circumference 30-33 cm
• Breathing
• Initially ?fast, short irregular
• Later ? more stable with rhythm
• Blood pressure become stable in 10 days.

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Is the Baby Healthy?

• Medical and Behavioral Screening
• Apgar Scale
• The Brazelton Neonatal Behavioral Assessment
  Scale
• Checks are also done for any structural or
  physical deformities (eg. spinal defect, cleft
  palate)
• Silver nitrate or tetracycline is usually
  dropped into neonate eyes? to prevent from
  bacterial infection while passing through birth
  canal.

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Apgar Scale

• Apgar Scale is a standard measurement of a
  newborns condition
• Introduced by Dr. Virginia Apgar
• Access newborn
• 1 min after birth
• 5 min after birth
• Assess
• Appearance (colour)
• Pulse (heart beat rate)
• Grimace (reflex)
• Activity (muscle tone)
• Respiration (breathing)

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APGAR SCALE
Sign 0 1 2
Appearance Blue, pale Body pink, extremities blue Entirely Pink
Pulse Absent Slow (below 100) Rapid (over 100)
Grimace No response Grimace Coughing, sneezing, crying
Activity Limp Weak, inactive Strong, active
Respiration Absent Irregular, slow Good, Crying
Score Above 7 (good/normal) 4 -7 average, need monitoring 3 Below need immediate attention, high risk situation Score Above 7 (good/normal) 4 -7 average, need monitoring 3 Below need immediate attention, high risk situation Score Above 7 (good/normal) 4 -7 average, need monitoring 3 Below need immediate attention, high risk situation Score Above 7 (good/normal) 4 -7 average, need monitoring 3 Below need immediate attention, high risk situation
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Brazelton Neonatal Behavioral Assessment Scale

• The Brazelton Neonatal Behavioral Assessment
  Scale (NBAS) (Dr. Berry Brazelton) serves 3
  purpose
• As an index of neurological integrity after
  birth
• To predict future development
• To assesses neonates' responsiveness to their
  physical and social environment
• Screening done on 3rd day and repeat again
  after several days.

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Brazelton Neonatal Behavioral Assessment Scale
(NBAS)

• Test on four distinct areas
• Social behavior (interactive behaviors in the
  home)
• Motor behaviors (reflexes muscle activities)
• Control of physiology (babys ability to quiet
  himself)
• Stress response (startle reaction)
• High score ? a neurologically well developed
  infant
• Low score ? a sluggish infant who need help in
  responding to social situations, or possible
  brain damage.

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Babies In-born Reflexes

• Reflexes ? an inborn, automatic response to a
  particular form of stimulation.
• Full term newborns come equipped with a
  variety of reflexes for use in dealing
  efficiently with stimuli present in their
  environment.
• Some reflexes are necessary for survival (eg.
  Rooting sucking reflexes)
• Reflexes are probably genetic in origin
  include a timing mechanism that allows them to
  fade away after a period of time.

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In-born Reflexes
Reflexes Eliciting Stimulus Response Developmental duration
Babinski Gentle stroke along sole of foot (heel - toe) Toes fan out big toe reflexes Disappears by end of first year
Moro Sudden lost of support Arms extended, then brought towards each other Disappear in 6 months
Palmer Grasp Rod of finger pressed against infants palm Object grasp Disappear in 3-4 months
Rooting Object lightly brushes infants cheek Baby turns towards object and attempts to suck Disappear in 3-4 months
Sucking Insert Finger in mouth Rhythmic sucking Disappear in 3-4 months
Walking Held baby upright. Sole of feet placed on hard surface Infant step forward as if walking Disappear in 3-4 months
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Rooting

• Stroke cheek near corner of mouth or object
  brushes the area
• Infant respon by turning head toward stimulation
• Disappears at 3 weeks when child begins to be
  able to voluntarily turn head
• Helps infant find nipple

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Moro Reflex

• Hold infant horizontally on back and let head
  drop slightly or produce sudden loud sound
  against surface supporting infant
• Infant response is to make an embracing motion by
  arching back, extending legs, throwing arms
  outward and then bringing them in toward the body
• Disappear at 6 months
• Probably in human evolution helped baby cling to
  mother

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Palmer Grasp

• Spontaneous grasp of adults finger
• Disappears at 3-4 months to allow reaching and
  grasping
• Prepares infant for voluntary grasping

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Tonic Neck Reflex

• Turn baby's head to one side while lying on back
• Infant responds by lying in a fencing position
  with one arm extended in front of eyes on side to
  which head is turned other arm is flexed
• Disappears at 4 months
• May prepare infant for voluntary reaching

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Growth And Nutrition

• PATTERNS OF GROWTH
• Children grow faster during the first years,
  especially during the first few months.
• This rapid growth rate tapers off during the
  second and third years

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Growth And Nutrition

• Influences on Growth
• Genes interact with environment, i.e. nutrition
  and living conditions, ? general health and
  well-being
• Well-fed, well-cared-for children grow taller and
  heavier than less well nourished and nurtured
  children
• Better medical care, immunization and
  antibiotics?better health

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Growth And Nutrition

• Nourishment
• Breast milk is almost always the best food for
  newborns and is recommended for at least the
  first 12 months
• Parents can avoid obesity and cardiac problems in
  themselves and in their children by adopting a
  more active lifestyle for the entire family--and
  to breastfeed their babies

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The Brain

• First 3 years of life is critical to babys
  brain development.
• Before after birth ? brain growth is
  fundamental to future development.
• It is estimated that about 250,000 brain cells
  are form every minute in the uterus.
• By birth, almost 100 billion nerve cell are
  formed, but not fully develop.

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Molding the Brain The Role of Experience

• Smiling, babbling, crawling, walking, and talking
  are possible due to rapid development of the
  brain, particularly the cerebral cortex

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Molding the Brain The Role of Experience

• Early experience can have lasting effects on
  emotional development and the capacity of the
  central nervous system to learn and store
  information
• Sometimes corrective experience can make up for
  past deprivation

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Infant States of Arousal

• States of arousal are different degrees of sleep
  and wakefulness
• Infants move in and out of 5 states throughout
  the day and night
• Regular sleep
• Irregular sleep
• Drowsiness
• Alert Activity
• Waking activity and crying
• Striking individual differences in daily rhythms
  exist that affect parents attitudes toward and
  interactions with baby.

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Perceptual Development

• (Sensory Perceptual Process)

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Early Sensory Capacities

• Touch
• Hearing
• Vision
• Taste
• Smell

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Touch and Pain

• Touch seems to be the first sense to develop
• Sensitivity to touch, pain, and temperature
  change is well-developed at birth.
• Pain experienced during the neonatal period may
  sensitize an infant to later pain, perhaps by
  affecting the neural pathways that process
  painful stimuli
• Reflexes reveal sensitivity to touch.
• Touch helps stimulate physical and emotional
  development.

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TASTE

• Babies are born with the ability to communicate
  their taste preferences to caregivers.
• Infant facial expressions indicate they can
  distinguish among several tastes.
• Newborns' rejection of bitter tastes is probably
  another survival mechanism, since many bitter
  substances are toxic

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Smell

• The responsiveness of infants to the smell of
  certain foods is similar to that of adults ?
  showed that some odor preferences are innate.
• A newborn infant is attracted to the odor of her
  own mothers lactating breast ? helps to find
  food source and to identify own mother? a
  survival mechanism.
• Newborns can identify the location of an
  unpleasant odor and turn head away.
• A preference for pleasant odors seems to be
  learned in uterus and during the first few days
  after birth

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Touch, Taste Smell

• Even newborns can smell, taste, and feel
• These skills are useful in recognizing parents
  and in feeding

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Studies conducted Smell and Taste

• Lipsitt, Engen Kye (1963) Baby showed
  negative response to the smell of ammonia.
• Steiner Baby showed diff. facial expression
  when exposed to different type of scent.
• Mac Farlane (1977) Baby can differentiate
  between own mothers milk and other mothers
  milk.
• Schmidt Beauchamp (1988) Babys ability to
  smell is almost equivalent to a 3 years old
  ability to smell.
• Harris friends By aged 4 mths old, baby like
  the taste of salt

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Hearing

• Well developed at birth
• Hearing is functional before birth? ability to
  discrimination sound develops rapidly after
  birth
• Hearing ? key to language development? so
  hearing impairments should be identified as early
  as possible
• Infants respond with changes in heart rate to
  loud sounds (even in the womb)
• Can hear wide range of sounds but are more
  responsive to some than others.
• Newborns prefer complex sounds such as voices and
  noises to pure tones.

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Hearing

• Newborns prefer speech that is high-pitched and
  expressive.
• Infants hear well, though not quite as accurately
  as adults
• Infants hearing is best for sounds that have
  pitches in the range of human speech
• Infants use sound to locate objects

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Developments in Hearing
4 6 months Sense of musical phrasing
6 months Screen out sounds from non-native languages
7 9 months Recognize familiar words, natural phrasing in native language
10 months Can detect words that start with weak syllables
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Studies conductedHearing

• De Casper Fifer (1980) Baby can differentiate
  mothers voices from others ? thru baby
  sucking pattern.
• Birnhold Benacerraf (1983) 28th week baby
  showed his/her response thru facial expression.
• Wertheimer (1961) Baby able to follow source
  of sound thru the clicker test.

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Vision/Sight

• Vision is the least developed sense at birth
• Newborns cannot focus their eyes very well and
  their visual acuity ? fineness of discrimination,
  is limited
• Newborns explore their environment by scanning it
  for interesting sights tracking moving objects.
• They cant yet discriminate colors, color vision
  will improve in a couple of months.
• Visual perception is poor at birth ? but improves
  to 20/100 by age 6 months
• Binocular vision? using both eyes to focus
• Perception of depth and distance at 4 or 5
  months

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Improvements in Vision

• Brain development helps infants reach adult
  levels of vision skills
• 2 months Focus and color vision
• 6 months acuity, scanning tracking
• 67 months depth perception

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Steps in Pattern Perception
3 weeks Poor contrast sensitivity. Prefer large simple patterns
2 months Can detect fine-grained detail. Prefer complex patterns.
4 months Can detect patterns even if boundaries are not really present
12 months Can detect objects if two-thirds of drawing is missing
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Steps in Depth Perception
Birth 1 month Sensitivity to motion cues
2 4 months Sensitivity to binocular cues
5 12 months Sensitivity to pictorial cues. Wariness of heights
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Studies conducted Sight

• Langlois friends (1990) Babies are more
  attracted to attractive and beautiful human
  faces.
• Fantz (1993) Babies prefer to look at pictures
  of human.
• Aslin (1987) 4 days old babies can
  differentiate between green and red.
• Babies prefer blue and red as compared to
  other colors.
• Gibson Walk (1960) Visual cliff experiment. 6
  mth babies has already develop in-dept
  perception in visual.

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Infants Scanning of Faces
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Face-like Stimuli
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Integrating Sensory Information

• By 1 month, can integrate sight and touch
• By 4 months, can integrate sight and sound
• 4- and 7-month-olds can match facial appearance
  (boy or man) with sound of voice

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Motor Development

• Maturity affect infant perceptual and motor
  abilities.
• Milestones of Motor Development
• Babies first learn simple skills and then combine
  them into increasingly complex systems of action
• Week 1 Motor ability progress
• Month 1 Chin lift
• Month 2 Reach for object

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Motor Development

• Newborn are not able to control their body
  movement ? no coordination.
• Most movements are due to inborn reflexes
  (rooting, moro, palmer grasp etc)
• Humans begin to walk later than other species,
  possibly because babies' heavy heads and short
  legs make balance difficult

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Motor Development

• How Motor Development Occurs
• Maturation in Context
• According to Thelen, normal babies develop the
  same skills in the same order because they are
  built approximately the same way and have similar
  physical challenges and needs

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Motor Development

• Cultural Influences on Motor Development
• Chances to explore their surroundings? motor
  development likely to be normal
• Some cultures actively encourage early
  development of motor skills

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Motor Development

• Training Motor Skills Experimentally
• Gesell concluded that children perform certain
  activities when they are ready, and training
  gives no advantage
• Interaction of biology and environment are
  involved in infant motor development

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Social development

• Baby's ability to interact with other people
• Develops thru regular interaction with babies,
• Feeding
• Cleaning
• Caring/loving
• Newborn can imitate facial expression.