FEU – IN MCN FACULTY LECTURERS 2020

♦ Health and Promotion - process for

developing the guideline on health
promotion interventions for maternal and
child health to help parents understand and
involve on the developmental stages of
their children.

♦ As a nurse we can also integrate

knowledge we know to promote well being
of a child and parents understand.
LO1: Assess normal growth and
development milestones from infancy
to adolescence age

LO2: Identify expected outcomes to

promote optimal growth and
development needs from infancy to
adolescence
LO3: Integrate knowledge of infancy
to adolescence growth and
development with nursing process to
achieve quality maternal and child
health nursing care
LO4: Help parents participate on the
developmental milestones of their
children
LO5: Promote better understanding of
parents on the different milestones
and health wellness of their child
A. Developmental task
(Trust vs Mistrust)
Erickson(1993)

♦ important for infants to establish

the ability to love or trust early in life
- Love is a synonym of trust
ROUTINE OF CARE
1. Aspiration- a potential threat to infants
on first year of age. Infants love to grasps
things and put into their mouth. Round
cylindrical object (1inch) or flexible objects
are dangerous to infants.
♦ Obstruct an infant’s airway passage.
♦ Signs and symptoms can happen right
after eating. Or they may happen over
time. Your child may not have all these
signs and symptoms. The signs and
symptoms may depend on the age of your
child, and how often and how much your
child aspirates.
♦ Some children who aspirate do not have
any signs or symptoms. This is called silent
aspiration
What parents should do in avoiding aspiration:

♦ Treatment for pediatric aspiration will

largely depend on the cause and the severity
of your child’s condition.
♦ Conservative therapy to prevent
aspiration is generally the first course of
treatment.
♦ Changing position during and after meals
can reduce your child’s risk of aspirating.
Posturing methods to treat aspiration:
♦ Place infants in an upright/prone
position during feedings
♦ Avoid placing babies under 6 months
in a lying position for approximately 1
½ hours after feeding
Posturing methods to treat aspiration

♦ Avoid feedings before bedtime

(within 90 minutes)
♦ Elevate the head of your child’s bed
by 30˚
♦ Second major cause of infant accidents.
♦ Infants roll over by 2 months of age. As a
preventive measure, no infant, beginning
with a newborn, should be left
unattended on a raised surface.
♦ Most infant falls occur at home. Usually,
these are a result of falling from an elevated
surface such as a bed, sofa, chair, stairs or
changing table.
♦ Infants under 12 months of age have
more fragile skulls, which makes falls
riskier for them.
♦“The younger they are, the more dangerous it is
for a serious head injury, no matter the mechanism
of the fall or how high it is.” Dr. Ye Mon
A. Never leave your baby unattended in
high places, such as on a tabletop, in a
crib with the sides down, or even on a bed
or sofa.
B. Don't leave your baby unattended in any
infant seat or "sitting" toy, such as a swing
or jumper. Use all the safety straps
provided
C. Remember that a baby with a pacifier or
other object in his or her mouth is at risk
for face and mouth injuries in addition to
other injuries from a fall.
D. A crib, the mattress should be lowered to
its bottom position, so the height of the
side rails increases
♦ Teaching car safety for
infants (as well as for the
whole family) is a vital
preventive health measure.

♦ Car seats should continue

to be used without
interruption through the
preschool age, or until the
child reaches 40 to 60 lbs.
♦ Infants up to 20 lb and
1 year old should be
placed in rear-facing seats
in the back seat because
an inflating front-seat
airbag could suffocate an
infant (AAP, 2009).
“ Child Safety in Motor Vehicles Act “
(RA 11229 Sec 1):
♦ states that Child restrain system refers
to a device , capable of accommodating a
child occupant in a sitting or supine position
is also designed to diminish the risk of
injury to the wearer in an event of collision
or vehicular accident.
♦ No child 12 years below of age shall be
allowed to sit in front seat of a motor
vehicle.
♦ Parents should never
transport unless an infant is
buckled into an infant car
seat in the back seat of the
car.

♦ Be aware of the proper

technique for placing an
infant in a car seat.
♦ Do not be distracted by an
infant while driving.

♦ Do not leave an infant

unattended in a parked car
(can become dehydrated
from excess heat, move gear
shift, or be abducted
REMINDER:
♦ Place all medication and
poisons in locked cabinets or
overhead shelves
♦ Never take medication in front
of infants
♦ Do not smoke or drink hot
liquids while holding or caring for
infant
REMINDER:
♦ Do not leave infants unsupervised
near hot-water faucets
♦ Do not allow infants to blow out
matches (don’t teach children that fire
is fun)
♦ Use no lead-based paint in any
area of the home.
C. Promoting Nutrition:
1. Breastfeeding - The first
choice for feeding an infant
during the first 12 months of life
is breast milk. All the necessary
nutrients, vitamins, minerals,
and water are provided by
human milk for the first 6
months of life.
C. Promoting Nutrition:
2. Solid food - Ages 4
months to 6 months,
most babies are ready
to begin eating solid
foods as a complement
to breast-feeding.
C. Promoting Nutrition:
Extrusion reflex - it is automatically
extruded or thrust out of the mouth by
the tongue. Parents not to interpret this
action as a food dislike but recognize it
as the reflex action that it is.
Usually fades 3-4 months.
C. Promoting Nutrition:
When to start Solid Foods:
• Your child can sit with little or no support.
• Your child has good head control.
• Your child opens his or her mouth and leans
forward when food is offered.
 AGE Food to Introduce Rationale

5-6 months Iron fortified like cereals, Aids in preventing iron-deficiency

orange juice or formula milk anemia; the least allergenic type
of food; an easily digested food

7 months Vegetables Good source of vitamin A; adds

new texture and flavors to die

8 months Fruit Best source of vitamin C, good

source of vitamin A; adds new
texture and flavors to diet

9 months Meat Good source of protein, iron, and

B vitamins

10 months Egg yolk Good source of iron

Limit to 2 To assess if they can tolerate it

tablespoon/feeding and avoid obesity

*Wheat, tomatoes, oranges, fish, and egg whites should be omitted if there are allergies in the family, because these foods
are most likely to cause allergies.*This is still supported by breastmilk
Weaning: The mother chooses one to feed a day and then begins offering fluid by the new method at that feeding. After 3
days to 1 week, the mother changes a second feeding.
D. Healthy Family Function:

♦ A primary task of parents during

the infant year is to learn to interpret
infants’ cues to decipher their needs.

♦ It is helpful if they can learn early

on to perceive an infant as a separate
individual with unique needs.
TEETHING The gums are sore and
tender before a new tooth
break the surface. As soon
as the tooth is through,
the tenderness passes.
Pain - infants can be
resistant to chewing for a
day or two and be slightly
irritable or cries a lot
Provide a soothing cool
teething ring to gums to
relieve pain
 THUMB Parents can be assured
that thumb sucking is
SUCKING normal and does not
deform the jaw line if it
stops by school age.

It does not cause “baby

talk” or any of the other
symptoms commonly
attributed to it

To ignore thumb sucking

an infant should have
adequate sucking pleasure
PACIFIERS Used when infants are
discontent after feeding
and searching something
put into mouth

Parents should attempt to

wean a child from a pacifier
any time after 3 months of
age and certainly during
the time the sucking reflex
is fading at 6 to 9 months
unless used at night for
sleeping,
CONSTIPATION Breastfed infants rarely
have constipation

Constipation may occur in

formula-fed infants if their
diet is deficient in fluid.
This can be corrected
simply with the addition of
more fluid. Just take note
there should be no fresh
blood and hard stool
LOOSE STOOLS Stools of breastfed infants are
generally softer than those of
formula-fed infants
Malabsorption syndrome (celiac
disease), or an inability to digest fat,
may manifest themselves first by
loose stool
Instruct mother to check the
duration, number of stools per day,
color, consistency, mucus or blood
Dehydration – occurs fast in infants
so attention must practice
MILARIA Prickly heat rash occurs in
warm weather
Clusters of pinpoint, reddened
papules with occasional
vesicles and pustules
surrounded by erythema
usually appear on the neck first
and may spread upward to
around the ears and onto the
face or down onto the trunk.
To prevent – bathing infant
twice a day in hot weather with
use of baking soda, use light
comfortable clothes
 DIAPER Infants have such sensitive
DERMATITIS skin that diaper dermatitis
(diaper rash) is a problem from
the first few days of life.
Cause – does not change
diaper frequently. Feces, urine
may cause irritation and
infection to infants. Also, too
tight diapers that can cause
friction to skin
To correct – frequent change of
diapers, clean buttocks and
perineal part every time diaper
change, and kept dry always
COLIC Colic is paroxysmal abdominal
pain that generally occurs in
infants under 3 months of age
and is marked by loud, intense
crying (Bolte, 2007)

Check feeding bottles for air,

Pacifier can be a comfort

Avoid gas forming food like

cabbage, don’t put warm
compress on abdomen it may
cause burn to infants
A. Developmental Task:
Autonomy versus shame and doubt -
♦ second stage of
Erik Erikson’s stages of
psychosocial development.
♦ Ages of 18 months to
age 2 or 3 years.
♦ Children at this stage are focused on
developing a greater sense of self-control.
B. Promote safety - accidents are a
leading cause of death in toddlers.
♦ Maintain child in car seat; do not be
distracted from safe driving by a child in a
car.
♦ Do not allow child to play outside
unsupervised.
♦ Do not allow child to operate electronic
garage doors. Supervise toddler who is
too young to be left alone on a tricycle.

♦ Teach safety with pedaling toys (look

before crossing driveways; do not cross
streets) but do not expect that toddler will
always obey these rules (in other words,
stay close by).
♦ Examine toys for small parts that could
be aspirated; remove toys that appear
dangerous.
♦ Do not feed toddler popcorn, peanuts,
etc.; urge children not to eat while running.
♦ Do not leave toddler alone with a
balloon.
♦ Keep house windows closed or keep secure
screens in place.
♦ Place gates at top and bottom of stairs.
Supervise at playgrounds.
♦ Do not allow child to walk with sharp
object in hand or mouth
♦ Do not leave toddler alone in a bathtub or
near water (including buckets of cleaning
water and washing machines)
♦ Do not allow toddler to approach strange
dogs.
♦ Supervise child’s play with family pets
♦ Never present medication as candy.
♦ Place all medication and poisons in locked
cabinets or overhead shelves where child
cannot reach them.
♦ Hang plants or set them on high surfaces
beyond toddler’s grasp.
♦ Be certain that small batteries or magnets
are out of reach.
♦ Post telephone number of nearest poison
control center by the telephone
♦ Do not leave toddlers unsupervised near
hot water faucets.
♦ Check temperature setting for hot water
♦ Do not leave coffee/tea pots on a table
where child can reach them.
♦ Never drink hot beverages when a child
is sitting on your lap or
playing within reach.
♦ Do not allow toddlers to blow out matches
(teach that fire is not fun); store matches out
of reach.
♦ Keep electric wires and cords out of
toddler’s reach; cover electrical outlets with
safety plugs
C. Promoting Nutrition:

♦ Toddler’s appetite has decreased so

food consumption will be less.

♦ Parents to place a small amount of

food on a plate and allow their child to
eat it and ask for more.
C. Promoting Nutrition:
♦ Toddlers usually do not
like food that is “mixed up”.

♦ Frequently they eat all of

one item before going on to
another. They often prefer
brightly colored foods to
bland colors
C. Promoting Nutrition:

SELF -
FEEDING
D. Daily Activities:
1. Dressing
♦ Encourage parents to give
up perfection for the benefit of
the child’s developing sense of
autonomy. If they need to
correct their clothing start with
a positive statement such as
“You did a good job,” before
making the switch.
D. Daily Activities:
2. Sleep
♦ They may begin the toddler
period napping twice a day
and sleeping 12 hours each
night and end it with one nap
a day and only 8 hours’ sleep
at night. Usually, toddlers
naturally fall asleep when they
are tired. They may begin to
resist naps.
D. Daily Activities:
3. Bathing
♦ Toddlers usually enjoy bath time,
and parents should make an effort to
make it fun by providing a toy, such as
a rubber duck, boat, or plastic fish.
D. Daily Activities:
4. Care of Teeth
♦ Toddlers need to have a toothbrush they
recognize as their own.
♦ Toward the end of the toddler period,
they can begin to do the brushing
themselves under supervision
E. Healthy Family Function:
♦ Parental concerns of the toddler
period usually arise because of a
conflict over
Autonomy.
1. Toilet Training
♦ Toilet training is one of the biggest tasks
a toddler tries to achieve.
♦ It should begin and be completed
according to a child’s ability to accomplish it,
not according to a set schedule.
1. Toilet Training
Parents tips when to start toilet training:
♦ Set aside some time to devote to the
potty-training process.
♦ Don't make your child sit on the toilet
against his or her will.
♦ Show your child how you sit on the toilet
and explain what you're doing
♦ Establish a routine.
1. Toilet Training
Parents tips when to start toilet training:
♦ Have your child sit on the potty within 15
to 30 minutes after meals to take advantage
of the body's natural tendency to have a
bowel movement after eating
♦ Praise all attempts to use the toilet, even if
nothing happens.
♦ Reassure your child that he or she is well
on the way to using the potty like a big kid.
2. Negativism
♦ Toddlers typically go through a period of
extreme negativism.
♦ They do not want to do anything a parent
wants them to do. Their reply to every
request is a very definite “no.”
♦ A toddler needs experience in making
choices
Ex: It’s lunchtime. Do you want
to use a big or little plate?”
3. Discipline
♦“Discipline” and “punishment” are not
interchangeable terms. Discipline means
setting rules or road sign, so children know
what is expected of them.
♦ Punishment is a consequence that results
from a breakdown in discipline, from the
child’s disregard of the rules that were
learned.
3. Discipline
♦“Timeout space” and “Warning” is a
technique to help children learn that actions
have consequences.
4. Separation Anxiety
♦ Separations are more difficult when
children are hungry, tired, or sick.
♦ Their behaviors at separations will be loud,
tearful and difficult to stop.
♦ Parents should be consistent, create a
quick good by rituals, give them attention,
keep your promise, be specific
5. Temper Tantrums
♦ Tantrums are a normal part of child
development. This is how young children
show that they're upset or frustrated.
♦ Learning to deal with frustration is a skill
that children gain over time. Tantrums are
common during the second year of life, when
language skills are starting to develop.
♦ As language skills improve,
tantrums tend to decrease.
♦ Give plenty of positive attention.

♦ Give plenty of positive attention- Offer

minor choices such as "Do you want orange
juice or apple juice?" or "Do you want to
brush your teeth before or after taking a
bath?"

♦ Keep off-limits objects out of sight

and out of reach.
♦ Distract your child - change the
environment, start a new activity

♦ Help kids learn new skills and

succeed-Praise them to help them feel proud
of what they can do.

♦ Consider the request carefully when

your child wants something.
♦ Know your child's limits. If you know
your toddler is tired, it's not the best time to
go grocery shopping or try to squeeze in one
more errand.