PERKEMBANGAN BAYI

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)

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 > girl) Head Circumference: 30-33 cm Breathing:

◦ Initially fast, short & irregular◦ Later more stable & with rhythm

Blood pressure become stable in 10 days.

Medical and Behavioral Screening1. Apgar Scale2. The Brazelton Neonatal Behavioral

Assessment Scale3. 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.

Apgar Scale is a standard measurement of a newborn’s 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)

SignSign 00 11 22AAppearanceppearance Blue, paleBlue, pale Body pink, Body pink,

extremities extremities blueblue

Entirely PinkEntirely Pink

PPulseulse AbsentAbsent Slow (below Slow (below 100)100)

Rapid (over Rapid (over 100)100)

GGrimacerimace No No responseresponse

GrimaceGrimace Coughing, Coughing, sneezing, sneezing, cryingcrying

AActivityctivity LimpLimp Weak, inactiveWeak, inactive Strong, Strong, activeactive

RRespirationespiration AbsentAbsent Irregular, slowIrregular, slow Good, CryingGood, Crying

Score: Above 7 = (good/normal)Score: Above 7 = (good/normal)

4 -7 = average, need monitoring4 -7 = average, need monitoring

3 & Below = need immediate attention, high 3 & Below = need immediate attention, high risk situationrisk situation

◦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.

Test on four distinct areas:◦ Social behavior (interactive behaviors in the home)◦ Motor behaviors (reflexes & muscle activities)◦ Control of physiology (baby’s 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.

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.

ReflexesReflexes Eliciting Eliciting StimulusStimulus

ResponseResponse DevelopmeDevelopmental ntal

durationduration

BabinskBabinskii

Gentle stroke Gentle stroke along sole of foot along sole of foot (heel - toe)(heel - toe)

Toes fan out: big Toes fan out: big toe reflexestoe reflexes

Disappears Disappears by end of by end of first yearfirst year

MoroMoro Sudden lost of Sudden lost of supportsupport

Arms extended, Arms extended, then brought then brought towards each othertowards each other

Disappear Disappear in 6 in 6 monthsmonths

Palmer Palmer GraspGrasp

Rod of finger Rod of finger pressed against pressed against infant’s palminfant’s palm

Object graspObject grasp Disappear Disappear in 3-4 in 3-4 monthsmonths

RootingRooting Object lightly Object lightly brushes infant’s brushes infant’s cheekcheek

Baby turns Baby turns towards object and towards object and attempts to suck attempts to suck

Disappear Disappear in 3-4 in 3-4 monthsmonths

SuckingSucking Insert Finger in Insert Finger in mouthmouth

Rhythmic suckingRhythmic sucking Disappear Disappear in 3-4 in 3-4 monthsmonths

WalkingWalking Held baby Held baby upright. Sole of upright. Sole of feet placed on feet placed on hard surfacehard surface

Infant step Infant step forward as if forward as if walkingwalking

Disappear Disappear in 3-4 in 3-4 monthsmonths

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

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

Spontaneous grasp of adult’s finger

Disappears at 3-4 months to allow reaching and grasping

Prepares infant for voluntary grasping

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

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

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 antibioticsbetter health

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

First 3 years of life is critical to baby’s 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.

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

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

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.

(Sensory &Perceptual Process)

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Touch Hearing Vision Taste Smell

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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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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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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 mother’s 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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Even newborns can smell, taste, and feel

These skills are useful in recognizing parents and in feeding

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 mother’s milk and other mothers’ milk.

Schmidt & Beauchamp (1988) : Baby’s 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 30

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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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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

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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De Casper & Fifer (1980): Baby can differentiate mother’s 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 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 can’t 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

Brain development helps infants reach adult levels of vision skills:

2 months: Focus and color vision

6 months: acuity, scanning & tracking

6–7 months: depth perception

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3 weeks Poor contrast sensitivity.Prefer large simple patterns

2 monthsCan detect fine-grained detail. Prefer complex patterns.

4 monthsCan 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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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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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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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

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

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

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

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

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

Baby's ability to interact with other people Develops thru regular interaction with

babies,:◦ Feeding◦ Cleaning◦ Caring/loving

Newborn can imitate facial expression.