Mărioara Boia Daniela Iacob Anikó Manea Camelia Budișan Ileana Enătescu Mirabela Dima Oana Costescu PRACTICAL NOTIONS OF GROWTH AND DEVELOPMENT COURSE Editura „Victor Babeş” Timişoara, 2020 1 Editura „Victor Babeş” Piaţa Eftimie Murgu nr. 2, cam. 316, 300041 Timişoara Tel./ Fax 0256 495 210 e-mail: [email protected] www.umft.ro/editura Director general: Prof. univ. emerit dr. Dan V. Poenaru Colecţia: MANUALE Coordonator colecţie: Prof. univ. dr. Sorin Eugen Boia Indicativ CNCSIS: 324 © 2020 Toate drepturile asupra acestei ediţii sunt rezervate. Reproducerea parţială sau integrală a textului, pe orice suport, fără acordul scris al autorilor este interzisă şi se va sancţiona conform legilor în vigoare. Traducere: Dr. Maciu Ana Maria Cristina - medic rezident Neonatologie ISBN 978-606-786-182-2 2 Table of contents CHAPTER I ........................................................................................................................... 4 INTRODUCTION ...................................................................................................................... 4 CHAPTER II .......................................................................................................................... 5 CLASSIFICATION OF INFANT CARE .................................................................................. 5 CHAPTER III ......................................................................................................................... 9 GROWTH AND DEVELOPMENT .......................................................................................... 9 CHAPTER IV ..................................................................................................................... 25 CHILDHOOD STAGES .......................................................................................................... 25 CHAPTER V ........................................................................................................................ 30 TERM NEWBORN .................................................................................................................. 30 CHAPTER VI ...................................................................................................................... 72 HIGH RISK NEWBORN ......................................................................................................... 72 CHAPTER VII ..................................................................................................................... 78 SMALL BIRTH WEIGHT NEWBORN ................................................................................. 78 PRETERM NEWBORN ...................................................................................................... 78 INTRAUTERINE GROWTH RESTRICTION ................................................................ 97 CHAPTER VIII ................................................................................................................. 105 VITAL SIGNS MONITORING IN NEONATOLOGY AND PEDIATRICS ...................... 105 CHAPTER IX .................................................................................................................... 118 PAIN MANAGEMENT OF A NEWBORN ......................................................................... 118 CHAPTER X ...................................................................................................................... 125 CLINICAL AND BIOLOGICAL PARTICULARITIES OF INFANTS AND SMALL CHILDREN ............................................................................................................................ 125 CHAPTER XI ................................................................................................................... 133 CLINICAL AND BIOLOGICAL PARTICULARITIES OF A PRESCHOOLER AND SCHOOL-AGE CHILD ......................................................................................................... 133 CHAPTER XII ................................................................................................................... 141 PUBERTY AND ITS INFLUENCE ON GROWTH. PUBERTY LAWS ............................ 141 PART II ................................................................................................................................. 157 CHAPTER I ....................................................................................................................... 158 GENERAL PRINCIPLES OF NUTRITION AND ALIMENTATION ................................ 158 CHAPTER II ...................................................................................................................... 176 PARENTERAL NUTRITION ............................................................................................... 176 CHAPTER III ..................................................................................................................... 186 BREASTFEEDING ............................................................................................................... 186 CHAPTER IV .................................................................................................................... 199 ARTIFICIAL FEEDING ........................................................................................................ 199 CHAPTER V ..................................................................................................................... 208 COMPLEMENTARY FEEDING .......................................................................................... 208 CHAPTER VI .................................................................................................................... 213 SMALL CHILD NUTRITION .............................................................................................. 213 CHAPTER VII ................................................................................................................... 217 NUTRITIONAL DISORDERS.............................................................................................. 217 CHAPTER VIII .................................................................................................................. 220 THE IMPORTANT ROLE OF PARENT-CHILD RELATIONSHIP IN THE CHILD'S SOMATIC AND MENTAL DEVELOPMENT .................................................................... 220 BIBLIOGRAPHY .............................................................................................................. 223 3 CHAPTER I INTRODUCTION Infant care represents a prophylactic side of pediatrics and consists of an assembly of means which ensure both somatic and mental growth and development of a child, from birth until adolescence, in a way that it maintains the child's good health. Infant care interests the child and its family, the socioeconomic environment, for maintaining both a good health and development of physical and intellectual performances of an individual. 4 CHAPTER II CLASSIFICATION OF INFANT CARE 1. Preconceptional care Represents all the preventive measures which can be taken by a couple, in order to conceive a healthy foetus and it targets the avoidance of teratogenic factors that determine prenatal insults: a) Infectious factors: Rubella virus, Cytomegalovirus and Toxoplasma Gondi infection lead to different major anomalies and determine almost 2% of the total complex malformations. Other infectious diseases related to malformations are as follows: Herpes virus, Coxsackie virus, Varicella Zoster virus, Treponema palidum, urinary tract infections. The following are examples of plurimalformative syndromes which appear due to certain infectious diseases: Congenital Rubella- causes the following anomalies: congenital cataract (fig. 1), congenital heart defects, IUGR, hearing loss, prolonged and severe jaundice, intellectual disability, liver and spleen diseases, pneumonias. Fig. 1. Newborn with congenital rubella - congenital cataract. CMV infection - the most severe anomalies: sensorineural hearing loss, visual acuity insult, neuropsychic and neuromotor disorder such as seizures, tetraparesis, diplegia, dyslexia, dysgraphia, adjustment disorders, intellectual disability, demise (20-30%), liver failure (fig. 2), DIC. 5 Fig. 2. Newborn with severe congenital CMV infection, hydrops fetalis Congenital toxoplasmosis - frequent anomalies: prematurity, IUGR, sight loss, brain calcifications, hydrocephalus, congenital heart defects, jaundice, hearing loss. b) Non-infectious maternal diseases: manifest diabetus mellitus may lead to various malformations; phenylketonuriamay lead to heart defects and intellectual dissability; spotting during the first trimester of pregnancy. c) Actinic factors (ionizing radiation): these have a mutagen effect when they act upon the zygote (chromosomal aberrations). d) Chemical factors: thalidomide which leads to various malformations; organomercury leads to neurological lesions, nicotinecauses small gestational age newborns; alcoholcauses small gestational age newborns, dismorphism/ malformations, intellectual dissability; drugs- anticonvulsants given during the first trimester; anticoagulants given during the first trimester; heparin may cause intrauterine fetal death, cytostatics always lead to malformations. e) Other teratogenic factors: Nutrition: amino acid deficiency; vitamins E, A, folic acid; oligoelements: Zn, Iodine; The ideal maternal age for conceiving is 25 to 35 years. 6 Fig. 3. Newborn with Down Syndrome Fig. 4. Occipital myelomeningocele 2. Prenatal infant care Prenatal infant care targets the protection of the expectant