Infancy Development from Birth to Age 3, 2nd Edition By Dana Gross – Test Bank

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Chapter 5: Physical Growth, Health, and Nutrition 

CHAPTER 5 AT-A-GLANCE

Key Topics	Detailed Outline	Readings &  Activities	Media Supplements	Professor Notes
Physical Growth			Video: “Infant  Massage: The  Power of  Touch”
	Measuring and  Predicting  Growth
	Failure to Thrive
	Brain  Development
	Maltreatment, the  Brain, and  Shaken Baby  Syndrome		Video:  “Portrait of   Promise:  Preventing  Shaken Baby  Syndrome”
Health and Safety		Lecture Launcher: Staying Safe and Healthy Morrongiello et al. (2004a,  2004b) http://www.healthychildcare.org/articles.cfm
	Newborn Screening	Hands On #1:  Newborn Screening
	Screening for  Lead Poisoning
	Infant Mortality
	Common Illnesses  and Immunizations
	Accidental Injuries	Hand On #2: Play It Safe
	Sudden Infant  Death Syndrome
Nutrition and  Feeding
	Nutritional  Requirements in  Infancy
	Breast Milk
	Infant Formula
	Nutritional  Requirements in  Toddlerhood
	The Problem of  Malnutrition

 

Chapter Outline

Physical Growth

Measuring and Predicting Growth

• Growth during the first 3 years is faster than at any other point after birth.

• Breastfed babies tend to be longer and leaner than babies who are not breastfed.

• Growth charts from the Centers for Disease Control and Prevention describe how samples of U.S. infants and children grew, whereas new growth charts from the World Health Organization are based on studies of exclusively breastfed infants from six different countries.

Failure to Thrive

• Most cases of failure to thrive are caused by a lack of adequate nutrition due to feeding problems, health problems, or oral or motor conditions.

• Some children with psychosocial short stature may be underweight and extremely short for their age due to neglect or emotional and psychological trauma.

• For children with psychosocial short stature, being moved to a new, caring environment often triggers a dramatic catch-up growth spurt.

Brain Development

• Brain development begins prenatally with the production and migration of neurons.

• Postnatal brain growth primarily consists of the interconnection of neurons and the formation of synapses involving axons and dendrites.

• Different regions of the brain develop most rapidly at different ages.

• Pruning of synapses begins at the end of the first year of life.

• Experience activates neurons, and repeated experiences strengthen neural networks.

Maltreatment, the Brain, and Shaken Baby Syndrome

• Animal experiments and clinical studies of children suggest that early adversity and stress harm the developing brain.

• Neurobiological components of the stress-response system develop and become organized in the early months of life, meaning that infants are capable of experiencing fear, anxiety, and psychological stress.

• The infant’s brain is especially vulnerable to injury caused by shaken baby syndrome.

• Abusive head trauma due to shaken baby syndrome is the leading cause of infant death from injury in the United States.

Health and Safety

Newborn Screening

• All U.S. newborns are screened for PKU, congenital hypothyroidism, and galactosemia.

• All newborns should also be screened for congenital hearing loss.

Screening for Lead Poisoning

• Untreated lead poisoning can result in brain damage, behavior problems, learning disabilities, seizures, and even death.

• Low-income, urban, and African American children have the highest rates of lead poisoning.

Infant Mortality

• Infant mortality rates in the United States vary by race and ethnicity as well as mother’ age, education, marital status, and health.

• Globally, infant mortality is linked to poverty, inadequate prenatal care, complications of pregnancy, malnutrition, lack of clean drinking water, and low rates of immunization against childhood illnesses and diseases.

Common Illnesses and Immunizations

• Infants’ immature immune system, and the tendency to place their hands, toys, and other objects in their mouth, makes them especially vulnerable to contagious illnesses.

• Immunizations against childhood illnesses and diseases save lives and protect health.

Accidental Injuries

• The major causes of death in infancy and early childhood are unintentional, preventable injuries.

• As babies and toddlers develop and gain new skills, parents and caregivers need to be aware of and anticipate new hazards.

Sudden Infant Death Syndrome

• Sudden infant death syndrome (SIDS) is the leading cause of death in infants between 1 month and 1 year of age.

• Place all healthy babies on their back to sleep and avoid the use of soft bedding.

• Other risk factors are maternal smoking, sleeping in an overheated room, and bed sharing.

• Some SIDS deaths may be caused by an abnormality in a portion of the brain.

Nutrition and Feeding

Nutritional Requirements in Infancy

• Children under the age of two years need more fat in their diet than any other age group.

Breast Milk/Infant Formula

• Until the age of about 4 to 6 months, infants can get all of their nutritional requirements through breast milk or formula.

• According to most experts, human milk is the preferred form of feeding for infants.

• The Baby-Friendly Hospital Initiative and other health education campaigns have increased breastfeeding rates and duration.

• Infant formula available today is the best alternative to breast milk that has ever existed.

• Experts recommend that parents not initiate complementary feeding until the baby is 4 to 6 months of age.

Nutritional Requirements in Toddlerhood

• Overweight and obesity are growing concerns in the United States, even among young children.

• Many toddlers do not get the recommended variety of minerals and nutrients.

The Problem of Malnutrition

• Worldwide, many infants and young children suffer from problems related to an insufficient amount of food or an inadequate intake of essential nutrients, protein, and calories.

• Infants and young children are more susceptible than older children to growth impairment caused by protein-energy malnutrition.

Key Words

Axons  (131) Branch-like structures that convey electrical messages outward from the neuron’s cell body and toward the synapse.

Body mass index (BMI) (128) A measure of weight in relation to height.

Colostrum (148) A thick, yellowish fluid, richer in protein and protective antibodies than the breast milk that is produced a few days after birth.

Complementary feeding (152) The transition from exclusive breastfeeding or formula-feeding to the inclusion of solid food in an infant’s diet.

Dendrites  (132) Branch-like structures that convey electrical messages from the synapse and toward the neuron’s cell body.

Electroencephalogram (EEG) (130) A measure of the brain’s activity that uses external electrodes placed on the scalp.

Experience-dependent  (133) Aspects of brain development that develop solely as a result of a person’s experiences.

Experience-expectant  (132) Aspects of brain development that “expect” to have certain kinds of stimulation and are ready to develop once they receive it.

Failure to thrive (129) Growth stunting that is caused by deprivation of physical contact.

Infant mortality rates  (138) Statistics representing the number of infants who die before reaching the age of 1 year.

Magnetic resonance imaging (MRI) (131) An imaging technology that reveals the brain’s structure.

Maltreatment  (133) Neglect, medical neglect, physical abuse, sexual abuse, or psychological abuse.

Micronutrient deficiency (155) A form of malnutrition that occurs when insufficient amounts of minerals and vitamins are consumed in the diet.

Myelin  (132) A fatty covering that insulates axons and increases the efficiency of neural functioning.

Neurotransmitters  (132) Biochemical substances that transmit information between neurons through release and uptake at synapses.

Positron emission tomography (PET) (131) An imaging technology that shows the amount of activity in the brain.

Protein-energy malnutrition (PEM) (155) A form of malnutrition that occurs when insufficient amounts of protein and calories are consumed in the diet.

Psychosocial short stature (130) A type of failure to thrive in which a child is both underweight and extremely short, often as a result of neglect or emotional and psychological trauma.

Shaken baby syndrome (SBS) (135) A form of maltreatment in which an angry or frustrated adult shakes an infant violently, resulting in brain damage or even death.

Sudden infant death syndrome (SIDS) (144) The diagnosis given when an infant younger than 1 year dies and a complete investigation is unable to identify a specific cause.

Synapses  (131) Spaces between neurons, in which biochemical messages are released and absorbed.

Synaptogenesis  (132) Formation of synapses in network of neurons.

Vesicles  (132) Neurotransmitter storage spaces at the end of the axon.

Think About It:  Questions for Reading & Discussion

1. How does experience shape the postnatal development of the brain?

2. What do you think I s the most significant reason for the decline in infant mortality rates in the United States and other developed countries?

3. What would you need to do in order to make your own home, apartment, or dormitory room safe for an infant? What would you have to do to make it safe for a toddler or preschooler?  Which age do you believe faces the greatest risk from accidental injuries? Explain.

4. What instructions should parents give their infant’s caregivers to prevent shaken baby syndrome? To prevent sudden infant death syndrome?

5. What are the benefits of breastfeeding?  Why don’t all parents breastfeed their infants as long as the experts recommend?  What could be done to increase the rate of breastfeeding?

6. Explain which health problem you think is more serious for infants and very young children – overnutrition (obesity and overweight) or undernutrition (malnutrition).

7. What can be done to address and remedy racial, ethnic, and socioeconomic disparities in infant health?

Lecture Launcher: Staying Safe and Healthy at Home and in Child Care

From a health and safety perspective, which is safer – home or child care?  Although students may have strongly held preconceptions about this question, neither the home nor the child care setting are inherently safe or risky.  The articles listed below can be used in a lecture highlighting the importance of remaining vigilant to possible hazards in the places where infants and toddlers spend their time. These sources support the notion that, in addition to setting up an environment in which infants and toddlers are free to explore, parents and other caregivers need to monitor young children and anticipate potential problems before they occur.

Morrongiello, et al. (2004a & 2004b) have studied toddlers’ in-home injuries.  In two back-to-back articles, they report their findings about the context, correlates, and determinants, as well as parental strategies, and their efficacy, for managing child injury risk.  Their studies suggest that many parents whose toddlers sustain injuries at home overestimate their young children’s ability to follow rules and prohibitions when they are not closely supervised.

The American Academy of Pediatrics maintains a webpage ( HYPERLINK “http://www.healthychildcare.org/articles.cfm” http://www.healthychildcare.org/articles.cfm) with full-text articles about safety awareness and health promotion in child care settings.  The articles include:

Copeland, K., Duggan, A., & Shop, T. (2005). Knowledge and beliefs about guidelines for exclusion of ill children from child care. Ambulatory Pediatrics, 5, 365-371.

Gupta, R., Shuman, S., Taveras, E., Kulldorff, M., & Finkelstein, J. (2005). Opportunities for health promotion in child care. Pediatrics, 116, 499-505.

Moon, R.Y., Aird, L., & Kotch, L. (2006). State child care regulations regarding infant sleep environment since the Healthy Child Care America – Back to Sleep Campaign. Pediatrics, 118, 73-83.

Moon, R.Y., Patel, K.M., & Schaefer, S.J.M. (2000). Sudden infant death syndrome in child care settings. Pediatrics, 106, 295-300.

Shope T.R., & Aronson S. (2005). Improving the health and safety of children in nonparental early education and child care. Pediatrics in Review, 26, 86-95.

Hands-On Learning Activities

Newborn Screening: To learn more about current practices and initiatives, visit the website of the Centers for Disease Control and Prevention ( HYPERLINK “http://www.cdc.gov/nceh/dls/newborn_screening.htm” http://www.cdc.gov/nceh/dls/newborn_screening.htm) and the National Center of Medical Home Initiatives for Children with Special Needs ( HYPERLINK “http://www.medicalhomeinfo.org/screening/newborn.html” http://www.medicalhomeinfo.org/screening/newborn.html).  Finally, visit the website for your own state (http://www.medicalhomeinfo.org/screening/index.html) in order to find out how many congenital conditions or disorders are included in mandatory newborn screening.

Play It Safe: The U.S. Consumer Product Safety Commission (CPSC) maintains a website ( HYPERLINK “http://www.cpsc.gov/” http://www.cpsc.gov/) with information about recalled or dangerous toys and products for infants and children.  As you check out the safety tips posted there ( HYPERLINK “http://www.cpsc.gov/tips.html” http://www.cpsc.gov/tips.html), notice how many are relevant to children from birth to age three.  On another CPSC webpage ( HYPERLINK “http://www.cpsc.gov/cpsclist.asp” http://www.cpsc.gov/cpsclist.asp), consumers can sign up to receive email alerts about recalled products, including those pertaining to infants and children.  Would you recommend that parents of infants and toddlers subscribe to this service?  Why or why not?

Suggested Videos and DVDs	Description
“Infant Massage: The Power of Touch,” (1990/2003, 47  mins), V.I.E.W. Video.	This video features step-by-step instructions in massage techniques for babies. It also includes explanations as to how massage can help an infant’s eating and sleeping habits and how massage encourages communication development. Highlights contain massage exercises for premature babies and children with cholic and guidance as to when infant massage should not be used.
“Portrait of Promise: Preventing Shaken Baby Syndrome,” (1995, 11 mins), Midwest Children’s Resource Center at Children’s Health Care and The Junior League of St. Paul, Inc.	Nationally recognized child abuse specialist Dr. Carolyn Levitt addresses the injuries that can occur when a baby or young child is violently shaken due to inconsolable crying, or anger and frustration of the parent or caregiver. She gives insight into the prevention of this serious form of child abuse.
“The Secret Life of the Brain: The Baby’s Brain: Wider than the Sky,” (2001, 58 mins), PBS.	Examines how the brain builds itself from conception through the first year of life. Neurobiologists study the intricate relationship between genes and the environment, and a study is done to find out if the difficulties premature babies have paying attention and learning later in life can be overcome by providing an environment that imitates the womb.  Also shows the case of an infant with a congenital cataract as an example of a critical period in development.

Test Bank for Chapter 5: Physical Growth, Health, and Nutrition

5-1. In normal, healthy infants, 

a.physical growth is slower from birth to age 3 than it is from age 3 to 5 

b.weight and length both double from birth to the age of 5 months

c.the rate of physical growth increases from birth to age 3

d.the rate of physical growth is faster than it will be again at any other point in the child’s life

Ans: D Topic: Physical Growth Type: K

5-2. _____ enable pediatricians and parents to compare an individual infant’s weight, length, and head circumference with the measurements of other children of the same age.

a.growth charts

b.Apgar scores

c.Brazelton percentiles

d.archival measures

Ans: A Topic: Physical Growth Type: K

5-3. Infants who are deprived of normal physical and social contact and who grow slowly even if they are fed an adequate diet may have a condition known as

a.preterm birth syndrome

b.failure to thrive

c.infantile autism

d.congenital regression

Ans: B Topic: Physical Growth Type: K

5-4. During infancy, the brain grows until it is approximately

a.50 percent of an adult’s brain by the age of 3 years

b.30 percent of an adult’s brain by the age of 3 years

c.50 percent of an adult’s brain by the age of 1 year

d.25 percent of an adult’s brain by the age of 1 year

Ans: D Topic: Physical Growth Type: K

5-5. The dense, fatty sheath that enhances the speed with which electrical messages can be sent between neurons is known as

a.axon

b.dendrite

c.myelin

d.synapse

Ans: C Topic: Physical Growth Type: K

5-6. Parents of infants should be concerned about all of the following except

a.failure to thrive

b.weight at the 95th percentile

c.dental decay

d.tripling birth weight by the age of 12 months

Ans: D Topic: Physical Growth Type: C

5-7. All of the following occur in the infant brain primarily during the prenatal period except

a.generation of neurons 

b.migration of neurons

c.pruning away of neurons

d.neural tube formation

Ans: C Topic: Physical Growth Type: C

5-8. All of the following statements about brain development are accurate except

a.myelination is complete in many areas of the brain by the age of 4 years

b.pruning of neurons occurs at different rates in different parts of the brain

c.the cerebral cortex develops more slowly than the parts of the brain that are responsible for basic body functions

d.experience-dependent aspects of the brain are open to the effects of experience as long as those experiences occur before the age of 3 years

Ans: D Topic: Physical Growth Type: C

5-9. Jamie was born with a cataract in one of his eyes.  What advice is the pediatrician most likely to give Jamie’s parents?

a.“We should not do anything about the cataract until we know whether it affects his vision or not.”

b.“We should operate to remove the cataract as soon as possible, ideally before Jamie is 2 months old.”

c.“As long as we operate before Jamie is 2 years old, there should be no effect of the cataract.”

d.“As long as Jamie’s other eye does not develop a cataract, no action needs to be taken.”

Ans: B Topic: Physical Growth Type: A

5-10. Amanda, an emergency medical technician, examines an infant whose babysitter reported that he stopped breathing after falling off of a couch where she had laid him for a nap.  Amanda resuscitates the baby but, on the way to the hospital, notices that there is also bleeding in the retinas of the baby’s eyes and no obvious bump on the outside of the baby’s skull.  She suspects that the baby is a victim of

a.Sudden infant death syndrome

b.Failure to thrive

c.Anencephaly

d.Shaken baby syndrome

Ans: D Topic: Physical Growth Type: A

5-11. Aleksi was maltreated as an infant when he lived in an East European orphanage.  Which of the following is not a likely outcome of that early experience?

a.a build-up of fluid on his brain that causes his head to swell

b.an exaggerated physiological response to perceived stress

c.an overstimulated amygdala

d.delays and abnormalities in multiple domains of development

Ans: A Topic: Physical Growth Type: A 

5-12. Mandatory newborn screening exists nationwide for all of the following conditions except

a.PKU

b.congenital hypothyroidism

c.galactosemia

d.deafness

Ans: D Topic: Health and Safety Type: K

5-13. Lead poisoning

a.is no longer a concern because lead was removed from paint in 1978

b.causes brain damage that may be only partly reversible

c.affects infants equally across all income levels

d.causes harm even after just one exposure

Ans: B Topic: Health and Safety Type: K

5-14. For every 1,000 children born in any given year, the number of children who die before reaching the age of 12 months can be calculated, yielding a(n)

a.infant health census

b.infant growth chart

c.infant mortality rate

d.child vitality statistic

Ans: C Topic: Health and Safety Type: K

5-15. In the United States, all of the following are among the most common causes of infant deaths except 

a.congenital malformations

b.sudden infant death syndrome

c.preterm birth

d.shaken baby syndrome

Ans: D Topic: Health and Safety Type: K

5-16. The major causes of death between birth and 3 years of age is/are 

a.contagious childhood illnesses

b.unintentional injuries

c.shaken baby syndrome

d.environmental toxins, such as lead and mercury

Ans: B Topic: Health and Safety Type: K

5-17. Which infant has the lowest statistical risk of dying before the age of 1 year?

a.an African American baby in the United States

b.a Japanese baby in Japan

c.a nonHispanic white baby in the United States

d.an African baby in Sudan

Ans: B Topic: Health and Safety Type: C 

5-18. Which infant is least likely to develop a common infectious illness?

a.a 9-month-old being cared for at home

b.a 9-month-old who attends group child care five days a week

c.a 6-month-old whose older sibling attends group child care

d.a 12-month-old who participates in a play group three days a week

Ans: A Topic: Health and Safety Type: C

5-19. All of the following statements about childhood immunizations are accurate except

a.it has been proven that the vaccine for measles-mumps-rubella does not cause autism

b.only the first of the recommended doses for each vaccine needs to be given

c.the consequences of contagious diseases, such as whooping cough, measles, and mumps, are worse than the pain of being inoculated with vaccines against those disease

d.although many contagious diseases have become rare in the general U.S. population, immunizations should still be given for those diseases

Ans: B Topic: Health and Safety Type: C

5-20. Unintentional injuries in infancy and early childhood

a.cannot be prevented – they’re just accidents that could happen to anyone

b.could be prevented if most parents had only one child

c.have already been reduced through legislation and regulation

d.cannot be reduced any further because most products, such as infant walkers, have already been redesigned to be safe to use

Ans: C Topic: Health and Safety Type: C

5-21. Which of the following steps should Anna’s parents take if they want to protect her from sudden infant death syndrome?

a.keep her out of nonparental child care until the age of 12 months

b.put her on her back to sleep, even at nap time

c.make sure that there are enough blankets, comforters, and quilts in her crib so that she does not get too cold when she is sleeping

d.have her sleep with them in their bed until the age of 9 months

Ans: B Topic: Health and Safety Type: A

5-22. Which infant is at greatest risk from sudden infant death syndrome?

a.a 9-month-old girl

b.a 9-month-old boy

c.a 2-month-old African American of either sex

d.a 12-month-old Native American of either sex

Ans: C Topic: Health and Safety Type: A

5-23. Stephen, a pediatrician who hopes to prevent SIDS, is likely to do all of the following except

a.ask mothers who smoke cigarettes either to quit or to avoid smoking around their babies 

b.encourage cosleeping between parents and infants

c.urge new mothers to breastfeed their babies

d.explain the importance of back sleeping for young infants

Ans: B Topic: Health and Safety Type: A

5-24. Wanda wondered whether her toddler’s child care setting promoted his health and safety.  As she read about this topic, she most likely discovered all of the following except

a.more injuries occur during warmer months than during colder months

b.more injuries occur on the playgrounds of child care settings than in other areas in those settings

c.children in group child care settings develop fewer infectious illnesses than children who are cared for at home

d.children in group child care have lower rates of injury than children who are cared for at home

Ans: C Topic: Health and Safety Type: A

5-25. Children under the age of 2 years

a.need more fat in their diets than any other age group

b.require the same amount of fat in their diets as other age groups

c.are relatively immune to the effects of malnutrition 

d.should be encouraged to consume portions that are larger than those that they would typically choose on their own

Ans: A Topic: Nutrition and Feeding Type: K

5-26. Until they are about _____ old, infants can get all of the nutrients they need from breast milk or infant formula.

a.2 to 4 months

b.4 to 6 months

c.8 to 10 months

d.10 to 12 months

Ans: B Topic: Nutrition and Feeding Type: K

5-27. Which statement is most compatible with the Baby-Friendly Hospital Initiative?

a.“It is important for mothers to feel comfortable opting not to breastfeed their baby.”

b.“Breastfeeding is a skill that must be learned and practiced.”

c.“Fathers should have as many opportunities to feed their baby as mothers do.” 

d.“Successful breastfeeding depends on newborns being in continual contact with their mother after birth.”

Ans: B Topic: Nutrition and Feeding Type: C

5-28. Worldwide, which of the following conditions poses the most serious health risk for infants and young children?

a.Vitamin A deficiency

b.Micronutrient overdoses

c.Protein-energy malnutrition

d.Peanut allergy

Ans: C Topic: Nutrition and Feeding Type: C

5-29. According to available statistics, who is most likely to breast feed her infant for the longest period of time?

a.Wendy, a 30-year-old who returned to her full-time job as a seamstress when her daughter was 3 months old

b.Siri, who grew up in Norway and moved to the United States just before her son was born

c.Angela, an adolescent mother of twins

d.Tammy, a 20-year-old mother who is a participant in the WIC program

Ans: B Topic: Nutrition and Feeding Type: A

5-30. Children living in refugee camps often do not consume enough protein and calories.  Which of the following is not an accurate statement about protein-energy malnutrition (PEM)?

a.it is responsible for half of all child deaths worldwide

b.it is less harmful to infants and toddlers than it is to older children

c.the majority of children suffering from PEM live in Asia and Africa 

d.nutritional supplementation can reverse some of the cognitive impairments associated with PEM

Ans: B Topic: Nutrition and Feeding Type: A