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these various milestones. All children are different. Some walk early others late. The average age at which children reach various milestones is given below. The individual child often differs widely from the average but is still quite normal. Pediatric Nursing and child health care 83 Table 2. Summary of normal developmental milestones: Average age motor development Language & social behaviors 1 month can lift head when prone can fix with eyes, often smiles 3-6 months good head control can follow an object with eyes, & play with hands 6-9 months can sit unsupported grasp actively, makes loud noise 9-12 months able to stand understand few words, tries to use 12-18 months able to walk grasp small objects with thumb and fingers 2 years able to run around can say several words, or even as much as he wants some sentences 3 years actively plying, is clever in climbing and jumping starts talking much Pediatric Nursing and child health care 84 Study Questions 1 . List factors that affect growth and development of fetus. 2. Discuss the differences between growth and development. 3. List factors that promote normal development in children Pediatric Nursing and child health care 85 CHAPTER SEVEN NUTRITION AND NUTRITIONAL DEFICIENCIES Learning Objectives: After studying the material in this chapter the student will be able to: - Identify the common causes of infant and child morbidity and mortality - State the most common complication of malnutrition and their management - List the most common forms of malnutrition in the developing Countries and their management - State the purpose of screening and identify children who need appropriate management - Perform weighing of babies under 3 years of age and interpret the weight according to weight for age chart - Classify nutritional status of children and manage accordingly including nutrition education. Pediatric Nursing and child health care 86 7.1 Normal feedings patterns: The main rule for feedings children Only breast milk during the first 4 months start adding porridge at 4 months. Add some protein to every meal after 4-5 months of age. Plain porridge is not enough for more than a few weeks. Add fruits and vegetable to at least one meal every day start when the child is 4 months old. Give a child at least three meals /day. Infants may require four to six small ones. Continue breast feeding until the child is able to manage on other foods probably this will be at 18-24 months of age. Use the common local carbohydrate food and add a suitable protein food. Prepare balanced meals. Make sure that the added protein is well mixed with the staple Carbohydrate food and that both are given in a suitable amount. A) Breast-Feeding: The food for babies is undoubtedly human breast milk. Nurses and midwives should encourage and support mothers to breast feed even if it is only achieved for a few weeks. However, if a mother has decided, for what ever the reason, Pediatric Nursing and child health care 87 to use a milk formula method of bottle feeding she should be given the same support, understanding, and help as the mother who breast feeds. Good Reasons for Breast-feeding: 1. Promote bonding between mother and child. 2. Many infections are far less common in breast fed babies. 3. The fat in human milk is better absorbed than the fat in cow’s milk 4. The danger of giving an over concentrated or a too diluted formula milk is avoided 5. The risk of eczema, asthma, and other allergic disorders is considerably reduced 6. Low birth weight and pre-term infants thrive best on breast milk 7. It helps for mental development Preparation for Breast Feeding: Ideally preparation for breast-feeding should be part of a health education program for both boys and girls while in secondary school. This early awareness should be expanded in antenatal sessions for both parents when baby is expected. This session should include: 1. Knowledge of the physiology of breast feeding 2. Management and comfort of breast and nipples 3. The importance of a well balanced diet during pregnancy Pediatric Nursing and child health care 88 and of the need of extra protein and calories while breast feeding. 4. Practical demonstration and discussion with a breastfeeding mother
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