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Case Study 3

A.V. is a nurse practitioner working with the public health department. Community assessments reveal that one rural community has a high rate of teenage pregnancy. A.V. conducts parenting classes at the local high school and aims to reach first-time expectant parents. Her goal is to provide parents with information about what to expect of a new baby and basic care for the infant.
She realizes that continuity with education may be an issue. Many of her previous classes began with high attendance at the beginning of her 12-week sessions. Over time, interest began to fade, and participation declined. She tries a different approach with the current series of lectures. She reduces the session to 6 weeks and changes the format to one hour of lecture combined with questions and answers, with the second hour consisting of interactive demonstration.

Questions for the case

*What recommendations would you give to a group of expectant teenagers that are attending to your Health Promotion and Disease Prevention educational sessions regarding breastfeeding. Include recommendation in how to increase the duration to this activity.

*Describe the relationship between culture and growth and development. Assess whether all growth and development milestones should be applied to all children regardless of cultural background.

*Design a teaching plan for parents regarding injury prevention during infancy. In your teaching plan you must include the home of an infant injury proof.

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Sample Answer

 

 

 

 

A.V.’s initiative to provide parenting classes to expectant teenagers in a rural community with a high rate of teenage pregnancy is commendable. The challenges she faces with maintaining engagement in her previous 12-week sessions highlight the importance of adapting educational strategies to the specific needs and contexts of this young population. Her new approach of shorter, more interactive sessions is a positive step.


Recommendations for Expectant Teenagers Regarding Breastfeeding and Increasing Duration

For A.V.’s sessions on breastfeeding, it’s crucial to present information in an engaging, relatable, and practical manner, while also addressing common barriers faced by expectant teenagers in a rural setting. The goal is not just to inform but to empower them to initiate and sustain breastfeeding.

Full Answer Section

 

 

 

 

  1. Involve Trusted Community Figures:
    • Invite successful young mothers from the community who have breastfed to share their positive experiences and practical tips.
    • Engage grandmothers or respected female elders to share traditional knowledge, correct myths, and underscore community support for breastfeeding. This helps bridge generational gaps and validate breastfeeding within cultural contexts.

Recommendations to Increase Breastfeeding Duration (Addressing Continuity Challenges):

A.V.’s new 6-week, interactive format is excellent for engagement. To specifically increase duration beyond the sessions, focus on building ongoing support networks and practical skills.

  1. Establish a Peer Mentorship Program:
    • Strategy: Recruit and train slightly older teen mothers (who have successfully breastfed for at least 6 months) to become peer mentors for expectant and new mothers.
    • Implementation: Facilitate regular meet-ups, or even create a dedicated WhatsApp group (common communication tool in Kenya) for quick questions, encouragement, and sharing experiences. Peers offer relatable advice and reduce feelings of isolation, which are significant barriers to long-term breastfeeding for young mothers.
  2. Practical Skill-Building with Continuous Reinforcement:
    • Strategy: Dedicate ample time in the interactive demonstration hour to hands-on practice. Don’t just show, let them do.
    • Implementation: Use infant dolls to practice various breastfeeding positions, proper latch, and burping techniques. Practice hand expression of breast milk, which is a vital skill, especially if pumps are unavailable. Provide clear, simple visual guides (posters, laminated cards) that they can take home. Consider short video demonstrations using local mothers.
  3. Leverage Community Health Volunteers (CHVs) for Home Support:
    • Strategy: Collaborate closely with local CHVs. Train them thoroughly on breastfeeding support and common challenges.
    • Implementation: CHVs can conduct follow-up home visits to new mothers. These visits provide personalized support, help troubleshoot problems in the home environment (e.g., latch difficulties, engorgement), reinforce the education, and build trust. This direct, accessible support is critical for continuity in a rural setting where clinic access might be challenging. CHVs can also act as a crucial link to A.V. for more complex issues.
  4. Involve Partners and Extended Family:
    • Strategy: Hold specific sessions or invite partners, grandmothers, and other key family members to parts of the breastfeeding sessions.
    • Implementation: Educate them on how they can support the breastfeeding mother (e.g., preparing food, fetching water, emotional encouragement, protecting the mother’s rest). A supportive family environment is paramount for breastfeeding duration.
  5. Celebrate Milestones and Provide Small Incentives/Recognition:
    • Strategy: Acknowledge efforts and successes.
    • Implementation: Offer small, practical incentives for achieving breastfeeding milestones (e.g., “breastfed for 6 weeks,” “exclusive breastfeeding at 3 months”). This could be a pack of baby soap, a small nursing wrap, or a certificate. This positive reinforcement can be very motivating for young parents.

Relationship Between Culture and Growth and Development

Culture profoundly influences every aspect of a child’s growth and development, shaping not only what behaviors and skills are valued and nurtured, but also the very timeline and context in which they emerge. It acts as a powerful lens through which caregivers interpret a child’s actions, set expectations, and provide opportunities for learning.

  • Caregiving Practices: Cultural norms dictate fundamental practices such as feeding schedules (on-demand vs. timed), sleeping arrangements (co-sleeping vs. separate rooms), physical contact (e.g., carrying infants in lesos or wraps vs. strollers), and weaning practices. These practices directly impact a child’s sensory experiences, emotional regulation, and early social interactions. For instance, in many Kenyan cultures, prolonged skin-to-skin contact, back-carrying, and co-sleeping are common, fostering constant physical closeness and responsiveness, which can influence attachment and social development.
  • Socialization and Language: Culture defines social roles, appropriate behaviors, and communication styles. Children learn their native language, social etiquette, and cultural values through observation and direct instruction within their cultural context. This affects their cognitive processing, communication skills, and how they interact with others. For example, children in multilingual Kenyan households may develop code-switching abilities earlier.
  • Motor Development: While basic motor milestones (e.g., sitting, crawling, walking) follow a universal biological sequence, cultural practices can influence their timing or how they are achieved. For example, cultures that emphasize more infant massage or opportunities for independent movement might see earlier gross motor skill acquisition. Conversely, practices that restrict movement (e.g., extensive swaddling, common in some traditional settings) might slightly delay some milestones.

 

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