Monitoring growth and development in children is a key aspect of care that helps the provider intervene early with interventions or treatment options.
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Monitoring growth and development in children is a key aspect of care that helps the provider intervene early with interventions or treatment options. Newborns to one month old can be one the most fragile and variable states, and involving the parents is just as essential as assessing the newborn. One initial physical development for a newborn is their height and weight. A common finding that needs to be educated, especially to ensure breast feeding mothers, that within the 3 days the child may lose up to 7% or 8% of their initial weight (DiTomasso, 2019). Explaining this to the parents is essential to help them continue to breast feed and feel confident knowing that the decrease in weight is normal. A red flag or potential abnormal finding would be in the child who is in the 5% to 10% range of the high end or low end for height and weight (Balasundaram, 2022). While all children are different, a low percentile in height or weight is as indicator for the provider to investigate further. There is a strong correlation between a breast-feeding mother’s diet and the weight gain of their child (Razack, 2019). If a breast-fed infant is not meeting their expected weight gain goals, then an assessment of the mother’s diet may be in order.
Another newborn growth and development assessment to look at in newborns are reflexes. One major reflex is the oral reflex that involves sucking and the rooting reflex. Oral reflexes play an important role in eating and breathing adequately in a newborn. A lack or oral reflexes could indicate a neurological problem or a central nervous system issue (Modrell, 2022). An oral reflex could also play a role in breathing and feeding which could lead mean inadequate oxygenation and nutrition. Any abnormality seen in the growth and development of a newborn should be investigated further for early intervention. As a new provider, and having never worked with pediatric patients, I will be steadfast in ordering a referral to further investigate any abnormalities on exam or reported by the parents.
References
Balasundaram P, Avulakunta ID. Human Growth and Development. [Updated 2022 Jan 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK567767/
DiTomasso D, Cloud M. Systematic Review of Expected Weight Changes After Birth for Full-Term, Breastfed Newborns. J Obstet Gynecol Neonatal Nurs. 2019 Nov;48(6):593-603. doi: 10.1016/j.jogn.2019.09.004. Epub 2019 Oct 11. PMID: 31610141.
Modrell AK, Tadi P. Primitive Reflexes. [Updated 2022 Mar 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554606/
Razack M, Parambath VA, Rajanbabu B. The relationship between weight gain in exclusively breastfed babies and maternal diet. J Family Med Prim Care. 2019 Dec 10;8(12):3832-3839. doi: 10.4103/jfmpc.jfmpc_613_19. PMID: 31879621; PMCID: PMC6924239.
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