Breastfeeding Nursing Care Plans Diagnosis and Interventions
Breastfeeding NCLEX Review and Nursing Care Plans
Breastfeeding is the practice of providing a child with a mother’s breast milk. According to the American Academy of Pediatrics, human breast milk is recommended for all newborns.
With few circumstances, this involves premature and ill babies. Breast milk is least likely to provoke allergic responses; it is affordable, conveniently available at all times of day or night, newborns readily accept the taste, and antibodies in mother’s milk can enable a baby to withstand infections.
Additionally, amino acids, the protein building blocks in breast milk, are well proportioned for the newborn, as well as carbohydrates, mainly lactose, and lipids. The nutrients, enzymes, and minerals in breast milk help the baby’s digestive tract.
Breastfed infants eat more frequently than bottle-fed babies because breast milk digests and empties the stomach faster.
Furthermore, continuous breastfeeding is an ideal nourishment and adequate to ensure optimum development and growth for the first six months after delivery. Breastfeeding is recommended during the first twelve months of life. Thus, infants withdrawn from breastfeeding before the age of 12 months should not be fed with cow’s milk but should instead be fed iron-fortified baby formula.
Benefits of Breastfeeding
1. Benefits of Breastfeeding for the Infant
- Breast milk contains leukocytes, which fight against prevalent respiratory tract infections.
- Breastmilk defends the infant’s body against various virus infections.
- Lactobacillus bifidus in mother’s milk prevents harmful bacteria from colonizing the digestive system, lowering the occurrence of diarrhea.
- Breast milk has the perfect electrolyte and mineral content for baby growth.
- Infants’ brains expand quickly because mother’s milk is heavy in lactose, which supplies accessible glucose.
- The nutrient levels of breast milk are sufficient to meet the infant’s demands while also sparing the infant’s kidneys from digesting a large renal solute load of wasted nutrients.
- Unlike cow’s milk, mother’s milk is free of allergens.
- Breastfeeding stops infants from gaining too much weight.
- The immune system of the infant becomes stronger.
- Constipation, diarrhea, gastroenteritis, gastrointestinal disorders, and neonatal necrotizing enterocolitis are diminished.
- There are fewer allergies and respiratory ailments such as asthma, respiratory syncytial virus (RSV), and whooping cough.
- Breastmilk reduces the likelihood of ear infections.
- There are lower incidences of bacterial meningitis.
- Improved vision and reduced retinopathy cases for the infant.
- Reduced neonatal mortality rates
- Sudden infant death syndrome (SIDS) rates are much lower.
- Overall, there is less disease and less hospitalization of the infants.
2. Benefits of Breastfeeding for the Mother
- Breastfeeding promotes faster postpartum weight loss by burning 500 additional calories per day to establish and sustain milk production.
- The uterus is stimulated to contract and resume to standard size.
- There is less postnatal hemorrhage.
- There are fewer incidences of urinary tract infection (UTI)
- Anemia is less likely to happen.
- Breastmilk lowers the likelihood of postpartum depression, and also improves the mother’s mood.
- Breastfeeding restores the mother’s calmness.
- Breastfed infants cry less and are less likely to get sick as children.
- Breastfeeding can benefit the entire family’s health in terms of body, mind, and soul.
- Mother’s milk is always pure and at the proper temperature.
- Mother-child physical or emotional attachment is strengthened.
- Breastfeeding encourages more significant skin-to-skin interaction and more holding and caressing moments.
- Many people believe that loving connection during childhood helps prevent social and behavioral difficulties in both children and adults.
- Breastfeeding mothers begin to recognize their infants’ signals, and babies start trusting caregivers.
- Reduced risk of developing breast cancer.
- Ovarian cancer risk is reduced.
- Rheumatoid arthritis and lupus risk are reduced.
- Reduced cases of endometriosis in lactating mothers.
- With age, there is less osteoporosis.
- Diabetes is less prevalent in breastfeeding mothers.
- Reduced cases of hypertension in breastfeeding mothers
- There is a lesser risk of cardiovascular illness.
Physiology of Breastfeeding
Breast milk is widely regarded as the best milk for newborns due to its benefits to both the mother and the child. Here is the physiology of breastfeeding:
- Breast milk is produced by acinar cells or alveolar cells.
- After the placenta is delivered, progesterone levels decline, stimulating prolactin.
- Prolactin enhances milk supply.
- In the fourth month of gestation, the acinar cells begin producing colostrum, rich in nutrition for the infant.
- Colostrum is produced for the first three to five days following birth.
- On the second to the fourth day, transitional breast milk substitutes colostrum.
- On the tenth day, true or mature mother’s milk is produced.
- The lactiferous sinuses, placed behind the nipple, serve as reservoirs for milk.
- When the infant sucks on the nipple, oxytocin is released, and the mammary glands’ gathering sinuses start to contract.
- The letdown reflex occurs when milk is forced forward through the breasts.
- The letdown reaction is triggered when a mother thinks about her infant or hears a baby cry.
- New milk, often known as hind milk, is generated following the letdown response, richer in fat than foremilk.
- Hind milk causes the newborn to grow faster than foremilk.
- The hormone oxytocin also aids in uterine contraction, causing the woman to experience mild tugging or cramps in the lower pelvis in the first several days of breastfeeding.
- Breastfeeding Patterns
- First feeding. The newborn baby is rapidly growing, which necessitates frequent feedings. Pay attention to the baby’s cues. It is typical and healthy for the infant to eat 8-12 times per day. That is roughly every 2-3 hours. Each nursing session may last 25-40 minutes in the early days, although this can vary depending on how hungry the baby is. Thus, it is necessary to keep in mind that, in addition to feeding, babies receive hydration, comfort, and snuggling time at the breast.
- Provide both breasts. Feed the baby on the fuller breast first until she spontaneously goes to sleep or comes off, then try to burp her and provide the other breast. Breastfed newborns do not even burp very often, but it never fails to attempt. Sitting the baby up to burp will also help wake her up, allowing her to eat more eagerly from the other breast.
- Cluster Feeding. During the day, the infant may feel the need to nurse more frequently—sometimes every hour. This ” cluster feeding ” occurs in the evenings during the first 4-6 weeks of a child’s birth; The mother can be confident that the baby is healthy if she just cluster feeds once throughout the day. Hence, follow the baby’s cues and provide her the breast anytime she shows signs of hunger. Cluster feeding ensures that the baby gets what she needs while increasing milk production.
- Growth Spurts. The infant’s eating patterns will shift as she develops and her body changes. These times are known as “growth spurts,” They are a typical component of the infant’s growth and development. The baby may spend one to two days breastfeeding more frequently and for more extended periods during this stage. During this stage, some babies may become more irritable. Moreover, growth spurts are often not anticipated, but they usually occur around 1-3 weeks, 4-6 weeks, three months, and six months. The baby will need to eat more often as she develops, and these additional feedings will help develop the milk production.
- Types of Breastfeeding Holds
- Cradle Hold. The most common breastfeeding position is the cradle hold. It is feasible to sit on a comfortable armchair with armrests. Place the infant tummy-to-tummy on the abdomen. The baby’s head is in the crook of the mother’s arm, and his or her face is against the breast. The baby’s knees are pressed on the other breast. The baby’s head, back, and legs should all be in a single direction. Check the baby’s position if the breast begins to ache during breastfeeding.
- Cuddle Hold. Put a pillow on the lap and place the baby on it. Use the hand on the side opposite the breast to lift the breast. Instead of keeping the baby’s head in the bend of the elbow as in the cradle position, use the opposite elbow to support the back of his neck and head with the hand resting between his shoulder blades. The infant is positioned chest to chest with the mother.
- Football Hold. Cradle the infant’s back of the neck in the palm, with the body under the breast towards the arm. To assist the baby’s bottom, place a cushion beneath the elbow while the other hand holds the breast up. This position allows the mother to regulate the baby’s head and facilitates a latch-on position. This type of breastfeeding hold is an excellent position for women who have undergone cesarean sections.
- Side-lying or Lying Cradle Hold. The mother should lie on the side and support the head with one arm. The baby is lying alongside the mother, with her head against the breast. Pull the baby in snuggly and lay a cushion behind the baby for assistance. Since the baby is not pressing on the mother’s tummy, this is a suitable position for moms who have had a cesarean delivery.
- Breast Care
- Even at bedtime, use a supportive bra. Check that it fits properly and is not too firm. Breastfeeding bras make feeding easier.
- Refuse to wear restrictive apparel and underwire bras, which can clog milk ducts and increase the likelihood of breast infections.
- Breastfeeding pads should be changed if they get sweaty, wet, or dirty.
- Take a shower every day. On the nipples, only use pure water since soap removes the essential lubricant produced by the ducts surrounding the nipples, causing them to become swollen and painful.
- Plugged Ducts and Mastitis Care Tips
A milk duct can become clogged in a breastfeeding woman, resulting in a hard, sensitive knot on the breast. Here are some pointers on how to treat such an area:
- Before breastfeeding, provide a warm compress to the affected region.
- Allow the baby to nurse frequently. If the clogged side is not overly sensitive, offer it first to the infant.
- Position the baby so that the chin or nose faces the clogged ducts if feasible. This technique will aid in the drainage of the affected area.
- Stimulate the stiffened area while breastfeeding, moving the fingertips from the chest to the nipple. To release milk left in the blocked breast after breastfeeding, use a manual expression or a breast pump.
- After breastfeeding, apply a cold compress to alleviate inflammation and discomfort.
- Increase the rest time, eat a nutritious diet, and drink plenty of water.
- Proper Breast Milk Storage
- Milk should be stored in a clean bottle or a disposable milk storage container.
- Fill every container halfway with milk for one feeding.
- Keeping 2-4 ounces of milk per container should reduce the amount of waste.
- To make an airtight seal, use a solid cap.
- Keep the bottle under warm running water for a few minutes, or place it in a bowl of hot water until the milk gets warm.
- Do not warm the milk through a microwave or stove. Rapid heating depletes nutrition and causes hot spots that might burn the infant’s mouth.
- Common Concerns in Breastfeeding
Some mothers enjoy breastfeeding their infants, while others are afraid to do so. These are attributed mainly to some of their breastfeeding concerns, and examples of these problems are as follows:
- Since the mother cannot see how much milk the baby is drinking, it causes her to overthink if the baby is getting enough milk from her.
- Because of the possibility of side effects of analgesia at birth, the infant does not suck well.
- When the infant is not hungry or is weary from crying from hunger, it cannot suck well.
- The mother is concerned because the infant’s stools are loose and thin, but this is normal because breastfed newborns’ stools are lighter and looser.
- The mother gets painful nipples due to the nipples being kept wet, and the newborn cannot hold the entire areola adequately.
- As milk production begins, the mother’s breasts engorge, causing lymphatic fullness.
- Because specific individuals make her feel uncomfortable, the mother does not want to nurse in public.
Breastfeeding Nursing Diagnosis
Nursing Care Plan for Breastfeeding 1
Risk for Ineffective Breastfeeding
Nursing Diagnosis: Risk for Ineffective Breastfeeding related to a poor infant sucking reflex secondary to breastfeeding as evidenced by the undesirable nursing process, inadequate emptying of each breast during each feeding, and perceived or actual scarcity of milk production.
- The patient will be able to communicate her understanding of the cause or contributing circumstances.
- Exhibit strategies for improving or enhancing breastfeeding.
- Accept accountability for practical breastfeeding.
- Achieve a mutually agreeable breastfeeding regimen, with infants satisfied after feedings and sufficient weight gain.
|Breastfeeding Nursing Interventions||Rationale|
|Examine the patient’s knowledge and the level of education provided about breastfeeding.||This intervention aims to teach the mother the most crucial things she needs to know about breastfeeding.|
|Encourage conversation and record any current or previous poor nursing experiences of the mother.||It is critical to consider previous negative breastfeeding experiences because they may be influencing the current condition. Hence, if the health care practitioners are aware of the mother’s past experiences, it will be easier to address breastfeeding difficulties.|
|Keep an eye out for any apparent indicators of suckling issues in the baby.||Early intervention for the infant’s suckling problem will assist both the baby and the mother resolve the issue as soon as possible. That is why it is crucial to watch the infant while breastfeeding closely; it is the best way to assess if the baby is getting enough milk from the mother or if he or she is having difficulty suckling the nipples.|
|Examine any visible indicators of an infant’s inadequate intake of milk.||Observe whether the baby latches onto the mother’s breasts with continuous sucking but limited audible swallowing or gulping, infant arching and wailing at the breasts with reluctance to latching on, reduced urine output or frequency of feces, and insufficient increase in weight. These are some of the obvious indicators that the newborn is not receiving enough milk from the mother.|
|Evaluate whether the infant is satisfied after feeding or if he or she is fussy and weeping within the first hour of breastfeeding.||It is critical to evaluate the baby’s fussiness or crying because it may indicate an inefficient breastfeeding process. It could also suggest that the infant has a poor sucking reflex.|
Nursing Care Plan for Breastfeeding 2
Deficient Knowledge / Knowledge Deficit
Nursing Diagnosis: Knowledge Deficit related to poor understanding of necessary information to achieve successful nursing and lack of awareness on proper breast care, different types of holds, and proper storage of milk secondary to breastfeeding, as evidenced by the occurrence of a breast infection, insufficient milk production, and incorrect position of the baby while breastfeeding.
- The patient will be able to understand the proper instructions for breastfeeding.
- The patient will learn to prevent the occurrence of breast infection.
- The patient will be able to ensure an effective breastfeeding process.
|Breastfeeding Nursing Interventions||Rationale|
|Evaluate the mother’s motivation and desire to learn about breastfeeding.||Learning requires energy. Thus, patients must sense a need or a reason for learning everything about breastfeeding. Nursing instructions, breast care, and typical breastfeeding concerns are essential things that mothers need to learn.|
|Explanations and demonstrations of the proper breastfeeding process should be clear, thorough, and comprehensible.||When patients have a basic understanding of what to expect with breastfeeding, they can better ask questions.|
|Give guidance on recognizing the signs and symptoms of a breast infection.||Breast infection symptoms include pain, swelling, redness, a hot-to-touch area on the breast, fever, chills, malaise, and general body aches. It is critical to be aware of these symptoms to address the problem as soon as it arises.|
|Demonstrate, teach, and provide hands-on assistance with breastfeeding positions such as cradle hold, football hold, and side-lying position.||The most critical aspect of effective breastfeeding is proper positioning and attachment. Attachment is often referred to as latching on. When the infant is positioned correctly and attached, it is easier for them to breastfeed and more relaxing for the mother.|
|Educate the mother about the proper storage of milk.||It is critical to preserve milk correctly to remain fresh and retain its nutritional and anti-infective properties. Breast milk can be kept in the refrigerator, freezer, or ambient temperature.|
Nursing Care Plan for Breastfeeding 3
Nursing Diagnosis: Acute Pain related to inflammation of the breast tissue secondary to breastfeeding-induced mastitis or lactation mastitis as evidenced by tenderness or warmth to the touch in the breast, breast enlargement, breast tissue thickening, or a breast lump, and continuous or intermittent pain or a burning feeling while breastfeeding.
- Reduce breast irritation and get rid of the clog
- Determine the source of the mastitis.
- Prevent mastitis from progressing to a breast infection or abscess.
|Breastfeeding Nursing Interventions||Rationale|
|Educate the patient on the early symptoms and indicators of mastitis.||Mastitis’ early signs and symptoms include breast inflammation, redness, soreness, and discomfort. It is critical to keep an eye out for these mastitis manifestations to avoid more severe complications.|
|Pump the affected breast every 2 to 2.5 hours throughout the day and every 3 hours each night until the sensations diminish.||This intervention aims to clear the blockage and minimize breast irritation.|
|Educate the patient on how to massage her breast while breastfeeding or start above the afflicted area and stroke toward the nipple.||Massages can reduce mastitis and inflamed breasts caused by blocked ducts. Thus this is an effective intervention.|
|Advise the patient that she should not wear a tight-fitting bra or apparel.||This intervention seeks to avoid or reduce the discomfort felt at the breast since a tight-fitting bra or clothing squeezes against the breast tissue and may cause additional pain.|
|If the symptoms persist, see a doctor right away. Nonsteroidal anti-inflammatory drugs and antibiotics may be prescribed by the health care practitioner.||This intervention seeks to keep the symptoms from worsening. Hence, the doctor must also educate the patient on the importance of finishing the complete course of antibiotics if prescribed.|
Nursing Care Plan for Breastfeeding 4
Nursing Diagnosis: Fatigue (Postpartum) related to lack of knowledge about proper positioning and scheduling of feedings and inadequate rest secondary to breastfeeding as evidenced by the interference of mother’s nursing goal, insufficient milk production due to stress, and anxiety.
- The patient will be able to reduce anxiety in breastfeeding by knowing the proper positioning and scheduling of feedings.
- The patient will be able to obtain adequate rest.
- The patient will understand the correlation between stress and milk production.
|Breastfeeding Nursing Interventions||Rationale|
|While breastfeeding, assess the patient’s and baby’s positions.||Breastfeeding in the appropriate position is beneficial to both the mother and the infant. Since the mother and infant are relaxed, this method will prevent further tiredness.|
|Assess the patient’s outlook for fatigue relief, readiness to participate in fatigue-reduction initiatives, and amount of family and social support.||This intervention will encourage active participation in the planning, implementing, and evaluation of fatigue-relieving therapy management. Social support will be vital in assisting the patient to implement adjustments to reduce weariness.|
|Educate the patient on the infant’s recommended or conventional feeding regimen.||The mother must understand that newborn babies should be breastfed 8–12 times each day for the first month. Since breast milk is quickly absorbed, babies are frequently hungry. Being aware of the baby’s standard feeding schedule will reduce the mother’s worry.|
|Instruct the mother to make sure she gets adequate sleep.||To avoid fatigue and anxiety brought on by her new role as a mother, she should not ignore herself and ensure that she has enough time to rest despite breastfeeding responsibilities.|
|Allow the patient to convey her fatigue sensations.||The patient’s perspective can provide helpful information on her awareness and motivation to reduce fatigue complaints.|
Nursing Care Plan for Breastfeeding 5
Nursing Diagnosis: Effective Breastfeeding related to the mother’s basic breastfeeding knowledge secondary to breastfeeding, as evidenced by the capacity to encourage effective latching on via proper positioning, eagerness to breastfeed the infant, effective mother-baby communication, and there is evidence of satisfaction after feeding.
- The mother will effectively breastfeed her infant and be satisfied with the breastfeeding procedure.
- The mother will be comfortable with the way she breastfeeds her child.
- The infant will develop and grow in accordance with recognized criteria.
|Breastfeeding Nursing Interventions||Rationales|
|Motivate the mother to have a constant skin-to-skin attachment with her child.||This intervention promotes parent-baby bonding and promotes the baby’s physical and developmental outcomes.|
|Refer the patient to a breastfeeding support group.||This intervention assists the mother in meeting her psychological and educational needs.|
|Encourage family members and significant others, particularly the mother’s spouse, to support and assist her during the breastfeeding journey.||This intervention will make the mother feel that she is not alone in her obligations. This technique will also help her acquire confidence because she will have someone assisting her.|
|Even if the mother is well-educated in breastfeeding, it is vital to evaluate her attitudes and views.||This technique tries to assist the mother in making intervention plans. It is beneficial to learn about the mother’s breastfeeding expertise and experience.|
|Teach a selected support person about breastfeeding techniques as well.||If someone in the same household also knows good breastfeeding practices, this intervention will assist the mother build confidence. This strategy will also boost the success of nursing procedures.|
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon
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