2 postsRe: Topic 1 DQ 2
A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.
Once the assessment of the infants growth has been completed and you are able to identify where the infant stands on the growth chart it is essential to obtain specific data on the infants nutritional status. As per the recommendations of infant health a 9 month old must be able to tolerate receiving complementary foods 3 to 4 times per daily while continuing to receive either breast milk and/or formula. It is essential for a nurse to assess the infants nutritional intake to compare it to the infant health recommendations.
The Center for Disease Control and Prevention (CDC) has provided specific milestones for assessments of which nurses and physicians can base their assessments on. As per the guidelines of the CDC, some milestones that infants present at 9 months include but are not limited to: being afraid of strangers (recognizing familiar faces), the understanding the word “no” (no touching, no eating, no biting), the ability to copies gestures (waving to say hello), making different sounds such as “babababa” (baby language), looks for things that the infant sees you hide, puts things in mouth, plays peek-a-boo, getting to a sitting position, pulls to stand, crawls, and stands when holding on to someone/something (CDC, 2018).
With this specific case the 9 month old is demonstrating slow development or slower than average infant. The nurse should recommend the mother to: continue breast feeding and modify diet plan, ensure adequate sleep, encourage monthly checkups for growth/development, and educate the mother on weaning diets.
Healthcare professionals must be able to appropriately identify the developmental milestones in order to be able to identify any infants whom are at increased risk of establishing developmental delays. There is a diversity of evidence-based screening tools of which assist healthcare professionals in identifying if infants are meeting their developmental milestones and indicating infants that at risk for developmental delays. The assessment tools include but are not limited to: Ages and Stage Questionnaire, Child Development Inventory, and the Parent’s Evaluation of Developmental Status (CDC, 2018). As per the CDC, it is also essential for parents to be educated on the developmental milestones. Thereafter the parents can incorporate these activities within their infants daily pursuits and it can make the parents aware of any unmet milestones that may need to be addressed with the healthcare providers (CDC, 2018).
CDC (2018). Developmental Monitoring and Screening for Health Professionals. Retrieved from: https://www.cdc.gov/ncbddd/childdevelopment/screening-hcp.html
CDC. (2018). Important Milestones: Your Baby By Nine Months. Retrieved from:
According to Table 1.1 in our textbook, a 9 month old baby should be able to crawl, sit without support, be able to get into a sitting position, pull self into a standing position, stand alone while holding on to support, and make stepping movements, bang objects on a table, transfer objects from one hand to the other, and feed themself finger foods (Green, 2018). The may also be able to drink from a cup with assistance, poke at objects with their finger, use a finger-thump pincer grasp to squeeze or pick up an object, scribble with a crayon or marker, take an object out of a container, get into a sitting position without assistance, stand alone, walk alongside furniture or “cruise”, and may be able to take a few steps without holding on (Green, 2018). Every baby is different, so it is always a good idea to look at the baby as an individual rather than comparing them to a sibling or a friend’s baby. Another thing that would be used to determine if this baby is growing at the appropriate rate would be to look at their birth weight and length and compare it to their current weight and length. This is because a baby will typically double their weight by 6 months and triple it by 12 months, with an additional 10 to 12 inches of growth by 12 months (Green, 2018). So, the babies current weight and length may be appropriate for them if they were premature or had a low birth weight for another reason. If the baby isn’t growing at an appropriate rate, it would be time for the pediatrician to look further into what may be restricting them from growing, such as insufficient intake. If the mother is breastfeeding, it could very well be that she isn’t producing enough milk and needs to supplement with formula in order to ensure that the baby is getting enough of the required nutrients to grow. According to the CDC, a baby can begin trying solid foods such as fruits, vegetables, meats, cereals, grains, yogurts and cheeses at 6 months of age (CDC, 2019) so, at 9 months, this baby should have already been started on solid foods, so if she hasn’t been started on solid foods yet it could very well be that she isn’t getting the appropriate vitamins and nutrients needed for growth. If for whatever reason the mother hasn’t started the baby on solid foods yet, I would recommend that she start them one food at a time and wait 3-5 days in between each new food to monitor for allergic reactions particularly when trying things like milk, eggs, fish, shellfish, tree nuts, peanuts, wheats, and soybeans (CDC, 2019). It could also be that the mother is feeding the baby solid foods, but is giving unhealthy snacks so I would educate her on giving the baby healthy foods like fruits and vegetables rather than foods high in sugar. All of these things should help the baby to start growing at a more appropriate rate.
Center for Disease Control and Prevention (CDC) (2019). When, What, and How to Introduce Solid Foods. Retrieved from https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/when-to-introduce-solid-foods.html#:~:text=Your%20child%20can%20begin%20eating,yogurts%20and%20cheeses%2C%20and%20more.
Green, S. (2018). Health Assessment: Foundations for Effective Practice. In Grand Canyon University [GCU], Health Assessment of the Infant (ch.1). Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/