THE PERIOD OF INFANTITY (BABY AGE). Theoretical lesson.

Anatomical and physiological features of children during infancy

Anatomical and physiological features of children during infancy

SKIN AND ITS ADDITIVES

SKIN AND ITS ADDITIVES

musculoskeletal system

musculoskeletal system

musculoskeletal system

10. musculoskeletal system

11. RESPIRATORY SYSTEM

12. RESPIRATORY SYSTEM

13. CARDIOVASCULAR SYSTEM

14. DIGESTIVE SYSTEM

15. DIGESTIVE SYSTEM

16. URINARY SYSTEM

17. URINARY SYSTEM

18. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

19. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

20. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

21. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

22. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

23. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

24. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

25. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

26. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

27. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

28. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

29. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

30. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

31. NERVOUS - MENTAL DEVELOPMENT OF CHILDREN of the 1st year of life

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infancy period

Age periods in children and their characteristics.)

The period of infancy conditionally begins on the 29th day of life and ends at 12 months. At this time, children grow intensively, add in body weight. Body length on average for the first year increases by 25 cm and reaches 75-80 cm, body weight triples, amounting to about 10.5 kg. Static functions develop, the child sits by 6 months, and walks by 1 year. From 5-6 months, milk teeth begin to erupt; by the year there are usually 8 teeth (front - 4 upper and 4 lower). A child is born with unconditional congenital reflexes, which include sucking, swallowing, blinking, sneezing, the act of defecation, urination, etc. As the central nervous system differentiates, starting from 2 weeks of life, conditioned reflexes develop. At first they are quite simple, for example, a reflex to the position during feeding, to preparing for feeding, but already from the 3rd month the reflexes become much more complicated: the child steadily fixes his gaze, follows the movement of an object, turns his head to the sound source, responds with a smile, active movements of the arms and legs to talk with him. Starting from 6 months - pronounces separate syllables, laughs out loud. By the age of one, children usually know about ten words, and from that moment the development of speech begins. The total duration of sleep in children 2-3 months is 16-18 hours, of which 10-11 hours at night and 6-7 hours during the day in 3-4 doses. At the age of 3 to 6 months, the duration of sleep is 16 hours a day, from 6 to 10 months - 15-16 hours, of which about 5 hours during the day in 2-3 doses. After 10 months, children switch to a double daytime sleep with a total sleep duration of 14.5-15 hours per day.

Due to the intensity of metabolic processes, a large need for food is characteristic, which is compensated by properly organized feeding. With any errors in the diet, diseases of the gastrointestinal tract, rickets, anemia, respiratory diseases easily develop, the child's body weight can quickly decrease, malnutrition develops. It is necessary to pay attention to excessive sweating, nape baldness, muscle tone disorders, an increase in the parietal and frontal tubercles, thickening of the epiphyses and ends of the ribs (“bracelets”, “rosary”), which indicates an active ongoing rickets. A decrease in the thickness of the skin fold and a decrease in tissue turgor suggest malnutrition. The screening test for deficiency anemia is a blood test.

In infants with diseases, especially infectious ones, there is a tendency to diffuse, general reactions; so, with pneumonia, influenza, dysentery, convulsions, meningeal phenomena may appear, toxicosis, dehydration easily develop. In this period, the prevention of these diseases and their timely diagnosis are very important. Children of the first year of life are subject to monthly dispensary observation with the measurement of body parameters, a thorough examination, blood and urine tests. After that, the state of health and development of the child is assessed.

Normal physical and psychomotor development baby, body resistance to infections and other adverse factors environment are possible only with proper nutrition, adequate regimen, care, hardening. In order to protect against infectious diseases, natural feeding and timely preventive vaccinations are especially important.

With full health, from the age of three months, combined prophylactic vaccinations begin according to the vaccinal calendar. It is necessary to strictly monitor compliance with the instructions and record any reactions to vaccination. Clinical examination of healthy children and vaccinations is the responsibility of the paramedic working in the office of a healthy child and the vaccination room.

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This period begins from 3-4 weeks of life and conditionally ends at 12 months. It is characterized by higher than in subsequent years, the pace of physical and mental development. The body weight of the child by the end of the first year of life triples. Height increases by 25 cm, head circumference - by 12 cm, and chest circumference - by 13-15 cm. The proportions of the body change significantly, approaching those of an adult, which is expressed in the predominant elongation of the limbs and, to a lesser extent, the trunk and head. Along with this, the child's body undergoes noticeable qualitative changes. In the first months of life, the processes of cell neoplasm are carried out, nerve cells acquire dendrites, fibers are myelinated. Static functions develop: by 2 months. the child holds his head well, being in an upright position; from 4–5 months rolls over from stomach to back, then from back to stomach; by 7 months sits on its own, and by the end of the year begins to walk. By 5 - 6 months. milk teeth begin to erupt, by the year there are usually 8 teeth.

In infancy, a child's mental development is carried out at a significant pace. As the CNS differentiates, starting from 2–3 weeks, and especially after a month, conditioned reflexes develop (1st signaling system). At first, they are quite simple, for example, a reflex to the position when feeding, and then become much more complicated. From 1 month the movements of the eyeballs become coordinated, the gaze is fixed on bright objects, auditory concentration appears, by the end of the 2nd month the child follows the movement of the object, smiles. From 3-4 months. he emotionally coos, recognizes loved ones, from the age of 6 months he babbles the syllables “ba”, “pa”, “ma”, laughs out loud. By the end of the year, the child pronounces the first meaningful words (from this moment the development of speech begins - the second signal system), fulfills simple requirements, understands the words of the ban. By this time, physical development is slowing down, mental development is ahead of it.

For proper development the child needs a clear organization of the regimen, nutrition, alternation of periods of sleep and wakefulness. Children 2-3 months old should be provided with a total sleep of 16-18 hours, of which 10-11 hours at night and 6-7 hours during the day in 3-4 doses; at the age of 3 - 6 months, the duration of sleep is 16 hours a day; from 6 to 10 months. - 15-16 hours, of which about 5 hours in the afternoon in 3 doses. After 10 months, children switch to a double daytime sleep with a total duration of 14.5 - 15 hours per day. After each sleep, the child should eat, and after each feeding, stay awake. All vital systems of the organism, adapted to extrauterine existence during the first month of life, are still unstable and easily upset under any irrational conditions. Properly organized feeding should provide a high need for a child of the first year of life in basic nutrients and calories. Unbalanced nutrition in conditions of intensive growth leads to the development of diseases associated with an easily occurring deficiency of certain substances. These include anemia, rickets, malnutrition. At the same time, the relative immaturity of the functions of the gastrointestinal tract makes it difficult to digest food and predisposes to the rapid development of gastrointestinal diseases.

In the first 3-4 months the child shows increased resistance to many infections (measles, scarlet fever, diphtheria, chicken pox, rubella, etc.) due to the preservation of passive immunity acquired in utero through the placenta. At the same time, it is sensitive to pyogenic microorganisms and especially to the intestinal flora. There is a tendency to generalize the inflammatory process, to a general response to any impact. So, with a number of diseases (pneumonia, influenza, dysentery), convulsions, meningeal phenomena, and toxicosis may develop.

1) THE PERIOD OF BREASTING AGE, ITS CHARACTERISTICS. MAIN FACTORS SHAPING THE HEALTH OF THE CHILD DURING THIS PERIOD

infancy period- from the 29th day of a child's life after birth until the end of the first year of life. This period is characterized by an intensive increase in the child's body weight and height, intense physical, neuropsychic, and intellectual development. The name itself speaks of the close contact of the child with the mother in this period. During infancy, the foundation of human health is laid. The infant has an innate need for active knowledge of the world around him.

Features of growth and development. Intensive increase in body weight. By 4.5 months, the body weight at birth doubles; by the end of the year, the body weight is 10–10.5 kg. Significant growth rates are noted: body length increases by 50% of the length at birth and reaches 75–77 cm by the year. The head circumference by the year is 46–47 cm, the chest circumference is 48 cm. The child's motor skills and motor skills are developing rapidly. There are three "peaks" of motor activity. The first - at the age of 3–4 months - is associated with significant morphofunctional changes in the projection visual zone; he is characterized by a complex of revival, joy at the first communication with adults. The second - at the age of 7–8 months - crawling activation, the formation of binocular vision and mastery of space. The third peak - 11–12 months - the beginning of walking. These types of motor activity are determined by sensory-motor connections, and the processes of growth and development are determined by the skeletal muscles of the child and his motor activity.

Features of the CNS. By the year, there is an increase in brain mass by 2–2.5 times. Intensive differentiation of brain nerve cells is noted in the first 5–6 months of a child's life. Of great importance in development is the orienting reflex, which reflects the child's innate need for movement and activity of the sense organs. Nerve connections between the child and surrounding people are established through facial expressions, gestures, voice intonations. The development of fine finger movements contributes to the development of the brain and speech. The emergence of a connection between the words and the response motor reactions of the child is of great importance, then the child's connection of the visual and auditory perception of objects with words, the names of objects when they are shown, the connection with individual actions ("give", "show") - this is the optimal course of development, necessary as a basis for subsequent periods of childhood. The need for contact with adults determines the mental development of the child.

EEG Features: at 2–3 months there is a stable rhythm, at 4–6 months the changes are unidirectional, and at 8–10 months progressive individualization is observed.

Features of the endocrine system. In the chest period in children, there is an increase in the function of the pituitary and thyroid glands. The level of thyroxine and triiodothyronine is higher than in adults. They stimulate the metabolism, growth and development of the child, ensure normal differentiation of the brain and intellectual development, but at the same time, the pituitary-thyroid system is the most vulnerable and sensitive to adverse influences, especially environmental and environmental factors. Clinically, this is characterized by a decrease in the rate of weight gain, the development of anemia and an increase in SARS. In the chest period, there is an increase in adrenal function and the biological activity of corticosteroids. There is a partial involution of the fetal zone of the adrenal cortex.

Features of immunity. Compared with the neonatal period, there is a slight decrease in the number of T- and B-lymphocytes, a decrease in maternal IgG, starting from 2–3 months. At 4–6 months, the first critical period of immunity is observed, which is characterized by a weakening of passive humoral immunity received from the mother, and the most low level specific antibodies - physiological hypoimmunoglobulinemia. Synthesis of its own IgG begins in a child from 2–3 months of age, its constant level is established after 8 months–1 year. The level of IgM by the end of the year of life reaches 50% of the adult level. The increase in secretory IgA is slow. The content of IgE in a healthy child during the year is insignificant, with manifestations of atopic dermatitis it increases significantly. The synthesis of IgM is characteristic of the chest period, leaving no immunological memory. In connection with the above, there is a high sensitivity to respiratory syncytial viruses, parainfluenza viruses and adenoviruses; measles, whooping cough atypically, leaving no immunity. Nonspecific resistance factors. In infants, a high content of lysozyme and properdin is observed, the level of complement in the blood serum rapidly increases, and from the first month of life, its content does not differ from the level of an adult. From 2–6 months, the final phase of phagocytosis to pathogenic microorganisms is formed, with the exception of pneumococcus, staphylococcus, Klebsiella, Haemophilus influenzae.

The period of infancy - from the 29th day of a child's life after birth until the end of the first year of life. This period is characterized by an intensive increase in the child's body weight and height, intense physical, neuropsychic, and intellectual development. The name itself speaks of the close contact of the child with the mother in this period. During infancy, the foundation of human health is laid. The infant has an innate need for active knowledge of the world around him.

Intensive increase in body weight. By 4.5 months, the body weight at birth doubles; by the end of the year, the body weight is 10–10.5 kg. Significant growth rates are noted: body length increases by 50% of the length at birth and reaches 75–77 cm by the year. The head circumference by the year is 46–47 cm, the chest circumference is 48 cm. The child's motor skills and motor skills are developing rapidly. There are three "peaks" of motor activity. The first - at the age of 3–4 months - is associated with significant morphofunctional changes in the projection visual zone; he is characterized by a complex of revival, joy at the first communication with adults. The second - at the age of 7–8 months - crawling activation, the formation of binocular vision and mastery of space. The third peak - 11–12 months - the beginning of walking. These types of motor activity are determined by sensory-motor connections, and the processes of growth and development are determined by the skeletal muscles of the child and his motor activity.

Features of the CNS. By the year, there is an increase in brain mass by 2–2.5 times. Intensive differentiation of brain nerve cells is noted in the first 5–6 months of a child's life. Of great importance in development is the orienting reflex, which reflects the child's innate need for movement and activity of the sense organs. Nerve connections between the child and surrounding people are established through facial expressions, gestures, voice intonations. The development of fine finger movements contributes to the development of the brain and speech. The emergence of a connection between the words and the response motor reactions of the child is of great importance, then the child's connection of the visual and auditory perception of objects with words, the names of objects when they are shown, the connection with individual actions ("give", "show") - this is the optimal course of development, necessary as a basis for subsequent periods of childhood. The need for contact with adults determines the mental development of the child.

EEG features: at 2–3 months a stable rhythm is noted, at 4–6 months the changes are unidirectional, and at 8–10 months progressive individualization is observed.

Features of the endocrine system. In the chest period in children, there is an increase in the function of the pituitary and thyroid glands. The level of thyroxine and triiodothyronine is higher than in adults. They stimulate the metabolism, growth and development of the child, ensure normal differentiation of the brain and intellectual development, but at the same time, the pituitary-thyroid system is the most vulnerable and sensitive to adverse influences, especially environmental and environmental factors. Clinically, this is characterized by a decrease in the rate of weight gain, the development of anemia and an increase in SARS. In the chest period, there is an increase in adrenal function and the biological activity of corticosteroids. There is a partial involution of the fetal zone of the adrenal cortex.

Features of immunity. Compared with the neonatal period, there is a slight decrease in the number of T- and B-lymphocytes, a decrease in maternal IgG, starting from 2–3 months. At 4–6 months, the first critical period of immunity is observed, which is characterized by a weakening of passive humoral immunity received from the mother, and the lowest level of specific antibodies is noted - physiological hypoimmunoglobulinemia. Synthesis of its own IgG begins in a child from 2–3 months of age, its constant level is established after 8 months–1 year.

The level of IgM by the end of the year of life reaches 50% of the adult level. The increase in secretory IgA is slow. The content of IgE in a healthy child during the year is insignificant, with manifestations of atopic dermatitis it increases significantly. The synthesis of IgM is characteristic of the chest period, leaving no immunological memory. In connection with the above, there is a high sensitivity to respiratory syncytial viruses, parainfluenza viruses and adenoviruses; measles, whooping cough atypically, leaving no immunity.

Nonspecific resistance factors. In infants, a high content of lysozyme and properdin is observed, the level of complement in the blood serum rapidly increases, and from the first month of life, its content does not differ from the level of an adult. From 2–6 months, the final phase of phagocytosis to pathogenic microorganisms is formed, with the exception of pneumococcus, staphylococcus, Klebsiella, Haemophilus influenzae.

Physical development infant and speech development is so fast that it is estimated by quarters of the year.

Child development 1-3 months. Weight gain by the end of the 1st month 500-600 g, in the second month of life - 800 g; in the third month - 700–800 g. Growth increases every month by 3 cm and head circumference - by 3 cm, chest circumference by 2.5–3 cm in 1 month.

Motor Functions: at 1.5–2 months, he holds his head, hand movements progress, and accidentally hits a suspended toy. Stretches out a hand to the subject, but still not enough. The first differentiated hand movements occur on the 2nd - beginning of the 3rd month of life.

Speech development: cooing appears from 1.5–2 months.

Neuropsychic development. In the first quarter of the year, a mental biorhythm is established in a child: sleep-wakefulness; transitional segments between them - falling asleep - awakening, which are 10 minutes. If the transitional intervals exceed 30 minutes, then this impedes the mental development of the child in the specified age period(1–3 months). At the age of 1–1.5 months, the child has a visual-auditory search and visual concentration on the face of an adult - listening, looking with wide eyes. The reaction of general mimic animation in response to the addressed speech of adults, especially the mother, is characteristic. From 2 months a conscious smile appears, and from 3 months - laughter, recognition of the mother; there is a pronounced need to communicate with an adult. From 3 months, the baby has the ability to look to find the source of the sound. By the end of the 3rd month, the duration of visual concentration is observed - 7–10 minutes. The formation of a positive mimic-somatic complex at the age of 3 months is very important - in response to addressed speech, sighs, throwing up the arms, and moving the legs appear.

Mental retardation - lack of active wakefulness.

Leading lines of development- this is what receives the greatest development at this age stage and is progressive for the further development of the child. At 1–3 months, this is the development of visual, auditory, orienting and positive emotional reactions.

Child development at 3-6 months. Body weight gain by months: 750–700–650 g. Body length increases by 2.5–2 cm, head circumference by 1 cm every month, chest circumference by 1–1.5 cm/month.

motor functions. Raises head in prone position - 3 months, lying on back - 4 months. Makes a bridge - 4.5 months. Raises head and torso high, leaning on hands - 6 months. Turns over on the stomach from a supine position - 5-6 months, on the back from a position on the stomach - 6 months. At 6 months, the child sits independently.

At the age of 3–6 months, the child has a rapid development of hand movements: at 3–4 months, he prefers to examine his hands; on the 4th month feels the blanket; at 4 months grasps an object and holds it in the hand for 20–30 seconds; on the 5th month, grasps the object with the imposition of fingers (“monkey” grasping); at 6 months, holds an object in each hand and examines them, or drags them into his mouth.

Development of speech functions. At 5 months - melodious cooing, self-imitation in cooing; at 5–6 months, he begins to pronounce the first syllables “ma”, “ba”. There is an ability to localize sound in space, a differentiated reaction to sound.

Neuropsychic development. A child of 3–3.5 months quickly searches for the source of the sound. At 5 months, self-imitation appears in cooing: slows down the movement, listens. A new qualitative acquisition appears in psychomotor development: visual-tactile-motor coordination, the cognitive triangle of the eye-hand-object, distinguishes the main forms of objects. In a child of 3–6 months, the dominant form of activity is playing with a toy. After 5 months, cognitive elements appear in response to novelty (whatever one does, the new becomes the main one). The reactions of communication with adults change, joy or fear manifests itself (the latter is a sign of increased nervous excitability).

Leading line of development- hand movement, preparatory stages of active speech - imitation of syllables.

If by 5-6 months the child continues to examine his hands - this early symptom mental retardation. Absence of elements of self-imitation in cooing.

Child development 6-9 months. Body weight gain by months: 600 g–500 g–500 g. Body length increases by 2 cm + 2 cm + 1.5 cm, head circumference for the second half of the year by 2.5 cm, chest circumference - .5 cm–1 cm per month.

motor functions. At 7 months, the child stands on its feet, holding onto a support, at the 7th month it crawls in a circle, at 7.5 months it crawls backwards, and at the 8th month it walks on all fours. From 8 months sits on his own, adhering to the support. A child of 8–9 months is constantly focused on some kind of activity, he needs to be taught new actions, for example, roll a ball, open boxes, close the lids near the pan, etc.

Development of hand movements. At 8 months the child uses the method of grasping "claws", and at 9 months. begins to grab objects with his fingers.

The development of speech. During this period, understanding of speech develops, the child listens carefully when he hears his name. From 6–7 months babbling appears, from 7–8 months sensory speech appears - an understanding of the meaning of individual words uttered by adults. This is expressed by turning the head, stretching the handles in the direction of the called object or person.

Neuropsychic development. At 6–7 months, knowledge of the names individual items. This is one of the necessary conditions for the formation of active speech in a child. At 8 months, he looks for the named object with a glance in response to the question “where?”. At 7–8 months, he makes “patties” in response to a request.

A persistent desire to achieve the fulfillment of one's desire is characteristic, while screaming, but not crying. Angry notes are heard in the voice, but he also understands the firm intonations of the mother at the same time. So you can bring up a reaction to the word “no”. At 8–9 months, the child carefully looks at objects, learns the name of the main toys. At the same time, he is interested in his reflection in the mirror. From 9 months, the appearance of the first words is noted (with the correct upbringing of the child). At 9 months, he watches a falling object, responds to the request "give me a pen."

Leading lines of development. This is the development of general movements, actions with objects. Development of preparatory stages of understanding active speech. Strive to achieve results.

Impaired mental function. A delay in mental development in this period may be indicated by throwing toys without interest in them and a delay in the development of speech functions.

Child development 9-12 months. Body weight gain by months 450 g–400 g–350 g. Body length increases by 1.5 cm every month.

motor functions. At 10 months, the child stands on his own for a few seconds (without support), walks, holding his hands to an adult or the arena barrier. At 11 months, he squats with the help of an adult; walks holding on to a support or one hand of an adult. At 12 months, the child gets up on his own without help. At the age of 1 year or the beginning of the 2nd year - walks independently.

Hand development. At 9–10 months, he grasps objects with two fingers, at 10 months he puts his fingers into holes. From 11 months, the baby manipulates toys, and at 12 months he has been playing with them for a long time.

The development of speech. There is a close relationship between the development of subtle movements of the fingers and the formation of speech (“leads” with a finger). At 9 months, there is a true situational understanding of speech addressed to him and an action response to a verbal instruction; looking for toys. At 9–10 months, the first conscious words appear, and by the end of the year, 8–10 words. There is a new interest - looking at picture books.

By the end of the year there is a connection between the name of the subject and the subject itself. This is the initial form of understanding speech by a child.

Neuropsychic development. From the age of 9 months, the child shows an increased interest in new objects, this is expressed by facial expressions of surprise and alertness, but at the same time he performs a purposeful action, and, as it were, foresees its result. At 9–10 months, the development of fine finger movements differs, which contributes to the development of the brain and speech (shows named objects, recognizable animals, birds in pictures, etc. with the finger of the hand). From 10–11 months, a reaction to a sound of a new quality appears - a connection with the content and meaning of this sound (barking dogs, ticking clocks, etc.). By 10–11 months, attachment to loved ones appears. At 11–12 months, an understanding of the generalizing function of the word is formed (big–small dog, black–white). Expressed interest in the rhythms of simple songs. There is a differentiated reaction to an unfamiliar face. Contact is not established immediately (at first the child "studies" an unfamiliar face). By the end of the year, he knows the name of many objects and performs 5-10 instructions - a combination of a word with an object and an action. Thus, at the request of an adult, he performs small assignments.

leading line of development. Development of general movements, actions with objects; understanding and development of active speech.

Impaired mental function. Lack of a differentiated selective response to an unfamiliar face. Reactions of fear and protest testify to the increased nervous excitability of the child.

An important period in which the question is decided whether the child will be independent is the second half of the first year of his life. At this time, the child shows interest in all people and things, "intelligence activities", and he should not be interfered with in its implementation.

According to psychologists, at the age of one year, a child has 37% of the logical ability of an adult and 16% of working memory. This is a man with his own ideas.

The main features of organs and systems

Respiratory system. The respiratory rate is 30–35 per 1 min, by the year 30. The respiratory rhythm in children during the first months of life is labile, has not yet been established. The lungs are airy, more full-blooded, poor in elastic and muscle fibers. The interstitial tissue in the lungs is more developed, richly supplied with blood vessels. Capillaries and lymphatic slits are wider than in an adult. In the first months of a child's life, a mosaic histostructure is noted. The lungs grow due to an increase in alveolar volume, in parallel, differentiation of all elements of the acinus occurs. The instability of the gas exchange system occurs at the age of 3 to 5 months.

circulatory system. The lumen of the arteries is wide, the lumen of the veins is equal to the lumen of the arteries. The circumference of the trunk of the pulmonary artery is greater than the circumference of the trunk of the ascending aorta. The pulse is 130 beats per minute, by the end of the year of a child's life it decreases to 120 beats per minute. Systolic blood pressure for children of the first year of life is calculated by the formula 75 + 2 n, where n is the number of months; diastolic pressure is .5 - 1/3 systolic. The muscle fibers of the heart are thin, the connective tissue is underdeveloped. The transverse striation of the heart muscle becomes clearly pronounced after 1 year of the child's life. The rate of blood flow in children is higher than in adults and decreases with age.

Heart growth is most intensive in the first 2 years of life, at the age of 12–14 years and 17–20 years. During the period of childhood, the mass of the myocardium of the right ventricle increases 10 times, and the left - 17 times.

Organs of the urinary system. The kidneys of an infant have a lobular structure and a relatively thin cortical layer. The diameter of the ureters is wide, the muscle tissue is poorly developed, the ureters are long, have bends, kinks easily occur, which can lead to stagnation of urine. Glomerular filtration in infants is 1/3–1/4 of the renal filtration of adults, by 5–6 months - 50–60%, and only by 2–3 years becomes normal. Sodium reabsorption is 99.8%, excretion is 0.2%, and therefore infants adapt more easily to a reduced intake of sodium and water with food than to excess. The kidneys do not sufficiently excrete non-volatile (organic) acids. The amount of hydrogen ions formed is 2-3 times higher, and the secretion by the kidneys is much lower, and therefore there is an ease of shifting the acid-base state towards acidosis. By the 1st year, the amount of urine is 600 ml. The act of urination in the first months of a child's life is carried out on the basis of congenital unconditioned spinal reflexes. As the child grows and develops, it turns into an arbitrary process, regulated by the subcortex and cerebral cortex. The number of urination in a child under 1 year old is 15–16, at 3 years old - 7–8 per day.

Growth and development in infancy, it is provided with a high level of metabolism: the child has 3 times more oxygen demand. Growth (plastic metabolism) consumes 76% of energy in the first 3 months of life, 28% at 4–6 months, 13% at 7–9 months, and 6% at 10–12 months. At the same time, 50% of energy is covered by fats, 39% - hydrocarbons.

An infant is characterized by a low dispersion of tissues and their richness in water, which ensures a high level of assimilation processes. characterized by a high water content relative to body weight - 80% (for comparison, in adults - 60%). The daily exchange of water in infancy is 50% (in an adult - 14%).

Organs and systems are characterized by a delay in the development of functions, ongoing differentiation of tissues, imperfection of protective barriers: skin, intestinal, hepatic, blood-brain, hematohistiocytic. In an infant, the imperfection of the biological rhythms of organs and systems, that is, the sequence of physiological processes, is noted. For example, daily fluctuations in the temperature rhythm are formed only by the 6th week of life, while the digestive rhythm is ready by the time of birth. Synchronization of the rhythm of the pituitary-adrenal system occurs by the end of the neonatal period, and the daily rhythm of electrolytes - by 4 months of life.

The nature of the pathology. Respiratory diseases, acute gastrointestinal diseases; food allergy; rickets, dystrophy, iron deficiency anemia. In infancy, hereditary diseases appear. Per last years the incidence of tuberculosis, syphilis, and possibly HIV infection has increased.

Infectious pathogens: respiratory viruses, pathogens of intestinal infections and acute childhood infections, bacillus tuberculosis, spirochete pallida, HIV.

Mode and upbringing of the child. The concept of "conditions" for the development of the child includes: age regimens of the day, feeding and nutrition, physical education, conditions for mental development, sanitary and hygienic conditions. Among the conditions for neuropsychic development, it is of great importance to take into account the leading type of child's activity.

The role of an adult is the leading one in ensuring the normal physical, mental development and health of children. a huge role plays the mother-child system. Maternal care is necessary, it must be strong, helpful and warm so that the child feels confident in the big world for him; however, this concern should not be all-forgiving. Affectionate friendliness has the same meaning for emotional development child like breast milk for the physical.

Up to 1 year of age, the number of hours of sleep can be determined by the formula 22–.5n, where n is the number of months of life. The wakefulness of the child must be active, an impulse to knowledge, then walking is necessary. Movement is one of the factors determining the processes of growth and development. In the first months of life, pay attention to the development of movements; in the position on the stomach, the child sees more objects. From 2.5–3 months, several times a day, let the baby rest his feet on a flat surface, holding his armpits; from 4–4.5 months, also holding, help him “dance” on flat surface. In this case, the child should lean not with his fingers, but with the whole foot. With the stubborn reliance of the child only on the "toe", this may be due to a violation of the central nervous system. From 6–7 months, the child can sit (but not plant!), He must sit down himself. From 7–8 months he can stand, holding on to a support for as long as he wants. It is not necessary to specifically hold the child in a standing position. From 7–8 months, lower to crawl on the floor, put on 2 pairs of sliders. Forms of movement of the child: crawling on his stomach, crawling on all fours, sliding on the buttocks and vertical walking from 10-11-12 months - he takes the first steps on his own initiative or with little encouragement.

The child must try his hand at knowing things. Already after 2 months of life, he expressed a reaction of surprise and interest in the toy. It is necessary to ensure that the toys are suspended in the crib at the level outstretched hand child, it is important to change toys. From 5 months, toys are not hung up, but laid out during wakefulness next to the child (stimulation for turning on the stomach). You should learn to take a toy that is held above the baby's chest or on the side. When positioned on the stomach, toys should be at arm's length (crawling encouragement). In addition, the leading role of hand movements and general movements in the development of speech understanding should be taken into account. Up to 6–7 months, active grasping of the object and exploratory manipulation of it is formed. At the same time, inter-analyzer ties are developing and strengthening. Knowing the names of certain objects is one of the necessary conditions for the active speech of the child and the appearance of the first words. Of great importance is the acquisition of experience in actions with objects and their generalizations, which are the genetic roots of thinking and speech (waving, tapping toys; open - close the lids of the boxes). The development of fine movements of the fingers and hand contributes to the development of the brain and speech. I. M. Sechenov emphasized that “the roots and thoughts of a child lie in feeling,” and the great teacher Sukhomlinsky said that “the thought of a child lies at the tips of his fingers.” The development of speech communication is an indicator of the normal development of the child.

Period early age(1–3 years)

The period of early age is determining the further development of the child and to a certain extent is critical, since in the first years of a child's life the program for the development of the organism is specified, the level of physical and mental development is formed. During this period, resistance to adverse environmental factors is formed. Of great importance early detection violations cognitive activity child. In addition, in the first 3 years of a child's life, hereditary data, hereditary burden for mental development, develop or slow down. During this period, resistance to adverse environmental factors is formed. Of great importance is the early detection of violations of the cognitive activity of the child. In addition, in the first 3 years of a child's life, hereditary data, hereditary burden develop or slow down. For mental development at this age, a powerful stimulus is the degree of surprise with the world around him.

Features of growth and development. Slowing down the increase in body weight (2nd year - 2.5-3 kg, 3rd - 2 kg) and growth (2nd year - 10-12 cm, 3rd year - 7-8 cm). Relative predominance of head height and body length over limbs. Intensive increase in muscle mass. Increasing motor activity, improving walking, mastering running, walking on an inclined plane. Further improvement of hand movements. Increased efficiency, wakefulness without fatigue - 6–6.5 hours.

Features of the CNS. Increase by 3 years of brain mass by 3 times. Myelination improvement. Strengthening the management of the functions of organs and systems from the cerebral cortex. The speed of changing one focus of excitation in the cerebral cortex to another. New for this age is the participation in the analysis of information of the associative areas of the brain (processing and imprinting information).

EEG. Very fast evolution up to 3 years of age. At the age of 4–5 years, a pronounced a-rhythm appears.

Neuropsychic development. The highest degree of emotional manifestations. The predominance of positive emotional reactions. Laying the foundations of intelligence. The development of speech. Speech becomes the main means of communication with adults and children. In the second year, 8–10 new words per month. In the 3rd year - 50-60 words. From 2 years 6 months to 3 years vocabulary 1200-1500 words, speech in simple phrases. The child easily repeats the phrases he hears. Fast development memory: remembering a specific event, establishing the relationship and sequence of events. The study of the characteristics of the subject - exploratory behavior. Developing action of visual and constructive activity. The formation of individual traits of character and behavior. The ability of the brain to develop internal inhibition is characteristic, on the basis of which volitional qualities personality. Selective attitude towards children. In the second year, the needs are higher than the possibilities available to the child, the desire for vigorous activity. At 2.5–3 years old, the child easily memorizes poems and songs, his speech is emotionally expressive. Elements appear role play. The central formation of a 3-year-old child is the "I" system. Curiosity is a motivating force for mental development. It is very important for neuropsychic development that a child has questions: “What?”, “Where?”, “Why?”, “Why?”, “Where?”, “When?”.