28 Physical Development in Infancy and Toddlerhood

Martha Lally; Suzanne Valentine-French; and Dinesh Ramoo

Learning Objectives

  • Summarize overall physical growth during infancy
  • Describe the growth of the brain during infancy
  • Explain infant sleep
  • Identify newborn reflexes
  • Compare gross and fine motor skills
  • Contrast development of the senses in newborns
  • Describe the habituation procedure
  • Explain the merits of breastfeeding and when to introduce more solid foods
  • Discuss the nutritional concerns of marasmus and kwashiorkor

Overall physical growth: The average newborn in the United States weighs about 7.5 pounds (between 5 and 10 pounds) and is about 20 inches in length. For the first few days of life, infants typically lose about 5 percent of their body weight as they eliminate waste and get used to feeding. This often goes unnoticed by most parents, but can be cause for concern for those who have a smaller infant. This weight loss is temporary, however, and is followed by a rapid period of growth. By the time an infant is 4 months old, it usually doubles in weight, and by one year has tripled its birth weight. By age 2, the weight has quadrupled, so we can expect that a 2-year-old should weigh between 20 and 40 pounds. The average length at one year is about 29.5 inches and at two years it is around 34.4 inches (Bloem, 2007).

Body proportions change from infancy to adulthood. Five bodies, from an infant to an adult, are shown on a grid displaying the differences in proportion of the body.
Figure 3.1: Changes in proportions

Body proportions: Another dramatic physical change that takes place in the first several years of life is the change in body proportions. The head initially makes up about 50 percent of our entire length when we are developing in the womb. At birth, the head makes up about 25 percent of our length, and by age 25 it comprises about 20 percent of our length.

The Brain in the First Two Years

Some of the most dramatic physical change that occurs during this period is in the brain. We are born with most of the brain cells that we will ever have; that is, about 85 billion neurons whose function is to store and transmit information (Huttenlocher and Dabholkar, 1997). While most of the brain’s neurons are present at birth, they are not fully mature. During the next several years dendrites, or branching extensions that collect information from other neurons, will undergo a period of exuberance. Because of this proliferation of dendrites, by age two a single neuron might have thousands of dendrites. Synaptogenesis, or the formation of connections between neurons, continues from the prenatal period, forming thousands of new connections during infancy and toddlerhood. This period of rapid neural growth is referred to as synaptic blooming.

 

Diagram of a neuron with dentrites coming in and an axon going outwards.
Figure 3.2: Components of the neuron

The blooming period of neural growth is then followed by a period of synaptic pruning, where neural connections are reduced thereby making those that are used much stronger. It is thought that pruning causes the brain to function more efficiently, allowing for mastery of more complex skills (Kolb and Whishaw, 2011). Experience will shape which of these connections are maintained and which of these are lost. Ultimately, about 40 percent of these connections will be lost (Webb, Monk, and Nelson, 2001). Blooming occurs during the first few years of life, and pruning continues through childhood and into adolescence in various areas of the brain.

Another major change occurring in the central nervous system is the development of myelin, a coating of fatty tissues around the axon of the neuron (Carlson, 2014). Myelin helps insulate the nerve cell and speed the rate of transmission of impulses from one cell to another. This enhances the building of neural pathways and improves coordination and control of movement and thought processes. The development of myelin continues into adolescence, but is most dramatic during the first several years of life.

At birth the brain is about 25 percent its adult weight and by age two it is at 75 percent its adult weight. Most of the neural activity is occurring in the cortex, or the thin outer covering of the brain involved in voluntary activity and thinking. The cortex is divided into two hemispheres, and each hemisphere is divided into four lobes, each separated by folds known as fissures. If we look at the cortex starting at the front of the brain and moving over the top (see Figure 3.3), we see first the frontal lobe (behind the forehead), which is responsible primarily for thinking, planning, memory, and judgment. Following the frontal lobe is the parietal lobe, which extends from the middle to the back of the skull and is responsible primarily for processing information about touch. Next is the occipital lobe, at the very back of the skull, which processes visual information. Finally, in front of the occipital lobe, between the ears, is the temporal lobe, which is responsible for hearing and language.

 

A diagram of the two hemispheres of the brain
Figure 3.3: The brain is divided into two hemispheres (left and right), each of which has four lobes (temporal, frontal, occipital, and parietal). Furthermore, there are specific cortical areas that control different processes.

Although the brain grows rapidly during infancy, specific brain regions do not mature at the same rate. Primary motor areas develop earlier than primary sensory areas, and the prefrontal cortex, which is located behind the forehead, is the least developed. As the prefrontal cortex matures, the child is increasingly able to regulate or control emotions, to plan activities, strategize, and have better judgment. This is not fully accomplished in infancy and toddlerhood, but continues throughout childhood, adolescence, and into adulthood.

Lateralization is the process in which different functions become localized primarily on one side of the brain. For example, in most adults the left hemisphere is more active than the right during language production, while the reverse pattern is observed during tasks involving visuospatial abilities (Springer and Deutsch, 1993). This process develops over time, however, structural asymmetries between the hemispheres have been reported even in fetuses (Chi, Dooling, and Gilles, 1997; Kasprian et al., 2011) and infants (Dubois et al., 2009). Lastly, neuroplasticity refers to the brain’s ability to change, both physically and chemically, to enhance its adaptability to environmental fluctuations and to compensate for injury. Both environmental experiences, such as stimulation, and events within a person’s body, such as hormones and genes, affect the brain’s plasticity. So too does age. Adult brains demonstrate neuroplasticity, but they are influenced more slowly and less extensively than those of children (Kolb and Whishaw, 2011).

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Physical Development in Infancy and Toddlerhood Copyright © 2022 by Martha Lally; Suzanne Valentine-French; and Dinesh Ramoo is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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