Infants and Children in Context. Tara L. Kuther

      Parental responses to having a low-birthweight infant influence the child’s long-term health outcomes, independently of perinatal risk, suggesting that the parenting context is an important influence on infant health (Pierrehumbert, Nicole, Muller-Nix, Forcada-Guex, & Ansermet, 2003). When mothers have knowledge about child development and how to foster healthy development, are involved with their children, and create a stimulating home environment, low-birthweight infants tend to have good long-term outcomes (Benasich & Brooks-Gunn, 1996; Jones, Rowe, & Becker, 2009). For example, one study of low-birthweight children demonstrated that those who experienced sensitive parenting showed faster improvements in executive function and were indistinguishable from their normal-weight peers by age 5; however, those who experienced below-average levels of sensitive parenting showed lasting deficits (Camerota, Willoughby, Cox, Greenberg, & the Family Life Project Investigators, 2015). Likewise, exposure to sensitive, positive parenting predicted low-birthweight children’s catching up to their normal-birthweight peers at age 8 in academic achievement, but exposure to insensitive parenting predicted much poorer functioning (Jaekel, Pluess, Belsky, & Wolke, 2015). Longitudinal research has found that low-birthweight children raised in unstable, economically disadvantaged families tend to remain smaller in stature, experience more emotional problems, and show more long-term deficits in intelligence and academic performance than do those raised in more advantaged homes (Taylor, Klein, Minich, & Hack, 2001).

      Interventions to promote the development of low-birthweight children often emphasize helping parents learn coping strategies for interacting with their infants and managing parenting stress (Chang et al., 2015; Lau & Morse, 2003). Interventions focused on teaching parents how to massage and touch their infants in therapeutic ways as well as increase skin-to-skin contact with their infants are associated with better cognitive and neurodevelopmental outcomes at age 2 (Procianoy, Mendes, & Silveira, 2010). One intervention common in developing countries where mothers may not have access to hospitals is kangaroo care, in which the infant is placed vertically against the parent’s chest, under the shirt, providing skin-to-skin contact (Charpak et al., 2005). As the parent goes about daily activities, the infant remains warm and close, hears the voice and heartbeat, smells the body, and feels constant skin-to-skin contact. Kangaroo care is so effective that the majority of hospitals in the United States offer kangaroo care to preterm infants. Babies who receive early and consistent kangaroo care grow more quickly, sleep better, score higher on measures of health, and show more cognitive gains throughout the first year of life (Boundy et al., 2015; Jefferies, 2012).

      In summary, a remarkable amount of growth and development takes place between conception and birth. In 9 short months, the zygote transforms into a newborn. Although there are a variety of risks to healthy development within the womb, most newborns are healthy. Infants are born with a surprising array of competencies, such as well-developed hearing, taste, and smell. Additional physical, cognitive, and psychosocial capacities develop shortly after birth, as we will see in upcoming chapters.

      Thinking in Context 3.4

      1 In what ways might newborns’ shifting states of arousal be adaptive?

      2 Parental responses to having a low-birthweight infant influence the child’s long-term health outcome. How might contextual factors influence parents’ responses? What supports from the family, community, and broader society can aid parents in helping their low-birthweight infants adapt and develop healthily?

      Apply Your Knowledge

      Best friends since first grade, Charmayne and Latisha were inseparable throughout childhood, adolescence, and now adulthood. Shortly after Charmayne discovered she was pregnant, Latisha revealed that she too was expecting. Together they learned about their developing babies, brainstormed baby names, and planned how to fit an infant into their cramped homes.

      Charmayne and Latisha also commiserated about the challenges of pregnancy. Charmayne worked as a nail technician at a busy nail and hair salon. It’s not uncommon for her customers to complain about the chemical odors, but she usually doesn’t notice the smell. Charmayne’s boss suggests that she wear a surgical mask and sometimes Charmayne complies but it’s hard to converse with her customers from behind a mask. Charmayne has always found it uncomfortable to sit at the manicurist table all day, but now her rapidly expanding pregnancy “bump” makes sitting and leaning over the table very difficult. Most days she takes an over-the-counter painkiller to ease the discomfort. In the past, her doctor has prescribed medical cannabis for her symptoms. Charmayne still has some and consumes it occasionally when the pain is overpowering. She figures that once in a while can’t hurt, especially if it helps her do her job.

      Latisha works as a server and bartender at a popular local restaurant. She loves her job, but most shifts leave her exhausted because she’s on her feet all day. Large tables of customers mean that she often carries heavy platters of food. Her pregnant body is changing so quickly that Latisha often finds herself off-balance, straining her back to compensate for her growing belly. After Latisha nearly dropped a heavy tray, her boss suggested that she work at the bar instead of serving food. Latisha happily complied, as she enjoys interacting with customers at the bar. Most of her customers are friendly. Sometimes regular customers will order alcoholic drinks for a big group of friends and ask her to share one with them. Sometimes the idea of an alcoholic drink makes her nauseous, but she usually agrees because happy customers mean big tips and she has a new baby to support. Usually the drink makes her feel better. Most nights Latisha stands outside during her breaks. She used to smoke during breaks, but she gave up cigarettes when she learned she was pregnant. Giving up nicotine was difficult, and Latisha missed the habit of smoking, so she tried vaping instead. Electronic cigarettes don’t give off smoke, so they can’t be that bad, she reasoned.

      One spring morning several weeks before her due date, Latisha gave birth to a baby girl. She seemed healthy, but tiny. Charmayne carried her daughter to term, giving birth a few days before her due date. Several months later, the best friends visited, placing their babies on the floor together for tummy time.

      1 Most women are exposed to some teratogens during pregnancy. Generally speaking, what are some examples of teratogens and other environmental influences on prenatal development?

      2 What teratogens and environmental influences on prenatal development did Charmayne and Latisha encounter?

      3 Suppose that Charmayne and Latisha give birth to full-term newborns, but one had a defect that was visible at birth. How might the principles of teratology account for variability in outcomes such as these?

      4 Latisha’s daughter is a low-birthweight infant. What are characteristics of low-birthweight infants and what can Latisha expect? How can she best care for her daughter?

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      Key Terms

       Prenatal development 62

       Ovulation 63

       Fallopian tube 64

       Germinal period 65

       Cleavage 65

       Blastocyst 65

       Implantation 65

       Embryo 65

       Embryonic period 65

       Amnion 66

       Placenta 66

       Neural tube 66

       Indifferent gonad 66

       Fetal period 66

       Fetus