Concept Map

Category 1

Alcohol/Substance use

Positive behavior

Based on interactions, the mother says that she does not smoke in the baby's room and avoids doing it at all costs. She is mindful of the baby's health by making an effort to smoke in the baby's room.

Negative behavior

Despite not smoking in the baby's room, the mother said that she smokes everywhere else in the house. Cigarette smoke lingers in a room after a few hours, depending on a room's ventilation as well as how frequently one smokes. The mother also mentions that the baby finds her cigarettes at times, and she let him chew them because he is teething. The rooms are bound to have a lingering smell of alcohol and/or cigarette smoke particles that do not completely clear out. According to the Center for Disease Control (CDC) reports, cigarette smoke in children may lead to severe asthma and other respiratory-related conditions, ear infections, and Sudden Infant Death Syndrome ("Health Effects of Secondhand Smoke", 2019). The mother also removes an empty alcohol bottle from her handbag, which likely suggests that she is an alcohol abuser.

Research-based recommendation

Children who grow with parents or relatives that are smokers are at high risk of developing chronic cough and phlegm, have slow neuro-development, develop cancer and cardiovascular disease, and be hospitalized for chronic bronchitis and pneumonia (Samet, 2021).

References

Health Effects of Secondhand Smoke. Centers for Disease Control and Prevention. (2019). Retrieved 31 January 2021, from https://www.who.int/tobacco/media/en/samet.pdf?ua=1.

Samet, J. (2021). Synthesis: The Health Effects of Tobacco Smoke Exposure on Children. Who.int. Retrieved 31 January 2021, from https://www.who.int/tobacco/media/en/samet.pdf?ua=1.

Professional/Ethical Communication

"I know you are trying to do what's best for your child by not smoking in his room, but I have to tell you that you are still causing him harm. It would help if you considered smoking cessation because of the risk you are exposing to your child. Also, if you cannot reduce how often you smoke, make sure to carry it outside where the smoke will not linger hours after. If you have an alcohol abuse problem, I can connect you with good group therapy whenever you are ready.

Category 2

Car Seat safety

Positive behavior

The mother ensures that every time she is driving, her child is in a car seat. She says she likes to make sure her child is in her field of vision when she looks back from the driver's seat.

Negative behavior

However, instead of placing the car seat facing backward as recommended for babies, she says she puts him facing forward. The mother refuses to adhere to instructions while she mentions that she has gotten into car accidents.

Research-based recommendation

According to CDC, 636 children of 12 years and below died of car accidents while about 97,000 were injured. Car seats are said to reduce child injuries by 82% ("Child Passenger Safety", 2020). A rear-facing car seat is recommended for children between the ages of 2-4 years ("Child Passenger Safety", 2020). The rear-facing seat provides children with maximum protection by absorbing the force, therefore, protecting their spine, neck, and head in the event of a crash. It also keeps them away from airbags. Rear-facing car seats have also been associated with less occurrence of injuries as compared to forward-facing car seats ("5 Reasons to Keep Your Child Rear-Facing for as Long as Possible", 2018).

References

Child Passenger Safety. Centers for Disease Control and Prevention. (2020). Retrieved 31 January 2021, from https://www.cdc.gov/injury/features/child-passenger-safety/index.html.

5 Reasons to Keep Your Child Rear-Facing for as Long as Possible. intermountainhealthcare.org. (2018). Retrieved 31 January 2021, from https://intermountainhealthcare.org/blogs/topics/pediatrics/2018/09/five-reasons-to-keep-your-child-rear-facing-as-long-as-possible/#:~:text=A%20rear%2Dfacing%20car%20seat%20will%20absorb%20most%20of%20the,in%20spine%20and%20head%20injuries.

Professional/Ethical Communication

"I would advise you to drive carefully to prevent another accident because of the child. Also, contrary to popular belief, a rear-facing car seat is safer for your child compared to a front-facing car seat. It would be appropriate to switch to the rear-facing car seat.

Category 3

Cognitive developmental milestones

Positive behavior

She says she reads and plays with the baby often, not always, but she makes time to play with him. She removes a book, and the baby can understand when he is told to turn the pages. This shows familiarity.

Negative behavior

The mother says that the child watches TV every evening and morning before going to sleep. She says the child imitates her; it makes one wonder what habits the child is picking up from the mother. The child is learning habits by observing his mother. This shows that his development is normal; however, the habits being learned are not positive ones. It is very alarming that the mother would let the baby chew her cigarettes on the pretext that he is teething. There are other safer options than her cigarettes. She also complains that the baby is always reaching for her phone, but it is clear that the mother is easily distracted by her phone and spends a considerable amount of time on it. This could be a reason the child reaches for it because he sees how the mother is enamored by it.

Research- based recommendation

Evidence has proven that screen watching of babies before 18 months is detrimental to their development. It takes the mentioned amount of time for a baby's brain to develop for the images and words on the screen to begin to make sense to them ("Why to Avoid TV for Infants & Toddlers", 2021). Watching TV takes time from social interactions, behavior, and etiquette that a child learns through interactions with other children and adults. Introduction of TV before 18 months leads to slow development of language and memory. This is not to say educational TV is bad because it has it’s advantages to those starting school; however, the timing is critical because to preschoolers, it makes sense because they interacted with the natural world and have learned to fit in, while to babies, they cannot process the information (Kostyrka-Allchorne et al., 2017). Excess screen times has also been associated with sleeping problems, anxiety, and depression disorders (Domingues-Montanari, 2017).

References

Domingues-Montanari, S. (2017). Clinical and psychological effects of excessive screen time on children. Journal Of Paediatrics And Child Health, 53(4), 333-338. https://doi.org/10.1111/jpc.13462

Kostyrka-Allchorne, K., Cooper, N., & Simpson, A. (2017). The relationship between television exposure and children's cognition and behaviour: A systematic review. Developmental Review, 44, 19-58. https://doi.org/10.1016/j.dr.2016.12.002

Why to Avoid TV for Infants & Toddlers. HealthyChildren.org. (2021). Retrieved 31 January 2021, from https://www.healthychildren.org/English/family-life/Media/Pages/Why-to-Avoid-TV-Before-Age-2.aspx#:~:text=Yes%2C%20watching%20TV%20is%20better,problems%20with%20sleep%20and%20attention.

Professional/Ethical Communication

"I would advise that you limit the amount of time you allow your child to view TV because it impacts his cognitive development. I would also suggest you spend quality time with the child and avoid phone interruptions; this may be one of the reasons why he is always reaching for the phone. The child is trying to grab your attention and also because he also sees that you spend a great deal of time on the cellphone.

Category 4

Safety

Positive behavior

The mother says that she has a safety gate at the bottom and top of the stairs to protect the child from tumbling down. Additionally, she also says that there are safety gates leading to the basement as well if he strays away. She also says that she puts her pots and pans handles facing away from the child to avoid him from reaching for them. She also says that she is usually around when the child is in the bathtub or in a swimming pool. She also says that she cooks on the back burners that the baby cannot reach for. She also says that she safely stores away medicine where he cannot reach for them.

Negative behavior

She leaves her anxiety pills and places them on the table. When the baby spills them, she orders him to collect them and put them back in the bottle. This is harmful because the baby may be tempted to swallow one of the pills. It also infringes on the safety of the child's health when she smokes in all the rooms in the house. Giving the baby and preparing his foods using tap water.

Research-based recommendation

Home visits are usually recommended as they can identify potential environmental sources of harm and provide solutions therefore increasing the baby's overall safety at home (Tiefenbachová & Zeleníková, 2019). Tap water may not be ideal for preparing baby foods because it contains germs that may lead to waterborne infections such as cholera. The child's immune defense is not fully developed; therefore, boiled water is better as it has lesser disease-causing microorganisms ("Water for Formula: Which Type Should You Use?", 2021).

References

Tiefenbachová, P., & Zeleníková, R. (2019). The effect of educational intervention by nurses on home environmental risk factors for falls. Central European Journal

Of Nursing And Midwifery, 10(2), 1019-1025. https://doi.org/10.15452/cejnm.2019.10.0009

Water for Formula: Which Type Should You Use?. Healthline. (2021). Retrieved 31 January 2021, from https://www.healthline.com/health/baby/water-for-formula.

Professional/Ethical Communication

"I would recommend that you don't let the child touch your anxiety pills and store them as far away from him as possible. Also, as mentioned earlier, avoid smoking in the house and keep your cigarettes away from him as well.

Category 5

Healthy teeth

Positive behavior

The mother says that she brushes the child's teeth in the morning and evening on a daily basis. The mother also says that the child attempts to feed himself food occasionally; she feeds him food knowing it is important for the growth of strong teeth and healthy gums.

Negative behavior

The mother lets the toddler chew on cigarettes. She also gives him a soda, instead of a nutrient-rich drink like milk that also promotes the health of teeth. Soda negatively affects the shape and texture of a child's teeth.

Research-based recommendation

The sugar contained in sodas is said to be triple the recommended amount by the WHO. Tooth decays and cavities are brought about by the excess sugars that remain and the acid that forms, therefore, due to the bacteria in the mouth. The best way to give babies sugar is by feeding them fruits and drinks such as milk ("How Soda and Juice Affect Toddler's Teeth | 1st Family Dental Blog", 2018). Prolonged baby bottle feeding may lead to baby bottle tooth decay. The decay begins at the incisors and slowly extends to the canines, premolars, and the molars. Additionally, the decay is further exacerbated because they usually contained sweetened drinks such as soda in this case (Achalu et al., 2020). A study in 2018 revealed that parents have knowledge of the proper food for good oral health but do not implement these practices (Djordjevic, 2018). In this case, the mother knows soda is bad for the child, but she continually gives him the bottle.

References

Achalu, P., Bhatia, A., Turton, B., Luna, L., & Sokal-Gutierrez, K. (2020). Sugary Liquids in the Baby Bottle: Risk for Child Undernutrition and Severe Tooth Decay in Rural El Salvador. International Journal Of Environmental Research And Public Health, 18(1), 260. https://doi.org/10.3390/ijerph18010260

Djordjevic, A. (2018). Parents' Knowledge about the Effects of Oral Hygiene, Proper Nutrition and Fluoride Prophylaxis on Oral Health in Early Childhood. Balkan Journal Of Dental Medicine, 22(1), 26-31. https://doi.org/10.2478/bjdm-2018-0005

How Soda and Juice Affect Toddler's Teeth | 1st Family Dental Blog. 1st Family Dental Blog. (2018). Retrieved 31 January 2021, from https://blog.1stfamilydental.com/how-soda-and-juice-affect-toddlers-teeth/.

Professional/Ethical Communication

"I would recommend that you remove the child from the bottle due to the effects it can have on his teeth. Additionally, avoid feeding him with soda because it contains more than the required toddler sugar. In place of sodas, feed the child with fruits that contain natural sugars and nourish the body by providing vitamins, mostly ascorbic acid. Also, keep the routine of brushing his teeth daily. However, avoid misplacing your cigarettes because children have the tendency to eat everything, they lay their hands on. Also, ensure your child is taking vitamin supplements."