📘 Essential for Pediatric Nursing, Growth Monitoring, IMNCI & Community Health Nursing
An infant is a child from birth to 1 year of age.
✅ This period is marked by rapid physical growth, emotional bonding, milestone achievements, and development of sensory and motor functions.
| 📏 Parameter | ⏱️ Timeline | 📌 Normal Values |
|---|---|---|
| 🟩 Weight | Birth to 1 year | ✔️ Doubles by 5 months ✔️ Triples by 1 year |
| 🟨 Height (Length) | Birth to 1 year | ✔️ Increases by ~25 cm by 1 year |
| 🟧 Head Circumference | At birth: ~33–35 cm | ✔️ Increases ~1.5 cm/month for 6 months |
| 🟥 Chest Circumference | Less than head at birth | ✔️ Equals head circumference by 1 year |
| 🟦 Teeth Eruption | Begins at ~6 months | ✔️ 6–8 teeth by 1 year |
| 🔢 Age | 🎯 Milestone |
|---|---|
| 1 month | Head lag present |
| 3 months | Holds head up when prone |
| 5 months | Rolls over from front to back |
| 6 months | Sits with support |
| 8 months | Sits without support |
| 9–10 months | Crawling and standing with support |
| 12 months | Stands alone; may start walking |
| 🔢 Age | 🎯 Milestone |
|---|---|
| 2–3 months | Holds rattle briefly |
| 5–6 months | Transfers object hand to hand |
| 8 months | Pincer grasp starts |
| 9–10 months | Picks up small objects |
| 12 months | Can use spoon; points to objects |
| 🔢 Age | 🗣️ Milestone |
|---|---|
| 2 months | Coos and gurgles |
| 6 months | Babbles (e.g., “ba-ba”, “da-da”) |
| 9 months | Understands “no”, responds to name |
| 12 months | Says 1–2 words with meaning |
| 🔢 Age | 🤝 Milestone |
|---|---|
| 1–2 months | Social smile |
| 6 months | Recognizes familiar faces |
| 8–9 months | Stranger anxiety begins |
| 12 months | Enjoys interactive games like peek-a-boo |
Q1. At what age does an infant typically triple their birth weight?
🅰️ 6 months
🅱️ 9 months
✅ 🅲️ 12 months
🅳️ 18 months
Answer: ✅ (c)
Q2. When does the social smile appear in a baby?
🅰️ 6 weeks
✅ 🅱️ 1–2 months
🅲️ 5 months
🅳️ 9 months
Answer: ✅ (b)
Q3. First tooth eruption usually occurs at:
🅰️ 3 months
✅ 🅱️ 6 months
🅲️ 10 months
🅳️ 1 year
Answer: ✅ (b)
Q4. Pincer grasp usually appears around:
🅰️ 5 months
🅱️ 6 months
✅ 🅲️ 8 months
🅳️ 10 months
Answer: ✅ (c)
Q5. Which of the following is a red flag in 12-month-old baby?
🅰️ Babbling
🅱️ Walking with support
✅ 🅲️ No response to name
🅳️ Stranger anxiety
Answer: ✅ (c)
📘 Essential for Pediatric Nursing, Maternal Health Nursing, IMNCI & Community Health
Breastfeeding is the process of feeding an infant with milk directly from the mother’s breast. It is the most natural and complete form of nutrition for infants during the first months of life.
✅ WHO recommends exclusive breastfeeding for the first 6 months, followed by complementary feeding with continued breastfeeding up to 2 years or beyond.
| Type | Description |
|---|---|
| 🟢 Exclusive Breastfeeding | Only breast milk (no water, juice, or food) for 6 months |
| 🟡 Predominant Breastfeeding | Breast milk + water/juice (no solid food) |
| 🟠 Partial Breastfeeding | Breast milk + formula or other milk |
| 🔴 Complementary Feeding | Breast milk + semisolid/solid food after 6 months |
| Component | Function |
|---|---|
| Colostrum | First yellowish milk (rich in antibodies, protein, Vitamin A) |
| Foremilk | Thin, watery milk – quenches thirst |
| Hindmilk | Thick, fat-rich milk – provides energy |
| Antibodies (IgA) | Provides immunity against infections |
| Enzymes & Hormones | Aid in digestion and development |
| 🟥 Maternal | 🟥 Infant |
|---|---|
| HIV positive (if replacement is safe) | Galactosemia (absolute contraindication) |
| Active TB (untreated) | Cleft palate with poor suckling |
| Herpes on breast | Serious prematurity (may need expressed milk) |
Q1. WHO recommends exclusive breastfeeding for how long?
🅰️ 3 months
🅱️ 4 months
✅ 🅲️ 6 months
🅳️ 1 year
Answer: ✅ (c)
Q2. What is the first milk called?
🅰️ Hindmilk
🅱️ Foremilk
✅ 🅲️ Colostrum
🅳️ Immunomilk
Answer: ✅ (c)
Q3. Immunoglobulin mainly present in breast milk is:
🅰️ IgG
🅱️ IgM
✅ 🅲️ IgA
🅳️ IgE
Answer: ✅ (c)
Q4. Breastfeeding is contraindicated in infants with:
🅰️ Vomiting
✅ 🅱️ Galactosemia
🅲️ Fever
🅳️ Cough
Answer: ✅ (b)
Q5. One benefit of breastfeeding for mothers is:
🅰️ Delayed labor
🅱️ Weight gain
✅ 🅲️ Reduced risk of ovarian cancer
🅳️ Risk of diabetes
Answer: ✅ (c)
📘 Essential for Pediatric Nursing, Community Health Nursing, IMNCI & Nutrition Programs
Complementary feeding is the process of introducing semi-solid and solid foods along with continued breastfeeding after the child reaches 6 months of age, to fulfill the increasing nutritional needs for growth and development.
✅ WHO and MoHFW recommend starting complementary feeding at 6 months, continuing breastfeeding up to 2 years or beyond.
“Breast milk alone is no longer enough after 6 months – complementary food is a must.”
| 📌 Age | 🥣 Feeding Type |
|---|---|
| 0–6 months | ✅ Exclusive breastfeeding only |
| After 6 months | ✅ Complementary foods + breastfeeding |
| By 12 months | ✅ Three meals + 2 snacks per day |
| After 1 year | ✅ Family food, mashed, soft, and nutritious |
| 🔢 Principle | 📋 Details |
|---|---|
| 🟩 Timely | Start at 6 months, not before or after |
| 🟨 Adequate | Meet energy, protein, micronutrient needs |
| 🟧 Safe | Hygienic food prep and clean utensils |
| 🟥 Properly Fed | Responsive feeding, encourage child, not force |
| 🍛 Type of Food | 🧠 Purpose | 📝 Examples |
|---|---|---|
| 🥣 Cereal-based | Energy, carbs | Rice, suji, khichdi, dalia |
| 🥬 Fruits & Vegetables | Vitamins, minerals, fiber | Banana, papaya, carrot, spinach |
| 🥛 Milk products | Calcium, protein | Curd, paneer (after 6 months) |
| 🥩 Protein sources | Growth and repair | Dal, mashed egg, fish, meat (well-cooked) |
| 🧈 Fats & Oils | Energy-dense food | Ghee, oil added in food |
| ✅ Do’s | ❌ Don’ts |
|---|---|
| Start with soft, mashed foods | Don’t delay beyond 6 months |
| Introduce one food at a time | Don’t give spicy or hard foods early |
| Continue breastfeeding on demand | Don’t stop breastfeeding suddenly |
| Maintain hygiene (clean bowls, hands) | Don’t use bottle feeding |
| Observe for allergy or intolerance signs | Don’t force-feed child |
| 🧒 Age Group | 🍴 Meal Frequency |
|---|---|
| 6–8 months | 2–3 meals + 1–2 snacks |
| 9–11 months | 3–4 meals + 1–2 nutritious snacks |
| 12–24 months | 3–4 meals + 2 healthy snacks |
Q1. Complementary feeding should begin at:
🅰️ 4 months
🅱️ 5 months
✅ 🅲️ 6 months
🅳️ 9 months
Answer: ✅ (c)
Q2. Which of the following is NOT suitable for complementary feeding at 6 months?
🅰️ Mashed banana
🅱️ Dal khichdi
✅ 🅲️ Hard nuts
🅳️ Boiled potato
Answer: ✅ (c)
Q3. Complementary feeding should be given:
🅰️ After stopping breastfeeding
✅ 🅱️ Along with breastfeeding
🅲️ Without water
🅳️ Once in a day only
Answer: ✅ (b)
Q4. Which principle of complementary feeding focuses on hygiene?
🅰️ Timely
🅱️ Adequate
✅ 🅲️ Safe
🅳️ Responsive
Answer: ✅ (c)
Q5. Recommended food texture at 6–8 months is:
🅰️ Hard and chunky
✅ 🅱️ Mashed and soft
🅲️ Fried food
🅳️ Dry food
Answer: ✅ (b)
📘 Essential for Pediatric Nursing, Community Health, Preventive & Social Medicine (PSM), and Public Health Exams
Immunization is the process of inducing immunity against a specific disease by administering vaccines, which stimulate the body’s immune system to recognize and fight pathogens.
✅ It can be active (vaccines) or passive (ready-made antibodies).
“Immunization is one of the most cost-effective public health interventions.”
| 🩺 Type | 📋 Description | 🧪 Example |
|---|---|---|
| 🟢 Active | Body produces its own antibodies | Vaccines (e.g., BCG, OPV) |
| 🟡 Passive | Ready-made antibodies are given | Hepatitis B immunoglobulin |
| 🟠 Natural | After natural infection | Measles infection |
| 🔴 Artificial | Given through vaccines or injections | Tetanus toxoid |
| 💉 Vaccine | 🕒 Age | 💪 Disease Prevented |
|---|---|---|
| 🟩 BCG | At birth | Tuberculosis (TB) |
| 🟨 OPV-0 | At birth | Poliomyelitis |
| 🟧 Hepatitis B-0 | At birth (within 24 hours) | Hepatitis B |
| 🟥 Pentavalent (1,2,3) | 6, 10, 14 weeks | DPT + Hep B + Hib |
| 🟦 OPV (1,2,3) | 6, 10, 14 weeks | Poliomyelitis |
| 🟪 Rotavirus | 6, 10, 14 weeks | Diarrhea (Rotavirus) |
| 🟫 PCV (Pneumococcal) | 6, 14 weeks, booster | Pneumonia, meningitis |
| ⬛ fIPV | 14 weeks | Inactivated Polio Vaccine |
| 🟩 MR-1 | 9 months | Measles & Rubella |
| 🟨 JE-1 | 9–12 months (endemic states) | Japanese Encephalitis |
| 🟧 Vitamin A | 9 months (1st dose) | Prevents blindness |
| 🟥 DPT-Booster 1 | 16–24 months | Diphtheria, Pertussis, Tetanus |
| 🟦 MR-2 | 16–24 months | Measles, Rubella |
| 🟪 OPV-Booster | 16–24 months | Poliomyelitis |
| 🟫 JE-2 | 16–24 months (endemic areas) | Japanese Encephalitis |
| ⬛ DPT-Booster 2 | 5 years | DPT |
| 🟩 TT (10 & 16 yrs) | School-going children | Tetanus |
| 🟨 Td (pregnant women) | 1st dose as early as possible | Tetanus, Diphtheria |
| 🟧 Booster Td | 4 weeks after first Td |
| 💉 Type | 🔬 Example |
|---|---|
| 🟢 Live attenuated | BCG, OPV, MR, Rotavirus |
| 🟡 Killed/Inactivated | IPV, JE |
| 🟠 Toxoid | Tetanus, Diphtheria |
| 🔴 Subunit/Conjugate | Hep B, Hib, PCV |
| 🌡️ Temperature | 🧊 Vaccine Stored At |
|---|---|
| 2–8°C | All UIP vaccines (except BCG diluent before mixing) |
| ❌ Avoid freezing | Pentavalent, Hep B, PCV |
| ❄️ Frozen storage | Polio (OPV can tolerate freezing) |
Q1. BCG vaccine is given to prevent:
🅰️ Hepatitis B
🅱️ Polio
✅ 🅲️ Tuberculosis
🅳️ Measles
Answer: ✅ (c)
Q2. Which vaccine is given at birth in the UIP schedule?
🅰️ Pentavalent
✅ 🅱️ BCG
🅲️ MR
🅳️ JE
Answer: ✅ (b)
Q3. The minimum interval between two Td doses in pregnancy is:
🅰️ 2 days
🅱️ 1 week
✅ 🅲️ 4 weeks
🅳️ 2 months
Answer: ✅ (c)
Q4. Which vaccine prevents pneumonia and meningitis?
🅰️ OPV
🅱️ Pentavalent
✅ 🅲️ PCV
🅳️ BCG
Answer: ✅ (c)
Q5. Cold chain equipment should maintain a temperature of:
🅰️ –4°C to –10°C
✅ 🅱️ 2°C to 8°C
🅲️ 10°C to 15°C
🅳️ Room temperature
Answer: ✅ (b)
📘 Essential for Pediatric Nursing, Community Health, Nutrition & National Health Programs
Infant and Young Child Feeding (IYCF) refers to a set of guidelines and practices to ensure the optimal feeding of children from birth up to 2 years, focusing on exclusive breastfeeding, timely complementary feeding, and continued breastfeeding.
✅ Developed by WHO and UNICEF and adopted under India’s National IYCF Guidelines (MoHFW, 2006, revised 2013).
| 🕒 Age | 🍽️ Feeding Practice |
|---|---|
| 🔵 0–6 months | ✅ Exclusive breastfeeding only (no water, honey, formula, etc.) |
| 🟢 6–24 months | ✅ Start complementary feeding at 6 months + continue breastfeeding |
| 🟣 Beyond 2 years | ✅ Continue breastfeeding as long as mother and child wish |
| 🔢 Practice | 📋 Detail |
|---|---|
| 🟩 Early initiation | Start breastfeeding within 1 hour of birth |
| 🟨 Exclusive breastfeeding | Only breast milk for first 6 months |
| 🟧 Responsive feeding | Feed based on hunger cues; no force-feeding |
| 🟥 Safe preparation | Maintain hygiene during food handling |
| 🟦 Minimum meal frequency | Age-specific meals + 1–2 healthy snacks |
| 🟪 Dietary diversity | At least 4 food groups daily |
| 🟫 Continued breastfeeding | Up to 2 years or beyond |
| 🍽️ Group | 🌿 Examples |
|---|---|
| 🥣 Cereal-based | Rice, wheat, dalia, suji |
| 🥬 Vegetables & Fruits | Carrot, papaya, spinach, banana |
| 🥩 Protein-rich | Egg, dal, mashed meat/fish, legumes |
| 🧈 Energy-dense | Ghee, oil, nuts (paste form) |
| 🧀 Milk products | Curd, paneer (post 6 months) |
| 🧒 Age Group | 🍴 Meal Frequency |
|---|---|
| 6–8 months | 2–3 meals + 1 snack |
| 9–11 months | 3–4 meals + 1–2 snacks |
| 12–24 months | 3–4 meals + 2 nutritious snacks |
| ❌ Myth | ✅ Fact |
|---|---|
| Water is needed even during breastfeeding | Breast milk contains enough water even in summer |
| Solid food should wait until 1 year | Complementary feeding must start at 6 months |
| Cow’s milk is best for babies | Not recommended before 1 year |
| Honey is healthy for newborns | Can cause infant botulism – avoid before 1 year |
Q1. When should complementary feeding begin according to IYCF guidelines?
🅰️ 3 months
🅱️ 9 months
✅ 🅲️ 6 months
🅳️ 1 year
Answer: ✅ (c)
Q2. Exclusive breastfeeding means:
🅰️ Breast milk + water
🅱️ Breast milk + formula
✅ 🅲️ Only breast milk (no other food/water)
🅳️ Breast milk + honey
Answer: ✅ (c)
Q3. Minimum number of meals for a 9-month-old infant as per IYCF is:
🅰️ 1
🅱️ 2
✅ 🅲️ 3–4 + 1–2 snacks
🅳️ Only breastfeeding
Answer: ✅ (c)
Q4. Which of the following is contraindicated before 1 year of age?
🅰️ Curd
✅ 🅱️ Honey
🅲️ Banana
🅳️ Mashed rice
Answer: ✅ (b)
Q5. Responsive feeding includes:
🅰️ Forcing food
🅱️ Feeding while child sleeps
✅ 🅲️ Feeding with interaction and cues
🅳️ Delayed feeding
Answer: ✅ (c)
📘 Essential for Pediatric Nursing, Community Health, IMNCI, and Nutrition Programs
Nutritional assessment is the systematic process of evaluating the nutritional status of an individual or population using clinical, anthropometric, dietary, and biochemical indicators.
✅ It helps detect malnutrition (undernutrition or overnutrition) and plan proper intervention strategies.
| 🔤 Component | 🔍 Explanation |
|---|---|
| 🟩 A – Anthropometric | Measurement of body size, weight, height |
| 🟨 B – Biochemical | Blood, urine tests to assess nutrient levels |
| 🟧 C – Clinical | Physical signs of deficiency/excess (e.g., edema, pallor) |
| 🟥 D – Dietary | Assessment of food intake patterns, diet history |
| 🟦 E – Environmental | Social, economic, and cultural factors influencing diet |
| 🧒 Indicator | 📋 What it Detects | 🧮 Cut-off/Normal Values |
|---|---|---|
| ✅ Weight-for-age | General malnutrition | < –2 SD = Underweight |
| ✅ Height-for-age | Chronic malnutrition (stunting) | < –2 SD = Stunted |
| ✅ Weight-for-height | Acute malnutrition (wasting) | < –2 SD = Wasted |
| ✅ MUAC (6–59 months) | Protein-energy malnutrition | < 12.5 cm = Moderate/Severe Acute Malnutrition |
| ✅ BMI (adults/adolescents) | Obesity or underweight | BMI < 18.5 = Underweight, > 25 = Overweight |
| 🧬 Test | 🎯 Deficiency Detected |
|---|---|
| ✅ Hemoglobin | Iron deficiency (Anemia) |
| ✅ Serum Albumin | Protein deficiency |
| ✅ Serum Vitamin A | Vitamin A deficiency |
| ✅ Serum Calcium | Calcium deficiency |
| ✅ Blood Glucose | Energy/nutritional status |
| 👀 Symptom | ⚠️ Possible Deficiency |
|---|---|
| Pale conjunctiva, fatigue | Iron (Anemia) |
| Night blindness, dry eyes | Vitamin A |
| Swollen gums, bleeding | Vitamin C |
| Edema, hair changes, flaky skin | Protein (Kwashiorkor) |
| Thin limbs, visible ribs | Energy (Marasmus) |
| 📝 Tool | 📋 Purpose |
|---|---|
| ✅ 24-Hour Recall | Records food intake in last 24 hours |
| ✅ Food Frequency Questionnaire | How often foods are consumed |
| ✅ Diet History | Pattern over a period (weekly/monthly) |
| ✅ Weighment Method | Weigh actual food consumed (research use) |
Q1. What is the most sensitive indicator of acute malnutrition in children?
🅰️ Height-for-age
✅ 🅱️ MUAC
🅲️ BMI
🅳️ Hemoglobin
Answer: ✅ (b)
Q2. Stunting in children is best assessed by:
🅰️ Weight-for-age
✅ 🅱️ Height-for-age
🅲️ BMI
🅳️ MUAC
Answer: ✅ (b)
Q3. Which test is used to assess iron deficiency?
🅰️ Serum calcium
✅ 🅱️ Hemoglobin
🅲️ Serum protein
🅳️ Blood glucose
Answer: ✅ (b)
Q4. A child with edema, thin hair, and apathy may have:
🅰️ Rickets
✅ 🅱️ Kwashiorkor
🅲️ Marasmus
🅳️ Anemia
Answer: ✅ (b)
Q5. BMI is used primarily for:
🅰️ Infant growth
✅ 🅱️ Adults and adolescents
🅲️ Bone development
🅳️ Dental health
Answer: ✅ (b)