Post natal
The Baby’s
Adaptation to
Labor and
The Newborn Baby
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
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)
The Newborn Baby
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
The Newborn Baby
Weight :
2.8 -3.2 kg
Length :
51-53 cm (Boy > girl)
Head Circumference:
30-33 cm
Initially fast, short & irregular
Later  more stable & with rhythm
Blood pressure become stable in 10 days.
Is the Baby Healthy?
Medical and Behavioral Screening
Apgar Scale
The Brazelton Neonatal Behavioral Assessment Scale
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
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
 Appearance
 Pulse (heart beat rate)
 Grimace (reflex)
 Activity (muscle tone)
 Respiration (breathing)
Blue, pale
Body pink,
extremities blue
Entirely Pink
Slow (below 100)
Rapid (over 100)
No response
sneezing, crying
Weak, inactive
Strong, active
Irregular, slow
Good, Crying
Above 7 = (good/normal)
4 -7 = average, need monitoring
3 & Below = need immediate attention, high risk situation
Brazelton Neonatal Behavioral
Assessment Scale
 The
Brazelton Neonatal Behavioral Assessment
Scale (NBAS) (Dr. Berry Brazelton) serves 3
 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.
Brazelton Neonatal Behavioral
Assessment Scale (NBAS)
Test on four distinct areas:
 Social behavior (interactive behaviors in the
 Motor behaviors (reflexes & muscle activities)
 Control of physiology (baby’s ability to quiet
 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
Babies In-born Reflexes
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.
Examples of Newborn Reflexes
Eye Blink
 Withdrawal
 Rooting
 Sucking
 Swimming
 Palmar Grasp
 Tonic Neck
 Stepping
 Babinski
In-born Reflexes
Eliciting Stimulus
Gentle stroke along
Toes fan out: big toe
sole of foot (heel - toe) reflexes
Disappears by
end of first
Sudden lost of
Disappear in
6 months
Rod of finger pressed Object grasp
against infant’s palm
Disappear in
3-4 months
Object lightly brushes
infant’s cheek
Disappear in
3-4 months
Insert Finger in mouth Rhythmic sucking
Held baby upright.
Sole of feet placed on
hard surface
Arms extended, then
brought towards each
Baby turns towards
object and attempts to
Disappear in
3-4 months
Infant step forward as if Disappear in
3-4 months
Stroke cheek near corner of
mouth or object brushes the
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
Moro Reflex
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
Palmer Grasp
Spontaneous grasp of
adult’s finger
Disappears at 3-4
months to allow
reaching and grasping
Prepares infant for
voluntary grasping
Tonic Neck Reflex
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
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
Physical growth and development follow the
maturational principles of the cephalocaudal
principle and proximodistal principle.
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
 Better medical care, immunization and
antibioticsbetter health
Growth And Nutrition
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
The Brain
First 3 years of life is critical to baby’s brain
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.
Molding the Brain: The Role of
Smiling, babbling, crawling, walking, and talking
are possible due to rapid development of the
brain, particularly the cerebral cortex
Each part of the brain is very important in infuencing a child development 
integration between child emotions and behavior.
Middle brain: Limbic System
• Covers motivation, emotions, & long
term memory, aggressive behavior,
body temperature, hunger, nerve
system activities, hormon secretion
Outer Brain: Cortex &
• Divided into
lobes/sections (folds)
with specific
• Placement of
‘intelligence’ & higer
mental process,
learning, memory,
thinking, language (last
to develop)
• Also control vision,
hearing, inventing.
Brain stem
Contro process such as breathing,
heartbeat muscle movement, kidney
process, reflex behavior, sleep,
arousal, attention,
balance/movement etc.
Regions of the Cerebral Cortex
Thin layer on the brain’s surface that
include lobes or sections:
Occipital lobe
 Process vision.
Temporal Lobe
 Process hearing
Parietal Lobe
 Process sensory stimuli
Frontal Lobe
 Critical thinking & problem solving
 Frontal cortex  area of the cortex
that controls personality and the
ability to carry out plans
Molding the Brain: The Role of
Early experience can have lasting effects on
emotional development and the capacity of
the central nervous system to learn and store
Sometimes corrective experience can make
up for past deprivation
Brain and Neurons ...OTAK & NEURON
First 3 years of life  children’s brain are actively building
and developing connections between the neurons cells.
Connections are developed when the brain are actively
receiving stimulus  process between receiving and
sending impulses between the cells.
Through axons/dendrites  send signals to other neurons
& receive incoming message through connection called
Infant States of Arousal
States of arousal are different degrees of sleep and
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.
Ways to Soothe a Crying Baby
Hold on shoulder and
rock or walk
Ride in carriage, car,
Combine methods
Let cry for short time
Adjustments to Parenthood
Gender roles
Parents’ relationship
Pre-birth counseling
 Interventions for high-risk couples
Early Sensory Capacities
 Hearing
 Vision
 Taste
 Smell
Touch and Pain
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
Relieve pain with anesthetics, sugar, gentle holding
Reflexes reveal sensitivity to touch, for example
touch on mouth, palms, soles, genitals
Touch helps stimulate physical and emotional
Newborn Senses of
Taste and Smell
Prefer sweet tastes at birth
Quickly learn to like new tastes
Have odor preferences from birth
Can locate odors and identify
mother by smell from birth
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
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
utero and during the first few days after birth
Studies conducted: Smell and Taste
Lipsitt, Engen & Kye (1963) : Baby showed negative
response to the smell of ammonia.
Steiner : Baby showed different 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 months old, baby like the
taste of salt
Baby likes the
smell of:
• Banana,
• Margerine
• Tangerine
Baby dislikes
the smell of:
• Amonia
• Rotten egg
Well developed at birth - sensitive to voices and biologically
prepared to learn language
Hearing is functional before birth ability to discrimination
sound develops rapidly after birth. E.g. 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 – i.e. prefer complex sounds to pure tones
Newborns prefer complex sounds such as voices and noises
to pure tones - learn sound patterns within days
Newborns prefer speech that is high-pitched and expressive.
There are only a few speech sounds that newborns cannot
discriminate, and their ability to perceive speech sounds
outside their language is more precise than an adult’s.
Hearing is a key to language development thus hearing
impairments should be identified as early as possible
Developments in Hearing
4 – 6 months
6 months
Sense of musical phrasing
“Screen out” sounds from non-native
Recognize familiar words, natural
7 – 9 months phrasing in native language
10 months
Can detect words that start with weak
Studies conducted:
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.
Vision - the least developed sense at birth
Newborns cannot focus their eyes very well
and their visual acuity  fineness of
discrimination, is limited
However, newborns explore their environment
by scanning it for interesting sights & tracking
moving objects.
They can’t yet discriminate colors but 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 & distance at 4 or 5 mth
Infants’ Scanning of Faces
Face-like Stimuli
Studies conducted: Sight
Langlois & friends (1990): Babies are more attracted
to attractive and beautiful human faces.
Fantz (1993): Babies prefer to look at pictures of
Aslin (1987): 4 days old babies can differentiate
between green and red.
Babies prefer blue and red as compared to other
Gibson & Walk (1960): Visual cliff experiment. 6
mth babies has already develop in-dept perception
in visual.
Steps in Depth Perception
Birth – 1
Sensitivity to motion cues
Sensitivity to binocular cues
5 –12
Sensitivity to pictorial cues.
Wariness of heights
Steps in Pattern Perception
3 weeks
Poor contrast sensitivity.
Prefer large simple patterns
2 months
Can detect fine-grained detail. Prefer
complex patterns.
4 months
Can detect patterns even if boundaries are
not really present
12 months
Can detect objects if two-thirds of drawing
is missing
Improvements in Vision
Brain development helps infants
reach adult levels of vision
 2 months: Focus and color
 6 months: acuity, scanning &
 6–7 months: depth perception
Integrating Sensory Information
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
Motor Development
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
Month 1
Month 2
: Motor ability progress
: Chin lift
: Reach for object
Denver Developmental Screening Test measures:
Gross motor skills (those using large muscles), such as
rolling over and catching a ball, and
Fine motor skills (using small muscles), such as grasping a
rattle and copying a circle.
Language development (for example, knowing the
definitions of words)
Personality and social development (such as smiling
spontaneously and dressing without help).
Motor Development
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
Milestone in motor develpment
Motor Development
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
Motor Development
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
Motor Development
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
Social development
Baby's ability to interact with other people
Develops thru regular interaction with babies,:
 Cleaning
 Caring/loving
Newborn can imitate facial expression.
What is attachment?
The most important form of social development
that occurs during infancy is ATTACHMENT, the
positive emotional bond that develops between
a child and a particular individual.
Bowlby viewed attachment as based on infant's
needs for safety and security (especially from
the mother)
Infant Attachment
an infant responds positively to specific others,
feels better when they are close, and seeks
them out when frightened.
Attachment provides
a sense of security to the child
 information about the environment
Infant Attachment
Critical for allowing the infant to explore the
Having a strong, firm attachment provides a
safe base from which the child can gain
 suggests that the tendency to form relationships
is at least partly biologically based.
Infant Attachment
Mary Ainsworth (1978) identified three major
attachment styles:
Secure  strong bonding
Avoidant  negative bonding
Anxious/ambivalent  display a combination of
positive and negative bonding

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