NRS 434 Topic 1 DQ 2

Consider the following patient scenario: 

A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).  

Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice. 


One of the fundamental information the nurse should make after assessing the infant’s growth is the infant’s nutritional status. Nutritional status can be defined as the condition of the body due to intake of absorption and usage of nutrition and the impact of the disease-related conditions (Johansson et al.,2019). A 9-month infant should be well breastfed using the correct procedures and have 3-4 suitable meals a day for proper growth and conducive body functioning.  

Giving a variety of foods will provide the baby with a variety of important nutrients, some of which are vital for growth and development. Knowing what type of food to feed is an important aspect the mother to put into consideration. This is mainly because infants experience rapid growth in the first year and are likely to experience iron deficiency, resulting in a critical health outcome (Rosas-Blum et al.,2018). The mother should concentrate on feeding the infant with healthy fats, especially omega -3 fatty acids, as they aid in promoting the development and appropriate functioning of body parts. A 9-month-old child should show features such as getting a sitting positionable to pull to stand and crawl may stand while holding on and begins to stand without help.  

It is vital to recognize developmental essential to point out infants at risk for developmental problems. There are various ways in which healthcare professionals can use in identifying the developmental issues in infants. These ways include stage and age questionnaires, child development inventory, and developmental status (Nekitsing et al.,2018). Educating the parents on essential measures to take concerning their infants is vital to avoiding development problems. This will help them be able to alert the healthcare professionals in case of early signs and symptoms.  





Johansson, U., Öhlund, I., Hernell, O., Lönnerdal, B., Lindberg, L., & Lind, T. (2019). Protein-reduced complementary foods based on Nordic ingredients combined with the systematic introduction of taste portions increase intake of fruits and vegetables in 9-month-old infants: a randomized controlled trial. Nutrients, 11(6), 1255.  

Nekitsing, C., Hetherington, M. M., & Blundell-Birtill, P. (2018). Developing healthy food preferences in preschool children through taste exposure, sensory learning, and nutrition education. Current obesity reports, 7(1), 60-67.  

Rosas-Blum, E. D., Granados, H. M., Mills, B. W., &Leiner, M. (2018). Comics as a medium for parent health education: improving understanding of normal 9-month-old developmental milestones. Frontiers in pediatrics, 6, 203.  


Hello Ordelis. 

This is an exceptional work and I agree with you. Essentially, there are different development markers in infants including communicational, physical, cognitive, and emotional markers (Iverson et al., 2019). Therefore, other than the nutritional status, other markers a nurse should assess for in a 9-month-old female infant include physical markers which entail ability to execute tasks such as sitting without support, making stepping motions, standing with the support of objects, and crawling (CDC, 2022). The communicational markers that a nurse should assess include responding to sounds, making sounds such as dada, acknowledging the word no, and pointing at things using the fingers.  The cognition markers include putting objects in mouth, picking up small objects, watching the direction of falling items, and aim for others when they hide (CDC, 2022). Finally, emotional markers include having favorite toys, hang on familiar people, and running from strangers. However, some developmental markers that a 9-month-old infant may or may not execute including ability to sit properly by self, drinking from cup without assistance, and standing alone and walk with the help of furniture (CDC, 2022) 


CDC. (2022). Important Milestones: Your Baby By Nine Months. Retrieved from 

Iverson, J. M., Shic, F., Wall, C. A., Chawarska, K., Curtin, S., Estes, A., … & Young, G. S. (2019). Early motor abilities in infants at heightened versus low risk for ASD: A Baby Siblings Research Consortium (BSRC) study. Journal of abnormal psychology, 128(1), 69. 




Replies to Marise Guillaume Charles 

The nine-month old infant growth of the head circumference and the height shows a great development as they both are on the 25th percentile but this does not match the weight which is just at the 5th percentile. This means that the baby is underweight because (Tadesse, Tadesse, Berhane, &Ekström, 2017) weight is supposed to be proportional to her height. At this age there are a lot of developments and personality traits that can be seen. Nurses should asses include being able to sit without support, crawling ability, standing with the support of a furniture and pulling self to a standing position and the grasping ability. Other developmental factors that nurses can assess are: Copying sound, using fingers to point, ability to bubble, uttering words such as mama and papa which can be described as the typical communication for a 9-month-old infant. After assessing the infant development, growth and nutrition, which showed that she was underweight, the recommendations would be to communicate about a healthy nutritional pattern that the parent should follow to help in healthy developments of the infant. This means the child should be eating solid foods such as cereal, vegetables and fruits and also being breastfed. Over the counter vitamin D supplement for mothers who are not breastfeeding and fluoride intake for the (Harriehausen, Dosani, Chiquet, Barratt, &Quock, 2019) child’s teeth developments are also recommended. 


Harriehausen, X. C., Dosani, Z. F., Chiquet, T. B., Barratt, S. M., &Quock, L. R. (2019, January 01). Fluoride Intake of Infants from Formula. Journal of Clinical Pediatric Dentistry, 43(1), 34-41. Retrieved November 10, 2020, from 

Tadesse, A. W., Tadesse, E., Berhane, Y., &Ekström, E. C. (2017, March 11). Comparison of Mid-Upper Arm Circumference and Weight-for-Height to Diagnose Severe Acute Malnutrition: A Study in Southern Ethiopia. Journal of Malnutrition Among Infants, 9(3), 267-268. Retrieved November 10, 2020, from 


Hello Mayreth.  

Your approach to the discussion question is impressive. Your post is clear, detailed, and well done. Undeniably, the patient in the case at hand is underweight. Different factors may contribute to the issue of underweight in children and it is important to understand them before giving recommendations to the mother. The problem of underweight could be due to poor dietary intake or infection, especially when the child is from low income settings. In turn, the infant may suffer from weakened immune system, lifetime disabilities, and poor education outcomes (Sigdel et al., 2020). The other reason for underweight is maternal health status, which is essential in establishing the overall child’s health condition (Harrison et al., 2018). For instance, failure to feed children colostrums characterizes a proximal cause while the level of education of mothers is a distal cause that is likely to cause underweight in children. Moreover, the underweight can be caused by development or behavioral problems, medical issues, social challenges, or the combination of these issues (Chowdhury et al., 2018). The best intervention that is recommended is educating mothers on dietary intake for the infant.  


Chowdhury, T. R., Chakrabarty, S., Rakib, M., Saltmarsh, S., & Davis, K. A. (2018). Socio-economic risk factors for early childhood underweight in Bangladesh. Globalization and health, 14(1), 1-12. 

Harrison, M., Brodribb, W., Davies, P. S., & Hepworth, J. (2018). Impact of maternal infant weight perception on infant feeding and dietary intake. Maternal and child health journal, 22(8), 1135-1145. 

Sigdel, A., Sapkota, H., Thapa, S., Bista, A., & Rana, A. (2020). Maternal risk factors for underweight among children under-five in a resource limited setting: A community based case control study. PloS one, 15(5), e0233060. 


Physical, verbal, emotional, and cognitive development characteristics are all developmental markers. A person’s physical development can be gauged by looking at their vertical position, weight, and head circumference (Cameron, 2022). A 9-month infant girl should weigh between 18 and 19 pounds, be between 27 and 28 inches tall, and have a head size of 44 centimeters. Trying to crawl, sitting without assistance, pulling oneself to standing, having to stand while holding a helper, and initiating walking motions are all further physical signs that the 9-month-old is ready to walk. A 9-month-usual old’s communication involves understanding the term no, making sounds like mama and dada, duplicating sounds, and pointing with their fingers. 

Aside from being fearful of strangers, the child is also attached to individuals they know and has a favorite item. Those with typical cognitive development at nine months will be able to view the route of falling objects, look for others when they hide, play peek-a-boo, put things in their mouths, shift stuff with one hand to the other effortlessly, and pick up small items between their thumb and the index smoothly. Another aspect is dental hygiene and the effects of teething which are also considered as developmental markers. 

The mother’s responses to another developmental concern and an assessment of the kid’s nutritional intake are critical in determining why the child is underweight. To provide suitable suggestions, a complete history and physical examination of the patient are required, as this client could be sent to the WIC program for food aid if that is a problem for the patient. In addition, if the youngster hasn’t already been introduced to solid foods, it’s recommended that they do so. Iron-fortified baby cereals such as rice, served with breastfeeding or formulae or freshwater by spoon, is recommended as the first solid food for babies. At around eight months, a child can start eating tiny portions of more substantial meals like crackers, pasta, cooked vegetables, and the like. If the child’s lack of enthusiasm in meals is caused by teething, consult your pediatrician. The nurse can also recommend a cold teething ring or excellent, soft foods to help reduce the child’s discomfort during teething. Good nutrition and care for a child are critical to their general health and well-being. 


Cameron, N. (2022). The measurement of human growth. In Human Growth and Development (pp. 317-345). Academic Press. 


Hello James.  

This is an exceptional work. Your post is in-depth, thoughtful, and well done. I agree with you, especially on the recommendations for the nutritional intake to address the issue of underweight. The other critical factor that should be considered is complementary feeding of the child using the locally-existing complementary foods and a thorough nutrition education to the mother to help in enhancing nutritional status of the child and nutrition knowledge of the mother (Lutter et al., 2021). In addition, a critical factor that needs to be considered is the role of mothers in addressing underweight in children (Cui et al., 2019). Notably, interventions to address underweight are mostly tailored towards the affected children but interventions targeting their mothers are rarely considered. In most cases, the social and individual circumstances of mothers have a significant impact on children nutritional status but are rarely considered (Sigdel et al., 2020). For instance, burden of underweight can be mitigated by emphasizing on education intervention for the mothers on the essence of nutrition. Likewise, the power of mothers in decision-making is vital factor in addressing underweight in children so the interventions to enhance the role of mothers in decision-making is crucial in eradicating the issue of underweight in infants.  


Cui, Y., Liu, H., & Zhao, L. (2019). Mother’s education and child development: Evidence from the compulsory school reform in China. Journal of Comparative Economics, 47(3), 669-692. 

Lutter, C. K., Grummer-Strawn, L., & Rogers, L. (2021). Complementary feeding of infants and young children 6 to 23 months of age. Nutrition Reviews. 

Sigdel, A., Sapkota, H., Thapa, S., Bista, A., & Rana, A. (2020). Maternal risk factors for underweight among children under-five in a resource limited setting: A community based case control study. PloS one, 15(5), e0233060. 


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