Question

Maggie, a 28-year-old G3P2 receiving postpartum instructions just before her discharge. She is married with a supportive husband and one older child she “tried to breastfeed but was unsuccessful”. She is committed to breastfeeding this child for one year but is concerned about her being able to. What are your concerns as her nurse and what would you include in her plan of care? List at least 6 points you would want to prioritize for her care.

Answer 1

• Ineffective breastfeeding is defined as difficulty providing milk to an infant or young child directly from the breasts, which may compromise nutritional status of the infant or child.
• Breastfeeding is a very beneficial process for both the mother and her baby. It has a lots of benefitss if a mother is continuosly breastfeeding her child during the first years of life
• It will provide protection to the bay from many diseases because breastfeeding decreases risk if sudden infant death syndrome, enhances baby's brain development of infections.
• Ineffective breast feeding can be used caused by many factors. some of which are presence of sore nipples, difficulty to sustain suckling at the breast, inadequate breast emptying during feeding and inadequate milk supply.

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 breast feeding
• Infant anomaly
• Nonsupportive partner or family members

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 the psychological 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 bresatfeeding.This is to prevent contradiction to what someone believes which may result to ineffective breastfeeding.

DESIRED GOALS OR OUTCOME

• 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
1. Explain to the mother and her immediate family members the process and importance of breastfeeding. Include th 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 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 breat 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