INFANT DEVELOPMENT          

Welcome to the HDFS 428 Infant Development Class Web Page.  On this page you will find the syllabus, assignment requirements, and the lecture outlines presented in each class.  Other submissions will appear from time to time so be sure to check this Web site every week.


headline     HEADLINE                                            

               NO CLASS ON NOVEMBER 12TH.  PLEASE USE THIS TIME TO
               COMPLETE ASSIGNMENT #5 WHICH IS DUE ON NOVEMBER 16TH.      
               THE NEXT GROUP MEETING WILL BE NOVEMBER 19TH.

                                            

SYLLABUS            #ASSIGNMENTS     #CLASS OUTLINES     STUDENT BROCHURES

             
                                                       HDFS 428
                                                        Fall 2001
                                                     MWF 1:25-2:15


Instructor:    Cynthia A. Stifter, PhD                                                Teaching Asst.:      Lilly Shanahan
Office:         105 White Bldg.                                                          Office:                   S208 Henderson
Hours:         M- 2:30-3:30                                                              Hours:                  W 12:15-1:15
Phone:         865-2666                                                                   Phone:                   863-0092
E-mail:         tvr@psu.edu                                                               E-mail:                   lxk191@psu.edu


Goals of this course:

Infancy is a period of rapid growth and development which is why HDFS has a course that focuses specifically on the first two years of life. In this course we will cover human development from conception through the second year of life. There are many areas of development within the infancy period. Because the primary goal of this course is to give you an in depth look at infancy we will limit ourselves to a few of the many important developmental changes that occur during this period. We will be discussing several aspects of prenatal development, perceptual development, temperament, emotional development and social development. We will also spend some time talking about the research methods through which we have come to understand how it is that infants develop. Specifically, within each of these areas, the purpose of this course is for you:

(1) to gain an appreciation of the contribution of the infant to his/her environment;
(2) to understand the importance of the environment to early development;
(3) to become familiar with the role of research in developmental psychology;
(4) to apply your knowledge to current and future parenting.

These goals will be accomplished through several methods. First, since this is a theory course the predominant mode of learning will be through lectures, readings and discussions. However, one of the most effective ways of learning about infants is through observing their behavior. Therefore, several assignments will be required so that you can apply what you are learning in the classroom and through your readings. Finally, films on certain aspects of infancy, videos from my laboratory, and guest speakers (maybe an infant or two) will be scheduled when possible.

Course Prerequisite:

Students must of have had HDFS 229 or PSY 213 and HDFS 312W to take this course.

Required Text:

Bornstein, M. & Lamb, M. (1992). Development in Infancy. McGraw Hill: New York

Additional Reading:

       Rosenblith, J. F. (1992).  In the Beginning: Development from Conception   to Age Two (2nd edition).  Sage Publications: London. Chapters 2-5.  Two   (2) copies of the chapters will be available in S-110 Henderson for copying   but can only be signed out for 2 hours.

Course Requirements:

Exams: Three (3) multiple choice/short answer/essay noncumulative exams worth 50% of your grade will be given in this course. Students may contribute questions to each exam. One week prior to the exam students submit by email a minimum of 5 questions. The questions will be compiled and shared only with those students who contributed. At least 10% of the questions will be included on the exam in one form or another. If you are unable to take an exam a make-up will be available, but BEWARE - it will have very few, more difficult, long answer questions.

Assignments:    One individual assignment and 5 group assignments worth a total of 50% of your grade are required.  The individual assignment (#6) is partially dependent upon group assignments #3-5. Groups will have an opportunity to evaluate their fellow group members’ contribution on three occasions.  The evaluations will be factored into the group members’ individual grade.  A 4 point scale (0 - 3) will be used.  Every quarter point less than a mean of 3 (perfect score) will result in a one point deduction from the individual grade.  So if a group member’s mean is 2.5 and they got a 90 for their assignment, the final grade for the assignment will be 88.

       Assignment 1 (10%) - prenatal health “brochure”
       Assignment 2 (10%) - observe 2 infants
       Assignment 3 ( -%) - decide on behaviors and coding system for your group’s observation
       Assignment 4 ( - %) -first observation
       Assignment 5 (- %) - second observation
       Assignment 6 (30%) -research paper

For the final project (#3-6) groups are required to observe 4 infants varying in age or gender.  All four infants must be observed 4 times, twice during one month, and twice one month later, for a total of 16 observations.  That is, you will do 8 observations (2 per child) during October and 8 observations (2/child) of the same children in November.  Details to follow.

Grades:     Each grade that you receive is based on 100 points.  Your percentage points are averaged and weighted according to the above percentages.  Final grades are based on the following percent distributions. +’s and -‘s are dependent upon the number of students within that range. It is rare for the distribution to be non-normal but under those circumstances, the distribution will be shifted accordingly.

       A = 90-100%, B = 80-89%, C = 70-79%, D = 60-69%, F = < 60%



Participation: Your attendance and participation in class is encouraged, particularly your attendance during group meetings (see above).

Dates

All dates are subject to change. All assignments are due by 5:00 pm on the date indicated below. Late assignments will result in a drop in grade each day that it is late and no assignment will be accepted more than two days late. It is strongly recommended that you keep both a disk copy and a hard copy of your assignments in case of unexpected loss.

Exam Dates: 9/24, 10/24, 12/12 (6:50-8:40 pm)

Assignments:        9/14    (Assignment 1)
                           10/1     (Assignment 2)
                           10/12    (Assignment 3)
                           10/22    (Assignment 4)
                           11/12    (Assignment 5)
                           11/28    (Assignment 6)

Group meetings are tentatively scheduled for: 8/31(acquaintance), 9/7 (Assignment 1), 9/26 (Assignment 2), 10/5 (Assignment 3), 11/19 (Assignment 4, 5 & 6).


Statement of Academic Integrity:

Violating academic integrity is considered a serious offense by the University and is treated accordingly. Violation of academic integrity includes all of the following: cheating on exams; having unauthorized possession of exams; and submitting the work of another person as your own (plagiarism). Students caught cheating on exams will receive a zero on that exam. Students caught cheating a second time or students violating academic integrity in any other way will receive an F for the course. Further information, including appeals processes, is provided in policy 49-20 of the current Policies and Rules handbook for students.

Plagiarism (from Webster’s New Collegiate Dictionary) - “ to steal and pass off the ideas or words of another as our own; to use a created production without crediting the source; to commit literary theft; to present as new or original an idea of product derived from an existing sources.” In other words, direct lines from another’s writing without quotes and appropriate citations is as serious an offense as cheating on an exam and will be dealt with accordingly.

   Course Topics                                                            Chapter                      Pages
I.      Introduction                                                                1   
II.    Prenatal Development and Birth                                      4                          99-118
        A.  Development                                                Rosenblith - 2              20-39
        B.  Environmental effects                                    Rosenblith - 3 & 4   
        C.  Labor and delivery                                       Rosenblith - 5   
        D.  Prematurity                                                            4                        125-127
                                                                                 Rosenblith - 2                39-51
III.     Research Methods                                                          3  

IV. Newborn Characteristics
        A. Reflexes                                                                  4                        129-132
        B.  Autonomic and Central Nervous System                 5   
V.     Perceptual Development                                              6   
VI.    Information Processing                                                7                        242-248
VII.  Emotional Development                                              10                       356-382
VIII. Temperament                                                             10                       382-408
IX.    Social Development                                                   11   
X.     Social Ecology of Infants                                              2   


 
                                                   

Assignments

         Assignment 1          Assignment 2          Assignment 3          Assignment 4&5

         Assignment 6           Report Guidelines

          Example of a Running Record

     Group Assignment #1

Influences on Prenatal Development and Neonatal Outcome


For this assignment, groups will choose a topic related to prenatal development and outcome and create a hand-out or brochure that discusses the topic. Members must organize themselves so as to divide responsibility for researching this topic equally. You can use library books, journal articles, and the Internet which has many sites on these topics. The information you present should NOT come from the class textbook. Each group must write up what they learned when researching their topic but the final product should be a one page information sheet, much like a brochure that you would hand out in a Health clinic. Groups must use more than one source and should include where you got your information, i.e., web site, journal article, book title, on your handout. The final product will be posted on the class Web page so be sure that it can be either emailed as an attachment or provided to me on a disk.

The brochure should cover the who, what, why, where, and how of the particular teratogen. Incidence rates, risk factors, symptoms, treatments, etc. should also be considered when writing up your hand-outs.

Groups will present their brochure with either one member presenting the hand-out or the group together. Presentations should only take 5 minutes. An overhead of the handout can be made prior to the class or the group may decide to copy hand-outs for all students in the class.

   A grade on the final product will be given to each individual of the group which will be adjusted, if necessary, by your group’s evaluation of your effort on this assignment (10%).                                    

                                                                Group Assignment #2
                                                                      Infant/Toddler Observation

 The purpose of this assignment is to familiarize yourself with observing young children.
For this assignment you and the other group members are to observe two infants/toddlers in the
daycare center at the Child Development Labs.  Each group must arrange to observe 2 children
for 15 minutes but at different times/days.  Each member of the group must observe each child
but should not overlap with the time and day of another group member, however, the times can
overlap if another member is observing the other child.  In other words, the only time two group
members should be observing together is if they are observing two different children.  The total
number of observations per child should be equal to the number of members (so if there are 5
members then your group should have 5 observations of that one child.)

 During the observation you must write exactly what you see during that 15 minutes.  That
is, keep a running account of what the child does for that 15 minutes.  Be sure to pick a time
when the infant/toddler is awake.  For an example of an acceptable running record, see the class
web site.  You do not have to type up your running record, however, it would be easier for all
concerned.

 Your group will have a brief time to meet to decide who will choose the infant/toddlers to
observe (and then inform the other members).  Another class time will be set aside to allow
members to go over what everyone saw and come to a conclusion about the two children you
observed with regard to their personality, background, health, etc.  Each group member must turn
in their running account of each child and a synopsis of the group conclusion.  The group
conclusion can be the same but each student must submit a conclusion. Your grade will be an
average of your group contribution and your individual grade.
 

Suggestions: (1) Anecdotes are useful to support a particular conclusion.  For example, if the
group decided that a child was shy, then give a description of a situation in which the child was
observed being “shy.”  (2) Your group might want to choose two children who vary on some
characteristic like age, gender, or ethnicity.  If so, then your group conclusion might include a
comparison of the two children. (3) Group members may want to photocopy their running record
for the other members of the group.
 
 

                                                  EXAMPLE OF A RUNNING RECORD

Kelsey is a white, 15 month old female at the Sense of Wonder day care.

Running Record of Kelsey’s activities on Tuesday, January 9, 2001 from 9:09am to 9:24am:
Kelsey is sitting quietly by herself at the table.
The instructor puts a bib on her-she does not resist.
Kelsey begins to play with the bib while watching 2 boys who are playing nearby.
Her gaze wanders to a different part of the class, back to the 2 boys, and then to the girl who is now sitting on her left.
The instructor places a waffle stick with syrup on a plate in front of her.
Kelsey picks up the waffle stick with her right (R) hand.
She then dips her left (L) finger in syrup that has dripped onto the plate and tastes it.
Next, she begins eating the waffle.
She spends a few minutes alternating between taking bites of the waffle and licking syrup off her L fingers which she repeatedly dips into the syrup (it actually looks as though she is trying to pick up the syrup).
The instructor places a cup of milk in front of her.  There is a lid on the cup.
She attempts to pick up the cup with her R hand, but the cup falls on its side.
Kelsey doesn’t seem to notice; she continues to eat her waffle and seems content.
The instructor puts the cup upright but Kelsey is not paying attention.
Kelsey happily continues to take bites of the waffle stick still in her R hand; she attends to events in her surroundings (i.e. she turns her head in that direction and watches).  For example, she watches as a girl arrives with her mother.
Kelsey switches the waffle stick to her L hand and continues to eat.
She puts the waffle down on the plate after a few moments and picks up the cup with both hands.  She proceeds to drink from the cup.
She tries to place the cup back on the table, but it falls on its side (on the table).  She does not attempt to pick it up.  Soon the instructor puts the cup upright and redirects Kelsey’s attention to her waffle.  She picks it up with her R hand and takes bites from  it.   Again she is attentive to events in her surroundings while she eats.
When she is finished her waffle stick, she sits quietly for a moment.  Then she simultaneously looks around, plays with some syrup that has spilled on the table with her R hand, and licks her L fingers.  She looks content.
She soon picks up the plate with both hands and licks the syrup on it.
She lifts up the cup with both hands and drinks.  Again, the cup falls on it’s side when she attempts to replace it and, again, the instructor places it upright.
Kelsey stares quietly at the instructor who asks her if she would like more food.
The instructor places a new waffle stick in front of her.
She picks up the waffle with her L hand and begins eating.  Soon she begins tearing off pieces of the waffle with her R hand.  She eats the torn-off pieces.
Soon she resumes taking bites of the waffle in the L hand.  She watches the instructors and the other 0-3 year olds around her (most of the class is sitting and eating waffles now and have been for awhile).
She finishes the waffle and again looks as though she is trying to pick up the syrup from the plate with her L hand.  She licks those fingers.
She gets another waffle stick and immediately dips her L index finger into the syrup that is on top of it.  She licks this finger.  She then picks up the waffle with her L hand and tears off pieces with the R hand to eat.
She watches a crying baby as she continues to eat.
 
 

   GROUP ASSIGNMENT #3   
   CHOOSING THE BEHAVIORS YOU ARE TO OBSERVE

   In your first assignment, you observed two young children for 15 minutes each.  This assignment should have given you a flavor of what children this age do and what is easily observable.  For this assignment groups must decide what behaviors they are going to observe for their large  research project.  Each group will observe 4 infants differing in age or gender and these infants must be seen twice during one month and twice again a month later (ex.: 2 boys + 2 girls seen 2 times in October and 2 times in November = 16 observations (4 observations per child). 

   Before the observations take place groups must choose a particular area of development, i.e., perceptual, cognitive, social, emotional, temperament and then choose 4 behaviors that reflect that specific area of interest.  In addition, the group must come up with a working definition of the 4 behaviors so that all members are observing the same thing.  Finally, groups must report who they will observe (approximate age, sex) and what sampling method they will use (event sampling, time sampling, or scales).

   Groups must complete the Assignment #3 form that describes their intentions.  Groups will get feedback about whether these behaviors are appropriate to observe and are defined sufficiently for any person to know what to observe.  Ex.  Group 12  is interested in motor development.  Your group chooses to observe gross motor skills in 4 infants who differ in age.  The infants/toddlers will be attending a local day care center.  Members will observe walking, crawling, running and climbing which are operationalized in the following ways....”  Please use the form to report your group’s intention.

   ASSIGNMENT #6
   INDIVIDUAL RESEARCH REPORT

   For your last assignment you are responsible for independently writing up a research report on the data you collected with your group.  That is, you will write up a paper following the RESEARCH GUIDELINES on the 16 observations your group did on 4 infants/toddlers.  Only the method, data and the presentation of the data (tables & graphs) can be shared among group members.  Members also have the choice to write up these sections on their own.  The introduction, purpose, and discussion must be done on your own.  The following are hints to help you accomplish this task.  Please remember that this paper is worth 30% of your final grade.  Your grade on the paper will be adjusted based on your group participation grade.  Because this paper is a product of 3 assignments, the group’s evaluation of your performance will be adjusted accordingly.  Each quarter point (.25) will be worth -3 points.  For example, if your mean evaluation was 2.5, 6 points will be deducted from the grade you get on your paper.

1.    You are to review one published research paper that does a study on the area of development your group is researching or on the specific behavior you are observing.  For example, if you are doing peer interactions you should look for a research article on peer behavior in toddlers.  Or, you can go more broadly to social development and review an article on, for example, the impact of mothering on later relationships.  The best way to do this is to go to the Periodicals Room and look at the recent journals in child development.  These are Child Development, Developmental Psychology, Infant Behavior and Development and Infancy.  Look through the table of contents and choose an article that fits this requirement.  Read the article and then summarize it in 5-7 sentences that includes: the purpose of the study, the methods (how they observed behavior), the results, and their conclusions.  DO NOT COPY ANY SENTENCES FROM THE ARTICLE -- THIS IS PLAGIARISM.  Use your own words to summarize.  You MUST include a copy of the ABSTRACT with your paper.  Failure to do so will result in a deduction of 5 points.  Finally, be sure to include the reference to this article at the end of your paper, also worth 5 points. 

2.    Your results should be presented in at least 2 formats.  You can either present the raw numbers in a table and graphs, or in the text of the paper and on graphs.  If you choose to use a table to report the frequencies then you should say something under the Results section that refers to the table and what is in it. The graph can be either a bar chart or a line chart and should represent the behaviors at the two time points.  The two observations which were done closely together should be averaged or added and reported as a percent or proportion.  For example, if you saw smiling 5 times on the first observation, and smiling 10 times on the second, you can either report the child smiled an average of 7.5 times or 25% of all behaviors (assuming a total of 60 behaviors, 25% = 15 total times smiling/60 total behaviors).  This would be for one time point.  Then you would have data from the 3rd and 4th observations for the second time point.  If you saw smiling 4 and 12 times, respectively then you would either report the a mean of 8 times or a percent of 13% (assuming a total of 60 behaviors).  Your chart should include results from both time points.  Example: a bar representing 7.5 for Time 1 and 8 for Time 2.  You must also expand your results to include a combination of the infants who are the same on one variable such as age or gender.  For example, if you observed a female smiling 15 times at Time 1 and another female smiling 15 times at Time 1 you could create a bar graph that compares the females to the males with the females showing a mean of 15 smiles vs., say, 8 for the males.  When combining subjects you will need to take an average of the 2 subjects.

3.    The Discussion section is where you draw your conclusions about the children you observed.  You should talk about each individual child and either females vs. males or younger infants vs. older infants, etc.  Here you should use anecdotes, situations or examples that explain your findings/conclusions.  Be creative.  Use what you have learned about child development to support your arguments.

4.    IMPORTANT: Other hints on writing your report.  Please use HEADINGS as seen in the guidelines.  Also, do not use the first person (“I”) when writing your report; rather use “The subject was observed doing ...”  Also check your spelling and grammar.  That is, read your report before you turn it in.  Points will be deducted for not following directions, spelling and grammar.
                                        

                                     RESEARCH REPORT GUIDELINES
 

                                                    INTRODUCTION

                        (This is where you summarize the article you read - 10 pts.)

Example
 A study by Stenberg and colleagues (Stenberg, Campos, & Emde, 1983) found that infants ...
  OR
 A study of infant anger (Stenberg, Campos, & Emde, 1983) found that infants...

     Purpose. (State what your intention was - 5 pts) The purpose of the present study was to...

Example
 The purpose of this study was to investigate the motor behavior of a pre- schooler during play time.

                                                    METHODS

Subjects.  (Describe your subjects in this section - 5 pts.) The subjects of this study were ....

Example
Subjects
    The subjects of this study were a four-year-old male, a four-year-old female, a 3-year-old male and a 3-year-old female.  All four subjects come from two parent families in which the mother does not work outside the home

Setting.  (Here you describe where you did the observation.  It should include general description if in large area or more specific details if in smaller area.  Also include number of adults and children present if appropriate - 10 pts.)  The subject of this study was observed during ...
  The setting in which the observation was recorded was ...

Example
Setting
    The subjects of this study were observed during outdoor free playtime which occurs from approximately 8:30 to 9:00 a.m.  Each child was observed twice within 48 hours.  The same 4 children were observed a second time 3 weeks later for a total of 4 observations per child.
 The setting in which the observation was recorded was a playground outside the building in which the pre-school is housed.  The playground consists of several pieces of play equipment such as a jungle gym, swings, sandbox, and sliding board.  There are also several small tricycles for the children's use.  During the observation, 5 adults and 25 children were present.  It appeared that the adults were either instructors or teaching assistants.

Procedure.  (This section describes in detail which behaviors you observed, an operationalization of those behaviors, how the behavior was coded and for how long - 25 pts.)  The behaviors observed were ...  The type of behavioral recording was ...
 Behaviors were recorded for ... (length of time)

Example
Procedure
    For the purposes of this study on motor behavior, the following behaviors were recorded:  number of times the subject used playground equipment; number of times subject ran during play; and number of times subject jumped during play.  Using playground equipment was defined as anytime the child used the swingset, jungle gym or sliding board for its intended purpose.  Running during play was defined as quick movement across the playground.  Jumping was defined as leaving the ground by jumping or jumping off playground equipment on the subject's own accord.  The behaviors were observed and recorded using the event sampling method.  Behaviors were recorded during the entire play session which lasted 30 minutes.

                                                      RESULTS

(Here is where you will report the numbers you recorded.  You can refer to a bar chart or table that reflects the frequencies or durations.  A percentage of total behaviors or mean of the frequency counts should be reported here for each subject at each time.  A line or bar graph should be used to represent the data - 15 pts.)

Example
                                                    RESULTS
     Observations of motor behavior for the subjects of this study showed that during the 30 minute play session the 4 year old male subject used playground equipment 10 times during the first observation and 8 times during the second observation which occurred one day later which totaled 18 times (T1), On the 3rd and 4th observations which occurred 3 weeks later (T2), the subject used play equipment a total of 5 times.  This subject also ran for a total of 12 times at T1 and 8 times at T2; and jumped during play 6 times at T1 and 6 times at T2.  The second subject ....   In percentages, at T1 the first subject of this study spent one- half (50%) of his total play behavior using the playground equipment while the percent of total behavior spent running during play was 33%.  Finally, 17% of the subject's play behavior was jumping.  At T2, ...
                                                     DISCUSSION
(This is the section in which you actually discuss and make sense of what you found.  Be creative! - 25 pts.)
 The purpose of this study was to ...
 The results of this study showed ...
 From the results we might conclude that ...
 Future research might....

Example
                                                    DISCUSSION
 The purpose of this study was to investigate the motor behavior of four pre-school children twice during outdoor play time and again 3 weeks later.  The results showed that the motor behavior of a four-year-old boy was spent primarily using playground equipment while the amount of running and jumping during play was somewhat less.  It appears that this subject enjoys play that involves objects rather than play that centers around his own physical abilities.  For example during one long play bout, the subject was intently playing with the jungle gym, developing an elaborate drama about firefighting.  It may be that he has limited physical capabilities and uses objects as a way of expressing what gross motor ability he does have.  Alternatively, it may be that his parents discourage this type of activity or his environment is not conducive to it.  In contrast to the male subject, the female subject .... The next step might be to investigate his behavior in a more confined setting.

                                                         References

 Stenberg, C., Campos, J., & Emde, R. (1983).  The facial expression of anger in seven-month-old infants.  Child Development, 54, 178-184. (5 pts.)

*** Copy of article Abstract - 5 pts. *****
 
 
 


Class Outlines

         Why Infancy?            Prenatal development             Prenatal influences

         More Prenatal Influences            Labor and Delivery         Research Methods    

          Basic Characteristics          Nervous System Development      Perceptual Development

         Temperament       Emotional Development   Attachment

          Social Development


  
I.  Why study infancy?

 II.  History of infant study

III.  Themes of development

 A.  Normative vs. Individual differences

 B.  Interactions among developmental areas

 C.  Directions of development

  1.  Cephalocaudal
  2.  Proximo distal

 D.  Competent infant

 E.  Nature vs. Nurture
 

 IV.  Developmental Concepts

 A.  Stability

  1.  Homotypic stability
  2.  Heterotypic stability
  3.  Mediational model

 B.  Continuity

 C.  Stages



Prenatal Development

I.    Why study prenatal development?

II.    Conceptualization/Fertilization

           A.  Infertility

III.    Three stages of development

       A.  Zygote (0-2 weeks)

               **** endometrium *****

               **** ectopic of tubal pregnancy *****

           B.  Embryo (2-8 weeks) - period of organogenesis

                   *** 3 support structures ***

                     1.  Amnion or amniotic sac
                     2.  Placenta
                     3.  Umbilical cord

                   **** 3 cell layers ***

                       1.  endoderm
                       2.  ectoderm
                       3.  mesoderm

           C.  Fetus (8 - 40 weeks)

                   *** marked by bone formation ***
                   *** quickening (4-5m) ***
                   *** lanugo (4-5m)***
                   *** vernix caseosa (5-6m) ***
                   *** age of viability (~ 28 weeks) ***

  
Prenatal Influences

I.    Chromosomal Abnormalities

   a.  genotype
   b.  phenotype

   A.  Detection

       1.  Triple screen blood test
                  ***alpha fetoprotein ***

       2.  Amniocentesis
       3.  Chorionic villus biopsy

   B.  Trisomy 21 (Down’s syndrome)

   C.  Sex Chromosome Disorders
      
       1.  Turner’s - XO
       2.  Klinefelter’s - XXY
       3.  Fragile X

II.    Genetic Defects

   A.  Tay Sacs Disease
  
   B.  Sickle Cell Anemia

   C.  Phenylketonuira (PKU)

   D.  Rh incompatibility

III.    Infectious Diseases

   A.  Rubella (German Measles)

   B.  Cytomegalovirus (CMV)
  
   C.  Sexually-transmitted diseeases

       1.  Herpes Simplex Type II
       2.  Syphillis
       3.  Gonorrhea
       4.  HIV/AIDS


   Prenatal Influences (continued)

IV    Conditions of the Mother

   A.  Age

       1.  Older mothers
       2.  Teenage pregnancy

   B.  Malnutrition

       1.  Overeating
       2.  Undernourished
       3.  Ideal weight gain

V    Teratogens

   A.  Narcotics

       1.  Cocaine
       2.  Heroin
           a.  Methadone

   B.  Thalidomide

   C.  DES

   D.  Smoking

   E.  Alcohol


   Labor and Delivery

I.    Labor

   A.  Prelude

       **** oxytocin ******
       **** lightening *****
       **** Braxton-Hicks (false labor ******

   B.  Onset of labor

   C.  Stages of labor

       1.  Effacement

           a.  Early Phase
           b.  Active Phase
           c.  Transitional Phase

       2.  Birth of the baby

           *****episiotomy ****

       3.  Delivery of the placenta

   D.  Presentations

       1.  Normal (vertex)
       2.  Transverse
       3.  Breech
              

II.    Childbirth Practices

   A.  Historical perspective
  
   B.  Standard delivery practices

       1.  Criticisms

           a.  Exclusion of significant others
           b.  Separation of mother from infant
           c.  Pregnancy as illness, delivery as surgery

   C.  Current approaches

       1.  Prepared childbirth

           a.  Dick-Read
           b.  Lamaze
           c.  Leboyer
           d.  Bradley

       2.  Home deliveries
       3.  Midwives, doulas

III.    Labor and Delivery Aids
  
   A.  Fetal monitoring
   B.  Forceps/vacuum extraction
   C.  Cesarean section
   D.  Drugs

       1.  Tranquilizers/sedatives
       2.  Analgesics
       3.  Anesthetics

IV.    Prematurity

   A.  Reasons
       1.  Abnormalities of the reproductive system
       2.  Multiple births
       3.  Maternal age
       4.  Adverse conditions

   B.  Problems associated with prematurity

       1.  Respiratory distress syndrome (RDS)
           ***** surfactant ****
       2.  Apnea
       3.  Feeding
       4.  Thermoregulation

   C.  Short-term effects

       1.  Lack of sleep-wake cycle
       2.  Difficulty with attention
       3.  Hypersensitivity
       4.  Bonding
   D.  Long-term effects

       1.  IQ

   E.  Interventions

       1.  Newborn Intensive Care Unit (NICU)



   Research Methods

I.    History of infant study

   A.  Baby biographies

II.    Research Procedures

   A.  Where

       1.  Naturalistic
       2.  Laboratory

   B.  Who

       1.  Parents
       2.  Researchers
       3.  Others

   C.  When

       1.  Control time
       2.  Any time

   D.  How

       1.  Live observation
       2.  Videotaping
       3.  Standardized situations

III.    Research Designs

   A.  Longitudinal
   B.  Cross-sectional
   C.  Natural experiments
   D.  Experimental

IV.    Interpretation and Measurement Issues

   A.  Correlational studies
   B.  Causality
   C.  Reliability
   D.  Validity


    BASIC CHARACTERISTICS


I.    Reflexes

   A.  Approach
   B.  Avoidance
   C.  Other

II.    Infant State

   A.  Cycles
   B.  Sleep
   C.  Crying
  
       1.  Types - Basic, Anger, Pain
       2.  Developmental course
       3.  Diagnostic Value
       4.  Adult reactions
       5.  Soothing
       6.  Colic

III.    Rhythmic Activities

   A.  Sucking

       1.  Nutritive
       2.  Nonnutritive


   NERVOUS SYSTEM DEVELOPMENT


I.    Nervous System defined

   A.  Anatomical

       1.  Central Nervous System
       2.  Peripheral Nervous System

   B.  Functional

       1.  Somatic
       2.  Autonomic

II.    Cellular level

   A.  Cell Body
   B.  Dendrites
   C.  Axon
   D.  Synapse
   E.  Myelin
          
III.    Development of the CNS

   A.  Structure
   B.  Weight
   C.  Proportion
   D.  Size

IV.    Measurement

   A.  EEG

V.    Heart Rate

   A.  Orienting response
   B.  Defensive response



PERCEPTUAL DEVELOPMENT

Perception - process of integrating the sensations derived from hearing, seeing, feeling, tasting, and smelling and giving them meaning

I.    Development

II.    Research Methods

   a.  Preference
   b.  Habituation
   c.  Conditioning

III.    Visual Perception

   a.  Acuity
   b.  Pattern preference
   c.  Face perception
   d.  Orientation
   e.  Movement
   f.  Color
   g.  Depth perception

       1.  Looming
       2.  Visual cliff

IV.    Hearing/Audition

   a.  Measurement
   b.  Acuity
   c.  Speech perception

V.    Taste/Smell/Touch

VI.    Cross-modal perception



EMOTIONAL DEVELOPMENT

I.    What is an emotion?

   A.  Structuralist approach
       1.  Primary emotions
       2.  Secondary emotions

   B.  Functionalist approach

II.    Theories of Emotion

   A.  Learning
   B.  Psychoanalytic
   C.  Differentiation/Cognitive
   D.  Biological/Ethological

III.    Facial Expressions

   A.  Inductively-derived
   B.  Template/Anatomically-based

IV.    Development of certain emotions

   A.  Smiling/Laughter
   B.  Anger
   C.  Fear

V.    Socialization of Emotion

   A.  Sensitivity to emotional signals
   B.  Social referencing


       



Student Brochures

Tay Sachs        Sickle Cell Anemia        Cystic Fibrosis        Rubella (German Measles)        CMV

Thalidomide        HIV/AIDS           Gonorrhea        Smoking        Alcohol        Cocaine


TAY-SACS DISEASE

What is Tay-Sachs Disease?
   Tay-Sachs Disease is a genetic disorder, caused by a defective gene.  Tay-Sachs occurs when a missing enzyme results in a build up of fatty substances in the nerve cells of the brain.  This results in a range of disabilities and death.

Who Gets Tay-Sachs Disease?
   Tay-Sachs is common among Jewish people of Ashkenazi origin. 

Why Does Tay-Sachs Disease Occur?
Tay-Sachs is a genetic Disorder, which affects babies who receive two defective recessive genes (one from the father and one from the mother).  Both Ashkenazi Jewish parents must be carriers of the recessive gene, in order to have a child with Tay-Sachs Disease. 

Where Does Tay-Sachs Disease occur in the Body?

   Tay-Sachs Disease occurs when large amounts of a fatty substance, known as Ganglioside (GM2), are deposited and piled up in the nerve cells of the brain.  This accumulation of Ganglioside is caused by the lack of an enzyme of Hexosaminidase A. 
   Early detection of Tay-Sachs Disease occurs in the retina of the eye, where a cherry-red spot forms.  This may be detected only by the use of an Opthalmoscope, an instrument designed for the examination of the eye and its background. 

How Does Tay-Sahcs Disease Occur?
   Tay-Sachs Disease is a genetic disorder that can only occur if both parents are carriers of the genetic mutation in the enzyme Hexosaminidase A. 

What are the Symptoms of Tay-Sachs Disease?
The symptoms of the Tay-Sachs Disease begin to appear at about 3 to 6 months of age.  Until this time the child will appear to develop normally.  The symptoms of Tay-Sachs include blindness, deafness, dementia, listlessness, irritability, paralysis, seizures, decreased muscle tone, loss of muscle function, temper or agitation, and delayed mental and social skills.  A child that suffers from Tay Sachs may also grow more slowly.

What Treatments are there for Tay-Sachs Disease?
At this time, there is no treatment for Tay-Sachs Disease.  Most children suffering from Tay-Sachs usually die by the time they are 5 years of age.  This includes children receiving the best of care.

What are the Risk Factors of Tay-Sachs Disease?
Risk factors for Tay-Sachs Disease include having an Ashkenazi Jewish background where both parents possess the recessive gene.

What are the Incidence Rates of Tay-Sachs Disease?
The incidence rate for Tay-Sachs is approximately 1 out of 3,600 Ashkenazi Jewish babies.  When both parents carry a genetic mutation in Hexosaminidase A (two recessive genes) there is a 25% chance of having a child with Tay-Sachs Disease.

Internet Resources:
http://www.ninds.nih.gov/health_and_medic...sorders/taysachs_doc.htm?format=printable
http://health.yahoo.com/health/diseases_a..se_feed_data/tay_sachs_disease/
https://www.mylifepath.com/article/gale/100268466



SICKLE CELL ANEMIA

What is Sickle Cell Anemia?
Sickle Cell Anemia (SCA) is an inherited red blood cell disorders. Normal red blood cells are round like doughnuts, and they move through small blood tubes in the body to deliver oxygen. Sickle red blood cells become hard, sticky and shaped like sickles. When these hard pointed red cells go through the small blood tube, they clog the flow and break apart. This can cause pain, damage and a low blood count, or anemia.

Who’s Affected?
SCA affects millions of people. It is particularly common among people whose ancestors come from Africa, Spanish-speaking regions, Saudi Arabia, India and Mediterranean countries. In the USA, it affects about 72,000 people, most of those whose ancestors are from Africa. The disease occurs in about 1 in every 500 African-American births and 1 in every 1,000-1,400 Hispanic-American births. Approximately 2 million Americans, or 1 in 12 African Americans, carry the sickle cell trait.

How does SCA occur?
The presence of two defective genes is needed for sickle cell anemia. If each parent carries once sickle hemoglobin gene and one normal gene with each pregnancy, there is a 25% chance of the baby being born with sickle cell anemia, a 25% chance of inheriting two normal genes and being disease free and a 50% chance of being a carrier of SCA.

Symptoms
·    Chest pain
·    Fever
·    Anemia
·    Shortness of breath
·    Fatigue
·    Abdominal swelling
·    Unusual headaches
·    Sudden weakness or loss of feeling
·    Pain that does not go away with home treatments
·    Painful erections that do not go down
·    Sudden vision changes

Risk Factors
Increase in mortality, especially in first 3 years of life. SCA also causes chronic anemia, damage of the liver, kidneys, lungs, bone and the central nervous system. In 70% of patients, the bones of the back and chest are affected by blocked blood vessels and damaged organs, which causes acute painful episodes.

Treatments of SCA
There is no cure for SCA, however doctors can do a great deal to help patients deal with their disease. Heavy pain killing drugs are used to combat painful episodes and to prevent complications. Blood transfusions are used to increase the number of healthy red blood cells in circulation. Transfusions are also used to treat spleen enlargement in children before the condition becomes life threatening as well as a preventative of strokes in children. Oral penicillin given twice a day to children starting at 2 months old to 5 years of age can prevent pneumococcal infection. The anticancer drug hydroxyurea reduces frequency of painful crises.  Daily health maintenance includes, good nutrition, hygiene, bed rest and protection against infections.


Cystic Fibrosis

Cystic Fibrosis affects about 30,000 children and adults in the U.S.

What is Cystic Fibrosis?

It is an inherited disease that mainly affects the lungs, causing thick mucus build-up that results in chest infections.  It can also affect the bowels and the pancreas, causing blockages and poor absorption of digested foods.

What are my chances of getting it?

A person must inherit this recessive gene from both parents to have cystic fibrosis.  It occurs mostly in Caucasians.  Many people may be carriers of the gene, but do not experience the symptoms because they did not receive both defective genes.

Symptoms and Complications:
  
For Newborns:
·    A blockage in the bowel
·    A failure to grow to their potential size
·    Frequent chest infections
·    Salty-tasting skin

For Children and young adults:
·    Enlarged liver and spleen
·    Infertility
·    Diabetes
·    Nasty smelling yellow stools
·    Frequent chest infections
·    A failure to grow to their potential size
·    A blockage in the bowel

Treatments:

TOBI (Tobramycin Solution for Inhalation)- A reformulated version of the common antibiotic improved lung function in people with CF and reduced the number of hospital stays.  The benefits are that it can be delivered in a more concentrated dose directly to lung infections more efficiently.

Pulmozyme- this is a mucus-thinning drug that reduces the number of respiratory infections and improved lung function. 

Ibuprofen- reduced the rate of lung inflammation in children with CF- under controlled conditions and high doses.

*For more info visit www.cff.org for treatment locations and contact numbers

Sources:  Cystic Fibrosis Foundation- www.cff.org, WEBMD-www.webmd.com, BUPA healthline-www.bupa.com



Rubella (German Measles)

Rubella is caused by a virus that can be easily spread through a cough or sneeze by an infected person.  It is primarily a minor childhood disease found in unvaccinated populations around the world. However, as many as 2 in 10 women are susceptible to rubella in the U.S.

The disease is potentially serious when a pregnant woman becomes infected within her first trimester.  There is an 85% chance of fetal miscarriage, premature delivery or birth defects.
Possible Effects on Fetus
Ø    Deafness
Ø    Cataracts
Ø    Heart defects
Ø    Liver and spleen damage
Ø    Mental retardation
The chance of these birth defects is rare if the disease is contracted after the 20th week of pregnancy.

Symptoms of Rubella
Ø    Low fever (102 F or lower)
Ø    Headache
Ø    Runny nose
Ø    Inflammation of eyes
Ø    Rash with skin redness or inflammation
Ø    Cloudy cornea
Ø    Noticeable discomfort

There is no treatment available, so it is important to make sure that you were vaccinated as a child or three months before pregnancy.

www.nfid.org National Foundation for Infectious Diseases
www.health.state.ny.us New York State Department of Health 
umm.drkoop.com University of Maryland Medicine 

Friedman, H and Prier, J. (1973).  Rubella.  Thomas/Publisher; Illinois. 



Cytomegalovirus

Pregnant Women Need To Be Aware Of the Risks of CMV

BASIC INFORMATION

What is it?
§   It is a virus that is a member of the herpes family

Who has it?
§   50-85% of all adults in the U.S. contract it by age 40.  Most of the time it is harmless and is inactive.
§    80% of toddlers in the U.S. shed the virus in one or more of their bodily fluids.

So why do pregnant women need to be concerned about it?
§    When transmitted prenatally, it is the most common viral cause of mental retardation, blindness, deafness, coordination problems, and other delays in development. It affects 1 in every 1,000 infants.  When transmitted this way t is called congenital CMV. 
§    Especially at risk are the fetuses of women who become infected for the first time during pregnancy or women who have recurrence of the infection while pregnant.

How does congenital CMV affect babies?
§    The virus can affect several parts of the body: the eyes (retinitis), the intestine (colitis), The throat/mouth (esophagitis), the brain (encephalopathy), the
     lungs (pneumonitis), and the spine (myelitis).
§   Developmental delays and/or varying degrees of mental retardation may result from congenital CMV. 

How many infants have problematic congenital CMV?

§   1% of all infants born in the U.S. have congenital CMV.  Of these, 10% are symptomatic.  Within that 10%, 20% will die.

Signs and Symptoms
§    Most adults do not have any sign or symptoms of CMV.  For this reason it often called “the silent virus”
§   When adults do show signs, they often include a sore throat, fatigue, and other mono-like symptoms.

Transmission of the Virus
§    CMV can be a sexually transmitted disease passed between people through any kind of bodily fluid.
§    Congenital CMV can also be passed from a pregnant women through the placental barrier to the fetus.  Infants can also contract the disease through
     vaginal secretions during birth, breast feeding, and contact with the saliva of  other infected children.
§    Despite its frequency, CMV is not highly contagious. 

FAQ

Q.    What should I do if I’m pregnant and concerned that I have CMV?
A.    Contact your doctor first.  A blood test should reveal whether or not you have the virus or not.  Keep in mind the risk of congenital in infants is significantly less in women who have already had the disease.  Treatment during pregnancy is not recommended.  Your doctor can explain to you the risks to the fetus as well as provide you with options.

Q.    Is there a cure?
A.    Currently no, but vaccination research is in progress.

Q.    How can I prevent getting CMV?
A.    Practice good personal hygiene, especially hand washing after contact with diapers or oral secretions.

Q.    I heard that breastfeeding may increase the risk of CMV to my infant.  What should I do?
A.    The most dangerous time for infants to get CMV is prenatally.  Although 40% of infants nursed by CMV mothers acquire the disease, it does not cause any
     symptoms at this age.

For more Information:

AIDS Treatment Data Network:
http://www.aidsinfonyc.org/network/simple/cmv.html

Bestfed.com: Nurturing Children Through Progressive Parenting
http://www.bestfed.com/katie/cmv.htm

Cytomegalovirus Infection, National Center for Infectious Disease:
http://www.cdc.gov/ncidod/diseases/cmv.htm

National Congenital CMV Disease Registry
http://www.bcm.tmc.edu/pedi/infect/cmv/cmvbroch.htm

Enders, G., Bader, U., Lindemann, L., Schalasta, G., Daiminger, A.  (2001). 
Prenatal Diagnosis of Congenital Cytomegalovirus Infection in 189
Pregnancies with Known Outcome.  Prenatal Diagnosis, 21, 277-362

Marx, J.  (1975).  Cytomegalovirus: A Major Cause of Birth Defects.  Science, 190,
1184-1186.

Stagno, S., Cloud, G.  (2001).  Working Parents: The Impact of Daycare and
Breast Feeding on Cytomegalovirus Infection in Offspring.  Proceedings of
the National Academy of Science, USA, 91, 2384-2389.



THALIDOMIDE: a nearly odorless, off-white, crystalline powder with the empirical formula of C13H10N2O4.


What did people use it for?
  To ease morning sickness symptoms

Chemie Gruenthal manufactured Thalidomide in 1953 in West Germany.   The sedative was made available in pill form on October 1, 1957 in West Germany, and in late 1959 in Canada.  It was distributed in at least 46 countries under numerous brand names for a few years.  Thalidomide was proven to be effective in reducing most of the symptoms of morning sickness in pregnant women.  However, those distributing the drug did not realize that Thalidomide molecules could cross the placental wall and affect the unborn fetus, creating devastating side effects, including death. There is no treatment.  The drug will effect the unborn child in whatever development stage it is in.

Although no proper census was ever taken, it has been estimated that there were between 10,000 and 20,000 babies born with disabilities as a consequence of the drug.  The numbers of babies miscarried or stillborn as a result of the drug remains to be unknown.  However, mortality at or soon after birth is thought to be about 40%.
Today, about 5,000 Thalidomide survivors around the world remain.  They are now in their late thirties and experiencing constant physical deterioration as a result of the stress placed on their different body structures.  The Teratogen was withdrawn from the market by 1962 in all countries and today remains under strict supervision. Thalidomide re-entered the market during the later 1960s. Thalidomide is being used because it inhibits the growth of HIV in test tubes, treats mouth ulcers effectively in people with HIV, and helps with weight loss in people with AIDS.  In addition, Thalidomide has been approved as a treatment for  a condition associated with leprosy.

Birth Defects caused by THALIDOMIDE:

Phocomelia Syndrome
Heart Defects
Missing eyes
Deafness
Kidney abnormalities
Mental retardation
Other behavioral problems

! Sources:
http://www.aap.org/visit/thalmain.htm
http://www.rxlist.com/cgi/generic2/thalidom.htm
http://www.thalidomide.ca



     HIV/AIDS

    INCIDENCE RATES
Perinatal preventative treatments have become prevalently available during the past decade. In the early 1990’s, in the United States an estimated 1,000 to 2,000 infants were born with HIV infection every year. Recent studies have shown that there has been a drastic reduction in mother-to-child HIV transmission rates. Prenatal care for mothers infected with HIV includes counseling, testing, and AZT treatment resulting in saved lives of children. In the US 91% of all AIDS cases among children have been because of HIV transmission from mother-to-child during pregnancy, labor, delivery, and/or breast-feeding.
HIV has always disproportionately affects African-American and Hispanic women. In 1998, of the 382 children reported with AIDS, 321 (84%) of them were African-American or Hispanic. It is reported that these women are not receiving the preventative treatments for various reasons. Unfortunately, despite the drug therapy available, there are still 1 in 5 newborns born to mothers with HIV who ultimately contract HIV through breast-feeding.
Without any type of intervention, the transmission rate from mother-to-infant would be about 25%, resulting in 1,750 HIV infected infants each year. The lifetime medical costs of these babies is projected to be 282 million dollars.
SYMPTOMS OF HIV
Being tested for HIV is the only true was to determine whether or not one is infected. A significant number of people infected with HIV do not experience any symptoms for many years. When people do express symptoms, they include; rapid weight loss, dry cough, recurring fever, profound and unexplained fatigue, swollen lymph glands in armpits, groin, and neck, diarrhea for more than a week, white spots or blemishes on the tongue, mouth or throat, pneumonia, blotches under the skin in the mouth, nose, or eyes, memory loss, depression, and other neurological disorders.
RISK FACTORS FOR TRANSMISSION TO THE NEWBORN
HIV positive pregnant women that do not receive adequate prenatal care are at the highest risk for transmitting HIV or AIDS to their unborn infant. This is due primarily to the lack of prenatal HIV/AIDS screening, and inability to receive Zidovudine or AZT as a treatment option. In addition, women who use drugs during pregnancy are the least likely to seek prenatal care, and these women have a greater risk of transmitting diseases to their unborn infants.
Transmission generally occurs at three times, 25 to 40% occurs in utero, 60-70% during the labor and delivery, and between 14-29% through breastfeeding. Three to four hundred babies are born every year with HIV.

TREATMENT OPTIONS EXIST!
There are three known treatments for women infected with the HIV virus, assumed to treat women and her unborn child. They are both preventative treatments, meaning their aim is to prevent the infant from acquiring the mother’s disease.
The first preventative measure is part of early prenatal care, which includes HIV counseling and testing. The second treatment is for a woman who is diagnosed with HIV, a drug called Zidovudine (AZT). AZT is offered to infected women during pregnancy, labor, and delivery. The infant will also receive AZT following birth for six weeks, and during labor and delivery it is administered to the mother through an IV. A third option, and important point to remember is that breast-feeding is never an acceptable idea for a HIV positive mother.
For more information, contact The National Pediatric and Family HIV Resource Center – 800-362-0071



Gonorrhea

What is Gonorrhea?
Gonorrhea is a sexually transmitted disease, caused by bacteria called Neisseria gonorrhoeae, or gonococcus. It can result in sterility in both males and females. Symptoms may include soreness or irritation of the genital area, abnormal discharge, bleeding and vomiting. Early detection is important so that treatment can start, and damage to the body is kept to a minimum. In women, this disease can lead to Pelvic Inflammatory Disease (PID).

How is Gonorrhea transmitted?
It can be contacted through any form of sexual contact. The infection will appear in the area of contact (throat, anus, penis, vagina).

Who gets Gonorrhea?
People between the ages of 15-30, males and females are the highest group at risk for the approximately 800,000 cases reported each year. Anyone who has any sort of unprotected sexual contact is at risk

What if I have Gonorrhea and I am pregnant?
While there is a risk for the baby to be born early or stillborn, the biggest risk to the baby is serious eye infections, which can lead to blindness. There is also a possibility that the baby can contract the disease itself through contact with the mother’s genital area. In severe cases, gonorrhea in the mother can cause systematic diseases such as meningitis and septic arthritis. Because of the nature of the bacteria, the baby can only become infected during labor and delivery. *Mothers should have at least one test for gonorrhea during pregnancy*

What kinds of treatment are available for my baby and me?
Drops (silver nitrate) are administered to all infants in hospitals to protect against eye infection and blindness. For treating mothers, certain antibiotics, such as penicillin and ceftriaxone can be taken, but only under the advice of a doctor.

For more information: www.sidelines.org, www.allcaremedicalmanagement.com, www.plannedparenthood.org, www.epigee.org/guide/stds.html#gonorrhea, www.niaid.nih.gov/factsheets/stdgon.html, www.health.state.ny.us/nysdoh/consumer/gonor.html, www.health.state.mo.us/Glrequest/ID/Gonorrhea3/html, http://www.ama-assn.org/special/std/support/educate/stdgon.htm



Smoking During Pregnancy

Risk Factors and Symptoms
~ Increased likelihood of miscarriage
~ Increased chance of stillbirth
~ Can cause placental previa
~ Can cause placental abruption
~ Increased risk of preterm birth
~ Increased risk of learning disabilities
~ Higher incidence SIDS
~ Reduces the delivery of oxygen to the  fetus
~ Increased risk of cleft palate
~ Risk of mental retardation
~ Increased risk of asthma and respiratory disorders
~ Increased chances of childhood leukemia

Treatments for Infants
~ Premature infants stay in the hospital longer, allowing them time to grow
~ Premature infants require more treatment, but there is still a greater chance of death

Side Effects of Treatments
~ Venilators:  may damage the infant’s lungs, which may lead to chronic breathing problems
~Oxygen:  if an infant needs oxygen, it may damage blood vessels in the eyes which could lead to poor vision
~ Antibiotics:  certain antibiotics may cause hearing problems

Incidence Rates
~ In Indiana, about 24% of pregnant women smoke
~ In Missouri, about 26% of pregnant women smoke
~ Rate of maternal smoking during pregnancy for the United States in 1995 was about 14%
~ This is much lower than most other developed nations

Prevention Method
~ There are many state-run programs to help pregnant women quit smoking
~ One such program in California is called Smoke Free Start for Families
   -Provides counseling to pregnant and postpartum women
   -Counseling can be in person or by phone
   -There is no limit to the amount of aid a woman can receive

Sources
http://www.state.in.us/isdh/programs/tobacco/unborn.htm
http://pregnancy.about.com/library/weekly/aa111998.htm
www.discoveryhealth.com
www.healthanswers.com
http://www.health.state.mo.us/Publications/97pnssex.html
http://www.forces.org/evidence/hamilton/mat-smok/file2.htm



               ALCOHOL: THE TERATOGEN

Fetal Alcohol Syndrome is a pattern of mental and physical defects that develops in some unborn babies when the mother drinks too much alcohol during pregnancy.
· FAS is defined by four criteria: maternal drinking during pregnancy; a characteristic pattern of facial abnormalities; growth retardation; and brain damage.

Problems to the fetus:
a.    timing of alcohol is important, most damaging in the first trimester
b.    alcohol can pass through the placental barrier to thee fetus
c.     incidence rate- 1 out of 1,500 fetuses contract FAS, but only 1 out of 600 babies are born with the condition

Here are just some of the possible defects that FAS babies can suffer from:
Growth deficiencies- small body size and weight; slower than normal development
Skeletal deformities- deformed ribs; curved spine; hip dislocations; bent, webbed, or missing fingers or toes; small head; limited movement of joints
Facial abnormalities- small eye openings; dropping eyelids; nearsightedness; failure of eyes to move in the same direction; short upturned nose; sunken nasal bridge; opening in roof of mouth; low-set or poorly formed ears
Organ deformities- heart defects; heart murmurs; genital malformations; kidney and urinary defects
Central nervous system handicaps- small brain; mental retardation--usually mild to moderate but occasionally severe; learning disabilities; short attention span; irritability in infancy; hyperactivity in childhood; poor body, hand, and finger coordination

FAS babies:
·weigh less                                                        ·are shorter than normal
·have smaller heads                                           ·have deformed facial features
·have abnormal joints and limbs                         ·have poor coordination
·have problems with learning                              ·have short memories
·often experience mental health problems            ·have disrupted school experience
·get into trouble with the law                               ·have alcohol and drug problems
·have difficulty caring for themselves and their children

Signs and Tests-
a.    pregnancy ultrasound (determine the growth of the fetus and the presence of intrauterine growth retardation)
b.    b. echocardiogram (test the blood alcohol level in pregnant women who exhibit signs of intoxication)

·Studies suggest that drinking a large quantity of alcohol at one time is more dangerous to the developing fetus than drinking smaller amounts more frequently. However, all major authorities agree that pregnant women should not drink at all. The Division of Alcohol and Drug Abuse from the National Institute on Alcohol Abuse and Alcoholism urges women who are pregnant or anticipating a pregnancy to abstain from drinking alcohol.

· Effect of maternal drinking levels: the minimal quantity of alcohol required to produce adverse fetal consequences is unknown.  There is variability from person to person through factors like nutritional status, environmental factors, co-occurring disease, maternal age, and genetic factors.

www.well.com/user/woa/fsfas.htm
www2.potsdam.edu/alcohol-info/FAS/FAS.html
www.mcf.gov.bc.ca/child_protection
www.niaa.nih.gov/publications/aa50.htm
wysiwyg://13/http://content.health.msn....asset/adam_disease_alcohol_in_pregnancy



COCAINE

WHAT IS COCAINE AND HOW CAN IT BE PASSED ON TO MY BABY?

·    Cocaine is a type of teratogen, which is an environmental agent that causes damage during the prenatal period
·    Cocaine crosses the placenta and enters the baby’s circulation.  It can be found in both the urine and the hair of an exposed newborn.  Elimination of cocaine is slower in a fetus compared to an adult therefore; it remains in the baby’s body for a longer period of time
·    Cocaine can also appear in the semen of the father, which may reduce, his sperm count or increase the number of abnormal sperm.  This can result in fertility problems
·    Cocaine can also be passed through the breast milk, which can cause cocaine intoxication                                       

WHAT ARE THE EFFECTS ON THE DEVELOPING FETUS?
·    The fetus’s blood pressure can soar
·    The heart rate accelerates
·    The fetus’s muscles may convulse
·    Blood vessels may constrict reducing blood supply from the mother to the fetus during brain development
·    This may result in intra-uterine growth retardation, brain hemorrhages, or cysts

WHAT ARE SOME OF THE RISK FACTORS INVOLVED?
·    Prematurity
·    Low birth weight
·    Small head
·    SIDS (Sudden Infant Death)
·    Birth defects
·    Stunted growth
·    Poor motor skills
·    Learning Disabilities
.
WHAT TYPES OF SYMPTOMS MIGHT THE BABY DEVELOP?
·    Breathing difficulties
·    Irritability
·    Tremors
·    Muscular rigidity
·    Sleeplessness
·    Hyperactivity
·    Vomiting
·    Diarrhea
·    Seizures

WHAT ARE THE INCIDENCE RATES?
·    It has been estimated that 10 percent of the obstetric population uses cocaine
·    Low birth weight has been found to occur in 22 to 34 percent of all infants exposed to cocaine in utero
·    Evidence of brain malformation or hemorrhage occurs in approximately 35 percent of exposed fetus’s
·    Fetal cardiovascular abnormalities caused by maternal use of cocaine have been reported to occur in 4 to 40 percent of babies exposed to cocaine in utero
·    Following the birth, withdrawal symptoms are experienced in 31 percent of newborns exposed to cocaine.  These include seizures, depression, lethargy, etc.

ARE THERE ANY TREATMENTS AVAILABLE TO BABIES EXPOSED TO COCAINE?
·    Level II ultrasounds can identify malformations caused by cocaine
·    Early intervention therapy can be used to stimulate language and communication development  in order to eliminate the damage caused by cocaine exposure

IF I WANT MORE INFORMATION ON COCAINE AND PRENATAL DEVELOPMENT WHOM CAN I CONTACT?
The National Clearinghouse for
Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
Toll Free: 1-800-729-6686
Fax: (301) 468-6433
E-mail: www.health.org
PCRM  (Physicians Committee for Responsible Medicine) 5100 Wisconsin Ave., Suite 400 Washington, D>C> 20010
Phone: 202-686-2210                      Fax: 202-686-2216                             E-mail: pcrm@pcrm.org










LINKS TO THE WEB

Below are some web sites that may be of interest to students of infant development.  I will try to update them as we continue through the course.

Prenatal Screening:
http://www.noah-health.org/english/pregnancy/pregnancy.html#PREBASIC

Family Web
    - a site that describes in simple terms what a woman can expect during her pregnancy