NANDA definition of an ineffective breastfeeding diagnosis is the "dissatisfaction or difficulty a mother, infant or child experiences with the breastfeeding process." This can include physical discomfort as well as lack of knowledge or skill for the mother and poor weight gain for the infant.
- 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)
- Basic breastfeeding knowledge
- Normal breast structure
- Normal infant oral structure
- Infant gestational age greater than 34 weeks
- Support sources [available]
- Maternal confidence
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.
- Feed successfully on both breasts and appear satisfied for at least 2 hr after feeding.
- Grow and thrive.
Assessment Focus (Refer to comprehensive assessment parameters.)
- Roles and relationships
- Values and beliefs
- Initiate breastfeeding within first hour after birth.
- Keep infant with mother
- Monitor effectiveness of current breastfeeding efforts.
- Determine support systems available to mother/family.
- Identify cultural beliefs/practices regarding lactation, letdown techniques, maternal food preferences.
- Assess mother’s knowledge and previous experience with breastfeeding.
- Encourage mother to drink at least 2000 mL of fluid per day or 6 to 8 oz every hour.
- Provide information as needed about early infant feeding cues (e.g., rooting, lip smacking, sucking fingers/hand) versus late cue of crying.
- Discuss/demonstrate breastfeeding aids (e.g., infant sling, nursing footstool/pillows, breast pumps).
- Encourage mother/other family members to express feelings/concerns, and Active-listen
- Educate father/SO about benefits of breastfeeding and how to manage common lactation challenges.
- Review techniques for expression (breast pumping) and storage of breast milk.
- Recommend avoidance of specific medications or substances (e.g., estrogen-containing contraceptives, bromocriptine, nicotine, alcohol).