General evaluation of the child's development
May 30, 2018
The most important indicator of a child's health is physical development - his weight, height, chest circumference and head. The average weight of the newborn is 3,500 g for boys and 3,375 g for girls. The average height is 51 and 50 cm, respectively. The head circumference of the newborn is on average 34-35 cm, the chest circumference is 32-34 cm. Thus, the circumference of the newborn's head is larger than the chest circumference by 1-2 cm.
Ratio of head and chest circles
Birth circlethe head is 34-35 cm, and the chest circumference is 1-2 cm less( 32-34 cm).Alignment of these sizes occurs at the age of 2-3 months. In the future, the circumference of the chest exceeds the circumference of the head;by 1 year, this difference is not less than 14 cm. Later, the child's head grows even slower, its circumference after 6 years increases by only 5-6 cm.
Measurement of the circumferences of the head and chest is made by centimeter tape. To measure the head, this tape is carried through the superciliary arches and the occiput, to measure the breast - through the nipples and corners of the scapula. Measure the growth and circumference of the head and thorax to children of the first year of life, once every 3 months, and then at least once a year.
Also to assess the development of the child should take into account the condition of the skin, development of movements, teething, mental development and other indicators.
Skin and subcutaneous fat layer
The skin of a healthy child should be pink, smooth, supple;The subcutaneous fat layer is sufficient, but not excessively developed. When examining a child in a children's institution, you must pay special attention to the skin: is it clean, is there any rash on it. The skin of a small child is thin, tender, abundantly supplied with blood through a branched network of superficially located blood vessels. She is easily injured and, if damaged, can serve as an entrance gate for infection. If fresh scratches or scratches are found when examining the skin, you should grease them with a solution of brilliant green, iodine or alcohol. If there are rashes, the child should be shown to the doctor, since many rashes are a sign of infection.
The bones of a newborn and infants contain few salts of calcium and other salts that make up the bones of an adult. Therefore, they are flexible and, if the child's position is wrong, it is easily bent. So, from the first months of life, deformations of the skull, thorax, curvature of the spine or legs may occur. At the birth of the child, the skull bones are separated from each other by connective tissue interlayers - seams. In the intersection of the joints, extensions of the connective tissue membrane - the fontanelles - are formed. A large fontanel is located between the parietal and frontal bones, a diamond-shaped;the average size of a newborn child is 2x2 cm. It closes by 12-15 months. To measure the large fontanel, a centimeter tape is placed between the opposite sides of the diamond( but not between its angles).A small fontanel is located between the parietal and occipital bones. It can be closed already at birth or closed in the first months of life, but no later than 3 months.
The muscles of the newborn are thin, weak. Movements made by handles and legs are messy. At the age of 1,5-2 months, lying on the stomach, the child raises his head and holds it;between 2 and 3 months begins to hold his head and with the vertical position of the body. Between 4 and 5 months with an improvement in the development of the muscles of the shoulder girdle a toy is enough;to 5 months keeps it in his hand. In 6-7 months the child sits, to 8 months rises to his feet, seizing the railing of the bed. In 9 months he walks on a bed or on the floor, leaning on furniture( edge of a sofa, a chair, stools, etc.), at 11 months the child is able to stand without support, by the year begins to walk. All these terms are average;in practice, there are deviations in one direction or another, even in healthy children.
Lymph nodes are probed in most children. They can be single and multiple, sometimes soldered in packages. Their dimensions may vary from small peas and even from millet grains to beans and more. A large number of lymph nodes, their large size, usually indicate a child's illnesses. With frequent catarrhal processes in the respiratory tract, with angina and chronic tonsillitis, cervical lymph nodes increase particularly, with oral cavity diseases - submandibular nodes, inflammatory processes in the thorax - axillary, etc.
The oral cavity of a young child is relatively small. Salivation in the first months of life is slight, the mucous membrane of the mouth remains dry. From 3-4 months the amount of mucus to be removed immediately increases. At first, when the child has not yet developed the reflex of swallowing the saliva filling the mouth, salivation is accompanied by drooling. The stomach of the newborn is small, located horizontally. The child of the first months of life easily belches. With good appetite and good weight gain, regurgitation is not a symptom of the disease. Some children at sucking swallow air( aerophagia), and then, in order for the baby to regurgitate less, it is necessary to hold it after feeding in an upright position for 20-30 minutes. The duration of food in the stomach in infants during breastfeeding 2-3 hours, with artificial - 3-4 hours, and with a large amount of fat in food( cream and other fatty mixtures) - even more.
Teething begins at the age of 6-7 months. From 6 to 8 months, lower middle incisors erupt, after 1-1.5 months - upper middle incisors, from 9 to 12 months - lateral incisors. Thus, a properly developing child by 1 year should have 8 incisors. At the 2nd year of life, the first small molars, fangs, and then the second small molars erupt. By the age of 2, the eruption of milk teeth is over. A total of 20. From the age of 6 begins the replacement of teeth: milk teeth fall out, and in their place appear permanent. The change takes place in the same order as the eruption of the milk teeth. Ends of teeth change to 12-14 years of life. Simultaneously with the beginning of the change of teeth at the age of 6-7 years, the baby has the first large molars, one on each side. By 12-14 years, grows on the second large molar tooth on each side, all of them 4. Thus, to the period of puberty there are 28 teeth. The remaining 4 large molars( "wisdom teeth") erupt already in the adolescence or even later.
The respiratory system of the child, especially the lungs, works with great intensity, as the volume of respiratory movements is limited, and the need for oxygen is high( for every kilogram of body weight the child of the first months of life consumes oxygen 2-3 times more than an adult).The newborn makes 40-60 respiratory movements per minute, at 6 months of age their number decreases to 35-40, by 1 year - to 30-35, at 5 years - to 25, at 10 years the number of breaths is 20-22, inage 12-14 years - 18-20 respiratory movements per minute. A small child breathes belly( abdominal, or diaphragmatic type of breathing).Therefore, to count the breath, the nurse, without pressing, puts her hand on the child's stomach. In view of the uneven breathing in small children, the number of respiratory movements is counted for a whole minute.
The child's heart relative to the total weight of his body is larger than that of an adult. The heart muscle is well developed. Nevertheless, in connection with the increased metabolism, the number of cardiac contractions and, consequently, pulse strokes in a child is much greater than that of an adult.
The pulse rate in children: the newborn has 120-140 beats per minute, by 6 months - 110-130, by the year - 110-120 strokes. By the age of 5, the number of heartbeats per minute should be no more than 100, by 10 years it is reduced to 80-85.The pulse of a small child can be considered on a radial artery, as in adults, or on the temporal artery. You can count by heart beat, putting your hand on the top of the heart. The pulse should be counted at least 15 or 20 seconds, respectively, multiplying the number of strokes by 4 or 3. The
excretory system A healthy infant has an average of 2-3 times a day, with breastfeeding more often. Usually it is uniform, ointment. The color is usually yellow, with an acidic aromatic odor. The urination of an infant is unconscious( according to the type of unconditioned reflex).The child of the first months of life urinates 20-25 times a day, closer to the year - 15-16 times.
Mental development of a child
A newborn baby sleeps almost the whole day, waking up only during the feeding hours. During the first year of life there is a rapid development of the cerebral cortex and, consequently, of higher nervous activity. In 1.5-2 months the child smiles. At 2 months, the first guttural sounds( walking), at 3-4 months - lingering, chanting pronounced sounds( "melodious" walking).At 4-5 months the child laughs loudly. At 5 months he clearly distinguishes mother and other familiar faces from strangers, there is babbling, at 8 months the child understands the meaning of some words;when naming, looking for the corresponding objects.
By 1 year the circle of words understandable to the child is expanding;the first meaningful words appear( the beginning of the child's own speech).He fulfills some requirements( "show," "give," etc.).Understands the prohibition.
From 1 year to 3 years, the child's independent speech develops rapidly. In the preschool age there is a further formation of the personality of the child. He is inquisitive, asks many questions to adults.
Under the influence of the environment, the child's character traits develop. In the preschool age there are concepts about morality, about duties. In the behavior of young children, excitation processes predominate, leading to rapidly onset fatigue. To restore the function of the cerebral cortex, the child needs a long sleep. The total duration of sleep per day: a newborn - 20-22 h, at the age of 1 month - 16-20 h, 1 year - 14-16 h, 3 years - 12-13 h, 4-7 years - 11-12 h,8-10 years - 10-11 hours, 11-13 years - 9-10 hours, 14-16 years - 8.5-9 hours. Including the duration of a night's sleep from the first months of life to 3 years is 10-11 hours