Assignment 1 1

Assignment 1

1.1 Describe, in-depth, stages of development from conception to birth in groups of 4 weeks.

Weeks 1-4
When a women ovulates a follicle releases an egg, this eggs travels down into the fallopian tubes to get fertilized, when the egg becomes fertilized it is then known as a zygote, the cells keep multiplying and rapidly grow which crates a small solid mass of cells,. Whilst this change is under way the zygote journeys through the fallopian tubes and into the uterus, it continues to grow and attaches itself to the lining of the womb which is known as implantation, this may cause slight spotting for the expectant mother.

Weeks 4-8
By week 4 the zygote will become an embryo, it is shaped like a tadpole and is around the size of a small seed. The embryo will begin to divide itself into 3 different layers, these layers will go on to eventually become the bodily tissue and the organs. The starting point for essential growth like the brain, backbone and spinal cord begins when the neutral tube attaches and develops onto the top layer of the embryo, the heart and circulatory system which is used to transport oxygenated blood around the body will inhabit in the middle layer, The last layer is the layer which will contain the beginnings of the urinary and digestive system and lungs.

The placenta and the umbilicle cord starts to prepare to draw nutrients through the womb, soon it will be able to also draw essential vitamins and take away unwanted waste, as well as this hormones will also be released such as HGC (human chorionic gonadotropin) and the pregnancy will then be detectable through using a pregnancy test.

By week 6 the umbilicle cord connects the baby to blood supply and the heart starts to beat, it has around 150 beats per minute. Hormones are released to help the embryo develop and small sections start to become visible such as the eyes, nose and ears, the head is much larger than the rest of the body and small buds start to appear on the embryo and protrude out, these are very early signs of the legs and arms.

Weeks 8-12
As the brain continues to develop it is beginning to swallow fluid and make its own digestive juices, taste buds start to form and movement may start to occur although it will be too early for the mother to feel anything.

By week 10 it is now considered as a fetus, the appearance is rapidly changing, the limbs are growing and starting to become longer and the back is beginning to straighten, facial features continue to develop as well as the ears, the jaw bone starts to form and the basic substance of the teeth will have started to develop.

Whilst all this change is under-way it continues to breath in fluid and other very important factors and vital organs continue to develop and grow, these include the liver kidneys and intestines whilst other organs have become functional such as the brain and lungs, as the brain becomes more advanced the fetus begins to move its fingers and may even use one hand more than the other and it will soon be able to open and close its hands. By week 11 all of the bones are present in the face and will start to form the ovaries or testes.

Weeks 12-16
Week 12 is the last week of the first trimester, morning sickness will start to wear off for the mother at this point. the fetus’s organs and intestines are developing fast and as the bowel starts to take shape it will begin to produce its own urine, it will then pee it out into amniotic fluid that surrounds them in the womb and they will then go onto swallow that urine as they swallow amniotic fluid. The skeleton of the fetus is also developing with the clatticle (collar bone) and the femur (thigh bone) developing first.

By week 14 and 15 the fetus is growing quickly and the body is more or less in proportion size wise, with the head now having caught up with the rest of the body, the limbs are still growing and the arms are now in proportion with the body although the legs still have nor caught up yet. The fetus is starting to behave more like a baby and may even be sucking its thumb at this point, it is making facial expressions like frowning and squinting and developing sucking, grasping and swallowing, it can determine the difference between light and dark although the eyelids are still fused shut and can even hear its mothers voice.

A fine layer of hair has now grown over the fetus’s body, this is called lanugo, the purpose of the lanugo is to keep it warm until eventually it will develop a layer of fat that will keep them warm after birth.

Weeks 16-20
Over the next 3 weeks the fetus will have a huge growth spurt and will double in weight. The nervous sytem begins making connections to the muscles, the limbs and joints have become fully formed and it begins to move with more purpose and has developed reflexes, it may even start to grab and even play with the umbilicle cord. The skin is still quite translucent and the blood vessels are visible from underneath the skin

By week 17 it is looking less like a fetus and more like a baby as the face now looks human, fingerprints are starting to develop and the eyelashes are growing, the eyes may still be fused shut but it can now move them around, it is moving around a lot by now and the expectant mother may even start to feel tiny movements.

The nerves start to form a covering of a fatty white substance known as myelin, myelin is vital for the nervous system to function and to develop properly. The genitals have formed and females are developing eggs in their ovaries, it has gained more limb control as the cartilage has bagan to harden to bone and pigment in the skin is developing which means it is now loosing its translucency.

Weeks 20-24
A thin, waxy, cream cheese like substance is now covering the fetus, this substance is called vernix casoesa, its job is to help protect the fetus from the surrounding amniotic fluid, the substance covers the whole body and there may even be some residue left when the baby is born.

The fetus has grown significantly and is around 26 cm long, it is mainly growing bigger and stronger although as the brain continues to develop it is working on very important sensory areas such as the babies sense of smell, taste, hearing as well as its vision and touch, its bowels are also still developing and it has started to produce moconium which is a mixture of all the things it has been swallowing such the amniotic fluid, dead skin cells and digestive secretion and this will be its first bowel movement one it has been born.

At week 21 the fetus had taste buds, it practices swallowing as it eats what enters the amniotic fluid and has started to gain weight, laying down some essential fat. The placenta continues to grow and provides nourishment for the baby. The lungs are rapidly developing and the fetus practices breathing , this is great practice for its first breaths outside of the womb. As the pancreas grows it produces essentials hormones such a insulin.

As for the appearance and characteristics the eyes are now formed although they are lacking in pigment, it is very common for a babies eye colour to change a few months after they are born. The body has all caught up and is in proportion but still doesn’t have much fat yet. As it grows it may have developed a pattern in waking, sleeping and movement patterns, as it practices somersault and wriggles around the mother may be able to see the baby moving from underneath her clothes, it is getting used to the noises it can hear from outside of the womb and may not startle as much at sudden noises.

Weeks 24-28
When the baby reaches 24 weeks it is then considered liable and if it happens to be born prematurely it will have a chance of survival, its lungs have now developed and it can breath in air rather than just the amniotic fluid. The babies ears have developed more and it can now work out different sounds like its mothers heart beat and her voice, the face is fully formed and it has eyelashes and eyebrows although they are white as they still have no pigment, the eyes have also started to open now but its vision is still underdeveloped.

If the mother is expecting a boy he’s testicles will begin to descent into the scrotum, all the major organs have been created and its cognitive functions are still developing too and it now has around 15% body fat, as for the brain it is in the last stages of development and is developing rapidly with last minute fine tuning.

Weeks 28-32
By week 28 the babies lungs are still developing but chances of survival increase if it was to be born prematurely, given the right help and medical assistance. A very important part of brain development called the Thalamocortical complex begins to become active, this is the part of the brain that is responsible of conciousness.

The heart beat is stronger than ever and can now be picked up through a stethoscope and not just a Doppler. Its eyesight has developed and will be able to see although not very far but it will be able to see its mothers face when breastfeeding.

By week 30 the brain starts to change in appearance, its is beginning to look more like an adult brain, as it changes it produces wrinkles and ridges -these provide more space for the brain so it can grow and develop further, as well as this the babies skin has now started to become a lot smoother as the vernix and the lanugo that has covered that baby is starting to disappear.

It will not be long until the baby is full term and it may begin to move into the engaged position by moving its head downward, it will start to make use of its bladder and the bone marrow produces red blood cells getting ready for the babies development and growth once it is born, the amniotic fluid has been decreasing as the baby has been growing and here is only around 1 litre of it left, it will continue to decrease as it grows even more and the body temperature will then be regulated by the brain cells and body fat instead.

Weeks 32-36
The baby now weighs just under 4 pounds and is still taking on more fat, it will continue to grow around half a pound per week from this point onwards. The skin is now starting to thicken and has become soft and opaque, its nose has developed more and can now smell, the babies bridge of its nose will grow later on after birth, this is why babies have a cute button nose. Other things that continue to change are the bones as they continue to thicken although the bones in the skull will stay soft, this enables the babies head to be born safely, sometimes when a baby is born the skull may overlap to help with squeezing it out, this is why babies are sometimes born with cone shaped head.

It continues to practice important skills such as its swallowing, kicking and sucking but as it grows there is less room to move around, it is almost full term now and can breath independently outside of the womb, as he gets ready for birth he starts to make he’s way down the pelvis.

Weeks 36-40
Weeks 36 to 40 are the final weeks of birth if the mother is lucky, it now weighs around 6 pounds and is about 48 cm in length. During these last few weeks as the baby makes its way further down the pelvis ready to engage it is putting on the last few ounces of fat, all of its organs are fully formed and its bowels are full of meconium, it can see around 2.5 cm, its is still shedding the vernix and some of the residue may be left when it is born, if the baby is late it will not have any effects of the development of the baby in its first year of life.

1.2 Explain the routine checks that are carried out during Antenatal care, postnatal care and the first year of life.

Antenatal care

Antenatal care is care that is carried out during pregnancy, these are tests and checks are designed to make the pregnancy safer are used to protect the well-being of mother and baby and make sure that the baby is growing and developing properly.

Weight and height checks
Checks on the mothers weight and height are carried out for multiple reasons, the main reason being to make sure that she is a healthy weight in good condition in the early stages of pregnancy, these checks will be carried out using a BMI (Body Mass Index) calculator, if the mothers diet is unhealthy then she may be asked to loose some weight as being overweight can lead to other problems such as gestational diabetes.

Scans
one of the main routine checks that every pregnant women will undergo is an ultrasound scan, the scan is carried out by a sonographer using a machine called a transducer, the sonographer will begin in a room with dim lighting to make sure that they can get some clear images of the baby, they will then proceed by applying gel to the women’s stomach, this ensures that there is sufficient contact between the machine and the skin, they will then glide the probe over the women’s stomach. The ultrasound scan works by building a picture of the baby in the womb by using sound waves, women are asked to make sure they have a full bladder before they begin the scan as this helps the ultrasound reach the womb.

The ultrasound scan is used to carefully examine the babies body, checking that it is growing properly and looking out for any abnormalities like spina bifida, extra limbs etc. One of the important things that the sonographer is able to analyse is the position of the baby and the placenta, if they find that the placenta is low down then the women may have to deliver by a c-section , if this is the case the women will be offered a follow up scan around 32 weeks to help them decide on next steps. Other things that they are able to look at are..

Ectopic pregnancy- this is when the embryo implants somewhere outside of the womb and most commonly in the fallopian tubes where it can not survive, to further prevent any more complications women should be treated immediately
Find the cause of any vaginal bleeding
Assessing how much amniotic fluid is present in the womb
If anything is found that is unusual or a cause for concern then the women will be referred to a doctor or a fetal medicine specialist.

The first scan is usually carried out around 12-14 weeks and is often referred to as the dating scan, this is because the main purpose of this scan other than looking for any problems is to check when the babies due date will be by getting a better idea of how many weeks pregnant the women is, based in the measurements of the baby. Mothers have the option to include a Nuchal translucency (NT) scan, the NT scan is part of the combined screening tests that assesses the risk of downs syndrome, it is done by measuring the fluid that is at the back of the babies neck.

The second scan that is called the anomaly scan and sometimes referred to as the mid-pregnancy scan and is offered to all pregnant women, the purpose of this scan is to check for any structural anomalies, stenographers are also able to determine the sex of the baby in this scan, although parents are warned that they can not be 100% certain.

All women are offered a different amount of scans depending on their health and they can be carried out at any stage of pregnancy, for example if the women has complications with diabetes, high blood pressure, if she is measuring smaller or larger than expected, has previously given birth to a small baby or is pregnant with twins she may be offered a growth scan around 28-40 weeks.

Injections and vaccinations

It is recommend that women have multiple injections and vaccinations as it will help protect her and her unborn child from a range of illnesses, infections and diseases such as..

whooping cough
This is a very serious condition and it can be life threatening on a mothers unborn child, half of babies under one years old will need hospital treatment if diagnosed with it. Pregnant women are usually vaccinated when they are between 16 and 32 weeks although they can have the vaccination up until they give birth, the vaccination also protects against polio, diphtheria and tetanus, it works by creating protective antibodies which pass through the placenta and give some to the baby, it is very effective and can protect the baby from having whooping cough in the first few weeks of life until he’s routine checks.

Flu
The flu vaccination protects both the mother and child from the flu virus and can be taken at any stage during pregnancy, it works the same as the whooping cough vaccination by passing through the placenta and providing the baby with some protection for the first few weeks of life. The flu vaccination is usually available from around September to January and it is free for pregnant women. It is highly recommend that pregnant women get vaccinated as soon as possible as there is a higher risk of complications for pregnant women if they catch the flu such as bronchitis, this is a chest infection that can lead to having pneumonia which can be life threatening, it can also result in the baby being born prematurely and can even cause the baby to be still born.

Hepatitis B
Hepatitis B is the name for a condition that causes inflammation of the liver, it is a contagious virus and can be passed through blood, semen and vaginal fluids, it can cause flue like symptoms and in some cases jaundice but the most effective way to detect it is through having a blood test, the test will check how high the viruses are in the blood and if necessary their doctor will advise that they take a medication called Tenofovir during their pregnancy to reduce the risk of passing it to the baby, this treatment is likely to begin in the third trimester depending on how high the levels are and treatment should continue for the first 4-12 weeks after birth.

This vaccination requires 3 separate doses, the second and third dose should be given 1-6 months after the first is given, it is extremely important that all doses are taken, this disease can result in the mother suffering from severe disease and a chronic infection for the baby, whilst most adults are able to fight the infection on their own unfortunately most babies who suffer from it cannot.

GTT Test

During pregnancy, to meet the babies needs the mother has to produce extra hormones to keep her blood sugar levels stable, these hormones are known as insulin, when her body fails to make enough insulin she may end up too much sugar in her blood and this is what causes Gestational Diabetes. Mothers are also at risk of gestational diabetes if they have had it in pregnancy before or if they are overweight.

If an expectant mother is considered to be at risk of Gestational Diabetes she will be offered a GTT test (glucose tolerance test), this test checks how well the mothers body regulates blood sugar levels. Diabetes can cause many problems for an expectant mother, some of these problems include..

The baby can grow larger than usual
Too much amniotic fluid can build up in the womb, this can cause premature labour and delivery problems and is known as polyhydramnois.
Pre-eclampsia

Urine tests
Tests on the mothers urine are carried out regularly throughout her pregnancy and it is checked for Protein or Albium, if either of these are found in the mothers urine it can indicate a sign of an infection and may need treatment, one of the things that it can be a sign of is Pre-eclampsia, Pre-eclampsia can lead to other problems during pregnancy and can be life threatening if its is ignored and not treated.

Blood pressure tests

A women’s blood pressure is tested when she is first pregnant and taken regularly throughout the duration of her pregnancy, taking an expectant mothers blood pressure is important because a rise in her blood pressure could cause Induced hypertension, this means the the women’s heart has to work a lot harder in order to pump the blood around her body, this can put strain on the heart and can effect the muscle. If a women’s blood pressure is lower in the middle of her pregnancy this is nothing to worry about although she may experience light-headedness.

Blood tests

Blood tests are very common in pregnancy and are regularly taken, these tests are carried out to make sure the baby is healthy and safe and to determine blood type – this is important information to have in case a blood transfusion is need at the time of birth. Most importantly these tests are carried out to screen for condition’s such as…

HIV
Diabetes
Rhesus disease
Anaemia

Signs of anaemia include the mother feeling very tired and can make her less able to cope with any loss of blood that may occur during birth, the mother will be offered Folic acid if it is found.

Blood tests are offered to all women although other women may offered additional tests if the are at risk of other conditions or infections, they will all receive written information about any tests that are going to take place although they are not mandatory they are recommended to protect health, if anything is found it is easier to reduce the risk of passing on the infection and is easier to treat if it is found early.

Amniocentesis

Amniocentesis is usually offered around 15-20 weeks and is used asses if there are any abnormalities in the pregnancy or if any are likely to occur, things they look at that can cause abnormalities are the age of the mother as well as her medical history and medical conditions. Consent must be given prior to the procedure, it is undergone by a needle that is used to extract a sample of amniotic fluid from the mother, it can detect conditions lie downs syndrome, spina bifida and Sickle cell anaemia.

Measuring mothers bump

A great way to keep track of a babies growth without having an ultrasound scan is by measuring the bump, women will usually have their bump measured at their antenatal appointments, a healthcare professional will physically examine the bump and measure the size of the uterus by starting from the top of the bump (fundus) down to the pubic bone, the amount of centimetres will give the healthcare professional an idea of how many weeks pregnant the women is, for example if she is measuring 21cm then she is likely to be around 21 weeks pregnant. If the bump is measuring larger than it should be it could mean that there is a lot of amniotic fluid surrounding the baby, If the bump is measuring smaller than expected then it may be a cause for concern, in both cases an ultrasound scan may be advised to get a better idea of measurements, to make sure the baby is developing how he should be and to check that there are no problems with how the placenta is working, unhealthy lifestyle choices such as smoking and drinking can cause the baby to measure small, if for whatever reason he is small there is a chance that he could catch up however this isn’t always the case.

Discussion of birth plan

A birth plan is offered to all pregnant women although they do not have to do one, the purpose is to discuss and record with the mother what she would like to happen during her labour and after she gives birth, things that are likely to be discussed are where or how she would like to give birth, for example some women choose to give birth in a birthing pool and some women would rather opt for a c-section delivery, they can discuss what pain relief they would like and who they would like to be their birthing partner. The birthing plan may be written on a special form or in some cases can be notes, it should be kept with the mother so when she goes into labour the birthing team have a good idea of what she would like although sometimes complications may arise and mother must understand that not all births go to plan.

Postnatal care

When a baby is around 6-8 weeks of age tests and checks are taken on him and the mother to ensure that they are both happy and in good health and progressing correctly, during these checks the health visitor will check that the mother is recovering well and she will check if her organs are retuning to where they once was and check that her uterus is retracting, mothers can help with the recovery process by doing gentle exercises and ensuring they are in good health and eating well although at this time she should not try and loose any weight as this can delay her recovery, the health visitor will also check…

Mothers weight
Her blood pressure will be checked
Urine may be checked
Stitches removed and checked if needed
If mother had a c-section they will check that her scar is healing nicely
Can perform a smear test if she would like one

As well as checks this is a great opportunity for the mother to ask for any advice, help and guidance such as support with breastfeeding, some mothers struggle greatly with breastfeeding so it is important that they have support and information as well as being shown important things like being shown how to latch the baby onto the breast, other things that mothers may need help and support with is weaning, it is recommended that mothers start to feed their children solids from 6 months although some mothers start before if they think their child is ready, they can get advice on what to feed their baby, babies have sensitive stomachs so should be introduced to solids very slowly, usually baby rice is recommended and starting with only 1 or 2 spoons at a time, there are also support groups available where mothers can go to get advice from healthcare professionals and share experiences with other mothers.
Some other things that a mother may need help or advice with are things such as..
Genital well-being such as discharge, pain, stitches etc..
If she is feeling low or depressed, this could be a sign of postnatal depression
Any trouble she may have with wind or incontinence
If the mother had a c-section performed she can voice any concerns
Any worries or concerns in general

Checks on newborn
As well as checks on the mother the health visitor will also make checks on the newborn to ensure that he is generally healthy and a personal health record is created, this is a little red book that is filled in by GP’s, health professionals and parents and keeps track of the babies health and progress, it records things such as weight and height as well as any vaccinations and should be updated every time the baby is seen in a healthcare setting. Checks carried out during a postnatal visit are things like…
Weight and height
Checks for any abnormalities on the heart, lungs, spine and the genitals
They may test the babies vision by making him follow objects with he’s eyes
Babies general health and making sure he is happy and well fed

Apgar scores
Apgar scored are performed right after the baby is born and then usually about 5 minutes after, it is the first test that the baby will undergo, it looks at the babies overall condition and evaluates if there are any concerns and if any action should be taken, the key things that are looked at are…
Appearance and the colour of its skin
Pulse and heart rate
Reflex responses which is known as grimace
Activity like muscle tone and movement
Respiration which is he’s breathing rate and how much effort he is making

After each category has been tested is it then given a score from 0-2, 0 being worst and 2 being best, anything that is normal will be scored at a 2, if the baby is struggling in any way with anything, for example he may have little movement or a slow pulse then he will be given a score of 1, if the baby doesn’t respond or has no pulse this would be a major concern and he would need medical attention as soon as possible and he would be scored with a 0

Weight and height checks
The weight and the height of a baby will be checked at each Postnatal appointment and recorded in the babies personal child health record (red book), this is done by using a chart which tracks the babies growth and development, by using the chart a healthcare professional can compare how the baby is growing against other babies at the same age. Parents will be given regular appointments to check their babies weight especially if they had a low birth weight, they can also make appointment themselves to see their GP or go to healthcare clinics to get their baby weighed and measured as often as they like.

Hearing screening
A process that is highly recommended after birth is a hearing screening, it is used to find out if the baby has any permanent hearing loss as quickly as possible, a lot of babies do not come from families with any history of permanent hearing loss so it is advised that all babies receive it. If a baby has permanent hearing loss it can have a huge impact on he’s development so finding it early is crucial as it gives babies support from an early age and a better chance of developing their language and how they communicate, communication is key to having healthy relationships and help the child bond with their parents. Whilst is is highly advised it is not mandatory and if parents decide they do not want to accept they will be given a check-list to help monitor their child’s hearing as they grow.

The test may be offered to the mother and baby before they are discharged from the hospital, otherwise the test should ideally be done within the first 4-5 weeks although it can be done within the first 3 months of the babies life so a healthcare professional will arrange to see the child at some point after they are discharged. It is done by performing an automated otoacoustic emission (AOAE) test which involves inserting a a small earpiece into the babies ear, once inside the healthcare professional will play gentle clicking noises from the earpiece and check the babies responses, if for whatever reason they are not able to get a clear test such as back-round noise or the baby being unsettled then they will be offered a second test, the second test may be the same as the first test or it may be a different test called a automated auditory brainstem response (AABR) test, this is done by placing three small sensors on the babies head and neck and is given small soft headphones to wear and again gentle clicking noises will be played to the baby. If the baby doesn’t show a response to either one ear or both of the ears then they will be referred to a hearing specialist which will provide then with more details and support, this appointment will be made within 4 weeks of the test.

Vitamin K injection
Vitamin K is extremely important as it is needed for blood clotting and by having low levels of it it can cause small cuts to bleed for longer and bruises can occur more easily from minor injuries, more serious effects of having low vitamin k is more severe bleeding such as in the brain which can lead to brain damage causing a serious condition called Haemorrhagic disease of the newborn (HDN), babies are at higher risk of HDN if their delivery involved things like forceps or ventouse, if they where delivered by a c-section or anything that may have caused bruising, other risks associated with the disease is whether the baby had any trouble with their breathing and getting enough oxygen to the brain or if the mother was taking certain medications during her pregnancy such as anticonvulsants.

Babies are born with low levels of vitamin K, this is because we get it from bacteria in the gut and our diet, babies do not have bacteria in their gut to produce it and the levels of vitamin k in breast and formula milk are not sufficient therefore it is recommend that babies receive the injection within the first 24 hours of life to make their vitamin k levels higher for longer, it can also be given by mouth although this is not as effective.

Whilst most babies are born with low amounts of vitamin K about 1 on 1000 babies suffer from a condition call VKDB this means that some babies are born with a deficiency to vitamin K resulting in them not having enough to make their blood clot, whilst some symptoms of the condition are more obvious such as bleeding from various parts of the body such as the nose, mouth or bottom sometimes it is not always visible and may be internal therefore making it harder to detect, because of this it is recommended that all babies receive vitamin k after birth to be on the safe side. VKDB comes in three different categories, the first is early VKDB and appears within the first 24 hours of life, the second is classic which appears within the first week of the child’s life and lastly which is the more serious of the 3 but also the rarest is late VKDB, this appears between 2-12 weeks, this is more serious as it is harder to detect and it is likely to be internal bleeding.

Blood spot tests
A blood spot test which is sometimes referred to as a heel-prick test is a very quick and safe test carried out on the baby, A special device is used to collect a small blood sample from the babies heel, 4 drops of blood are taken onto a special card and it is then sent off to be tested, this sample is used to check for any illness’s and is offered to all babies when they are around 5 days old although is is not compulsory and parents must give consent prior, information will be given to the parents explaining the process and purpose and if they decide to go thought with it then they will receive the results when the baby is around 6-8 weeks, this test checks for various different things such as…
Sickle cell disease
Cystic fibrosis
Congenital hypothyroidism
Metabolic diseases

Checks during first year of life
In the first year of a child’s life he will undergo a range of checks and be given vaccinations throughout the year to protect him against multiple things such as
Diphtheria
Tetanus
Pertussis
HIB
Hepatitis B
Polio
Pneumococcal disease.
Regular postnatal visits will be made to the mother and child to asses the babies environment insuring he is being taken care of and ensuring the parents understand the needs of their child like their safety, tips on diets and normal behaviour.

Checks on mothers will be carried out on mothers to ensure that they are happy and healthy with scheduled checks and tests with her GP to check for postnatal depression, postnatal depression is a very serious condition and effects 1 in 10 mothers, symptoms of postnatal depression are…
A persistent feeling of sadness
Bad sleeping patterns and not being able to sleep even though they are very tired
Lack of energy and getting no enjoyment and fulfilment from the world
Difficulty bonding with their child
Withdrawing from having any contacts with friends and family
Poor concentration and decision making
Frightening thoughts such as harming her baby
A range of support id offered to mothers if they are experiencing any of these symptoms and are encouraged to speak up and discuss any feelings with a mental health professional, counselling, physiological therapy and anti-depressants can also be used.

1.3 Describe factors that may impact upon the development of a baby during pre-conception, each stage of pregnancy and during the first year of life.

Pre-conception

Pre-conception checks should be arranged if a women is planning on becoming pregnant , the purpose is to find out if there is anything that could effect a women’s pregnancy and to help her increase her chances of having a healthy pregnancy. During these checks a women will be asked a series of questions including questions about her weight and diet, lifestyle, medical history and family medical history, any medication she may be on and past pregnancies. Things that will effect a women becoming pregnant and her pregnancy are below.

Poor general health and well-being
Women who are planning on becoming pregnant should ensure that their bodies are in the best condition possible, this will not only help her to conceive but will give her the best possible chances of having a healthy pregnancy with little complications, not only should she be physically healthy but she should have good mental health and well-being, becoming pregnant comes with a lot of stress an worry which will effect both the mother and the child, which is why a women’s mental state should be at its best in order to deal with any emotions and complications that she may experience, if a women’s has a poor mental state she will find it harder to deal with her emotions and could lead to depression during pregnancy, post-partum depression and could also lead to bad decision making like drinking alcohol and taking drugs which come with many more complications.

Smoking
If a women is planning on becoming pregnant then she should ensure that she does not smoke or be around second hand smoke, if a women is exposed to smoke it can increase her risk of infertility and make it harder for her and can take a lot longer to become pregnant. If a women is already a smoker then it is a good idea for her to quit at least a few months before she becomes pregnant, not only to get the best benefits from it but also because giving up smoking can be a stressful ordeal, so if a mother was to attempt to quit just as she falls pregnant it could cause her a lot of stress which may have an impact on her unborn child.

Alcohol
Drinking Alcohol before becoming pregnant can have very similar effects to smoking, it has been known to reduce the chances of conception and it can also be linked to miss-carriages, it can effect a women’s menstrual cycle and even stop her from ovulating, although it is not just women that it can effect, low sperm count has been linked to drinking alcohol in men, making it harder for couples to conceive, as well as this drinking alcohol can effect a persons overall health including mental health, especially when it is excessive and as mentioned before poor health will also cause difficulties getting pregnant.

Drug abuse
Just like smoking and drinking alcohol, taking drugs whilst pregnant make it a lot harder for women to fall pregnant. Drugs like marijuana and cocaine can interfere with a women’s monthly cycle and can suppress fertility altogether, there has also been evidence to show that cocaine can even damage a women’s fallopian tubes. Not only does taking drugs come with physical impacts, it also impact on a women’s social health, domestic violence is often linked to drug taking along with women having poor general health and living on the streets, mental a psychiatric health problems are a common occurrence too. Men who take drugs can also suffer from fertility problems, drug abuse is know to effect a man’s sperm count, quality and mobility.

Bad diet
Women who eat healthy and treat their body right have the best chance at getting pregnant and having a healthy pregnancy. It is recommended that women are at a healthy weight when they are planning on becoming pregnant, ideally with a BMI between 20 and 25. Women who are overweight before they become pregnant have an increased risk of having complications such as gestational diabetes during their pregnancy, it has also been linked to pre-eclampsia and in some cases miscarriage, although it is not just women who are overweight that are at risk of problems, women who are underweight are known to have babies with low birth weights and during pregnancy can measure small for dates, these can have impact on the babies health and development after birth.

Antetatal
during a women’s pregnancy she should take special care to maintain a healthy lifestyle to ensure the best possible outcome for her unborn child, listed below are some examples of things that can effect her pregnancy.

Nutrition and diet
good nutrition and diet it very important to a developing child, women are encouraged to eat vitamin rich foods and folic acid is recommended as lack of it can cause birth defects, women are also warned not to eat certain foods such as soft cheeses and raw foods such as sushi. A women’s caffeine intake should be reduced or stopped altogether as it is shown to effect fetal heart rates.

Alcohol
Its is recommended that women do not consume alcohol during pregnancy, when a women drinks alcohol it passes through her umbilical cord to the baby and so does her baby, the baby its still developing and drinking alcohol at any time in pregnancy can have serious consequences on their unborn child, it cause fetal alcohol spectrum disorders (FASDs), children with FASDs can suffer from multiple physical and mental disabilities, children can be born with abnormal facial features such as philtrum, other characteristics can include a small head size, many are born with a lower weight and height of the average child. Sufferers may have learning disabilities which can lead to hyperactive and challenging behaviours, they have been known to have poor coordination, memory and have problems with their speech, vision an hearing, other internal problems include problems with their heart, kidney and bones as well as many other problems.

Smoking
It is strongly recommended that mothers do not smoke during pregnancy and to also avoid second-hand smoke, when women smoke they inhaling lot of poisonous and harmful substances, the main ones being nicotine and carbon monoxide, these all go directly to the baby as they are passed through the mothers bloodstream, this can effect her unborn child greatly, as she smokes she is reducing the amount of oxygen to her baby, this can increase the baby’s heart rate. The chemicals that are inhaled during smoking can lead to other problems for the baby like having a low birth weight and premature birth, it also increases the risk of SIDS (sudden infant death syndrome) and still birth, as well as running the risk of the baby developing respiratory problems and birth defects.

Drug abuse
When a women take drugs during pregnancy it passes through the placenta to the baby, women should not take any illegal drugs if they want their baby to develop and grow properly, even in small amounts, it can deprive the baby of oxygen and make it harder for the placenta to work properly and cause a serious condition called placenta abruption, placenta abruption is when the placenta comes away from the uterus which can be life threatening for both the mother and baby as it can cause severe bleeding. Another condition is called placental insufficiency when the placenta struggles to carry important nutrients ad oxygen to the baby.

If the mother takes drugs regularly she may experience withdrawals when she has not had any, for her baby this means that he may have withdrawals too, some baby’s are born addicted to drugs and suffer from neonatal abstinence syndrome (NAS), baby’s who are unfortunate enough to suffer from this have similar symptoms to what an adult has when they are heavily addicted to drugs and sometimes need to be treated with morphine and methadone.

Mental health issues

Mental health problems is very common in pregnant women and is more likely to occur if she has had mental health problems in the past, the effects of metal health can have a huge impact on health and well-being and cause long term issues for both the mother and child. When a mother suffers from mental health and experiences stress or anxiety it can lead to changes in hormones such as cortisol and adrenaline and this can have an effect of how the baby is developing in the womb, the baby can have problems in later life academically and may have problems with developing relationships, they are more likely to be anxious children and can suffer from symptoms of attention deficit disorder amongst other develop-metal issues.

Help and support will be offered to the mother from her GP or health visitor and they may set up a care plan to help her recover, help that is available includes psychological help like counselling or sometimes medication will be given although medication can put the baby at risk of condition’s including congenital abnormalities called teratogenesis or perinatal syndromes, whilst medications has its risks mental health can lead to more serious condition’s which can occur on their own or can occur alongside depression, such as
panic disorder
generalised anxiety disorder
obsessive compulsive disorder
post-traumatic stress disorder
tokophbia
Bipolar

Both medication and mental health can put the baby at risk so the doctor will weigh out their options and decide what is the necessary procedure for each individual.

Foods to avoid

During pregnancy women should pay close attention to what they put into their body, not only is it important that their diet has nutritional value that benefits their growing baby but she should watch ut for certain foods that may make her feel unwell or even harm her baby, listed below are food which pregnant women should look out for.
Soft cheeses
Pregnant women should pay close attention to what kids of cheese they put into their bodies, hard cheese is ok to eat as long as it was made from pasteurized milk but women should avoid soft moist cheeses unless they have been cooked, these kinds of cheese are a perfect environment for bacteria to grow like listeria which can lead to severe illness, miscarriage and even still-birth, soft moist cheese include blue veined cheeses like Danish blue, other cheeses they should avoid include mould-ripened cheeses like bri and Camembert. Other food products that contain listeria and should be avoided completely is pate.

Eggs
Most women take the safest option when they are pregnant and ensure that all their eggs are well done before they eat them in order to avoid salmonella although in some cases this is not necessary, if an egg has a red lion stamp on the shell it is considered a low risk of salmonella therefore its is safe to eat raw or partially, if the lion stamp is not present or if she is eating out, is unsure where the eggs are sourced or is eating quail or duck eggs then she should ensure they are thoroughly cooked, salmonella isn’t likely to harm the baby however it can cause severe diarrhoea and vomiting.

Raw/undercooked meat
Whilst pregnant women may be tempted to eat their steak medium rare they should make sure that any meat they eat has been fully cooked in order to kill any bacteria that is present. Eating raw meat carries the risk of catching a rare but dangerous infection that can damage the baby called Taxoplosmosis, a parasite that is found in raw and undercooked meat, it is also found in cold cured meats such as chorizo and salami as these meats have not been cooked they have cured and fermented, however the bacteria can be killed if the meat it frozen prior to eating. Other things that can contain Toxoplasmosis include unpasteurised milk, soil, cat faeces and water that has not been treated.

Fish
Fish is very good for the development of the baby as it is rich in vitamins and most fish is safe to eat in pregnancy although pregnant women should take care and limit the amount they eat of certain types of fish and avoid others. Fish they should avoid completely are Shark, Merlin and swordfish and they should limit how much tuna they have, tuna contains more mercury and it can have an effect of the baby’s development of the nervous system, they should have no more than 2 tuna steaks or 4 cans of tuna per week. Other fish to avoid include any raw fish such as sushi unless is has been frozen before to kill any bacteria or any oily fish, these kinds of fish include salmon, trout, herring and mackerel, this is because these fish can contain pollutants.

Other foods to avoid
Liver
Game
Fish oil or vitamin A supplement
Anything that contains unpasteurised milk
Unwashed fruit and veg as it may contain soil
General health and well-being
All of the elements above contribute to a mothers health and well-being. A mother should make sure that she cares for herself in every way, an excellent diet will not make up for having bad mental-health, she should ensure that she has lots of support behind her and she is looking after herself mentally and physically, these can all have an affect on the mother once she gives birth, if she is suffering from mental health during her pregnancy then she is more likely to suffer from postnatal depression after she gives birth and may find it hard to bond with her child. Mothers can find advice on how they should take care of themselves at their local health centres and by seeing health professionals, they should also make sure they attend all of their antenatal appointments so their health is monitored regularly.

Health issues i.e diabetes
When a women becomes pregant she should talk her her GP and let them know about any health problems she has such as diabetes, depression etc, he can then take approprate action dpending on the issue, below are some health issues that can affect a womens pregnancy

Diabetes- if a womens sugar levels are high during her pregnancy affact her babies development and she is also at higher risk of pre-eclampsia.
Depression- can affect the way a mother bonds with her child and can lead to other mental health problems.
Asthma- women with asthma are more likely to deliver by c-section and suffer from pre-eclampsia, it can also cause a low birth weight and prematurity
Eating disorders- women who have eating disorders should make them know immidiately, they can lead to further mental health problems such as postnatal depression, the changes that a women goes through in pregnancy can worsen the eating disorder and this will affect her unborn child, it can also cause birth defects and premature birth.
High blood pressure- this can lead to health conditons such pre-eclampsia and placental abruption, women with high blood pressure also have a higher chance of having a premature baby and a baby with a low birth weight.
Epilepsy and seizure disorders- women who suffer from these are at higher risk of miscarriage and still birth and can the baby although taking medication runs the risk of birth defects.
Thyroid disease- an over-active thyroid can affect the fetus causing poor weight gain and sometimes heart failure, and under-active thyroid can affect the mothers help and also cause the fetus to have birth defects.
STI’s-cn be passed to the baby and cause low birth weight, brain damage, hearing problems, liver problems, blindness and even still birth, it can also cause her waters to break early and can cause an infection in he women’s uterus after labour

Perinatal

Whilst a mother can have a perfectly healthy pregnancy circumstances at the time of birth can effect a child development later in life, one example is if the child is deprived of oxygen this can lead to condition’s such as Cerebal palsy and learning difficulties, other examples are listed below.

Prematurity
Premature babies can suffer from
Developmental delays
Higher risk of infection
Immature lungs can cause breathing problems
Dysplasia
Apnea and bradycardia
Anaemia
Heart murmurs

C-section
During a natural birth a baby is exposed to the friendly bacteria in the birth canal that helps with the child immunity, when a child has is delivered under a c-section he has less opportunity to get exposed to this bacteria therefore is at risk of having an underdeveloped immune system, other factors that a c-sections can have an impact on are…
Brain development
Breathing issues
Delayed breast feeding
Less concentration

First year of life

In the first year of a child’s life he will have regular checks that track physical growth and monitor health o make sure there are no potential signs of trouble.

Things that can effect a child during the first year of life include..

Home environment
During a child’s first few years of life their brain undergoes crucial social, emotional and motor development amongst many important other things, every time a child tries a new experience and puts their senses to use a connection is made to their brain, these connections will have a lasting effect on the child and will shape how the child behaves, thinks, feels and learns. If a child is raised in a loving environment with good relationships and regularly bond with their parents this will help with the child’s development and help them to flourish, a child learns by watching and copying what they see, if their parents regularly interact, play and teach them and their home is a nurturing and safe environment then it will make a huge difference on their growth and abilities like learning, social skills and empathy.

Children that are not raised in these kind of environments and are exposed to abuse and neglect as well as seeing their parents suffer from mental health can experience a lot of stress themselves which can cause problems now and in the future, it can effect their brain development and have an effect on their self esteem and create behavioural problems and delays, a child’s behaviour can be dealt with in a more suitable manner such as their parents giving clear explanations about right from wrong and giving them praise when they are well behaved, if a child parents are suffering from any mental health issues they should seek help from healthcare professionals and support from friends and family in order to protect themselves and their child. All these factors will help create who the child will become later on in life so it is important that they are lead by a good example.

Alcohol
As mentioned before it is extremely important that children are lead by a good example, children who watch their parents abuse alcohol are taught that it is acceptable and normal and is at higher risk of developing an unhealthy relationship with alcohol later on in life, as well as this alcohol abuse usually leads to other problems and can mean that the child is exposed to things they shouldn’t be, it can cause their parents mental health problems, the child could be exposed to their parents fighting more and acting drunk and irresponsible amongst many other things, all these things will contribute to a child’s development and can cause them to have issues with interacting with people, learning and may have anger issues.

Smoking
If possible children should be kept away from cigarette smoke at all times, second hand smoke contains thousands of dangerous chemicals and some are known to cause cancer, breathing it in can be fatal especially on a child’s lungs that are still developing and those who suffer from asthma. Whilst many parents try to keep their smoke away from their children by smoking outside and not in the home it does not protect the child because the chemicals in second hand smoke are still exposed to them through their carer so the best way to avoid the child from becoming exposed to these chemicals is to stop smoking altogether although doing this will not completely eliminate the problem, environmental tobacco smoke occurs in public places , it comes from the smoke that has been inhaled nd then breathed out and the tips of cigarettes, pipes and cigars and it is almost unavoidable.

Children who are exposed to smoke are at higher risk of SIDS, they are also known to get more illnesses such as ear infections, coughs and colds, tooth decay and suffer from respiratory problems with poor lung development which can lead to lung cancer. As well as health problems children who watch their carers smoke are more likely to smoke themselves later on in life.

Drug abuse
Drug abuse is one of many things that a child should never be exposed to, parents who take drugs may find it harder than others to deal with looking after a child and family life and subsequently not fully fulfil the parenting role or care for their child as thy should, parents who take drugs often have difficulties with relationships and have trouble managing their finances as drugs usually come first, they may also bring the wrong kinds of people in their home making it an unsafe environment, all of this can then have an impact on the mothers mental health which can create more problems.
All these points have an effect on the child and can greatly effect the way they develop, if a parent doesn’t respond to their child because they are high on drugs then the child may feel lonely and unloved as there is no nurturing and their needs are not being met, this can have an affect on the child emotionally and make it hard for them to form good relationships with people, if the child is brought up in an unsafe environment they may be anxious children, it can also effect them academically, they may have delays with speech and behaviour problems. For children who grow up with drug taking being the norm they are more likely to take drugs themselves later on in their life.

Disabilities
Different disibilities will effect children in different ways, children who have learningdifficutie

General overall health
a child’s overall health will depend on many things like if he was born a normal birth weight, is he being properly assessed with regular check ups and are he’s nutrition and dietary needs being met.

Mental health
In order for a child to develop and blossom properly they should be in a warm and nurturing environment, insuring that he feels loved and cared for will have a big impact on he’s health later on in life. If the other is feeling low or depressed they may withdraw from their child or take out the way they feel on them which can sometimes lead to parents abusing children. If parents are suffering from metal health they should seek support from their GP or health visitor, one of the main mental health issues mothers suffer from is post-natal depression, this amongst many other mental health problems can affect the mother and child’s relationship and result in the child having bad mental-health and may find it hard to build relationships with other people, this can lead onto other problems with learning and confidence.

Abuse and neglect
If a child is abused or neglected it can have a major impact on them, if a child is abused their pre-frontal cortex decreases in activity, this can have consequences on their learning, planning and problem solving, abuse can cause problems with their self-confidence, personality, speech and can cause anxiety and depression later i life.

Play
Insuring that a child’s pay is both exciting and stimulating has a big effect on their overall performance, play helps children learn and explore new things and teaches them skills that they will benefit from later on in life