Nursing diagnosis – effective breastfeeding

Effective Breastfeeding
DEFINITION
Mother-infant dyad/family exhibits adequate proficiency and satisfaction
with breastfeeding process
DEFINING CHARACTERISTICS
• Ability to promote successful latching on through correct positioning
(mother)
• Adequate elimination pattern for age (infant)
• Appropriate weight pattern for age (infant)
• Eagerness to nurse (infant)
• Effective communication pattern (mother and infant)
• Evidence of contentment after feeding
• Expressed satisfaction with breastfeeding (infant)
• Regular and sustained sucking and swallowing at breast (infant)
• Signs and symptoms of oxytocin release (mother)
RELATED FACTORS
• EFFECTIVE BREASTFEEDING
• Basic breastfeeding knowledge
• Infant gestational age 34
weeks
• Normal breast structure
• Support source
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Coping
• Growth and development
• Knowledge
• Nutrition
• Values and beliefs
EXPECTED OUTCOMES
The mother will
• Breast-feed infant successfully and will experience satisfaction with
breastfeeding process.
• Continue breastfeeding infant after early postpartum period.
The infant will
• Feed successfully on both breasts and appear satisfied.
• Grow and develop in pace with accepted standards.
SUGGESTED NOC OUTCOMES
Breastfeeding Establishment: Infant; Breastfeeding Establishment:
Maternal; Breastfeeding Maintenance; Breastfeeding: Weaning;
Hydration; Knowledge: Breastfeeding
INTERVENTIONS AND RATIONALES
Determine: Assess mother’s knowledge and experience with
breastfeeding to focus teaching on specific learning needs.
Assess mother’s attitudes and beliefs about breastfeeding to help
plan for interventions.
Monitor height and weight of infant to ensure infant meets the
standards for breastfeeding.
Perform: Weigh and measure the infant. Provide a quiet and private
environment to enhance the development of breastfeeding skills.
Inform: Educate mother and selected support person about
breastfeeding techniques to improve chance of success. Have the
mother perform return demonstration of techniques as appropriate:
• Clean hands and breasts before nursing.
• Position infant for feeding (infant should be able to grasp most of
the areola).
• Change positions to decrease nipple tenderness and use both
breasts at each feeding.
• Remove infant from the breast by breaking suction; avoid setting
time limits in the early stage.
• After breastfeeding, place clean pads on breasts.
Teach mother how to use warm showers and compresses, relaxation
and guided imagery, infant suckling, holding the infant close to the
breasts, and listening to the infant cry in order to stimulate letdown.
Teach mother about nutritional needs including an extra 500 calories
and two additional 8-oz glasses of fluid per day to maintain adequate
milk supply and to limit caffeine and food that causes discomfort.
Teach caregivers to assist patient with self-care activities in a way
that maximizes patient’s potential. This enables caregivers to participate
in patient’s care and encourages them to support patient’s independence.
Teach mother what to expect from a breastfeeding infant to prepare
her for breastfeeding at home. The infant should pass from 1 to 6
stools and wet 6–8 diapers per day. Stools should be soft to liquid and
nonodorous. Infant should feed every 2–3 hr or as needed and appear
content. Explain that the infant also needs nonnutritive sucking.
Getting an upset neonate to breast-feed can be extremely difficult.
Attend: Encourage mother to express concerns about breastfeeding
to reduce anxiety. Assist the mother and family in planning for
home care. The mother needs to rest when the infant sleeps, practice
self-care, learn techniques for expressing and storing breast milk,
and recognize signs of engorgement and infection. A mother who
stops breastfeeding when she returns home and resumes work usually
does so because of fatigue.
Manage: Refer patient to support group for breastfeeding mothers to
help meet emotional and learning needs.
SUGGESTED NIC INTERVENTIONS
Breastfeeding Assistance; Family Support; Lactation Counseling;
Nutritional Management; Parent Education: Infant
Reference
Noel-Weiss, J., et al. (2006, May–June). Developing a pre-natal breastfeeding
workshop to support maternal breastfeeding self-efficacy. Journal of Obstetric,
Gynecologic, and Neonatal Nursing, 35(3), 349–357.

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