EXTRAUTERINE STAGE OF DEVELOPMENT

Neonatal period

The neonatal period (neonatal) begins with the birth of the child and lasts 4 weeks.

Early neonatal period - the main period in the process of adapting the child to the new
conditions of life - lasts from the moment of tying the umbilical cord to the end of the
7 th night life. Passage of the fetus in the natural birth canal causes birth stress with
successive voltage functional activity of hormonal systems involved in the processes
of adaptation. In the first hours of life increases the release of catecholamines and
glucocorticoids, followed by a shift to a "long-term protection measures" - increased
secretion of thyroid stimulating hormone (TSH), adrenokor-tikotropnogo hormone
(ACTH) and thyroxine (T 4). High concentration of catecholamines in cord blood at
birth contributes to the initiation of respiration, the formation of lung function,
cessation of secretion of liquid light. With the first breath a newborn respiratory
organs begin to function. Balancing the pressure in the aorta and pulmonary artery
leads to the cessation of blood flow through the ductus arteriosus and of blood coming
from the right atrium via the oval window to the left. There is a complete "integration"
of the pulmonary circulation, established adequate breathing with effective gas
exchange. Zapustevayut Umbilical vessels, and child nutrition becomes enteral (his
most preferred option - breastfeeding). During the first few days of life, the reduction
in initial body weight by 5-6% due to loss of fluid that they consider physiological
phenomenon. Immediately after birth the kidneys themselves homeostatic function,
blood flow in them is greatly increased by reducing the resistance in the renal vessels.

To the state, reflecting the adaptation of the child to the new conditions of life, are
also physiological Qatar skin, physiological (conjugation-million), jaundice, etc. (see
Chapter 4 "border states"). The body temperature of newborn is unstable, the energy
needed for its maintenance and motor activity of 55 kcal / kg / day. Birth stress,
alteration of functions of respiration and circulation, the immaturity of adaptive
mechanisms of the child affect the metabolism. Metabolic processes in infants are on
anaerobic or glikolitiches-coma way. If adequate oxygenation is not installed, may
develop metabolic acidosis, and hypoproteinemia. Gas exchange newborn is the same
as an adult, catabolic phase of exchange is replaced by anabolic begins an intensive
weight gain and body length, develop analyzers (primarily visual) begin to form
conditioned reflexes and coordination of movements.

In connection with the predominance of the central nervous system (CNS) inhibition
processes newborn sleeps most of the day. The sound and auditory stimuli, the child
reacts to the docking reaction. Since opening his eyes, ie the first hours of life, begins
to operate the visual channel of communication. An indicator of the perception of
object motion newborns are eyeballs - Tracking i'fik-satsiya gaze of set-to-month life.

Breathing, circulation, digestion and separation take place with the maximum
intensity: the frequency of respiratory movements (NPV) 40 per minute, heart rate
(HR) of 140-160 per minute, number of urination 20-25 times a day. The first act of
defecation within 24 h after birth. Stool color changes in the offspring of black and
green (meconium) to yellow-brown. The frequency of bowel movements in the period
novorozh-dennosti corresponds to the frequency of feedings and the number of food
and an average of 3-5 times per day.

The presence of circulating hormones in the mother's newborn may be accompanied

by sexual crises (see Chapter 4 "border states"): the girls celebrate reaction from the
uterus - appear bloody menstrualnopodobnye selection. As girls and boys may be the
reaction of the mammary glands (up to the secretion of colostrum).

By 3-4-th week of life the skin is cleaned and becomes pink. Protection against many
viral and some bacterial infections provide IgG, transmitted from mother to
child.Functions of the T-lymph-tsitov slightly reduced.

Diseases of the neonatal period were primarily attributable to unfavorable factors

acting in utero or at birth. During this period reveal malformations, hereditary
diseases, diseases caused by antigenic incompatibility between maternal and fetal
erythrocytes [hemolytic disease of the newborn (HDN) of rhesus (Rh) - or group
(ABO) incompatibility], perinatal CNS lesions of hypoxic-go, traumatic, or infectious
genesis, the effects of intrauterine infection or infection at birth. In the first days of
life may occur pyo-septic diseases (eg, pyoderma), bacterial and viral respiratory and
intestinal diseases. Ease of infection in newborns due to lack of secretory IgA
antibodies and low (AT), belonging to the class IgM.

Thoracic period

Thoracic period lasts from 29 to 30-th day before the end of the 1 st year of life. Basic
processes of adaptation to life vneutrobnoy completed, begin rapid physical, motor
and mental development. The intensity of metabolic processes is very high in the
continuing immaturity of anatomical structures, functional limitations of the
respiratory system and digestive tract. Passive immunity to many childhood infections
(measles, rubella, diphtheria, etc.), acquired in utero through the placenta and
supported vneutrobno mother's milk is stored for 3-4 months.

Over the chest during the child's body length increases by 50%, and weight more than
tripled. Relative energy needs of children of this age is 3 times higher than that of an
adult, and covered with a considerable amount of food. Therefore, it is important
rational feeding.

The most significant differentiation of tissues occur in the nervous system. During the
first year of life improved motor function. In 1-1,5 months the child begins to hold his
head in 6-7 months - sit, to a year - to walk independently. At the age of 6 months
baby teeth erupt by the end of their first year of life is usually eight. The psyche of the
child is developing as rapidly. Beginning with the first month of life the child fixes his
gaze on the bright objects, by the end of the 2 nd month following the motion of the
object, smiling. An important line of functional maturation of the cerebral cortex - 3
months. By this time, formed the state of quiet wakefulness with the characteristic of
this condition main pp-rhythm on the electroencephalogram (EEG), accelerating the
transfer of information in the cerebral cortex and its treatment. After 2-3 months there
are a differentiated perception of objects, memory, formed behavioral responses. One
of the most important acquisitions for 6 months - the function of speech, formed at the
base of developing mechanisms of perception, attention and emotional sphere of the
child. The first reaction of sound - a cry that signals the functional status of the child
(hunger, discomfort). About 3 months the child pronounces the sounds, "gulit", begins
to recognize loved ones. By 4-6 month gulenie goes into babble. At 6 months the
child repeats certain syllables ( "a", "PA", "yes" and others), laughing loudly. By the
end of the year, he utters the first words (the active dictionary can contain 10-15
words), performs simple requirements, understands the ban. For normal physical and
psychomotor development of infant, his resistance to infections and other adverse
environmental factors need proper nutrition, rational treatment, tempering,
compassionate care, affectionate communication. To protect against infectious
diseases is especially important breastfeeding and the timely implementation of
preventive vaccination.

Intensive growth, differentiation of organs and much tension metabolic processes are
the backdrop against which is easy to develop (especially in dim, one-sided, redundant
power and errors of care), diseases such as malnutrition, paratrofiya, anemia, rickets,
acute digestive disorders, atopic dermatitis, recurrent obstructive syndrome. The
development of acute respiratory infections (ARI) may be complicated by
pneumonia. Passive immunity is obtained from the mother due to AT, gradually
weakens, and in the second half of the first year of life, children can get sick of
measles, chicken pox and other childhood infectious diseases.

Preschool period

Preschool period (1 to 3 years) is characterized by a gradual slowing of weight gain

and body length, the continued maturation of the nervous system, the expansion of
conditioned reflex connections, the emergence of the second system, the formation of
lymphoid tissue, nasopharynx, increase muscle mass. By 2 years completed 20
eruption of milk teeth. During this period, children are actively in contact with the
outside world, are lively, curious, when dealing with adults and older children they
have perfected it. Vocabulary to 2 years up to 300, to 3 years - up to 1500 words. By
the end of the 3rd, the children say, long sentences, talk, their speech is characterized
by a pronounced creation of words (use modified forms of sound words, working out
their own). The rapidly expanding motor possible - from walking to running, climbing
and jumping. Starting from 1,5 years ago children were sleeping about 3 hours at
night - 11 hours during this period through the game and monitor the actions of adults
are learning employment and life skills. U Child clearly manifested personality traits,
so education becomes a key element of child care. At this time, it is important to
properly organize a regime of a child, so as not to overload his impressions and to
protect against the adverse effects of the environment. The main physiological
systems have a greater degree of maturity: NPV becomes smaller and amounts to 25-
35 per minute, heart rate of 100-120 per minute, random urine, stool 1-2 times a
day. Acute indigestion, pneumonia, bronchitis, anemia often develops, but milder than
in infants. Against the background of physiological hyperplasia of lymphoid tissue
often develops tonsillitis, adenoids, lymphadenitis. In connection with the expansion
of contacts between children and other children, some pathologies are ARI, acute
intestinal infection (DCI), as well as acute childhood infections - whooping cough,
rubella, chicken pox, measles, scarlet fever, etc.

Preschool period

Pre-school period (from 3 to 7 years) is characterized by the expansion of contacts

between children and the environment. The increase in body mass slows down, is the
first physiological traction in length, significantly increases the length of the
extremities. In 5-6 years, begins the change of milk teeth to permanent, the child
moves to mode feeding adult. Immune protection reaches a certain degree of maturity.
In 3-4 years maintained close interaction of visual perception and movement. Practical
manipulation (grasping, feeling) - a necessary factor in the visual identification. From
4 to 7 years, the rapid increase in the amount of attention. At this time, children
usually begin kindergarten, intensively developing their intellect, more complex
motor skills and labor, there are subtle coordinated movements. By age 5 children
properly speak their native language, memorize poems, retell fairy tales. Emerging
differences in behavior, hobbies and games for boys and girls. Emotional
manifestations are much more restrained. By the end of this period the child is
prepared for school.

Consistently activated by various links in the endocrine system. The leading role in
this period belongs to the thyroid hormone, and co-matotropnomu hormone (STH)
pituitary. The maximum activity of the thyroid gland found in the 5 years of age.
Still high incidence of SARS and other infectious diseases. In connection with
increasing sensitization of the organism increases the proportion of chronic diseases
such as bronchial asthma, rheumatic fever, hemorrhagic vasculitis, nephritis, etc. The
lack of adequate skills of Conduct for increased mobility often leads to injury.

Junior School yuzrast

Primary school age includes the period from 7 to 11 years. Completed the structural
differentiation of tissues, there is a further increase in body mass and internal organs,
become more pronounced sex differences: boys differ from girls on the growth rate of
maturation, physique. There is a complete replacement of milk teeth to permanent.
Are developing motor skills such as agility, speed, endurance, successfully
assimilated thin differentiated skills - email, needlework. For 12 years ends with the
formation of the nervous system, the cerebral cortex in the structure similar to that of
an adult. Physiological parameters of respiratory and cardiovascular systems also are
close to those of adults. Continuing development of higher nervous activity,
significantly enhanced metabolic processes in the brain, improves memory, increases
intelligence, are produced by volitional qualities. At this stage there is a change of
social conditions (the beginning and the transition to a meaningful learning in school),
increased demands on adolescents, increasing self-esteem. By the end of primary
school age (prepubertal period), to the extent of structural and functional maturation
of the brain and improved neurophysiological mechanisms underlying the basis of
higher mental processes, increase the functional and adaptive capabilities of the child.
After 8 years mark pronounced growth of the ovaries, with 10 years of increased
growth of the uterus, prostate and testicles, as well as qualitative changes in their
structure and functions. It starts with the gradual development of their reproductive
lives. There remains a high incidence of infectious diseases, gastrointestinal and
allergic diseases. Classes at the school greatly restrict the movement of pupils, there
are problems of violations of posture and visual impairment. Often find pockets of
persistent infection (caries, tonsillitis, cholecystitis).

Senior School ozrast

Senior school, or adolescence, age - from 12 to 17-18 years. It coincides with sexual
maturation. Within a short period of time for boys and girls mature reproductive
system, its morphological and functional state reaches that of adults of 17-18 years. At
puberty is an intense sexual differentiation, caused by the activities of the endocrine
glands.Increases the activity of pituitary-gonadal and pituitary-adrenal relationships
governing the development and formation of the sexual sphere. On the organization of
the brain affects not only the maturation of its own structures, but also endocrine
changes. This period is characterized by a rapid increase in body size, a sharp change
in the function of the endocrine glands. Before the onset of puberty content of
gonadotropins in the blood of girls and boys is low. Period from 1 year before the first
signs of puberty saw as a stage of sexual infantilism. However, a slight and gradual
increase in secretion of pituitary hormones, and sex glands - an indirect evidence of
diencephalic structures maturation. The concentration of testosterone in the blood of
boys aged 7-13 years is small, but increases significantly, from 15 years, with the
stabilization of the concentration of the hormone to 20 years. In parallel with the
pubertal development of the larynx occurs mutation rates - an important sign of the
degree of sexual maturity boys. In the ovaries of mature germ cells, is a synthesis of
many hormones (estrogen, androgen, progesterone). Already in the 10-12 years,
against a background of low content of estrogen on some days with the increases in 2-
3 times. The closer the menarche, the more frequently observed a similar transient
increase in excretion of estrogen.The average age of menarche - 12-13 years. In 16-17
years, most girls have the correct menstrual-ovarian cycle. Increasing the length of the
body especially pronounced during puberty, so in 12-14 years, girls were often ahead
of boys in physical development. During the sprouting Leap, aged about 12 years,
girls grow by about 8 cm per year. In boys, a "jump" happens later - about 14 years
when they grow on average by 10 cm per year. Significantly increase muscle strength
and performance. Increasing the neuro-motor and mental activity, the intensity of
growth of weight and body length require hard work of the endocrine glands, nervous
system and high intensity of metabolic processes, thus necessitating the introduction
of additional nutrients. Accelerated physical and sexual maturity is not always parallel
to the intellectual development, physical maturation is faster and end sooner.

In adolescence, often choose a profession, it is time for self-determination and

personal development, time of the adoption of gender and sexual development of a
sense of conformity.'s Thinking becomes more independent, active, creative. You
receive the ability to self-sacrifice, loyalty and trust.

Particular attention should be drawn to the heart of the diversity of morphological

variants of its development, the lability of heart rate, the imperfection of
neurovegetative control. At this stage, are often met with functional disorders of the
cardiovascular and autonomic nervous systems ( "youthful heart," "junior high blood
pressure, distsirku-lyatornye disorders). Also widespread nutritional disorder (obesity,
degeneration) and diseases of the digestive tract (gastritis, duodenitis, peptic ulcer
disease). With the onset of puberty detect defects in the development of sexual
apparatus (dysmenorrhea, amenorrhea, etc.) may worsen infec-but-allergic disease,
tuberculosis. In connection with the hormonal changes are possible deviations in the
functioning of the endocrine apparatus (hypo-or hyperthyroidism, etc.). The
imbalance of hormonal influences, a temporary decrease in the immune properties of
the skin, enhanced function of the sebaceous glands in both boys and girls are often
accompanied by a pustular disease of the skin, especially on the face. This is a
difficult period of psychological development, striving to assert themselves, often
with a dramatic revision of the entire system life values, attitudes towards themselves,
their parents and peers.

To determine the biological age using signs, reflecting the process of biological
maturation. In all the periods of childhood, there are distinctive body proportions and
characteristics of physical and psychomotor development. In infants and preschool-
age ^ of biological age would be a loss of innate and unconditional appearance of
conditioned reflexes, finesse primary teeth and the formation of nuclei of ossification,
development of motor skills and speech. In the preschool years an important sign of
maturity believe the emergence of permanent teeth, and in junior and senior school
age - the development of secondary sexual characteristics, intelligence, physical
ability.

Must be stressed that every child is characteristic of the individual rate of biological
development, while his biological age may be somewhat different from the age of his
peers.