Infants gain 150 to 210 g (5-7 oz) weekly until approximately 5 to 6 months of age
At 6 months of age the birth weight has at least doubled
Weight gain slows in the second 6 months
Birth weight is tripled by 1 year
Length occurs in spurts rather than gradually
By 1 year the length has increased by 50%- mainly in the trunk rather than the legs
Head growth is also rapid
By 1 year of age the head growth has increased by 33%
Closure of the cranial sutures occurs, with the posterior fontanel closing by 6 to 8 weeks of age and the anterior fontanel closing by 12-18 months of age
Posterior fontanel closes by 2 to 3 months of age
Anterior fontanel closes by 12 to 18 months of age
Six to eight teeth should erupt in infants’ mouths by the end of the first year of age.
The first teeth typically erupts between the ages of 6 and 10 months (average age 8 months).
Some children show minimal indications of teething (sucking or biting on their fingers or hard objects and drooling)
Other are irritable, have difficulty sleeping, have a mild fever, rub their ears, and have decreased appetite for solid foods
Maturation of systems
Respiratory movements are mostly abdominal
Predisposed to respiratory issues:
Close proximity of trachea to bronchi
Short, straight Eustachian tube closely communicates with the ear-infection to ascend from pharynx to the middle ear
HR slows and the rhythm is often sinus arrhythmia
Breastfeeding provides a complete diet for infants during the first 6 months
Breast milk should never be thawed or rewarmed in the microwave – to prevent oral burns from uneven warming of the milk
Iron-fortified formula is an acceptable alternative to breast milk.
Cow’s milk is not recommended
It is recommended to begin vitamin D supplements within the first few days of life to prevent rickets and vitamin D deficiency
Iron supplements are recommended for infants who are being exclusively breastfed after the age of 4 months
Alternative sources of fluids (juice or water) are not needed during the first 4 months of life. Excessive intake of water could result in hyponatremia and water intoxication
After the age of 6 months, 100% fruit juice should be limited to 4 to 6 oz per day
Solids are introduced around 6 months of age
Indicators for readiness include interest in solid foods, voluntary control od the head and trunk, and disappearance of the extrusion reflex.
Iron-fortified cereal is typically introduced first due to its high iron content
New foods should be introduced one at a time, over a 5-to-7-day period, to observe for manifestations of allergy or intolerance, which might include fussiness, rash, vomiting, diarrhea, and constipation
Vegetables or fruits or fruits are started first between 6 and 8 months of age. After both have been introduced, meats ay be added
Citrus fruits, meats, and eggs are not started until after 6 months of age
Breast milk/formula should be decreased as intake of solid foods increases, but should remain the primary source of nutrition through the first year
Table foods that are well-cooked, chopped, and unseasoned are appropriate by 1 year of age
Appropriate finger foods include ripe bananas, toast strips, graham crackers, cheese cubes, noodles, firmly cooked vegetables, and raw pieces of fruit (except grapes).
Weaning can be accomplished when infants show signs of readiness and are able to drink from a cup (sometime in the second 6 months).
Gradually replace one bottle or breastfeeding at a time with breast milk or formula in a cup with handles
Bedtimes feedings are the last to be stopped.
Introduction of solid foods into the infant’s diet at this age is primarily for taste and chewing experience not for growth
Administration of Oral Iron Supplements
Ideally, iron supplements should be administered between meals for greater absorption.
Liquid iron supplements may stain the teeth; therefore administer with a dropper toward the back of the mouth (side). In older children, administer liquid iron supplements through a straw, or rinse mouth thoroughly after ingestion.
Avoid administration of liquid iron supplements with whole cow’s milk or milk products because these bind free iron and prevent absorption.
Educate parents that iron supplements will turn stools black or tarry green.
Iron supplements may cause transient constipation. Caution parents not to switch to a low-iron–containing formula or whole milk, which are poor sources of iron and may lead to iron deficiency anemia
In older children, follow liquid iron supplement with a citrus fruit or juice drink (no more than 3–4 oz).
Avoid administration of iron supplements with foods or drinks that bind iron and prevent absorption