Ineffective Breastfeeding: Nursing Diagnosis & Care Plan

Ineffective Breastfeeding

Ineffective Breastfeeding is defined by Nanda as a difficulty providing milk to an infant or young child directly from the breasts, which may compromise nutritional status of the infant/child.

Breastfeeding is a very beneficial process for both the mother and her baby. It has a lot of benefits if a mother is continuously breastfeeding her child during the first years of life. It will provide protection to the baby from many diseases because breastfeeding decreases risk if sudden infant death syndrome, enhances baby’s brain development and decreases development of infections. Moreover, it is also beneficial for the mother because it prevents post-partum bleeding and risk of developing breast cancer. These are the several benefits of breastfeeding.

At some point, mothers do not have the ability to breastfeed their child as much as they wanted to and this is called as the ineffective breastfeeding. This is a difficulty of a mother to breastfeed her child.

Ineffective breastfeeding can be caused by many factors. Some of which are the presence of sore nipples, difficulty to sustain suckling at the breast, inadequate breast emptying during feeding, and inadequate milk supply. These are the possible causes why mothers experience unsuccessful breastfeeding.

Causes or Related Factors:

• Poor infant sucking reflex
• Poor knowledge on the importance and benefits of breastfeeding
• Delivering a premature infant
• Mothers who have undergone previous breast surgery
• Maternal breast anomaly
• Interruption in breastfeeding
• Infant anomaly
• Nonsupportive partner or family members

Defining Characteristics

• • Inadequate infant stooling
  • Infant arching at breast
  • Infant crying at the breast
  • Infant crying within the first hour after breastfeeding
  • Infant fussing within one hour of breastfeeding
  • Infant inability to latch on to maternal breast correctly
  • Infant resisting latching on to breast
  • Infant unresponsive to other comfort measures
  • Insufficient emptying of each breast per feeding
  • Insufficient infant weight gain
  • Insufficient signs of oxytocin release
  • Perceived inadequate milk supply
  • Sore nipples persisting beyond first week
  • Sustained infant weight loss
  • Unsustained suckling at the breast

Nursing Assessment

Nursing Assessment	Rationale
1. Assess the factors that can promote or impede the process of breastfeeding.	·      It will let the nurse know whether the mother has the ability to perform exclusive breastfeeding to her child or not.
2. Assess the structure of the mother’s breast and nipples.	·      It will determine the presence or absence of breast anomaly which may not permit breastfeeding.
3. Assess the mother’s knowledge regarding the process of lactation and breastfeeding	·      It will determine the level of awareness of the mother on the importance of breastfeeding and lactation
4. Assess psychosocial factors that may contribute to ineffective breastfeeding	·      This is to provide information on the causes of possible presence of ineffective breastfeeding either physical or psychological.
5. Assess presence of support groups (partner and family members)	·      Support from immediate family members gives motivation for the mother to pursue and continue with the goal because there are people who will be there to encourage her.
6. Assess the client’s cultural beliefs and values related to breastfeeding	·      It will give an idea on what are the beliefs that the client is following regarding breastfeeding. This is to prevent contradiction to what someone believes which may result to ineffective breastfeeding.

 

Desired Goals/Outcomes:

• Achieve an effective breastfeeding
• Verbalization of breastfeeding problems and know how to manage it correctly
• Improve health status of the infant by reduction or no signs of infection
• Improve maternal health as evidenced by no signs and symptoms of breast cancer
• Infant shows an adequate intake during breastfeeding
• Mother increases self-esteem related to the infant feeding process
• Mother determines alternative methods of infant feeding if unable to continue exclusive breastfeeding

Nursing Interventions/Rationale

Nursing interventions	Rationale
Independent
1. Explain to the mother and her immediate family members the process and importance of breastfeeding. Include the health benefits to both mother and her child	It will let the client and her support groups to have a better understanding on the benefits of breastfeeding. It will motivate them to achieve their goal.
2. Explain the correct positioning of the mother and infant during breastfeeding by demonstrating the proper technique.	It will let the mother and baby to have a successful breastfeeding through correct positioning. This will prevent disruption of the process.
3. Check the infant’s ability to grasp the areola of the breast with his/her lips, tongue and jaw.	Proper positioning of the infant during breastfeeding aids in the success of the process.
4. Check the infant’s ability to suck breast milk	This will also aid in having a successful breastfeeding.
5. Promote relaxation and comfort during breastfeeding process	This will prevent disruption of the breastfeeding process.
6. Encourage the mother in doing the correct positioning during breastfeeding. Help the mother in doing so if needed.	Repetition of the process will motivate the mother to have a successful breastfeeding.
7. Check the flow of milk from the mother’s breasts. Allow switching of feeding from one breast to another to have proper emptying of both breasts	It will determine the amount of milk produced by each breast to prevent ingestion of air by the infant during feeding.
8. Explain and discourage bottle feeding during the first years of infant’s life	It will let the mother and support groups to understand the effects of not having exclusive breastfeeding.
9. Let the infant burp after every feeding. Teach the mother how to let her baby burp after each feeding.	This will educate the mother to have a good burping position for the infant to prevent backflow of milk ingested.
10. Determine the presence of ineffective breastfeeding and the different alternatives	This will help the mother and support groups not to be discouraged in breastfeeding the infant. It will help them meet the desired goal in all acceptable methods.
Collaborative
1. Make referrals to neonatal nutritionists and lactation specialists if necessary	It will prevent problems of malnutrition if there is suspected ineffective breastfeeding.