Postnatal Development

From Embryology
WHO report- child growth standards.jpg

Introduction

It would seem obvious to say that development does not stop at birth. In fact many systems (cardiovascular, respiratory, gastrointestinal, homeostasis) undergo significant changes at birth, and many others (neural) have not yet completed their development.

Postnatal development can be broadly divided into the age categories of: Neonatal (birth to 1 month), Infancy (1 month to 2 years), Childhood (2 years to puberty), Puberty (12 years to mid-teens) and Young Adult a new category (late teens to early twenties).

Neurological development continues postnatally with both growth and reorganization of the central nervous system. The amount of simple physical growth is shown by the skeletal flexibility designed around the brain and spinal cord, which allows continued postnatal growth of these structures. The World Health Organization (WHO) recently identified early postnatal motor skill development in terms of "motor milestones"[1], this was released along with new [{{growth charts)).

Many factors causing abnormal development can also lead to childhood mortality. In developed countries, we sometimes forget that every year (mainly in developing countries) some 12 million children die before reaching their fifth birthday, many of them during their first year of life. Of these, 70% are killed by one of five causes (diarrhoea, pneumonia, measles, malaria or malnutrition) and often by some combination of them (WHO Fact Sheet N96 November 1995).

For more child population data look at the section below on Child Health Statistics of the world, between and within specific countries.


Note this current project focuses on prenatal development, so postnatal content is not as detailed.


Postnatal Links: birth | neonatal | neonatal diagnosis | milk | Nutrition | growth charts | Disease School Exclusion | vaccination | puberty | genital

Postnatal Neural

The links below are to a set of postnatal Neural Exam Movies by Paul D. Larsen, M.D., University of Nebraska Medical Center.

Newborn normal

Newborn-normal-behaviour.jpg Newborn n 03.jpg Newborn n 17.jpg Newborn n 20.jpg Newborn n 27.jpg
behaviour tone positions reflexes head

Newborn abnormal

Newborn ab 01.jpg Newborn ab 03.jpg Newborn ab 17.jpg Newborn ab 20.jpg Newborn ab 27.jpg
behaviour tone positions reflexes head

Neural Exam Movies


Normal Newborn Neural Exam Movies  
Normal Newborn Neural Exam Movies

The newborn neuromuscular system can be initially assessed by 6 quick tests (posture, square window, arm recoil, popliteal angle, scarf sign and heel to ear). The following short videos show clinical examination of these assessments and a number of neonatal reflexes.

Later developmental assessment includes behaviour, reflexes (primitive and postural), muscular tone, and motor (gross, fine, co-ordination).

Normal Newborn Neural Exam Movies

Newborn Behaviour
Newborn-normal-behaviour.jpg
 ‎‎Behaviour
Page | Play
Newborn n 02.jpg
 ‎‎Cranial Nerves
Page | Play
Newborn Tone
Newborn n 03.jpg
 ‎‎Resting Posture
Page | Play
Newborn n 04.jpg
‎‎ Tone Upper Limb
Page | Play
Newborn n 05.jpg
‎‎ Arm Traction
Page | Play
Newborn n 06.jpg
 ‎‎Arm Recoil
Page | Play
Newborn n 07.jpg
 ‎‎Scarf Sign
Page | Play
Newborn n 08.jpg
 ‎‎Hand Position
Page | Play
Newborn n 09.jpg
 ‎‎Lower Limb
Page | Play
Newborn n 10.jpg
 ‎‎Leg Traction
Page | Play
Newborn n 11.jpg
 ‎‎Leg Recoil
Page | Play
Newborn n 12.jpg
 ‎‎Popliteal Angle
Page | Play
Newborn n 13.jpg
 ‎‎Heel to Ear
Page | Play
Newborn n 14.jpg
 ‎‎Neck Tone
Page | Play
Newborn n 15.jpg
 ‎‎Head Lag
Page | Play
Newborn n 16.jpg
 ‎‎Head Control
Page | Play
Newborn Positions
Newborn n 17.jpg
 ‎‎Prone Position
Page | Play
Newborn n 18.jpg
 ‎‎Ventral Suspend
Page | Play
Newborn n 19.jpg
 ‎‎Vertical Suspend
Page | Play
Newborn Reflexes
Newborn n 20.jpg
 ‎‎Tendon Reflexes
Page | Play
Newborn n 21.jpg
 ‎‎Plantar Reflex
Page | Play
Newborn n 22.jpg
 ‎‎Reflex Suck,Root
Page | Play
Newborn n 23.jpg
 ‎‎Moro Reflex
Page | Play
Newborn n 24.jpg
 ‎‎Galant Reflex
Page | Play
Newborn n 25.jpg
 ‎‎Stepping Reflex
Page | Play
Newborn n 26.jpg
 ‎‎Grasp Reflex
Page | Play
Newborn Head
Newborn n 27.jpg
‎‎ Head Shape
Page | Play
Newborn n 28.jpg
‎‎Head Circumference
Page | Play
Neural Exam Movies: normal behaviour | cranial nerves | Newborn Tone - resting posture | upper extremity‎ | arm traction | arm recoil | scarf sign | hand position | lower extremity | leg traction‎ | leg recoil‎‎ | popliteal angle‎ | heel to ear | neck tone | head lag‎ | head control | Newborn Positions - prone | ventral suspension | vertical suspension | Newborn Reflexes - deep tendon reflexes | plantar reflex‎ | suck, root | Moro | Galant | stepping‎ | grasp | Newborn Head - head shape and sutures‎ | head circumference‎ | Neonatal Diagnosis


Abnormal Newborn Neural Exam Movies  
Abnormal Newborn Neural Exam Movies

The newborn neuromuscular system can be initially assessed by 6 quick tests (posture, square window, arm recoil, popliteal angle, scarf sign and heel to ear). The following short videos show clinical examination of these assessments and a number of neonatal reflexes.

Later developmental assessment includes behaviour, reflexes (primitive and postural), muscular tone, and motor (gross, fine, co-ordination).

Newborn Behaviour

Newborn ab 01.jpg
 ‎‎Behaviour
Page | Play
Newborn ab 02.jpg
 ‎‎Cranial Nerves
Page | Play

Newborn Tone

Newborn ab 03.jpg
 ‎‎Resting Posture
Page | Play
Newborn ab 04.jpg
 ‎‎Upper Limb
Page | Play
Newborn ab 05.jpg
 ‎‎Arm Traction
Page | Play
Newborn ab 06.jpg
 ‎‎Arm Recoil
Page | Play
Newborn ab 07.jpg
 ‎‎Scarf Sign
Page | Play
Newborn ab 08.jpg
 ‎‎Hand Position
Page | Play
Newborn ab 09.jpg
 ‎‎Lower Limb
Page | Play
Newborn ab 10.jpg
 ‎‎Leg Traction
Page | Play
Newborn ab 11.jpg
 ‎‎Leg Recoil
Page | Play
Newborn ab 12.jpg
 ‎‎Popliteal Angle
Page | Play
Newborn ab 13.jpg
 ‎‎Heel to Ear
Page | Play
Newborn ab 14.jpg
 ‎‎Neck Tone
Page | Play
Newborn ab 15.jpg
 ‎‎Head Lag
Page | Play
Newborn ab 16.jpg
 ‎‎Head Control
Page | Play


Newborn Positions

Newborn ab 17.jpg
 ‎‎Prone Position
Page | Play
Newborn ab 18.jpg
 ‎‎Ventral Suspend
Page | Play
Newborn ab 19.jpg
 ‎‎Vertical Suspend
Page | Play

Newborn Reflexes

Newborn ab 20.jpg
 ‎‎Tendon Reflexes
Page | Play
Newborn ab 21.jpg
 ‎‎Plantar Reflex
Page | Play
Newborn ab 22.jpg
 ‎‎Reflex Suck,Root
Page | Play
Newborn ab 23.jpg
 ‎‎Moro Reflex
Page | Play
Newborn ab 24.jpg
 ‎‎Galant
Page | Play
Newborn ab 25.jpg
 ‎‎Stepping Reflex
Page | Play
Newborn ab 26.jpg
 ‎‎Grasp Reflex
Page | Play


Newborn Head

Newborn ab 27.jpg
 ‎‎Head Shape
Page | Play
Newborn ab 28.jpg
‎‎Head Circumference
Page | Play



Newborn Abnormal Links: behaviour | cranial nerves | Newborn Tone - resting posture | upper extremity‎ | arm traction | arm recoil | scarf sign | hand position | lower extremity | leg traction‎ | leg recoil‎‎ | popliteal angle‎ | heel to ear | neck tone | head lag‎ | head control | Newborn Positions - prone | ventral suspension | vertical suspension | Newborn Reflexes - deep tendon reflexes | plantar reflex‎ | suck, root | Moro | Galant | stepping‎ | grasp | Newborn Head - head shape and sutures‎ | head circumference‎


Normal 3 Month Neural Exam Movies
Normal 3 Month Neural Exam Movies

The neuromuscular system can be initially assessed by 6 quick tests (posture, square window, arm recoil, popliteal angle, scarf sign and heel to ear). The following short videos show clinical examination of these assessments and a number of reflexes.

Later developmental assessment includes behaviour, reflexes (primitive and postural), muscular tone, and motor (gross, fine, co-ordination).


3 Months Neural Exam Movies: normal behaviour | cranial nerves | Tone - head and trunk control | upper extremity‎ | hand movements | lower extremity Positions - supine | prone | ventral suspension | vertical suspension | Reflexes - Deep tendon reflexes | Plantar reflex‎ | Root | Moro | Galant | Grasp | Asymmetric tonic neck‎ | Neural Exam Movies | Neonatal Diagnosis

3 Month Behaviour

03mo 04.jpg
 ‎‎Behaviour
Page | Play
03mo 02.jpg
 ‎‎Cranial Nerves
Page | Play
normal behaviour cranial nerves

3 Month Tone

03mo 03.jpg
 ‎‎Control
Page | Play
03mo 03.jpg
 ‎‎Tone Upper Limb
Page | Play
03mo 04.jpg
 ‎‎Hand Movements
Page | Play
03mo 05.jpg
 ‎‎Lower Limb
Page | Play

3 Month Positions

03mo 04.jpg
 ‎‎Supine Position
Page | Play
03mo 04.jpg
 ‎‎Prone Position
Page | Play
03mo 04.jpg
 ‎‎Ventral Suspension
Page | Play
03mo 04.jpg
 ‎‎Vertical Suspension
Page | Play

3 Month Reflexes

03mo 04.jpg
 ‎‎Deep Tendon
Page | Play
03mo 04.jpg
 ‎‎Plantar Reflex
Page | Play
03mo 04.jpg
 ‎‎Suck-Root
Page | Play
03mo 04.jpg
 ‎‎Moro Reflex
Page | Play
03mo 04.jpg
 ‎‎Galant Reflex
Page | Play
03mo 04.jpg
 ‎‎Grasp Reflex
Page | Play
03mo 04.jpg
 ‎‎Neck Tone
Page | Play
3 Months Neural Exam Movies: normal behaviour | cranial nerves | Tone - head and trunk control | upper extremity‎ | hand movements | lower extremity Positions - supine | prone | ventral suspension | vertical suspension | Reflexes - Deep tendon reflexes | Plantar reflex‎ | Root | Moro | Galant | Grasp | Asymmetric tonic neck‎ | Neural Exam Movies | Neonatal Diagnosis
Normal 12 Month Neural Exam Movies  
Normal 12 Month Neural Exam Movies

The following short videos show clinical examination of neural development assessments and a number of reflexes.


12 Months Neural Exam Movies: Shy | Social and Language | Cranial Nerves | Tone - Tone | Reflexes - deep tendon reflexes | plantar reflex‎ | Parachute | Pincer Grasp | Beads in the Cup | Play Ball | Transition in and out of Sitting | Creeping | Stoop and Recover | Motor/Gait - Stand, Walks with Support | Toddler’s Gait | Head Circumference | Neural Exam Movies
Normal 18 Month Neural Exam Movies
Normal 18 Month Neural Exam Movies

The following short videos show clinical examination of neural development assessments and a number of reflexes.


Neural Exam Movies: Wants | Understanding | Points to Pictures | Points to Body Parts | Cranial Nerves Motor/Coordination - Blocks in Cup | Beads in Cup | Stacking Blocks | Pincer Grasp and Handedness | Drawing/Scribbling | Tone | Deep Tendon Reflex | Throwing Ball | Walking
Normal 30 Month Neural Exam Movies  
Normal 30 Month Neural Exam Movies

The following short videos show clinical examination of neural development assessments and a number of reflexes.


Neural Exam Movies: Establishing Relationship | Follows Commands | Points to Pictures | Names Pictures | Response to Questions | Pointing to and Naming Body Parts | Motor/Coordination - Using Puppets | Using Measuring Tape | Block Tower | Drawing | Tone | Deep Tendon Reflex | Kicking and Throwing a Ball | Walking, Running


Abnormalities

There are many birth and perinatal associated abnormalities. In particular the perinatal period is a time when fetal systems that have either not yet been functional (respiratory, gastrointestinal, neural) or are extensively remodelled (cardiovascular, placental). There are also a number of maternal issues.

The International Classification of Diseases (ICD) has two entire chapters committed to the childbirth and the perinatal period, the major sub-headings are shown below. More detail is available on the chapter pages, Chapter XV Pregnancy Childbirth and Chapter XVI Perinatal Period. The World Health Organization's ICD classification used worldwide as the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.

Chapter XV Pregnancy, childbirth and the puerperium (O00-O99)

The codes included in this chapter are to be used for conditions related to or aggravated by the pregnancy, childbirth or by the puerperium (maternal causes or obstetric causes)

Excludes Certain diseases or injuries complicating pregnancy, childbirth and the puerperium classified elsewhere: external causes (for mortality) (V, W, X, Y); injury, poisoning and certain other consequences of external cause (S00-T88.1, , T88.6-T98); mental and behavioural disorders associated with the puerperium (F53.-); obstetrical tetanus (A34); postpartum necrosis of pituitary gland (E23.0); puerperal osteomalacia (M83.0); supervision of high-risk pregnancy (Z35.-); supervision of normal pregnancy (Z34.-).

Chapter XVI Certain conditions originating in the perinatal period (P00-P96)

Includes conditions that have their origin in the perinatal period even though death or morbidity occurs later.

Excludes congenital malformations, deformations and chromosomal abnormalities (Q00-Q99); endocrine, nutritional and metabolic diseases (E00-E90); injury, poisoning and certain other consequences of external causes (S00-T98); neoplasms (C00-D48); tetanus neonatorum (A33)

Major sub-headings are shown below, select the sub-heading link to see details.


Links: XV Pregnancy Childbirth | International Classification of Diseases - XVI Perinatal Period | International Classification of Diseases | Human Abnormal Development

References

  1. WHO Multicentre Growth Reference Study Group. (2006). WHO Motor Development Study: windows of achievement for six gross motor development milestones. Acta Paediatr Suppl , 450, 86-95. PMID: 16817682

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Cite this page: Hill, M.A. (2018, May 25) Embryology Postnatal Development. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Postnatal_Development

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© Dr Mark Hill 2018, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G