Break in continuity of the breastfeeding process as a result of
inability or inadvisability to put baby to breast for feeding
• Continued desire to maintain lactation and provide breast milk for
infant’s nutritional needs (mother)
• Failure to receive nourishment at breast for some or all feedings
• Lack of knowledge about expressing or storing milk (mother)
• Separation of mother and infant
• Contraindications to
• Infant illness
• Maternal employment
• Maternal illness
• Need to wean infant abruptly
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Values and beliefs
The mother will
• Express her understanding of factors that necessitate interruption
• Express comfort with her decision about whether to resume
• Express and store breast milk appropriately.
• Resume breastfeeding when the interfering factor ceases.
• Have adequate milk supply when breastfeeding resumes.
• Obtain relief from discomfort associated with engorgement.
• Ensure that infant’s nutritional needs are met.
SUGGESTED NOC OUTCOMES
Breastfeeding Maintenance; Knowledge: Breastfeeding; Motivation;
Parent–Infant Attachment; Parenting Performance; Role Performance
INTERVENTIONS AND RATIONALES
Determine: Assess mother’s understanding for interrupting breastfeeding
to evaluate need for further instruction.
Assess mother’s desire to resume breastfeeding when reasons for
interruption are no longer a factor. The mother may not wish to
Assess mother’s emotional reactions to having to interrupt breastfeeding.
Emotional feelings may affect resumption after interruption.
Perform: Review mother’s daily routine to advise her how to incorporate
breastfeeding into her schedule. Mother must have a plan in
order to carry on usual routine and still make sure the baby is fed
Inform: Instruct mother in methods for expressing and storing breast
milk. Demonstrate the use of a breast pump utilizing the following
– Initiate pumping 24–48 hr after delivery.
– Pump a minimum of 5 times a day.
– Pump a minimum of 100 min a day.
– Pump long enough to soften breasts each time regardless of
Instruct mother in ways to prevent breast engorgement to prevent
discomfort that may keep infant from sucking effectively. Teach the
mother about the use of nipple shield (if appropriate). The shield is
designed to alter flat or inverted nipples.
Attend: Provide emotional support and encouragement to help
improve patient’s confidence and motivation to resume breastfeeding
Reassure mother that infant’s nutritional needs will be met
through other methods to allay her anxiety.
If mother must pump for a prolonged period, encourage her to
use a piston-style electric pump. Using an electric pump rather than
a hand pump produces milk with a higher fat content.
Involve patient in planning and decision making. Having the ability
to participate will encourage greater compliance with the plan to
If mother chooses not to resume breastfeeding, advise her to wear
a supportive bra, apply ice, and take a mild analgesic to alleviate
discomfort associated with engorgement.
Manage: Refer to a lactation support group for continued assistance
in resuming breastfeeding after an interruption.
Provide appropriate educational home assessment. If possible,
have a home health nurse visit the mother and infant to assess
SUGGESTED NIC INTERVENTIONS
Attachment Promotion; Bottle Feeding; Emotional Support; Infant;
Lactation Counseling; Parent Education; Teaching: Individual
Spatz, D. L. (2006, January–March). State of the science: Use of human milk
and breastfeeding for vulnerable infants. The Journal of Perinatal &
Neonatal Nursing, 20(1), 51–55.