The Postnatal Period

The moment of birth signals the end of nine months of development and anticipation. Of course, it is also called a neonate, and parents will go home to begin their new life together. First however the staff at the hospital or birthing center must make sure the new family gets off to a good start.

Examining the Newborn

Shortly after delivery, the neonate's physical condition is evaluated using a rating system called then Apgar scale. the infant is given are rating from 0 to 2 on each of five item : pulse , breathing , muscle tone , responsiveness , and skin color . A total score 7 to 10 is considered normal. A lower score is a sign that the baby needs special medical attention. Usually the Apgar evaluation is given one minute after birth. The baby is also given a brief examination to check for any conditions that would require special care. Within 60 minutes of delivery, drops of silver nitrate or an antiseptic ointment are put in the baby's eyes to guard again infection. The baby is weighed, measured, and perhaps washed. A permanent copy of the baby's foot -prints are made for public record. Two bands giving the baby's family name are clamped to the wrists or ankles. The mother wears a bracelet which contains the same information. Identification is done before the baby leaves the delivery room or birthing room to avoid any mix- up in identity.

The Apgar Scale








Under 100

Over 100



Slow , irregular

Good , crying

(baby's reaction when nose is irritated)


Some movement of extremities

Active motion


No response


Cough or sneeze


Blue or pale

Body pink, limbs blue

Completely pink

Signs of a Healthy Baby

Both appearance and behavior give clues to a baby's health:

  • A healthy baby is plump, but not fat.
  • Increases in height and weight are steady.
  • Eyes are bright and clear, alert and interested.
  • Hair is glossy.
  • Skin is velvety and smooth.
  • A healthy baby is generally happy, active curious.
  • The baby does not tire easily.
  • Muscular control is appropriate for age.
  • Movements are quick and positive, never listless.


Birth to twelve months

One month

  • Lifts chin when placed on stomach.

Two months

  • Lifts chest well above surface when placed on stomach.

Three to four months

  • Reaches for objects, but unsteadily.
  • Holds up heads steadily.
  • Rolls from side to back or back to side.
  • Has complete head control when sitting on lap.
  • Holds head erect when carried.

Five to six months

  • Sits alone briefly.
  • Reaches and grasp successfully but awkwardly.
  • Turns completely over when laid on back or stomach
  • Prefers to sit up with support.
  • Uses hands to reach grasps, crumble, bang, and splash.

Seven to eight months

  • Reaches for spoon.
  • Pull self up in playpen.
  • Sits up steadily.
  • Propels self by arms, knees, or squirming motion-cannot creep or crawl.
  • Eats with fingers.
  • Pick up large objects.

Nine to ten months  

  • Walks when led
  • Reaches for and manipulates objects with good control.
  • Pick up medium size objects as well as large ones.
  • Stands holding on to furniture other supports
  • More skillful with spoon.
  • Creep on hands and knees.

Eleven to twelve months

  • Stands alone.
  • May be walking alone.
  • Show preference for one hand over the other.
  • Holds and drinks from a cup.
  • Fits blocks or boxes inside each other.
  • Picks up small objects using thumb and forefinger.

Average Cognition Development Birth to Twelve Months

One to two Months

  • Follows moving objects with eyes.
  • Gains information through senses.
  • Prefers faces to objects.
  • Cries to indicate needs.
  • Can distinguish between familiar voices.

Three to four Months

  • Recognizes care gives' faces.
  • May show fear of strangers.
  • Grasps object that touch hand.
  • Tries to swipe at objects.
  • Interested in own hands and feet.
  • Practices making sounds.
  • Responds when caregiver talks.
  • Smiles and laughs.

Five to six months

  • Is alert for periods up to two hours.
  • Reaches and grabs objects.
  • Studies objects carefully.
  • Looks for objects that are dropped.
  • Plays peek - a - boo.
  • Recognizes own name.
  • Distinguished between friendly and friendly and angry voices.
  • Indicate pleasure and displeasure with sounds.

Seven to Eight Months

  • Imitates the actions of other.
  • Understands cause and effect.
  • Remembers things that have happened.
  • Smiles at self in mirror.
  • Sorts objects by size.
  • Solves, simple problems.
  • Recognizes some words.
  • Babbling imitates inflections of speech.

Nine to ten Months

  • Searches for hidden objects.
  • Handles medium - size objects skillfully.
  • Takes objects out of containers and puts them in.
  • Plays pat -a cake.
  • Responds to some words.
  • May say a few words
  • .Obeys simple commands or directions.

Eleven to Twelve Months

  • Handles objects skillfully.
  • Likes to look at picture books.
  • Fits blocks or boxes inside one another.
  • Known parts of body.
  • Can pick up small objects.
  • Recognizes many words.
  • Speaks some words regularly.



Large Motor Skills

Small Motor Skills

1 to 1½ YEARS

Improves from walking a few unsteady steps to walking well.
Slides down stairs backwards, one at a time.
Stoops to pick up toys.

Turn pages of a book, several pages at a time.
Picks up small objects easily using thumb and forefinger Scribbles.

1½ to 2 YEARS

Runs fairly well Can stand on one foot.
Learns to walk up and down stairs, holding on both feet on each step.
Throws objects overhand.

Buttons large buttons.
Pulls down zippers.
Turns door knobs.
Stacks several cubes to from a tower.


Walks with more coordination and confidence.
Climbs, even in unsafe places. Jumps of bottom step.
Pushes self on wheeled toys.

Turn pages of a book one at time.


Runs, but cannot stop accurately; runs into things.
Alternates feet going up stairs, but not going down.
Throws ball over head , but inaccurately.
Kicks balls.

Builds towers of about eight blocks.
Draws horizontal and vertical lines, circles.
Strings large beads.

3 to 4 YEARS

Jumps up and down.
Skips and hops,  Balances on one foot.
Walks on tiptoe. Rides a tricycle.
Catches a ball with arms straight.

Builds towers of about nine or ten blocks Makes a bridge of three blocks.
Cuts with scissors.
Draws recognizable pictures.
Uses a fork and spoon with little spilling.

Average Motor Skills Development Ages Four to Six

Four Years

  • Skips and hops.
  • Laces shoes.
  • Dresses and undresses self.
  • Cuts on line with scissors.
  • Can jump forward as well as up and down.
  • Throws overhand with less body participation.

Five Years

  • Ties shoelaces.
  • Draws recognizable person.
  • Skillfully picks up very small items.
  • Draws alphabet letters.
  • Stands and balances on tiptoe for short period.
  • Buttons, snaps, and zips clothes.

Six Years

  • Throws and catches balls with more ease and accuracy
  • . Builds block towers to shoulder height.
  • Cuts, pastes molds, and colors skillfully.
  • Writes entire words.


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