Child Development

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Type of Family

Nuclear Family- mum and dad living with their child(ren).

Advantage: parents can raise their children without interference from other relatives.

Disadvantage: the child(ren) might have to be looked after by someone outside the family if both parents work etc.

Extended Family- units have more relatives living nearby (or in the same house)

Advantage: there is always a relative nearby to help look after the kids.

Disadvantage: relatives feel free to interfere with raising the kids.

Single-Sex Family- occur when homosexuals have children.

Advantage: most people agree that it doesn't disadvantage the kids.

Disadvantage: some children might feel they need someone of the same sex as them to confide in.

One Parent Family- the family structure may change if one parents leaves or dies.

Disadvantage: It's hard for one person to bring up child(ren) on their own.

Reconstituted Family- or step family- are made when an adult who already has a child marries or moves in with a new partner with a child.

Advantage: bigger family, new people

Disadvantage: Sibling rivalry is common with step-siblings. 

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Deciding when to have a baby

Factors to consider:

  • responsiblilties of being a parent
  • your lifestyle and how you want to live
  • your family and how the new baby fits in

Bad reasons to have a baby:

  • having a baby to have someone to love or to have someone who will love you
  • some people feel pressure from their families to have kids
  • peer pressure from friends
  • having a baby to get the extra benefit from the government
  • women start to feel their biological clock ticking 
  • having a baby to bring a couple closer
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Male Reproductive System

Sperm Duct- carries the sperm from the testes.

Penis- when sexually stimulated, the erectile tissue of the penis fills with blood and becomes hard and erect. during the male ******, the penis ejaculates *****.

Foreskin- a flap of skin that protects the head of the penis.

Urethra- the tube passing through the penis which carries urine and *****.

Scrotum- the bag of skin that holds the testes.

Testis- after puberty, sperm are made in the testes all the time.

Epididymis- collects and stores the sperm from the testis.

Prostate gland- also makes fluid for the sperm to swim in.

Seminal Vesicle- makes a fluid called seminal fluid for the sperm to swim in, sperm + fluid = *****.

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Female Reproductive System

Ovary- the ovaries produce eggs, one egg is released each month.

Endometrium- the lining of the uterus, it breaks down and comes away each month if a fertilised egg doesn't get implanted in it.

Cervix- the neck of the uterus at the top of the ******. 

Vagina- the penis goes in here during ******l sexual intercourse and ejaculates sperm.

Uterus (womb)- it grows during pregnancy to fit the baby, and during childbirth it contracts to push the baby out. 

Fallopian tube (oviducts)- carries the egg towards the uterus, fertillisation takes place in the fallopian tube.

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Contraception

Barrier methods-

  • Condom
  • Female Condom (Femidom)
  • Diaphragm

Hormones to stop implantation-

  • Combined Pill
  • Mini-Pill
  • Injection
  • Implant

IUD (Intra Uterine Device) or IUS (Intra Uterine System)- made of copper to stop implantation. 

Other methods: 

  • Natural planning- finding out when the woman is most fertile and avoiding sexual intercourse on those days.
  • No sex
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Pregnancy Testing

Signs of Pregnancy: 

  • missed period
  • feel or be sick (morning sickness)
  • constipation
  • wee a lot
  • breasts are tender or swollen
  • the areola (skin surrounding the ******) can go darker
  • vaginal discharge
  • feeling tired, dizzy or faint 
  • can go off certain foods when pregnant

Pregnancy lasts for 40 weeks:

1) the starts of pregnancy is calculated as the first day of the womans last menstrual period

2) the date when her egg was fertilised and she actually conceived is about two weeks later that

3) once the woman has confirmed that she's definitely pregnant, she needs to make an appointment to see a midwife

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Conception

Fertilisation:

1) Sperm are deposited in the ****** and swim up the through the cervix, into the the Fallopian tubes. 

2) Fertilisation needs to take place quite high up in the Fallopian tube, because an unfertilised egg only survives for about a day.

3) When the sperm reaches the egg, they surround it and eventually one gets through the egg membrane

4) The egg membrane instantly changes to stop any more sperm getting in. 

5) The nucleus of the successful sperm fuses with the nucleus of the egg. Egg + Sperm = Zygote.

6) After fertilisation, the zygote divides and becomes a ball of cells.

7) After 7 days, the ball of cells reaches the uterus, and implants itself into the lining. This is called implantation. 

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Development of the Foetus

1) Right after Fertilisation- Zygote to Cell Ball- the zygote divides several times into a morula.

2) At 4 days (Blastocyst)- it is ready to implant into the lining of the uterus at this point.

3) At 4 weeks (Embryo)- the embryo is implanted and connected to the mother by the umbilical cord. At this point the bones and organs start to develop. It's 4-6mm long. 

4) A 8 weeks (Foetus)- it has arms and legs and the fingers and toes are forming, the spine is developing. It is almost 2cm long. 

5) At 12 weeks- the foetus is fully formed. The heart beats twice as fast as an adults. Eyelids grow and the eyes stay closed until week 26. It's now about 6cm long from head to bum and weighs 10-14g.

6) At 24 weeks- the foetus is covered in a downy hair called lanugo and a white waxy grease called vernix. It measures up to 30cm and weighs 700g.

7) At 36 weeks- the head of the foetus drops down into the mother's pelvis, ready to be born. This is called engaging. The foetus may have 2 inches of hair on its head. 

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Development of the Foetus

The Placenta-

  •  connects the mother's blood to baby's blood
  • food and oxygen diffuse from the mother's blood to the foetus's blood
  • carbon dioxide and urea diffuse from the foetus's blood to the mother's blood. they're processed by her kidneys, along with her body's waste products.
  • harmful substances can cross the placenta from mother to foetus

Amniotic fluid- 

  • is inside the amniotic sac
  • it supports its limbs while it strecthes its tiny muscles
  • the foetus may drink some of the fluid
  • the foetus doesnt drown as it doesn't use it's lungs yet- it gets its oxygen through the placenta

Ectopic pregnancies occur outside the uterus. This means it implants itself somewhere else in the abdomen, or in the fallopian tubes. They're extermely dangerous to the mother's health so need to be terminated. Often the fallopian tube is removed too. 

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Multiple Pregnancies

Indentical twins (uniovular twins)- 

1) are produced when one egg is fertilised, and then splits into two cells.

2) each fertilised egg cell develops into a baby.

3) the twins share a placenta and amniotic sac.

4) they have the same genes, the same sex and look exactly alike.

5) if the fertilised egg doesn't quite split into two, the twins will be conjoined.

Non identical twins (binovular twins)-

1) are formed when two eggs are released by the ovaries at the same time, and fertilised by two sperm.

2) they have separate placentas and amniotic sacs.

3) they have different genes, one could be a boy and one could be a girl. 

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Miscarriage

Signs of Miscarriage:

1) Heavy bleeding from the ******. Light spotting is ok if there's no pain. 

2) Pain that is like period pain means the uterus has started to contract to push the foetus out.

3) A clear or pinky fluid gushing from the ****** means the amniotic sac has broken. 

4) Women sometimes experience the signs of miscarriage, like bleeding but the foetus doesn't die. This is known as threatened miscarriage.

Causes of Miscarriage:

  • not enough progesterone 
  • infection in the mother's body
  • serious defects in the development of the foetus
  • genetic disorders in the foetus
  • auto-immune disease (where the mother's body treats the foetus as a forgein object
  • fibroids (growths in the uterus)
  • Toxins (drugs)
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Diet During Pregnancy

Special food requirements:

  • Folic acid- prevents spina bifida in the baby, found in fruit, green veg, beans etc
  • Vitamin C- for healthy skin, to strength immune system, found in fruit and veg
  • Calcium- helps the baby's bones develop, found in dairy products and green veg
  • Iron- the unborn baby stores enough iron in its liver for the first 6 months after found, found in red meat, eggs, apricots etc
  • Fibre- helps avoid constipation (a symptom of pregnancy), found in fruit, vegm wholemeal bread/pasta etc

Foods to avoid:

  • soft cheeses- can contain listeria bacteria (listeria infection)
  • raw eggs (mayonnaise)- risk of salmonella poisoning
  • reheated ready meals- can cause foodd poisoning and listeriosis
  • undercooked meat- risk of food poisoning and toxoplasmosis
  • unwashed veg- can carry toxoplasmosis
  • liver- too much Vitamin A can damage the developing foetus
  • peanuts- can give the baby peanut allergy and can kill
  • shellfish
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Antenatal Care

A woman has her first antenatal appointment when she's around 8-10 weeks pregnant. There are six more appointments- at 16, 28, 34, 36, 38 and 41 weeks. First pregnancies have three extra check ups- at 25, 31 and 40 weeks. 

First appointment:

  • General health, weight and height are checked
  • Blood tests are done - amenia (lack of iron), rubella, blood group, rhesus factor, Hep B, syphilis, HIV etc.
  • Blood pressure is checked (at every appointment)- pre-eclampsia
  • Urine samples are tested (at every appointment)
  • The uterus is checked from 16 weeks onwards- foetal heartbeat

Screenig tests:

  • two ultrasound scans
  • combined test for down's syndrome
  • triple or quad test (for woman who can't have the combined test)
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Diagnostic Tests

Chorionic Villus Sampling (CVS)-

1) a needle is inserted through the wall of the uterus. A sample of the placenta is removed and tested.

2) the test detects down's syndrome (not a routine test)

Amniocentesis-

1) a needle is inserted through the mother's skin, into the uterus and into the amniotic sac. some amniotic fluid is taken and foetal cells it contains are tested.

2) the test shows up abnormalities like Down's syndrome. It's only done if screening has shown there's a risk or if there's a family history.

(there is a risk of miscarriage or foetal damage with amniocentesis and CVS)

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Labour- First Stage

Labour has started:

  • painful contractions start, 20-30 minutes apart
  • the waters break- the amniotic sac bursts, and amniotic fluid comes out
  • the woman can have a 'show' of bloody mucus from her ******, this is the mucus plug that seals the cervix coming away
  • the start of labour can also bring nausea, vomiting, diarrhoea and backache

First Stage:

  • contraction (20-30mins apart) speed up until they're every 2 minutes 
  • waters break
  • contractions gradually widen the cervix (dilation of the cervix)
  • the end of the first stage is called 'transtion'. it's over when the cervix is fully dilated
  • on average this stage can take 15 hours for a first baby
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Labour- Second Stage

1) The cervix is wide enough for the baby to move out of the uterus and into the ******. 

2) This is when the mother needs to start pushing with each contraction.

3) Crowning is when the baby's head is at the opening of the ******.

4) Pushing the baby's head out is the hardest part. It needs to go slowly so the skin between the ****** and **** won't tear.

5) Once the head is out, the midwife eases the shoulders out one at a time. The rest of the baby follows. 

6) At the end of the second the stage, the baby is born.

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Labour- Third Stage

1) The umbilical cord is clamped in two placesm and it's cut in between the two clamps.

2) The contraction don't stop yet. They carrty on until the placenta comes out through the ******. The midwife can give the mother an injection of oxytocin to speed up the contractions and get the placenta out sooner. 

3) The placenta is about the size of a plate. It's checked by the midwife, and then usually thrown away, but the mother can keep it if she likes.

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Painkillers and Medical Assistance

Pain relief- 

  • breathing exercises help to ignore the pain
  • pethidine makes the mum drowsy
  • TENS stimulates the nerves to kill the pain
  • gas and air works quickly
  • epidural numbs the body from the waist down

Inducing the birth- babies more than 2 weeks overdue are induced or if the mothers health is at risk eg pre-eclampsia. It can be done by tearing the amniotic sac to artificially break the waters. The hormones oxytocin and prostaglandin can be used to start the contractions.

Forceps and Ventouse- the help pull the baby out when the mother is too tired. Premature babies and breech babies (babies facing feet or bottom down) may be pulled with forceps. 

Episiotomy- a cut is made under local anaesthetic in the skin between the ****** and ****. It's done to make the opening of the ****** wide enough for a big baby, to avoid the ****** tearing right the way through to the rectum.

Caesarean Section to surgically remove the baby

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Family Preparation

Clothes and Nappies- layette (including: vests, all-in-ones, cardigans, hats, socks, bootees and an outdoor play suit. New babies need plenty of nappies. The basic choice in nappies is between cloth ones and disposable ones. Disposable nappies are more convenient, but some parents prefer to use reusable cloth nappies as they're more enviromentally friendly.

Cots, Bedding, Matress- all have to be first hand

Baby proofing- 

  • corner protectors
  • hot-tap covers
  • latches
  • baby monitors
  • stairgates
  • playpen

Babies need a lot of love, cuddling and general attention, a family needs to prepare for this!

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A Newborns Appearance

  • The umbilical cord is clamped
  • The baby has a soft spot on its head called the fontanelle. It takes 12-18 months for it to close up.
  • Some babies have some hair on their heads. The hair sometime falls out and completely different coloured hair grows to replace it.
  • Light skinned babies usually have blue eyes when they're born and dark skinned babies have brown eyes. The colour of the eyes often changes in the first few months.
  • Most newborn babies have their eyes shut most of the time.
  • The baby's hands are curled in and its arms and legs are usually slightly bent- similar to the foetal postion in the unterus. 

Skin and birthmarks:

  • The baby may have white spots on its face called milia. They're blocked sebaseous glands which unblock naturally after a few days.
  • It might have vernix on its skin still.
  • It might have lanugo. It's more common for premature babies to have lanugo.
  • Stork bites, Strawberry marks, Port wine stain, Mongolian spots.
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Reflexes

Sucking reflex- a baby sucks a finger or ****** placed in its mouth

Rooting reflex- when the baby's touched on the cheek, it turns towards the touch, looking for a ******.

Grasping reflex- the baby grasps anything put in its hand.

Startle reflex- loud noises or bright lights startle the baby. it clenches its fists and bend its arms.

Moro/Falling reflex- sudden movements make the baby think it's being dropped. it throws its arms out, then brings them together.

Stepping reflex- a baby held upright over a flat surface makes walking movements. (this reflex disappears at around 6 weeks)

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Special Care Units

Incubator- 

  • keeps a constants temp, to keep the baby warm
  • it filters and humidifies the air to stop the baby's skin drying out, to keep germs out and to stop breathing in dust
  • it's got portholes so nurses and parents can reach in and touch the baby. 

Ventilator- 

  • babies whose lungs arent mature need help to breathe
  • the ventilator provides exactly the right amount of oxygen for the baby

Monitor- 

  • sensor pads are attached to the baby's skin to check breathing, heartbeat and blood oxygen.
  • the sensors are linked to a display screen and an alarm, which alerts nurses if there's a problem. 

Naso-Gastric Tube- 

  • Premature babies who can't **** or swallow need food to be given direct to the stomach. 
  • A tube goes up the nose and down the throat into the stomach. 

IV Lines- 

  • IV (intravenous) lines are needles conncected to tubes that put liquid and drugs directly into the baby's bloodstream.
  • If the baby can't digest food properly yet then it can be fed through an intravenous line instead.

Light Therapy- treats jaundice

  • Lots of premature babies have jaundice- a yellowing of the skin caused by the breakdown of old red blood cells. 
  • Light therapy units above the incubator help to clear up jaundice. The baby's eyes need protecting from the ultraviolet light though. 
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Breast Feeding

  • In pregnancy, hormones progesterone and oestrogen stimulate milk glands to produce colostrum.
  • Colostrum varies in colour, but is often thick and yellowish. It contains proteins and antibodies which protect the baby against illness. This baby's feeds for the first 3-5days are colostrum. 
  • When the baby is born, the milk glands stop producing colostrum and start producing milk, which is expressed 3-5says after the baby is born. The process of producing milk is called lactation.
  • The baby is sucking on the breast stimulates the production of two hormones- prolactin, which stimulates milk production from the milk glands, and oxytocin, which makes the muscles round the milk glands contract. The baby's gums and lips press down the on the areola around the ****** to trigger the release of the hormones- this is called the 'let down' reflex. 

Advantages: 

  • free
  • no prep
  • cpntains exactly the correct nutrients for the baby, these help with digestion, brain development and growth
  • contains anitbodies
  • breast feeding helps the mother lose weight after pregnancy
  • physical contact helps bonding between baby and mum
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Bottle Feeding

Making up a Formula

  • Boil kettle. Water needs to be at least 70 degrees, so don't let it cool for more than 30 minutes.
  • Wash hands.
  • Use sterile equipment.
  • Add right amount of water.
  • Add right number of scoops of formula. Level scoops with a knife. 
  • Shake until throughly mixed.
  • Run bottle under cold water to cool. Serve at 37 degrees.
  • Use the bottle within 2 hours or throw the milk away. Do not put bottles in the fridge and then reheat them.

Advantages:

  • some woman can't breast feed
  • with bottle feeding, it's easy to see exactly how much milk the baby's had
  • anyone can feed the baby and therefore bond with the baby
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Weaning

Changing from an all milk diet to solid food is a gradual process. Babies start off trying a few mushy foods, but still get most of their nutrients from breast or bottle feeding. They have fewer and fewer milk feeds as they get older. 

Babies start on mushy foods at 6 months- mashed fruit and veg, baby rice etc. salt shouldn't be added to their food, no nuts, no gluten (eg wheat), no honey, no fatty foods

Babies can start having meat and fish between 7 and 9 months. They also tend to have finger foods. They can have egg as long as the yolk is cooked hard. It is ok for babies to eat gluten now. Avoid spicy foods. 

Babies should be eating 3 chopped or minced meals a day 9 months. Ideally they should be eating 3 or 4 servings of starchy foods, 3-4 servings of fruit and veg and 2-3 servings of meat, fish, eggs or pulses everyday. Rusks are god for babies whose teeth are coming through.

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Problems to Weaning

1) Before the age of 6 months, a baby's digestive system still isn't fully developed. Trying to feed them solid foods too early can lead to digestive problems and allergies. 

2) Weaning too early can mean a baby doesn't get enough of the essential nutrients found in milk. 

3) It can also lead to overfeeding and a greater risk of being overweight later in life. 

4) Under no circumstances should you give a baby solid food until it's 4 months old. And you definitely shouldn't feed them foods containing gluten (eg bread) fish, shellfish, eggs, nuts, seeds or soft cheeses until they're at least 6 months old.

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