NEWBORN INFANT (Neonate)

Anyone who looks through the window of a hospital nursery is bound to be impressed by the fact that individuality begins at birth, or before. Practically any group of newborn infants show startling variations in both physical and psychological characteristics—in size, shape, general appearance, physical maturity, as well as activity level, feeding behavior, and emotional adjustment. There are, however, certain normal limits to these variations, and it is important to know these in order to establish a base line for assessing future development, and to predict whether a specific child will be faced with difficulties. This article will therefore outline the physical characteristics, behavior, and beginnings of personality which are generally found in newborn infants.Newborn infants average 7.5 lbs. in weight and 19.5 inches in length, with a range of 3 to 16 lbs. and 17 to 21 inches. Girls are slightly larger than boys, but the differences are wide within both sex groups. These variations depend on many factors, such as family tendencies, maternal diet, economic status (infants in poorer districts are smaller than in better districts due to maternal nutrition), ordinal position (the firstborn usually weighs less than later-born infants), and fetal activity (excessive activity leads to underweight).At birth the typical infant has bluish-gray eyes which roll about in an unco-ordinated manner. His neck is short and creased, his tear glands do not secrete, his skin is deep pink but likely to be blotchy, his muscles are small and poorly controlled, and his bones are soft and flexible. Compared to an adult, his proportions seem almost grotesque, since his head seems too large for his body, his cranium too high, his face too broad and flat, his arms and legs too short, his shoulders too narrow, and his abdomen too large. In a word, he is hardly the cherub his parents are likely to expect—and this is even more the case when the infant is bruised or misshapen due to a difficult birth, or red and wizened because he arrived ahead of schedule. Even though his appearance usually improves greatly within two or three weeks, the shock of the first impression may have a disturbing effect on parents who are not prepared for it.When he first enters the world, the human infant is more immature and therefore more helpless than any newborn animal. His autonomic nervous system is so undeveloped that it cannot adequately regulate the basic homeostatic processes, and consequently pulse rate, respiration, blood pressure, body temperature, sleep, and elimination are all highly unstable. He is totally incapable of voluntary activity and therefore behaves in a random, purposeless fashion. Even though he can move and has a considerable repertoire of reflexes, he constantly makes diffuse and unco-ordinated responses.The senses of smell, taste, pain, and temperature are ready to function at birth or shortly after, but the two distance senses of hearing and vision are poorly developed. The infant therefore can respond to light merely by turning his head or closing his eyelids, but he cannot focus his eyes or follow a quickly moving object. In most cases he is totally deaf at birth since the middle ear is filled with amniotic fluid, but even when it drains out, hearing usually remains poor for a time because the inner ear is not completely formed.The cerebral cortex is also undeveloped at birth, and the neonate is incapable of learning, with the possible exception of the formation of unstable conditioned responses in feeding. The combination of poor muscular co-ordination and undeveloped mentality makes it impossible for him to communicate his needs in any specific way. All he can do is squirm or kick or cry when he is hungry or uncomfortable, and others have to guess what he wants.The human infant, then, is so immature at birth that he would be unable to survive without constant care. If his parents give him an adequate amount of attention, he will be relaxed and happy, and his development will proceed normally. On the other hand, if he gets either too much or too little care, he may be seriously and lastingly damaged. Anxious mothers keep their children in a helpless condition after the infant stage has passed by fussing over them and waiting on them night and day. This makes them dependent and deprives them of opportunities to learn skills needed for growing up at a normal rate. On the other hand, some infants are raised in homes or institutions where they receive too little warmth and attention during infancy. This often has drastic effects on all phases of development, physical, emotional, social, and intellectual.Finally, it is important to re-empha- size the wide variations among normal newborn infants, due largely to hereditary factors but also to prenatal environment and the birth experience itself. Some neonates look like the typical advertisement of a chubby baby, while others look like wrinkled old men. One child will quickly fall into regular patterns of feeding and sleeping, another will have trouble taking his food and falling asleep. There is a high degree of individuality too in the nature and amount of crying, and in activity patterns, for some infants are almost constantly fretful and restless while others appear relaxed and tranquil.In view of these variations, it is highly unwise for parents to establish rigid expectations or measure their own infants against others. Such expectations pave the way for disappointment, anxiety, and tenseness—reactions which are bound to be upsetting not only to the parents but to the baby as well. False expectations also make the parents turn a deaf ear to reassurance from the doctor. A far wiser approach would be to recognize that every child has a “right” to an individual personality and an individual rate of development from the moment of birth onward. See BIRTH ADJUSTMENTS.

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