This chapter examines the characteristics and development of newborn babies.

1. Newborn Appearance

1. During the first few weeks after birth-sometimes called the neonatal period-infants have a unique look, sound, and feel.
2. Most neonates have puffy facial features.
3. Contributing to the newborn's interesting appearance is a condition called molding in which the head is squeezed and misshaped during the trip through the birth canal.
4. Before and after birth, babies' bones consist mainly of cartilage and hence are very soft.
5. A newborn's head also has an open space between the bone tissue called the fontanelle. This allows the baby's head to safely compress during birth.
6. The body of the newborn is oddly proportioned. The relative size of neonatal body parts reveals growth patterns that will guide development throughout early childhood.
7. One of these growth patterns is the cephalocaudal growth gradient which refers to the tendency of human development to proceed from the top down
8. Infants' and children's heads (and brains) grow more rapidly than their legs and feet.
9. Another growth pattern which is obvious in the newborn is the proximodistal growth gradient which refers to a growth trend that proceeds from the center of the body out.

2. Diversity in Newborn Status

1. Introduction

1. These various experiences have been categorized into what child specialists call psychological states
2. These states are described in relation to how aroused and alert the infant is
3. Three of these are sleeping states
4. How much time newborns spend in specific states and how rapidly, predictably, and good-naturedly they shift from one state to another will vary from one infant to another

2. Sleeping

1. In the first weeks of life, a baby may sleep between 16 and 20 hours in each 24-hour period
2. These hours of sleep are not continuous; new babies usually take brief naps of about 4 hours followed by periods of wakefulness
3. As infants get older, they tend to sleep for longer continuous periods and remain awake for more extended intervals as well
4. Much individual variation in sleeping routines exists within all cultures
5. Some children sleep for long periods right after birth; some sleep infrequently, even into childhood
6. Babies may be born with "biological clocks" that regulate cycles of eating and sleeping
7. Another source of variation in newborn sleep patterns is culture
8. In many families in Africa, India, Okinawa, the Philippines, and Mexico, for example, babies sleep with a mother or grandmother for over a full year after birth
9. Some Korean-American children, for example, will sleep with their mothers until age 5
10. Irregular sleep, during which rapid eye movement (REM) sleep occurs is a state in which the brain is especially active; adults often dream during REM.
11. Infants in REM sleep twitch, whimper, and grimace, while in regular sleep they are passive and motionless
12. Babies are in REM sleep for much longer periods than adults; over 30% of a newborn's life is spent in this sleep state
13. The autostimulation theory holds that REM sleep exercises the nervous system.
14. Newborns need stimulation but spend very little time awake; therefore, their brains provide much-needed internal stimulation while they are in REM sleep

3. Alert and Waking Activity States

1. Alert and waking states are most critical for infant development
2. It is during these periods that babies explore their world and exercise their senses and motor abilities
3. In order to spend useful time in alert and waking states, babies must be able to soothe themselves or be soothed by parents when they are upset
4. Infants who are in a crying state for inordinate amounts of time or who are easily drawn from quiet, alert activity to extreme upset may not benefit from the same level of cognitive and social stimulation
5. The length of time babies spend in waking and alert states and their ability to return to these states quickly after upset varies across cultures
6. Biological factors as well as differences in parenting practices may account for these variations
7. In one study, babies of diverse backgrounds were presented with a variety of objects, pictures, and sounds
8. Puerto Rican babies were more alert when these stimuli were presented
9. Puerto Rican babies virtually never cried, even when stimulation was increased
10. Caucasian newborns have been found to be more easily perturbed and excitable, and African-American babies have been observed to spend more time than babies of other cultural groups in motor activities during waking states
11. Differences in state patterns may explain why parents of different cultures interact with their babies in different ways.
12. Navajo children are quiet and alert much of the time, and their parents are passive and less verbal in their interactions with them
13. Euro-American babies may become upset more easily during waking periods; mothers of these cultural groups are found to respond more quickly and often to crying and fussiness
14. African-American babies are more motorically active during waking hours, and their mothers spend much time in physical play with them

4. Crying

1. Crying is the universal way that babies communicate their needs
2. It may be that concern about crying is a part of human biological heritage
3. Parents can very well distinguish their own infant's cries from those of other infants
4. They can also very accurately distinguish urgent cries, which are loud and long, from less urgent ones
5. Parents in all cultures take action in some way when their babies are upset
6. The belief that responding too often to babies' cries will spoil them has been refuted by research
7. Children were actually found to cry less in the second 6 months of life if their mothers responded consistently during the first 6 months
8. The most fascination finding of this research was that infants of responsive mothers were more advanced in communication abilities at age 1
9. Crying is communication; if mothers respond to cries, their babies may more often experience the power of vocalization
10. Responding was found to take many forms among the parents studied
11. Some important reactions to crying that had not previously been studied (talking to a baby from across the room) were useful parent responses
12. Patterns of responsiveness and crying vary significantly across families and ethnic groups
13. In some societies, quick responding does not always lead to less crying
14. In research on Bedouin tribes people in Israel, babies whose parents responded immediately to even minor whimpers or fussiness were found to cry a great deal during the first year of life
15. Excessive crying may not be viewed as an altogether bad thing within some societies

3. Breastfeeding and Culture

1. Only in recent times has bottle feeding become an option
2. Most newborn babies in the world still breastfeed
3. Breastfeeding is most prevalent in less-developed countries
4. In Iran, breastfeeding is considered one of the "rights" of infancy
5. Children from non-Western countries are likely to be breastfed for longer periods before weaning
6. By 1966 only 18% of American mothers were breastfeeding; bottle-feeding was viewed as a sign of modernization.
7. There has been a revival of breastfeeding in the United States, with over half of mothers in recent years choosing to breastfeed their newborns
8. New evidence suggests that breastfeeding can be beneficial to newborns' health
9. Mother's mild is believed to retard the growth of certain bacteria and to serve as an important immunological agent for babies
10. Formula companies, facing shrinking Western markets, had begun to market their products in impoverished countries, touting bottle feeding as a modern alternative to breastfeeding
11. Not only is formula feeding costly to mothers with scarce resources it brings a risk of infection due to use of contaminated water and lack of proper sterilization

4. Reflexes

1. A newborn's movements are not differentiated; the infant cannot purposefully move just one body part or another.
2. Some believe that the act of swaddling-wrapping the baby's entire body snugly in a blanket-is comforting because it stills these active, uncontrollable, whole-body movements
3. Reflexes are involuntary movements that are built in to a baby's nervous system
4. Some reflexes simply disappear with development
5. (Refer to table 5-2)
6. Some reflexes are crucial for survival
7. Besides the survival functions of some reflexes, they can be an important diagnostic tool for pediatricians
8. Reflexes may also serve as the basis for important early parent-infant play
9. Since newborns have a limited range of social behaviors, reflexes provide parents with an early, enjoyable, though perhaps primitive, interpersonal contact

5. Exploration and Habituation

1. Can newborns, who are unable to purposefully move and who have limited power to interpret the world, engage in exploration?
2. Infant research suggests that they can
3. When a young baby gazes out at a parent or a mobile dangling over the crib, she is exploring the world
4. When another listens intently to the sounds of the family dog barking he also is exploring the world
5. Not only do newborns perceive sights and sounds; they can recognize and distinguish among them
6. We know that babies are able to explore because of a phenomenon called habituation
7. When newborn babies study an object or a sound for a period of time, they appear to become familiar with it
8. The stimulus becomes less interesting and exciting to them
9. When this occurs, babies are said to have habituated to a particular stimulus
10. Newborns of some cultural groups habituate faster to new sights and sounds
11. This information shows that some infants can be expected to adjust more quickly to new experiences and events than other infants

6. Newborns with Special Needs

1. Some newborns have special needs caused by unfavorable conditions before, during, or after birth
2. Some special needs may be the result of genetics, others of environmental influences
3. Many challenging conditions are a function of socioeconomic status and culture
4. Genetic Disorders

1. Some children are afflicted with genetic disorders that affect development
2. Amniocentesis-a procedure which genetic information is obtained from a small sampling of amniotic fluid as early as the twelfth week of pregnancy
3. Chorionic villus biopsy, tissue is drawn from the outer membrane of the amniotic sac; this procedure allows detection of genetic disorders as early as the ninth week of pregnancy
4. Some disorders escape detection during pregnancy
5. The most comprehensive and widely used test of newborn functioning is the Neonatal Behavioral Assessment Scale (NBAS); this assessment, the pediatrician observes or tests the newborn baby's repertoire of behaviors, including reflexes, states, responses to stimuli, and soothability

5. Environmental Risk Factors

1. Developmental problems at birth are sometimes the result of teratogens-harmful agents in the environment
2. Newborns of mothers who smoke, drink, or abuse drugs during pregnancy may show signs of developmental problems at birth, including birth defects and brain damage

6. Poor Health Status and Prematurity

1. Although the incidence of neonatal deaths has declined in recent years, almost all industrialized nations have lower rates of infant death than the United States
2. Illness-some infants who survive the first year suffer from serious illness resulting from poor health status or genetics
3. Severe health problems are more common among babies from families of low socioeconomic status
4. Impoverished babies also suffer more frequently from milder, common illnesses
5. Anemia-iron-deficiency anemia is especially prevalent among newborns in this country; chronic anemia has been associated with infant death, poor health, and a broad range of developmental problems in later life

7. Prematurity and Low Birth Weight

1. Low-birth-weight infants who survive are at risk of poor developmental outcomes
2. Premature births are those in which a child has been born at least 3 weeks before the end of the full 38- to 42-week gestational period
3. Babies who are less than 5.5 pounds at birth are also sometimes considered premature
4. Premature babies are extremely vulnerable; their mortality rate is high
5. Premature infants behave differently; they are often less alert and responsive and are more difficult to feed
6. They can also be less predictable in sleep patterns and hypersensitive to stimuli
7. Premature babies who are held, touched, and talked to frequently gain weight more quickly and are more developmentally advanced than those who do not receive this special intervention
8. In addition to increasing the likelihood of prematurity and low birth weight, poverty contributes to developmental risks for such infants after birth

8. Sudden Infant Death Syndrome-sudden infant death syndrome (SIDS) strikes fear in the hearts of parents around the world
9. What is frightening about SIDS is that babies simply stop breathing and die silently, for no apparent reason, usually at night
10. The causes of SIDS are unknown
11. When infants are routinely put down to sleep on their sides or backs, the risk of SIDS is reduced by 50%
12. Although babies of all cultural and socioeconomic groups can be stricken by SIDS, those in poverty and of African-American and Native American backgrounds are at greatest risk

VII. Review Critical Concepts

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