BIRTH TO FIRST THREE

YEARS
Halimatus Saadiah binti Aiap
(MPP141123)
Siti Zanariah binti Abdul Jalil
(MPP141106)

Review

How Birth Has Changed

In old days, women deliver child at home
The development of science: delivery at
hospitals
Today: delivery in birth centers

Child Birth Process

Dilation of the cervix
Descent of the baby
Expulsion of the umbilical cord and placenta

The Birth Process

The Birth Process(Continue)

Electronic Fetal Monitoring
Vaginal VS Cesarean Delivery
Medicated VS Non-medicated Delivery

The Birth Process:

Electronic Fetal Monitoring.
To track fetus's heartbeat during labor and delivery.
To indicate how the fetal heart is responding to stress
of uterine contraction.
advantage- detect serious problems and alert the
physician or midwife to help, provide valuable
information in high-risk deliveries.
Disadvantages- costly, restricts mothers movements
during labor, high false-positive rate.

The Birth Process:

Vagina vs Cesarean Delivery.
Vagina delivery usual method of childbirth
Cesarean delivery using surgery in
childbirth
Cesarean delivery uses when labor
progresses too slowly, when fetus seems to
be in trouble, when mother is bleeding
vaginally, fetus is in the breech position or
transverse position and when the head is too
big to pass through the mothers pelvis.

Cesarean rate increase.

Older first-time mother- Tend to have
multiple births.
Premature infants- reduce the risk of
dying
Physicians fear of malpractice suits .
Womens preferences.

The New-born Baby

Size and Appearance.

Body Systems.
Medical and Behavioral Assessments.
States of Arousal.

The New-born Baby: Size

Average weight for new baby born in
Malaysia is 3kg.
Boys are heavier then girls.
Malaysian babies are about 200 to 300
grams lighter than the Caucasian babies.
Babies who are more than 4kg are
considered as Macrosomia (big) baby.
Average length vary from 48-51cm (1920inch)

Factors that affect newborn babys

size
1.
2.
3.
4.
5.
6.
7.

Size of parents
Multiple births
Birth order
Mothers health during pregnancy
Nutrition during pregnancy
Babys health
Premature baby.

The New-born Baby: Appearance

Large head (one-fourth the body length)

Receding chin
Pinkish cast
Thin peeling skin
Mongolian spots (black and blue
marks of bruises)
Covered with vernix caseosa (cheesy
vanish)

The New Baby Born: Body System

Heartbeat is fast and irregular
Blood pressure does not stabilize
Need more oxygen
-Anoxia may cause permanent brain injury,
mental retardation, behavior problems or
death.
Instinctively suck to take in milk and their gastrointestinal
secretions digest it.
Maintain body temperature by increasing their activity
when air temperature drops.
Greenish-black waste will be excreted.
Develop neonatal jaundice (skin and eyeball look yellow)

The New-born Baby:

Medical and Behavioral Assessment
The Apgar Scale by Dr.Virginia Apgar
(1953)
- standard measurement of newborns condition .
- assesses appearance(color), pulse(heart rate), grimace
(reflex irritability), activity(muslce tone) and respiration
(breathing)
- check at 1 minute, 5 minutes, 10 and even up to 20
minutes after birth.
- newborn is rated on 0,1 or 2 on each measure, for a
maximum score of 10.

APGAR SCORE

The New-born Baby:

Medical and Behavioral Assessment
(Continue..)
Assessing Neurogical Status: The
Brazelton Scale -to measure neonates
responses to the
environment.
Neonatal Screening for Medical
Conditions
-to detect rare disease
-nowadays, single blood specimen can
be
screened for 20 or more

The New-born Baby:

State of Arousal.
An infants physiological and behavioural
status at a given movement in the periodic
daily cycle of wakefulness, sleep and
activity.
Most newborn babies sleep 18 hours a day
(75% of their time) but wake up every 3 to
4 hours, day and night, for feeding.
Newborns sleep alternates between
regular (regular) and irregular(active)sleep.

 Beginning of 1st month, nighttime

sleep periods gradually lengthen.
More wakeful in the daytime need
less sleep when baby grows.
Baby 6 months, an infant sleeps for 6
hours straight at night.
2 years old baby sleeps about 13
hours a day, including afternoon nap.

Complication of Childbirth.
3 types of complication:
Low birth weight
Postmaturity birth
Stillbirth

Complications of Childbirth
Low Birth Weight:

Post maturity
Birth:

Stillbirth:

Term used to describe

babies who are born
weighing less than 2500
grams.

Baby delivered after

more than 42 weeks in
the uterus and also
considered as post
mature.

Sudden death of a baby

while still in the uterus.

Causes for low birth

weight:
1. Preterm
(premature) birth.
- born before
completing the 37
weeks of gestation.
- the baby has less
time in the mothers
uterus .
2. Fetal Growth
restriction (Small-for
date)

Causes:
1.A mother has had
one or more previous
post terms
pregnancies.
2.Sometimes a
mothers pregnancy
due-date is
miscalculated because
she is not sure of her
last menstrual period.

Causes is stillbirth:
1.Mother with diabetes or
high blood pressure.
2.Infection in the mother
or in the fetal tissues.

Survival And Health

Causes of infant mortality:
Birth complication
Birth defects
Sudden infant death syndrome (SIDS)

Survival And Health

Causes of infant mortality:
Birth Complication:

Birth Defect:

Sudden Infant Death

Syndrome (SIDS):

Low birth weight

Post mature
Stillbirth

Are health
conditions that are
present at birth.
Can cause
problems in overall
health, how the
body develops.
Heart failure.

Also call as crib

death
Is sudden,
unexpected and
unexplained death
of baby under the
age 1 although if
they are well and
healthy.

Prevent:
-eating a healthy diet
and taking vitamins
-exercise and rest
-getting early and
regular prenatal care.

Prevent:
-no smoking(to
pregnant women or
babies)
-babies head under
covered.

Immunization for Better

Health.

Vaccination is also known as

immunization.
Protects a child against serious
childhoods infections.

 When children are immunized, they

have antibodies and are protected
from certain diseases.
If they are not protected and come in
contact with one of these infections,
they may become very ill and
experience complications, or even die.

 In the first months of life, a baby is protected

from some infectious diseases by antibodies
transferred from mother to baby during
pregnancy.
When these antibodies wear off, the baby is at
risk of serious infection.
Vaccine only work best when they are given at
the right time.

Malaysia Immunization
Programme

Children With Working Parents

During this century, strong economic pressures
encourage parents to work together to support the
family income.
This resulted in a focus on the expansion of the
children had multiple responsibilities in the job.
When both parents work, some children feel
neglected.
But, a family with two wage earners can be positive
influence on children

 Why children felt neglected when their parents are

working?
Parents feel overworked or unappreciated to their job,
they may vent their frustration and anger to their
children.
Children are receiving less one to one attention and
interaction.
Parents burnout and too tired to interact with
children.
Less guidance, affect the school performance and
behavioral problem.

 But there are children who benefit when their parents

working.
Children feel proud that their parents career
(motivation)
Train the children to become independent and build
up the responsibility among the siblings.
Working mother felt that they were being good role
models for the family.
Help to make the life more meaningful.

 As parents, we need to have;

Maltreatment: Abuse and

Neglect

 What is child maltreatment?

Any act or series of acts of commission or omission by a
parent, or other caregiver that result in harm, potential for
harm or threat of harm to a child.

What is child abuse?

Overt actions that cause harm, potential harm, or threat of
harm to a children. Act of commission are deliberate and
intentional .

What is child neglect?

The negligent treatment of a child by a parent or by a
caretaker under circumstances, indicating harm or
threatened harm to the childs health or welfare.

Physical Abuse
1st type of children maltreatment identified by
professionals
The most visible marks to the victims (injury)
Example: hitting, punching, kicking, shaking,
throwing, burning, stabbing, or choking a child.

2,789 cases reported in 2009, which jumped to 3,257 in 2010.

The number then went up to 3,428 in 2011, keeping up a
consistent uphill trend. There were 3,831 cases recorded in
2012.
The five main types of abuse encountered are physical abuse
(29%), bullying (26%), sexual abuse (20%), neglect (14%)
and emotional abuse (11%)
(http://www.theantdaily.com/Don-t-miss-these/Child-abusecases-on-the-rise-in-Malaysia)

Sexual Abuse
Sexual exploitation or sexual activities with a child under
circumstances that indicate that the childs health or welfare is
harmed or threatened.
But have a lot of argument
Professionals finalize that the actions if can caused the sexual
arousing considered as sexual abuse.
Forms of sexual abuse: pedophilia, incest and child
pornography.

Touching sexual
offenses
Fondling
Making a child touch an
adults sexual organ
Penetrating a childs
vagina or anus no matter
how slight with a penis

Nontouching sexual Sexual exploitation

offenses
Engaging in indecent
exposure or

soliciting a child for the

exhibitionism

purposes of prostitution

Exposing children to
pornographic material
Deliberately exposing a

or any object that

child to the act of sexual

doesnt have a valid

intercourse

medical purpose.

Engaging a child or

Masturbating in front of
a child

Using a child to film,

photograph, or model
pornography.

SEXUAL ABUSE AND MURDER CASE OF CHILD

NURUL SYAFIQAH BINTI ABDULLAH
22 JANUARI 2014
PAKA, TERENGGANU

Psychological Abuse
Parental behaviors that actively harm their childs
mental health.
Interaction between an adults behavior and a childs
vulnerabilities.
Example: bullying, verbal aggression, ignoring,
rejecting and isolating
Babies with less severe emotional deprivation can
grow into anxious and insecure children who are slow
to develop and who have low self-esteem.

Physical Neglect
Failure to meet the minimal physical needs of the
child
The minimal of acceptable care.
Malnourished (extreme neglect)
Example: Appropriate shelter, adequate supervision,
child endangerment, chronic sleepiness, hunger, poor
personal hygiene, fire hazards or other unsafe
conditions in the house.

Emotional Neglect
The failure to meet the minimal physical needs of the
children.
Difficult to identify
Sole type of maltreatment (difficult to define and
prove)

Medical Neglect
The failure to provide prescribed medical
treatment.
Religious belief conflict
So, parents refusing to permit their child to
receive the life saving medical intervention
Delay in seeking treatment

Educational Neglect
The failure to meet legal requirement for school
attendance.
In Malaysia, there is a circular recommending
compulsory education to children of primary school
The failure of parents to send their children to school
will result in the possibility of their fine.
The school and community must work together to
identify the children who drop out of school.

Abandonment
Most extreme act of neglect
Leaving a newborn anywhere from a hospital to a
trash bin, kicking a child from home.
In Malaysia, every year there are certainly cases of
baby dumping is happening in society, especially
among youth.
Promiscuity among teenagers is one of the factors
that led to baby dumping is increasing.

PHYSICAL, COGNITIVE AND

PSYCHOSOCIAL DEVELOPMENT
During birth until about two weeks to one
month the infant was called neonate.
They begin to use their abilities to adapt the
environment.

Physical and Motor Development

Neonatal Reflexes
Stimulus repeatedly elicits the same response
Serve a definite purpose
But, not all possess them to the same degree.
Have some neonates demonstrate much
weaker reflex action than the other

Early Physical Development

 Brain development
3 distinct layer: ectoderm, mesoderm and endoderm.

 Estimates are that the babys brain:

 Motor development
Proceeds at a steady rate
Occur in a head to feet direction
An infants ability to control its head signals
advancing motor development.

Sensory and Perceptual Development

Sensation and Perception

Visual Perception
Hearing
Touch
Smell
Taste

 Sensation and Perception

Sensations occur when information interacts with
sensory receptors the eyes, ears, tongue, nostrils,
and skin.
Perception is the interpretation of what is sensed.

 Visual Perception
The newborns vision is estimated to be 20/400 to
20/800 on the Snellan chart about 1030 times
lower than normal adult vision (20/20).
By 6 months vision improves to 20/100.
By 8 months, vision approximates that of an adult.
By 4 months all color-sensitive receptors are
functioning at adult capacity.

 Hearing
In the last few months of pregnancy, a fetus can hear
sounds (the mothers voice, music, etc.)
Infants are born with the ability to discriminate
speech sounds from any language, but without
constant exposure, they lose the ability by their 1st
birthday.

 Touch
Newborns respond to touch, particularly with the
sucking & rooting reflex.
An important ability that develops during the first
year is to connect information about vision with
information about touch.
Newborns can feel pain.

 Smell
Newborns can differentiate odors.
Young infants show a preference for the smell of their
mothers breast by six days old.

 Taste
Sensitivity to taste may be present at before birth.
Two-hour-old newborns made different facial
expressions when they tasted sweet, sour, and bitter
solutions.
At 4 months of age, infants prefer salty tastes, which
newborns found adverse.

Cognitive Development
Piagets theory:
Mental growth takes place in four discrete stages.
For birth to two years children, the cognitive
development is happen at the Sensorimotor Stage.
Infants are egocentric at birth because they do not
experiences the external world as separate from
themselves.
The awareness that object exist independent of their
perception.

 Learn the decentering process

Six stages that Piaget found from the observation of
his own three children.

 Progress through the sensorimotor period leads to four major

accomplishments:
I. Object permanence- There are permanent object around them
II. A sense of space-There is a spatial relationship among
environmental objects
III.Causality-There is a relationship between actions and their
consequences.
IV.Time sequence-One thing come after another.

 Language in Infancy
This is the basic sequence of language acquisition:

THE LANGUAGE SEQUENCE

LANGUAGE

AGE

Crying

From birth

Cooing

5-8 weeks

Bubbling

4-5 months

Single words

12 months

Two words

18 months

Phrases

2 years

Short sentences and questions

3 years

Conjunctions and prepositions

4 years

Psychosocial Development
Relationship between the child and mother.
the mothers commitment to the child
Reciprocal interactions to recognize the childs
active role in its development
As an adults, we have to respond to infants
interactions to establish the relationship.

 What is relationship?
Relationship is a pattern of intermittent interactions
between two people involving interchanges over an
extended period of time.

CHILDREN

 Physical appearance
Facial expressions
Attractiveness
Learn the tune of the
relationship

Critical personality trait

Individuals behavioral style
in interacting with the
environment.

Compatibility between
parental and child behavior

 Lisina (1983), 4 criteria on the first determining and

need for interaction exists:
Criteria

Explanations

1. Attention to an adults

- Infant recognizes the adult as the

object in some activity

2. Emotion displayed towards at

the adults

- Infant sees the adult not as a

mere object, but as someone who
brings pleasure.

3. Actions directed at the adults

- Infant is evaluating its role in the

relationship.

4. Reactions to an adults actions

- Infant is beginning to evaluate

what has happened by observe the
adults behavior

 Attachment
The infants develop a secure attachment to their
mother.
They trying to have the willingness and to seek out
the future relationship.
According to Bowlby (1969) attachment is a
canalized developmental process.

 Theories of attachment
Bowlby

Psychoanalitic

Person attaining
or maintaining
proximity to
some other close
individual

Infants become
attached to those
who provide the
oral satisfaction.

Behaviorist

Cognitive

Important of
reinforcement

Intellectual
achieving

Physical contact,
comforting, and
types of
stimulation.

Developing sense
of competence

Importance of
feeding
Able to cope with
the world
Developing sense Total range of
of trust
A predictable
reinforcement
sequence of
behaviors
(protest, despair
and detachment)

 Many attachment theories tend to focus on the mother

about the early relationship with the children.
The other family members also bring a lot of
importance to the early relationship with the children.

 The relationships with other family members:

Conclusion
We have to change from viewing the infant as a
passive organism to one that actively seeks stimuli.
From birth, children begin to establish a network of
relationships that influences their development.
We finally know that the infants first relationship
have an important function in social development.