4.4 The Neonatal Environment

Annotations:

• events of the 1st month and how parents might optimize the development of young infants

1. Brazelton training

   Annotations:

   • assesses strength of infant reflexes and infant's responses to 26 situations 
2. Breast or Bottle?
   1. Breast milk contains several advantages
      1. + effects on immune system and weight gain
3. Identifying At-Risk Newborns
   1. Screening using the Apgar test

      Annotations:

      • assesses newborn's heart rate, respiration, color, muscle tone, and reflexes
      1. Given 5 min after birth
         1. Good: 7+
         2. Bad: 4-
            1. Immediately gets post-natal medical intervention
   2. younger and smaller babies have lower chances of survival
      1. LBW, 65% of infant mortality
         1. Poor nutrition and pre-natal care
         2. Multiple births
      2. Problems
         1. More likely to develop neurobehavioral problems
         2. Respiratory difficulties; lack of surfactant

            Annotations:

            • prevents air sacs of the lungs from sticking together
      3. Solutions
         1. Breast milk
         2. Kangaroo care

            Annotations:

            • therapeutic to infants; resting on a parent's chest
            1. maintain heart rate, oxygen rate, and temperature
         3. Massage Therapy
            1. more relaxed
            2. gain more weight
         4. Programs teaching parents how to provide responsive care at home
4. Risk and Resilience
   1. Study in Kauai, Hawaii
      1. Effects of prenatal and perinatal complications decrease over time
      2. Outcomes of early risk depend on the quality of the post-natal environment
         1. Personal Resources

            Annotations:

            • Qualities (intelligence, sociability...etc) in genetic make up of children help them choose more nurturing and stimulating enviros to cope with
         2. Supportive post natal environment