The Newborn Infant

CHAPTER III
INTRODUCTION
A. Signal of the Approaching Birth

1. Abdominal Cramps
a. False Pains – are pains that are infrequent and irregular,
beginning in the back and spreading to the abdominal area of
the mother’s body.
b. True Pains – are pains that are increasing in frequency,
intensity, and duration with the passage of time.
2. Escape of fluid from the vagina
- This is the amniotic fluid which has come from the rupturing
of the amniotic sac in which the infant had been housed through
out the pre-natal period.
B. Periods of Labor

 Labor – is the process of giving birth.

The Three periods of Labor are :

a. Preparation – it is made for the emergence of the fetus

from the mother’s body. The contractions of the uterine
wall force the lowermost part of the uterus, the cervix, to
dilate and when it is completely dilated, uterine
contractions become stronger and the fetus is pushed
downward through the cervix and the vagina and expelled
from birth canal. This takes from 12 to 16 hours.
b. Expulsion – This lasts from 1-3 hours for first born
compared with 15-30 minutes to later-born children.
c. Afterbirth – is the stage when the placenta, the remnants
of the ruptured amniotic sac, and the umbilical cord are
separated from the wall of the uterus and expelled from
the body.
 The entire time needed for the total birth process ranges from
an average of 15 hours for later-born children and to over a day
for first born.
 The normal position of the body of the fetus during birth is
head downward. In 96% of all births, the vertex presentation
occurs in which the head of the fetus is in the mother’s pevic
cavity and its buttocks are up naer the mother’s ribs. The most
favourable position is head downward toward the mother’s
back and with the top of the fetal head directed upward towards
the mother’s abdomen.
C. When vs. How Born
1. Types of Birth

a. Cephalic or Headfirst – also known as vertex

presentation. As mentioned before this is the normal
process of birth. The head is delivered first, followed by
the body and the extremities.
b. Breech – a birth in which the infant’s buttocks appear
first, followed by the legs and finally the leg.
c. Transverse Presentation – The position of the fetus is
crosswise the mothe’s uterus.
2. Types of Delivery

a. Natural or Spontaneous – the position of the fetus in the

mother’s uterus and the size of the mother’s reproductive
organs makes it possible for the fetus to emerge into the
world in the normal, head-first position.
b. Instrument – in which the position or the size of the fetus
requires the use of instruments applied to the head of the
fetus. The instrument, called forceps,is used to pull the
through the birth canal.
c. Caesarean section – type of deliveryin which the fetus is
delivered into the world through a slit in the in the matern
abdominal wall instead of throughthe birth canal.
 It is said when a person is born is of slight importance. On
the other hand, of how he is of major importance. Not only
does the actual process of birth affect him temporarily or
permanently, to a slight or to a major degree, but the type
of birth affects the attitude of his parents towards him.
PERIOD OF THE NEWBORN
 According to the medical standard, this extends from birth
to the end of the second week, or until the navel is healed.
A. Period of Infancy
a. Period of Partunate – consists of the first fifteen tothirty
minutes of life including the time during and
immediately after parturition.
b. Period of the Neonate – covers the remainder of the
infancy period and is characterized by making of
adjustments essential to a life free from protection of the
intrauterine environment.
B. Period of Adjustments

1. A plateau stage in development

– the period of the newborn in which there is no marked
development. This lasts until the weight lost after birth has
regained.
2. There are four important adjustment the newborn infant
must make when he is born. These are :

a. Adjustment to temperature changes – In the sac in the

mother’s uterus, he is accustomed to a constant
temperature around 100 degrees. But after birth, the
temperature is between 68-70 degrees and will vary.
b. Adjustment to breathing – in the amniotic sac in the uterus, the
fetus is surrounded by a fluid environment and all the oxygen
comes from the placenta through the umbilical cord. After
birth the infant must inhale and exhale air.
c. Adjustment to nourishment – in the sac in the mother’s uterus,
the supply of nourishment has been from the placenta through
the umbilical cord. But after birth the taking of nourishment is
through the mouth by sucking and swallowing.
d. Adjustment to elimination – formerly the form of
elimination is through the umbilical cord and the maternal
placenta. After birth, the elimination of waste products is
through the excretory organs.
3. Factors that will determine how quickly and how
successful the newborn infant will make the four major
adjustments are as follows :
a. Type of birth experience he has had.
b. Length and severity of the labor.
c. Type of pre-natal environment he has had.
C. Critical Period

1. The critical periods are :

a. First day of life – most critical time.
b. Second and Third days – next most critical days.
2. Factors that influence mortality rate during the neonatal
period are the following :

a. Sex differences – there are more boys that die than girls.
b. Racial differences – non-whites have higher mortality
than whites.
c. Economic level – there is the highest mortality rate in the
families of the poorest economic groups.
d. Birth weight and gestation period – the lesser the birth weight
of the infant, and the shorter the gestation period, the higher
the mortality rate in the neonatal period.
e. Birth order – there is an increase in neonatal mortality with an
increase in birth order.
STAGES OF PHYSICAL DEVELOPMENT
AT BIRTH
A. Size

1. The size of the infant is characterized by :

a. The average weight of the newborn infant is 7.5
pounds. The average height is 19.5 inches.
b. Male infants are slightly larger than female infants.
c. Heavy infants lose more weight and for at longer time
than light infants.
 d. First born infants generally lose less than those born later.
e. Infants born summer and autumn regain their weight
slightly sooner than those born winter and spring.
f. Second and later born infants can be fed sooner than first-
born, and boys earlier than girls.
2. Factors that affect the variability in birth size are as
follows :

a. Maternal diet – the poorer the mother’s diet the smaller

the infant will be.
b. Economic status – infants from poorer districts are
slightly smaller than infants from better districts. And
negro infants are smaller than white infants.
c. Ordinal position – first-born infants are average, smaller
than later-born.
d. Fetal activity – when excessive, this may cause fo the
infant to be considerably underweight for his body length.
B. Pysical Proportions

1. The physical characteristics of infants are :

a. The infant’s head is one-fourth of the entire body
length, while in the adult, it is one-seventh.
b. In the infant, the ratio between the cranium and the
face is 8:1. In the adult it is 1:2.
 c. The infant’s face is broad and short because of lack of
teeth,the undevelop condition of the jaws, and the flatness of
the nose.
d. The arms, legs, and trunk are smaller in relation to the
head.
e. The abdominal region of the trunk is large and bulging,
while the shoulders are narrow.
C. Infantile Features

1. The infantile features of the newborn may be summarized

as follows :
a. The eyes are bluish gray but change gradually to
whatever the permanent color may be.
b. Tear glands are inactive so crying are not accompanied
with tears.
c. The neck is short and skin has deep folds.
d. Muscles and bones are soft, small and uncontrolled.
e. Flesh is firm and elastic, while the skin is deep pink in
color.
f. Sometimes a soft growth of hair is found on the body,
mostly on the back, but it soon disappears.
g. Once in every 2,000 births, the infant is born with one
or two teeth.
D. Physiological Functions
1. The basal pulse rate of the infant at birth is from130 to
150 beats per minute. After birth it is 117 beats per
minute.
2. Breathing is rapid, irregular and abdominal in type. Later
it becomes regular rhythmical and deeper.
3. The heart is small and needs a rapid beating to maintain
the normal blood pressure.
4. There are 8.6 feedings during the first six days of life.
This is reduced to 7.9 on the seventh day.This is true
when self demand feeding is used.
5. Defecation occurs most frequently during the first half
hour after feeding, with a median of 4.7 defecationsin 24
hours.
6. Voidings in a 24-hour period averages 18.6 times,
generally occurring within an hour after feedings.
7. Newborn infants sleep from 15 to 20 hours daily.
8. The infant is weakened by hunger, pain, and internal
sources of discomfort.
MOTOR ACTIVITIES
A. Categories of Motor Activities

1. Mass activity – is activity which includes general

movements of the whole body.
a. Factors that influence mass activity are :

1) Bodily conditions
a. Crying
b. Hunger
c. Pain
2) Environmental conditions
a. Light
b. Darkness
c. Auditory stimuli
2. Specific activities – are activities which involve certain
limited areas of the body.
a. Reflexes
b. General responses
Some of the several reflexes present at birth :

a. Pupillary corneal
b. Conjunctival
c. Lip
d. Tongue
e. Chin
f. Breathing
g. Achilles tendon
h. Darwinian (grasping)
i. Patellar
j. Triceps
k. Biceps
l. Abdominal
m. Cremasteric
n. Moro
o. Sucking
p. Visceral
q. Flexion
r. Knee
s. Pharyngeal
t. Heart action
u. Sneezing
v. Babinski
The common general responses are :

a. Visual fixation on light

b. Spontaneous eye movements
c. Shedding tears
d. Feeding responses
e. Sucking fingers
f. Yawning
g. Hiccupping
h. Rhythmic mouth movements
i. Slight frowning and wrinkling of the brow
j. Turning and lifting the head
k. Sitting
l. Turning movements
m. Hand and arm movements
n. Prancing and kicking
o. Leg and foot movements
p. Body jerks
VOCALIZATION OF THE NEWBORN
A. The Birth Cry

 Marks the beginning of vocalization

 Birth cry is physiological.
It serves two purposes :
a. to supply the blood with sufficient oxygen.
b. to inflate the lungs.
 Birth cry is not a true precursor of speech
B. Changes and Development

– during the first 24 hours after birth, the infant’s cry may
take on different meanings according to the pitch, intensity,
and continuity of cry.
 C. Stimulation of Cry

– Stimuli which arouse the infant’s cries come from:

a. Environment
b. Physiological Condition
1. Hunger 4. Wet diapers
2. Pain of discomfort 5. Vomiting
3. Fatigue or lack of exercise
D. Bodily Accompaniments of Crying

1. Squirms
2. Kicks
3. Flexes and extends arms, legs, fingers and toes.
4. Rolls body and turns head from side to side.
E. Amount of Crying

– How much the newborn cries is an individual matter.

F. Explosive Sounds

– are another type of vocalization which are commonly

referred to as “coos”, “grunts” and “gargles”.
G. Other Sounds

1. Sneezing
2. Yawning
3. Whining
4. Hicupping
SENSITIVITIES OF THE NEWBORN
The different sensitivities of the newborn are :

1. Sight
2. Hearing
3. Taste
4. Smell
5. Skin sensitivities
6. Organic sensitivities
EMOTIONS OF THE NEWBORN
A. Three Distinct Emotional Reaction That Occur Shortly
After Birth ( according to Watson ) Are :

1. Fear
2. Rage
3. Love
B. There Are Two Emotional Responses That the Newborn Is
Equipped With ( according to Bakwin ) :

1. Pleasant or Positive
2. Unpleasant or Negative
CONSCIOUSNESS OF THE NEWBORN

 James (1890 ) attempted to describe the infants

consciousness and he stated “baby assailed by eyes, ears,
nose, skin and entrails all at once, feels it all as one great,
blooming, buzzing, confusion.
 CONDITIONING IN THE NEWBORN
Conditioning – the process where there is a transfer of
response from an original to a subtle stimulus.
BEGINNINGS OF PERSONALITY
A. Differences in personality are apparent shortly after birth.
Difference may be partly due to :
1. Age
2. Circumstances of delivery
3. Health condition
B. Shirley (1933) states that a “nucleus of personality exists
at birth and this nucleus persists and grows and
determines to a certain degree the relative importance of
the various traits. Some change is doubtless wrought by
environmental factors, but this change is limited by the
limitations of the original personality nucleus.”
PREMATURE BIRTHS
A. Prematurity

– means a condition in which the newborn infant is

relatively unfit for extra-uterine life because his pre-natal
development has not been completed.
B. Criteria of Prematurity

1. Length of gestation period –

2. Birth size
C. Seriousness of Prematurity

1. Having 1,000 grams (2lbs.,3 oz) or less survival is rare.

Weight is more important than age.
2. The ratio of male to female deaths in the post-natal
prematurely period among prematurely infants is 2 to 1.
3. Prematurity is more common among first born than later
born children.
4. A premature infant has only one ninth the chance for a
life a full term infant has.
D. Traditional Beliefs

1. In Ancient times before the dawn of Christianity, these

are the common practice :
a. To put prematurely born infants to death at birth.
b. To put them on a mountainside, with other defectives
and allow them to perish.
2. Premature infants are likely to be overprotected. That is
why it is a disadvantage from the start.
E. Facts About Prematurity

 The healthy premature infant does not acquire any

unnatural precocity ; neither does he suffer any setback.
 The premature infant develop faster in his early post-natal
environment than do infants who are born at full term.
F. Characteristics of Premature Infants

1. Physical development – weight, height, illnesses, sight

(retrolental fibroplasia).
2. Developmental status
3. Motor control
4. Speech
5. Intelligence
6. Intelligence
7. Emotional behaviour
8. Social adjustments
9. Nervous traits or Behavior disorder
 a. Some indication of behaviour disorder are :

Thumb and finger sucking, nail biting, masturbation,

psychomatic difficulties (poor sleep, fatigability), emotional
difficulties (irritability, shyness, temper outbursts etc.),
disturbances in the intellectual field (concentration and
attention difficulties, forgetfulness), dogged determination
not to comply with direction, peculiar gestures with the
hands, and hypersensitivity to sounds.
 b. Possible causes of nervous traits :

1) Benton – hereditary factors, birth injuries, faulty nurture

and initial feeding habits.
2) Jersild – prematurely born children are overprotected at
first, then pushed to enable them to catch up to children
born on full-term.
Thank you for listening!