Nursing diagnosis – ineffective breastfeeding

Ineffective Breastfeeding
Definition
Dissatisfaction or difficulty a mother, infant, or child experiences
with the breastfeeding process
DEFINING CHARACTERISTICS
• Actual or perceived inadequate milk supply (mother)
• Arching and crying when at the breast (infant)
• Evidence of inadequate intake (infant)
• Fussiness and crying within the first hour of feeding (infant)
• Inability to latch on to nipple correctly (infant)
• Insufficient emptying of each breast
• Unsatisfactory breastfeeding process (mother and infant)
RELATED FACTORS
• INEFFECTIVE BREASTFEEDING
• Infant anomaly
• Infant receiving supplemental
feeding with artificial nipple
• Knowledge deficit
• Maternal ambivalence
• Maternal anxiety
• Nonsupportive family
• Nonsupportive partner
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Communication
• Roles and relationships
• Values and beliefs
EXPECTED OUTCOMES
The mother will
• Express physical and psychological comfort in breastfeeding practice
and techniques.
• Show decreased anxiety and apprehension.
• State at least one resource for breastfeeding support.
The infant will
• Feed successfully on both breasts and appear satisfied for at least
2 hr after feeding.
• Grow and thrive.
SUGGESTED NOC OUTCOMES
Breastfeeding Assistance; Emotional Support; Lactation Counseling;
Nutritional Management; Parent Education; Support Group
INTERVENTIONS AND RATIONALES
Determine: Assess factors that influence mother’s decision to breastfeed.
Assessment information will be used to develop interventions.
Monitor condition of breasts and nipples to identify problems that
might interfere with feeding to pinpoint problem areas.
Assess readiness of mother to breast-feed and ability of infant to
feed.
Monitor mother’s breastfeeding technique. Improper technique,
which impedes feeding, will cause the mother to experience anxiety.
Perform: Position mother in Fowler’s position to enhance mother’s
relaxation during feeding. Place infant in proper position for optimal
feeding to produce proper sucking motion.
Inform: Teach mother and selected caregiver the techniques for
encouraging letdown, including warm shower, breast massage, physically
caring for the neonate, and holding the neonate close to the
breasts.
Teach mother techniques (e.g., lying on her side, positioning the
infant correctly, holding the nipple with C position, talking to and
cuddling the infant) that will help the infant latch on to the breast.
Instruct mother to remove infant from the breast to be burped
midway during the feeding to allow for expulsion of air that is
swallowed.
Attend: Ask frequently during hospitalization whether the mother
has questions while she is attempting to breast-feed. This will give
her the confidence she needs to continue when she gets home.
Provide mother and infant with a quiet, private, comfortable environment
in which to breast-feed. Decreasing stressors will help to
promote successful breastfeeding experience.
Encourage expression of fears and anxieties between the mother
and the infant to reduce anxiety and increase the mother’s sense of
control over the process.
Manage: Offer written information, a reading list, or a referral to a
breastfeeding support group to allow for review of information after
discharge:
Refer to home health nurse for a follow-up visit in the home.
Refer to a nutritionist for information on good nutrition and fluid
management.
SUGGESTED NIC INTERVENTIONS
Breastfeeding Assistance; Emotional Support; Lactation Counseling;
Infant; Parent Education; Support Group
Reference
Lewallen, I. P., et al. (2006, August). Toward a clinically useful method of
predicting early breastfeeding attrition. Applied Nursing Research, 19(3),
144–148.

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