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Chapter 4Child DevelopmentCaprice Paduano
CHAPTER 4 KEY QUESTIONS
W
hat is the normal process of labor?
W
hat complications can occur at birth, and what are their
causes, effects, and treatments?
W
hat capabilities does the newborn have?
BIRTH
N
eonate The term used for newborns
T
he neonate’s outward appearance is caused by a variety of factors in its
journey from the mother’s uterus, down the birth canal, and out into the
world.
W
e can trace its passage, beginning with the release of the chemicals that
initiate the process of labor.
LABOR: THE PROCESSOF BIRTH BEGINS
A
bout 266 days after conception, a protein called corticotropin releasing
hormone (CRH) triggers the release of various hormones, and the process that
leads to birth begins.
O
ne critical hormone is oxytocin, which is released by the mother’s pituitary
gland.
W
hen the concentration of oxytocin becomes high enough, the mother’s uterus
begins periodic contractions.
LABOR: THE PROCESSOF BIRTH BEGINS
L
abor proceeds in three stages:
I
n the first stage of labor, the uterine contractions initially occur around
every 8 to 10 minutes and last about 30 seconds. As labor proceeds, the
contractions occur more frequently and last longer.
T
oward the end of labor, the contractions may occur every 2 minutes and
last almost 2 minutes.
LABOR: THE PROCESSOF BIRTH BEGINS
D
uring the final part of the first stage of labor, the contractions
increase to their greatest intensity, a period known as transition.
D
uring the second stage of labor, which typically lasts around 90
minutes, the baby’s head emerges further with each contraction,
increasing the size of the vaginal opening.
LABOR: THE PROCESSOF BIRTH BEGINS
E
pisiotomy An incision sometimes made to increase the size of
the opening of the vagina to allow the baby to pass
T
he third stage of labor occurs when the child’s umbilical cord
(still attached to the neonate) and the placenta are expelled
from the mother.
BIRTH: FROM FETUS TO NEONATE
T
he exact moment of birth occurs when the fetus, having left the
uterus through the cervix, passes through the vagina to emerge
fully from its mother’s body.
I
n most cases, babies automatically make the transition from taking
in oxygen via the placenta to using their lungs to breathe air.
THE APGAR SCALE
A
pgar scale A standard measurement system that looks for a
variety of indications of good health in newborns
A
noxia A restriction of oxygen to the baby, lasting a few
minutes during the birth process, which can produce brain
damage
APGAR SCALE
PHYSICAL APPEARANCEAND INITIAL ENCOUNTERS
A
fter assessing the newborn’s health, health-care workers next deal
with the remnants of the child’s passage through the birth canal.
A
thick, greasy material called the vernix smoothes the passage
through the birth canal; it is no longer needed once the child is
born and is easily cleaned away.
PHYSICAL APPEARANCEAND INITIAL ENCOUNTERS
N
ewborns’ bodies are also covered with a fine, dark fuzz
known as lanugo; this soon disappears.
T
he newborn’s eyelids may be puffy due to an accumulation of
fluids during labor, and the newborn may have blood or other
fluids on parts of its body.
PHYSICAL APPEARANCEAND INITIAL ENCOUNTERS
B
onding Close physical and emotional contact between parent and
child during the period immediately following birth, argued by
some to affect later relationship strength
A
lthough mother–child bonding does not seem critical, it is
important for newborns to be gently touched and massaged soon
after birth.
PHYSICAL APPEARANCEAND INITIAL ENCOUNTERS
T
he physical stimulation they receive stimulates the production
of chemicals in the brain that instigate growth.
APPROACHES TO CHILDBIRTH: WHERE MEDICINE AND ATTITUDES MEET
P
arents in the Western world have developed a variety of strategies
—and some very strong opinions—to help them deal with
something as natural as giving birth.
N
o single procedure will be effective for all mothers and fathers, and
no conclusive research evidence has proven that one procedure is
significantly more effective than another.
ALTERNATIVE BIRTHING PROCEDURES
L
amaze birthing techniques
B
radley Method
H
ypnobirthing
CHILDBIRTH ATTENDANTS:WHO DELIVERS?
T
raditionally, obstetricians, physicians who specialize in delivering babies,
have been the childbirth attendants of choice.
I
n the last few decades, more mothers have chosen to use a midwife, a
childbirth attendant who stays with the mother throughout labor and delivery.
A
doula is trained to provide emotional, psychological, and educational support
during birth.
PAIN AND CHILDBIRTH
P
ain is a subjective, psychological phenomenon that cannot be
easily measured.
C
onsequently, the experience of pain during labor is difficult for
women in labor to interpret, thereby potentially increasing their
anxiety and making the contractions seem even more painful.
PAIN AND CHILDBIRTH
U
ltimately, every woman’s delivery depends on such variables
as how much preparation and support she has before and
during delivery, her culture’s view of pregnancy and delivery,
and the specific nature of the delivery itself
USE OF ANESTHESIA ANDPAIN-REDUCING DRUGS
T
he use of medication during childbirth is a practice that holds both benefits
and pitfalls.
A
bout a third of women who receive anesthesia do so in the form of epidural
anesthesia, which produces numbness from the waist down.
A
newer form of epidural, known as a walking epidural or dual spinal-epidural,
uses smaller needles and a system for administering continuous doses of
anesthetic.
POSTDELIVERY HOSPITAL STAY: DELIVER, THEN
DEPART?
T
he American Academy of Pediatrics states that except in
unusual cases, women should stay in the hospital no less
than 48 hours after giving birth.
F
urthermore, the U.S. Congress passed legislation mandating
a minimum insurance coverage of 48 hours for childbirth.
NEWBORN MEDICAL SCREENING
T
he American College of Medical Genetics recommends that
all newborns be screened for 29 disorders, ranging from
hearing difficulties and sickle-cell anemia to extremely rare
conditions such as isovaleric academia, a disorder involving
metabolism.
PRETERM INFANTS:TOO SOON, TOO SMALL
P
reterm infants Infants who are born prior to 38 weeks after conception (also
known as premature infants)
L
ow-birthweight infants Infants who weigh less than 2,500 grams (around 5
1/2 pounds) at birth
S
mall-for-gestational-age infants Infants who, because of delayed fetal growth,
weigh 90% (or less) of the average weight of infants of the same gestational
age
PRETERM INFANTS:TOO SOON, TOO SMALL
L
ow-birthweight infants are highly vulnerable to infection, and because their lungs
have not had sufficient time to develop completely, they have problems taking in
sufficient oxygen.
A
s a consequence, they may experience respiratory distress syndrome (RDS), with
potentially fatal consequences.
D
espite the difficulties they experience at birth, the majority of preterm infants
eventually develop normally in the long run.
VERY-LOW-BIRTHWEIGHT INFANTS: THE SMALLEST
OF THE SMALL
V
ery-low-birthweight infants Infants who weigh less than 1,250
grams (around 2 1/4 pounds) or, regardless of weight, have been
in the womb fewer than 30 weeks
V
ery-low-birthweight babies are in grave danger from the moment
they are born, due to the immaturity of their organ systems.
VERY-LOW-BIRTHWEIGHT INFANTS: THE SMALLEST
OF THE SMALL
H
owever, medical advances have led to a higher chance of
survival, pushing the age of viability, the point at which an
infant can survive prematurely, to about 22 weeks.
WHAT CAUSES PRETERM AND LOW-BIRTHWEIGHT
DELIVERIES?
A
bout half of preterm and low-birthweight births are
unexplained, but several known causes account for the
remainder.
I
n some cases, premature labor results from difficulties
relating to the mother’s reproductive system.
WHAT CAUSES PRETERM AND LOW-BIRTHWEIGHT
DELIVERIES?
I
n other cases, preterm and low-birthweight babies are a
result of the immaturity of the mother’s reproductive system.
F
actors that affect the general health of the mother all are
related to prematurity and low birthweight.
LOW BIRTHWEIGHT FACTORS
POSTMATURE BABIES:TOO LATE, TOO LARGE
P
ostmature infants Infants still unborn 2 weeks after the mother’s
due date
D
ifficulties involving postmature infants are more easily prevented
than those involving preterm babies, since medical practitioners
can induce labor artificially if the pregnancy continues too long.
CESAREAN DELIVERY: INTERVENINGIN THE PROCESS OF BIRTH
C
esarean delivery A birth in which the baby is surgically
removed from the uterus, rather than traveling through the
birth canal
C
esarean deliveries occur most frequently when the fetus
shows distress of some sort.
CESAREAN DELIVERY: INTERVENINGIN THE PROCESS OF BIRTH
C
esarean deliveries are also used in some cases of breech position,
in which the baby is positioned feet first in the birth canal.
A
cesarean delivery also presents some risks for the baby.
F
etal monitor A device that measures the baby’s heartbeat during
labor
INFANT MORTALITY AND STILLBIRTH:THE TRAGEDY OF PREMATURE DEATH
S
tillbirth The delivery of a child who is not alive, occurring in
fewer than 1 delivery in 100
I
nfant mortality Death within the first year of life
CHILDBIRTH-RELATED LEAVE POLICIES
CHILDBIRTH-RELATEDLEAVE POLICIES, CONT’D
POSTPARTUM DEPRESSION:MOVING FROM THE HEIGHTS OFJOY TO THE DEPTHS OF DESPAIR
P
ostpartum depression, a period of deep depression following
the birth of a child, affects some 10% of all new mothers.
P
ostpartum depression may be triggered by the pronounced
swings in hormone production that occur after birth.
POSTPARTUM DEPRESSION:MOVING FROM THE HEIGHTS OFJOY TO THE DEPTHS OF DESPAIR
W
hen depressed mothers interact with their infants, they are likely
to display little emotion and to act detached and withdrawn.
T
his lack of responsiveness leads infants to display fewer positive
emotions and to withdraw from contact not only with their
mothers but with other adults as well.
THE COMPETENT NEWBORN
A
s developmental researchers have begun to understand
more about the nature of newborns, they have come to
realize that infants enter this world with an astounding array
of capabilities in all domains of development: physical,
cognitive, and social.
PHYSICAL COMPETENCE: MEETING THE DEMANDS OF A NEW ENVIRONMENT
T
he world faced by a neonate is remarkably different from the
one it experienced in the womb.
N
eonates emerge from the uterus practiced in certain types of
physical activities.
PHYSICAL COMPETENCE: MEETING THE DEMANDS OF A NEW ENVIRONMENT
R
eflexes Unlearned, organized involuntary responses that occur automatically
in the presence of certain stimuli
T
he sucking reflex and the swallowing reflex permit Kaita to begin right away
to ingest food.
T
he rooting reflex, which involves turning in the direction of a source of
stimulation (such as a light touch) near the mouth, is also related to eating.
FIRST ENCOUNTERS UPON BIRTH
SENSORY CAPABILITIES: EXPERIENCING THE
WORLD
A
lthough their visual acuity is not fully developed, newborns
actively pay attention to certain types of information in their
environment.
I
nfants can discriminate different levels of brightness.
SENSORY CAPABILITIES: EXPERIENCING THE
WORLD
T
here is even evidence suggesting that newborns have a
sense of size constancy.
T
hey seem aware that objects stay the same size even though
the size of the image on the retina varies with distance.
SENSORY CAPABILITIES: EXPERIENCING THE
WORLD
I
n addition to sight and hearing, the other senses also function
quite adequately in the newborn.
I
t is obvious that newborns are sensitive to touch.
A
t birth, the senses of smell and taste are also well developed.
EARLY LEARNING CAPABILITIES
C
lassical conditioning A type of learning in which an organism
responds in a particular way to a neutral stimulus that normally
does not bring about that type of response
O
perant conditioning A form of learning in which a voluntary
response is strengthened or weakened, depending on its
association with positive or negative consequences
EARLY LEARNING CAPABILITIES
H
abituation The decrease in the response to a stimulus that
occurs after repeated presentations of the same stimulus
LEARNING IN INFANCY
SOCIAL COMPETENCE: RESPONDING TO OTHERS
D
ue to variations in research results, the jury is still out on exactly
when true imitation begins, although it seems clear that some
forms of imitation begin very early in life.
C
ertain characteristics of neonates mesh with parental behavior to
help produce a social relationship between child and parent, as
well as social relationships with others.
SOCIAL COMPETENCE: RESPONDING TO OTHERS
S
tates of arousal Different degrees of sleep and wakefulness
through which newborns cycle, ranging from deep sleep to
great agitation
SOCIAL INTERACTION FACTORS