GROWTH AND DEVELOPMANT OF NEWBORN

Demographic data:
Name: Date:

Age: Ward:

Sex:

Classification:

Diagnosis:

Hospital Number:

SI. No Growth and Development – Book Picture Child’s Picture Remarks

1. PHYSICAL DEVELOPMENT
Biological Development
Temperature 36.5 C
Heart rate : 120-160 beats/mt
Respiration : 30-60 breaths/mt
Blood pressure:
Systole-70 to 90 mm of Hg
Diastole-40 to 60 mm of Hg
Weight:2.5 to 3.5 kg
Length:50 cm at birth
Head circumference:33 to 35cm
chest circumference:31-33 cm
2. Skin Appearance
Soft, smooth and opaque.
Color: pink
Vernix caseosa: Whitish greasy material that
covers the body
Milia : Pearly white papules scattred
On the chin, nose, fore head and cheeks.
Erythema toxicum: Skin with a red, yellowish
white papule in the center
Mongolian spot: Dark blue or purple macular
spots
HEAD
It should turn as far as the shoulder in the both
direction
1.Fontannels
Anterior (soft spot): Diamond shape.4-6cm in
diameter and closes between 7 and 18 months
or 11/2year.
Posterior (lambdoid fontanelle ): Triangular in
shape and closes in 6-8 weeks from birth or
11/2month
2.Caput succedaneum
A diffuse oedematous swelling of the soft
issues of the scalp that may extend across
suture lines
3.Cephal haematoma
A sub parietal haemorrhage that never extends
across the suture line
FACE
Eyes
Symmetrical
White sclera.
Symmetry of movement
Usually dark iris until 3-6 Months
Ears
Position should be similar on both sides (their
normal location is determinate by drawing an
Imaginary horizontal line from the inner
canthus of the eyes perpendicular to the vertical
axis of the head)
Hearing
Alert and stops movement in the presence o
conversation or noise
Nose
Symmetrical and parent
Mouth and chin
It should open at equal angles bilaterally
CHEST:
Bell shape
Mildly protuberant
One inch less than head circumference
ABDOMEN: Soft
UMBILICUS: Normally positioned midway
between the xiphoid process and pubis
Cord should contain two arteries and one vein
GENITALIA AND ANUS
Female
Term body: labia majora covers the labia
minora.
Pre term baby: clitoris is prominent.
Vaginal orifice is pink.
Glistering is patent.
Male
The glands is completely covered by the
foreskin at birth.
MUSCULO-SKELETAL SYSTEM
Spine: It is normal curvature. Extremities
symmetrical in position and presence of normal
active and passive motion.
Resting posture: The term newborn lies with
hips abducted and partially flexed, and knee
flexed.
CENTRAL NERVOUS SYSTEM
REFLEXES
Rooting reflex:
When the cheeks or corner of the mouth is
stroked. The infants head should turn towards
the stimulates and the mouth should open.
Sucking reflex:
When touching or stroking the lips the mouth
open and sucking movements begin.
Swallowing reflex:
The passage of food from the posterior aspect
of the mouth to the stomach.
Gagging reflex:
When the posterior pharynx is stimulated with
food there is an immediate return of undigested
food.
Extrusion:
When substance placed on anterior position of
tongue will be expelled out.
Blinking:
Protection of the eye by rapid eye lid closure
when the eyes are exposed to bright light.
Dolls eyes:
Normally eyes do not move when the newborn
head slowly turn to the right or left side.
Palmar Grasp:
When the objects are placed in the newborn’s
palm, the newborn grasp.
Plantar Grasp:
When object touches the sole of the foot at the
base of the toes, grasp around the very small
objects.
Dancing or stepping reflex:
Hold neonate in the vertical position with the
feet touching a flat, firm surface, there will be
rapid alternating flexion and extension of the
legs.
Babinski reflex:
Stroking the aspect of the foot with a relatively
sharp object from the heel up toward the little
toe and across the foot toward the big toe there
will be fanning of the toes.
Tonic neck reflex:
Turning the head quickly to one side while the
infant is supine, arm and leg on the side the
head is turned toward extend. Arm and leg on
the opposite side flex.
Moro/startle reflex:
The newborn head is suddenly allowed to drop
 backward an inch, there will be symmetric
abduction and extension of the arms and legs
with fanning of fingers.
3 NUTRITION:
Calories:120calories/kg/day
Protein:2.5to3.5gm/kg/day
Fat:30gm/kg/day
Iron:0.27mg/kg/day
Calcium:200mg/day
Vitamin D:400I.U daily
Vitamin C:50 mg/day
Fluids:20ml/kg/day
4 NEEDS OF THE NEWBORN
Love and affection
Need for human contact
Sensory stimulation
Sucking
Breast feeding 2-3 hourly
Demand feed 8-10/day
Maintaining body temperature
Hygienic needs
Prevention of injury/aspiration
Provision of optimal nutrition
Monitoring weight, vital signs, Output,
(1ml/kg/hour)
Observation of body Temperature, hydration
status.
Watch for danger signs of new born like
hypothermia, hypoglycemia, jaundice apnoea,
etc,
 GROWTH AND DEVELOPMANT OF INFANT
Demographic data:
Name: Date:

Age: Ward:

Sex:

Classification:

Diagnosis:

Hospital Number:

SI. No Growth and Development – Book Picture Child’s Picture Remarks

1. PHYSICAL DEVELOPMENT
Biological Development
Temperature: 36.50 C
Heart rate: 110-150 beats/min
Respiration: 25 – 45breaths/min
Blood pressure: 80/60 +/- 20/10 mm of Hg
Height:
< 6 month = 2.5 cm/mth
7 – 12 mth = 1.5 cm/month
Height at 1 year = 75 cm
Weight: age in months +9/2
1-6 mth = 30 gm/day
7-12mth = 15 gm/day
Weight at 1 year = 9-10kg
Head Circumference (HC):
Increase by 1.5 cm per month during first 6
month
0.5 cm in second 6 months.
Chest Circumference (CC):
Usually 1-2 cms lesser than HC HC and CC
equalizes by one year
Dentition:
6-8 months: two lower lateral incisors erupt
7-9 months: upper lateral incisors erupt 12th
month has 6 to 8 deciduous teeth.
2. GROSS MOTOR SKILLS
Milestone:
1st month: Social smile
2nd month: Coos/vocalizes
3rd month: Head control
4th month: Hand control
5th month: Turns over
6th month: Sits alone
7th month: Crawls
8th month: Creeping
9th month: Stands with support
10th month: Walks with support
11th month: Stands alone
12th month: Walks alone
3 FINE MOTOR SKILLS
2nd month: Hands may be open
3rd month: Holds hands in front of face stares
at them
4th month: Bring hands together in midline
plays with finger
5th month: Holds a rattle
6th month: Reaches for object
7th month: Holds feeding cup
8th month: Eats finger food, drinks from cup
with assistance
9th month: Picks up object
12th month: Holds crayons
4 PSYCHOSOCIAL DEVELOPMENT
(Eric Erickson)
Sense of Trust vs Mistrust:
Complete dependence on care giver.
5 PSYCHOSEXUAL DEVELOPMENT
(Freud)
Oral stage:
Need for sucking pleasure
6 SPIRITUAL DEVELOPMENT
(Fowler)
Undifferentiated:
Feeling of trust, warmth and security from the
foundation for the later development of faith.
7 INTELLECTUAL DEVELOPMENT
(Jean Piaget)
Sensory motor (0-2 yrs):
Stimuli are recognized, absorbed and
incorporated in to existing action
8 MORAL DEVELOPMENT
(Kohlberg)
Pre-conventional mortality stage 0
(0 to 2 yrs): Unable to understand good or bad
the good is what I like and want
9 LANGUAGE/SPEECH DEVELOPMENT.
Receptive language: Responds to human
voices
Expressive language: Cries when hungry or
uncomfortable
6 – 8 words at one year
10 PLAY
Solitary play: infants can play alone for longer
periods
11 NUTRITION
Calories: 120 kcal/kg/day
Protein: 2.5 – 3.0 gm/kg/day
Fat: 4 – 5 gm/kg/day
Iron: 10 mg/day
Vitamin D: 400 IU daily Fluids: 120 ml/kg/day
Calcium: 400 mg/kg
12 PROBLEMS
Falls
Suffocation
Aspiration or swallow foreign bodies
Near drowning
 Burns
Poisoning
Motor vehicle accident
Development problems:
Maternal deprivation
13 NEEDS OF INFANT
Need for sucking and safety
Play and sensory stimulation
Social and emotional need
Love and security from primary care giver
Need for warmth
Need for sensory stimulation
Dependence progressing to independence
Discipline leading to self control
Developing self esteem
Meeting the nutritional need
Urine output 1 ml/kg/hour
 GROWTH AND DEVELOPMANT OF TODDLER (1-3 YEARS)
Demographic data:
Name: Date:

Age: Ward:

Sex:

Classification:

Diagnosis:

Hospital Number:

SI. No Growth and Development – Book Picture Child’s Picture Remarks

1. PHYSICAL DEVELOPMENT
Biological Development
Temperature:36.5C
Pulse: 90-130 beats/min
Respiration: 26 -28 breaths/min
Blood Pressure: 99/64 +/- 26/24 mm of Hg
Height
Age in years x 6 + 77 cm
2years – 85 cm
Weight
Age in years x 2 +8 kgs 2years – 12 kg
2.5 years – 4 times than at birth
Dentition
2years: 16 teeth
21/2 years: 20 teeth (primary teeth completes)
2. GROSS MOTOR SKILLS
15 months:
Assume standing position
Walks without support
Creeps upstairs
18 months:
Walks quickly
Runs, often falls
Walks upstairs by holding one hand
24 months:
 Throws ball over hand without falling
Steady gait
Can walk head – toe gait
Walks backward well
Initiates well
Walks up and down stairs
30 months:
Stands on one foot alone momentarily
Can throw a large ball overhead 4 to 5 feet
Rides a walker or pedal car
Jumps well in place with both feet off floor
3 FINE MOTOR SKILLS
15 months:
Builds a tower of 2-3 cubes
Open boxes and put fingers at holes
Scribbles spontaneously
Stretch out arm and legs to help in dressing
18 months:
Holds cup with both hand
Holds a cup, grasp a spoon
Eats with spoon but spills frequently
Makes line with crayons
Begins to turn page
Builds a tower of 3-4 cubes
Transfer object from one place to another
Removes simple garments
24 months:
Senses of autonomy is shame and doubt
Builds a tower of 6-7 cubes
30 months:
Self feeding with occasional spilling
Buttons one large front button
Unbuttons large front buttons
4 PSYCHOSOCIAL DEVELOPMENT
(Eric Erickson)
Autonomy vs Shame & Doubt:
If children succeed in the developmental tasks
of this stage in their maturing process, they will
have a degree of self control. If they do not
succeed they will doubt their own worth and
that of others and will have
sense of shyness doubt and shame.
5 PSYCHOSEXUAL DEVELOPMENT
(Freud)
Anal stage:
Obtain pleasure from the feeling of a distended
bladder, from masses of faeces in the rectum
and from the
release of content from those organs.
6 SPIRITUAL DEVELOPMENT
(Fowler)
Intuitive projective faith:
Imitates religious behaviour such as
bowing the head in prayer, but does not
understand the meaning.
7 INTELLECTUAL DEVELOPMENT
(Jean Piaget)
Sensory motor stage (15-18 months)
Pre-operational stage (24 to 30 months)
Beginning of mental representation of events
ad differentiates past and present.
8 MORAL DEVELOPMENT
(Kohlberg)
Pre conventional morality stage 1:
Birth – 2yrs: The good is what the child likes
and wants
2-3 years: Child’s if punished for doing it, its
wrong; if not punished it must be right.
9 LANGUAGE/SPEECH DEVELOPMENT.
1yr – 6 to 8 words
2yrs - 300 words
3 yr - 900 words
10 PLAY
Parallel play:
Playing beside and watching each other but not
interacting directly.
11 NUTRITION
Calories: 1300-1500 kcals/day.
Proteins: 1.7 to 2 gm/kg/day.
Fat: 4-5gm/kg/day.
Iron: 15-20 mg/day.
Calcium: 500mg/day.
Fluids: 90-100ml/kg/day.
12 BEHAVIOURAL CHARACTERISTICS
Negativism: doing opposite things
Temper tantrum: roll on floor, shouting,
asking aloud, holding breath etc.
Ritualistic behavior: particularly activity is
performed in particular manner only
Ambivalence: demonstrating love and hatred
towards same person at same time
Curiosity: interested in know more on things
Dawdling: slowness in doing things
Ego centric: think that everything belongs to
them
13 NEEDS OF TODDDLER
Love and security
Security blanket – toys/articles of parents
Toilet training (2yrs, day time bladder)
Control, 2 ½ years, night time bladder control
Development of self esteem
Dental care
Setting of limits – rules and guideline
Encouragement of independence
 Feeding, dressing, toileting and grooming

14 HEALTH PROMOTION AND

ANTICIPATORY GUIDANCE:
Nutrition
Accident prevention
Immunization
Dental hygiene
 GROWTH AND DEVELOPMANT OF PRESCHOOLER (4-6 YEARS)
Demographic data:
Name: Date:

Age: Ward:

Sex:

Classification:

Diagnosis:

Hospital Number:

SI. No Growth and Development – Book Child’s Picture Remarks

picture
1. PHYSICAL DEVELOPMENT
Biological Development
Temperature:36.5C
Pulse: 90-110 beats/min
Blood Pressure
Systole: 95-105 mm of Hg
Diastole: 53-68 mm of Hg
Height
 Age in yrs x 6 + 77cms
 3 years = 90.5-101.5cms
 4 years = 95-100cms
 5 years = 103-115cms
Weight
Age in yrs x 2 + 8kgs
Dentition
No. of Teeth:
2. GROSS MOTOR
3 years
 Walks on a straight line.
 Walks backward.
 Runs without looking at feet.
4 years
 Kicks a ball.
 Rides bicycle.
  Runs on tip toes.
 Balances on one foot 3-5 seconds.
5 years
 Jumps form greater heights.
 Climbs ladder.
 Alternates feet when descending
stairs.
 Balances on one foot 8-10 seconds.
FINE MOTER
3 years
 Builds a tower of 9-10 blocks.
 Copies a circle.
 Uses scissors with one hand to cut.
 Shows preferences to handedness.
4 years
 Can help with simple household
tasks.
 Copies a square.
 Draws a simple face.
5 years
 Copies a triangle.
 Crosses vertical lines.
 Copies letter, may be able to print
own name.
 Draws three body parts of man.
3 PSYCHOSOCIAL DEVELOPMENT
(Eric Erickson)
Sense of Initiative VS Guilt
Independent and trust worthy, they are
ready to find out what they can do.

4 PSYCHOSEXUAL DEVELOPMENT
(Freud)
Phallic stage
Oedipus Complex – Boys desire their
 mothers while experiencing an increased
hospitality towards their fathers.
Electro Complex – Girls want their
fathers and find their mothers in their way.
5 SPIRITUAL DEVELOPMENT
(Fowler)
Intuitive Projective Faith
Imitates religious behaviour such as
bowing the head in prayer, but does not
understand the meaning.
6 INTELLECTUAL DEVELOPMENT
(Jean Piaget)
Intuitive phase (4-7 years)
Children can repeat the event in play that
occurred many hours or day before unable
to accomplish true inductive or deductive
reasoning. Believes that all objects in the
environment are there to satisfy the human
needs.
7 MORAL DEVELOPMENT
(Kohlberg)
Pre-conventional morality stage 2
Confirm to rules strictly for the purpose of
self interest that is to avoid punishment
and to have favours returned.
8 LANGUAGE/SPEECH
DEVELOPMENT
 3 years – 900 words.
 4 years – 1500 words.
 6 years – 2100 words.

9 PLAY
Cooperative Play – children begin to
exchange ideas with other children and
gradually to interact with them in play
activities.
10 NUTRITION
Calories: 1300-1500 kcals/day.
Proteins: 3gms/kg/day.
Fat: 4-5gm/kg/day.
Iron: 10mg/day.
Calcium: 500mg/day.
Fluids: 90-100ml/kg/day.
11 DEVELOPMENTAL PROBLEMS
Selfishness.
Hurting others.
Destructiveness.
Enuresis.
Encopresis.
Bad language.
Masturbation.
Sibling rivalry.
HEALTH PROBLEMS
Dental carries.
Nutritional deficiency.
Worm infestation.
12 NEEDS OF PRESCHOOLER
Love and security.
Independence.
Managing the bed time problems.
Discipline leading to self control.
Meeting the nutritional needs.
Accident prevention.
Respect individuality of children.
Help to expand their skill and develop their
potential and mastery of self control.
Provides sense of initiation.
Set limits to children’s behaviour.
Toileting, napping, healthy practices.
Play indoor and outdoor games.
Dental hygiene.
Optional vaccines.
 GROWTH AND DEVELOPMANT OF SCHOOL AGE (6-12 YEARS)
Demographic data:
Name: Date:

Age: Ward:

Sex:

Classification:

Diagnosis:

Hospital Number:

SI. No Growth and Development – Book picture Child’s Picture Remarks

1 PHYSICAL DEVELOPMENT
Biological Development
Temperature:36.5C
Pulse: 85 +/- 10 beats/mt
Respiration:20+/-3 breath/mt
Blood Pressure:100/60+/-16/10 mm of Hg
Height (Age in years x 6 + 77cms)
6 yrs - 116 cm
12 years - 150 cm (increase of 5 cm per year)
Weight (Age in yrs x 2 + 8kgs)
12 years - 40 kg (increase of 2-3 kg/year)
Dentition : Shredding of deciduous teeth and eruption of
permanent teeth at 6 – 7 years.
2 GROSS MOTOR SKILLS
Refine acquired skills
Regular exercise parts
Runs, jumps, climbs, hops
3 FINE MOTOR SKILLS
Use both hand independently
Draw a person with 18-20 parts
Co-ordination continuous to improve
4 PSYCHOSOCIAL DEVELOPMENT
(Erick Erickson)
Sense of industry vs Inferiority
Engage in task in real world Highly motivate in
 purposeful activity,
Eg-include them in planning menu.
Encourage the child to identify his potentials
5 PSYCHOSEXUAL DEVELOPMENT
(Freud)
Latent phase
Associate with same sex
Peers ignore the opposite sex.
6 SPIRITUAL DEVELOPMENT
(Fowler)
Mythical literal faith
Follows the rituals practiced in the family/society
Believes others,differentiate their thinking
7 INTELLECTUAL DEVELOPMENT
(Jean Piaget)
Concrete operational stage: (8-10 Years)
Able to understand, read, write and do arithmetic
Developing problem solving abilities
Asks questions
Formal operation thought (11-12 years)
Develop abstract and deductive reasoning Short interest
span
8 MORAL DEVELOPMENT
(Kohlberg)
Conventional morality They need law and order
9 LANGUAGE/ SPEECH DEVELOPMENT
20,000 – 30,000
10 PLAY (Newhall)
Social or competitive play
Girls
Cooking, grooming
Teaching
Boys
Kites, cycling and team sports
11 NUTRITION
Calories: 1600 – 2200 kcal/day
 Proteins: 3-4 gms/kg/day
Fat: 4 -5 gms/kg/day
Iron: 15-20 mg/day
Vitamin - A: 5000 IU/day
12 PROBLEMS
Health Problems
Motor vehicle injuries
Drowning, burns, poisoning, bodily damages such as
lesions, wounds, scabies, dental caries, disorders of
continence etc.,
Developmental Problems
Oruancy
Fear of darkness (night mares) Juvenile delinquency
School phobia Stealing
Nail biting, teeth grinding Lying
Ties
Hurting others
13 NEEDS OF SCHOOL AGE
Nutrition (eating habits)
Dental hygiene
Exercise
Sex education
Accident prevention
Love and security Meeting emotional need, schooling ,
parenting Immunization
Parental guidance
 GROWTH AND DEVELOPMANT OF ADOLESCENT (13-18YEARS)
Demographic data:
Name: Date:

Age: Ward:

Sex:

Classification:

Diagnosis:

Hospital Number:

SI. No Growth and Development – Book picture Child’s Picture Remarks

1 PHYSICAL DEVELOPMENT
Biological Development
Temperature:36.5C
Pulse: 60-80 beats/min
Respiration: 14-20 breaths/min
Blood Pressure: 124/74 +/- 74/16 mm of Hg
Height (Age in years x 6 + 77cms)
Boys: 149.8 cm
Girls: 150.7 cm
Weight (Age in yrs x 2 + 8kgs)
Boys: 36.9 kg
Girls: 38.5kg
Dentition: Eruption of 2nd molar (12 – 12 years)
Eruption of 3rd molar (17-21 years)
2 SECONDARY SEXUAL DEVELOPMENT
Boys:
Broadening of shoulders from the age of 13 year
Increasing in size of breast
Increase in size of genitalia
Growth of public, axillary chest and face hair
Deeping of voice
Production of spermatozoa
Girls:
Broadening of hips
Development of breast Growth of pubic, axillary hair
 Attained menarche
Menstrual cycle – regular
Change in the vaginal secretion
3 FINE MOTOR SKILLS
Able to do all activities like an adult.
4 PSYCHOSOCIAL DEVELOPMENT
(Erick Erickson)
Early – Identity vs Role confusion
Who am I?
Intense loyalty to peer group Begins to separate from
parents
Later – Intimacy vs Isolation
Develops intimacy with self and persons of both sexes.
5 PSYCHOSEXUAL DEVELOPMENT
(Freud)
Genital phase
Masturbation and sexual fantasies are common.
6 SPIRITUAL DEVELOPMENT
(Fowler)
Conventional faith
Personal and social values evolved to support their
identity explore religious affiliation.
7 INTELLECTUAL DEVELOPMENT
(Jean Piaget)
Formal Operational Stage
Thinking is oriented to things and events that they can
observe directly.
8 MORAL DEVELOPMENT
(Kohlberg)
Post conventional stage
Able to differentiate from right and wrong.
9 LANGUAGE/ SPEECH DEVELOPMENT
Continue to learn new concepts.
10 PLAY (Newhall)
Social or competitive play:
Such as sports, parties, telephone conversation,
 watching TV computer, games, etc.
11 NUTRITION
Calories: 2200 – 2800 kcal/day
Proteins: 1 gms/kg/day
Iron: 15-20 mg/day
Calcium: 600 – 700 mg/day
Vitamin - A: 5000 IU/day
12 PROBLEMS
Risk for parenting and family maladjustment
Risk for parenting and family adjustment
Dietary habits and sexual and emotional abuse
Risk for depression and suicide
Learning and school problem
Hero worship and teenage pregnancy.
HEALTH PROBLEMS
Hypertension
Hyperlipidemia
Infectious disease
STD
Drug and alcoholism
Anemia
Dysmenorrhea
13 NEEDS OF ADOLESCENT
Self care – supervision of health problem,
Promotion of disease detection and treatment (self
breast examination / testicular examination)
Sex education
Prevention of anemia
Accident prevention
Dental hygiene
Prevention of additives behavior(tobacco, alcohol)
Communication
Trusting and productive relationship
Provide opportunity for exchange of thoughts and ideas.