Domain 2. Nutrition
Class 1. Ingestion
Diagnostic Code: 00216
Nanda label: Insufficient breast milk production
Diagnostic focus: Breast milk production
Introduction to Nursing Diagnosis: Insufficient Breast Milk Production
Breast milk is the fundamental source of nutrition for babies, supplying them with proteins and other essential nutrition. For many mothers, however, they may experience a struggle in terms of producing sufficient quantities of breast milk. This can lead to frustration, confusion and even feelings of helplessness at times. Fortunately, nursing diagnosis helps to provide strategies that mothers can implement to help increase their breast milk production.
NANDA Nursing Diagnosis Definition
The National Alliance for Nursing Diagnosis (NANDA) defines insufficient breast milk production as “a reduced amount of milk produced by the breasts, leading to inadequate nutrition for the infant”. This specific nursing diagnosis can arise from a wide variety of underlying causes, making it important to learn more about each individual case in order to develop the most effective treatment plan.
Defining Characteristics
The various attributes used to define this particular nursing diagnosis are generally divided into subjective and objective categories. In terms of subjective symptoms, mothers may experience feelings of guilt, anxiety or depression related to their inability to provide adequate nutrition for their infant; meanwhile on the objective side, mothers may simply be unable to produce an adequate amount of milk necessary to feed their baby.
There are several factors that can potentially lead to insufficient breast milk production. These include but are not limited to hormonal issues (such as hypothyroidism), physical malformations within the breast, pain or trauma experienced by the mother during or after labor, or even complications arising from medications the mother has consumed during her pregnancy. For example, certain antibiotics may impede the effectiveness of lactation hormones, compromising the production of breast milk.
At-Risk Population
Certain populations of women may also be more prone to insufficient breast milk production than others, including those with a history of breast-feeding difficulties, preterm deliveries, or any woman who is struggling with breastfeeding.
Suggestions for Use
Fortunately, there are steps that can be taken to help mothers better cope with and even address the issue of low breast milk supply. First and foremost, it is important for mothers to stay well-hydrated, since dehydrated breasts do not respond well to lactation hormones. It is also recommended that mothers practice skin-to-skin contact with their newborns, as this has been shown to stimulate the production of lactation hormones. Furthermore, mothers should get plenty of rest and nutrition, since these factors can also influence the overall output of breast milk. Regular pumping or breastfeeding on demand will also help to stimulate the lower supply of breast milk.
Suggested Alternative NANDA Nursing Diagnoses
In cases where nursing diagnosis suggests that the mother is dealing with low breast milk production, there are other alternative diagnoses that can be suggested by a practitioner. These include nipple and/or breast trauma, delayed lactogenesis, inadequate breastfeeding knowledge/skills, or premature infants. Additionally, psychosocial care plans may be needed in cases of postpartum depression and other similar psychological complications.
Usage Tips
In order to maintain the most accuracy when employing nursing diagnosis, it is important to obtain detailed medical histories from the mother and her infant. Additionally, specific clinical information such as assessment data and analysis of the infant’s development and growth should also be taken into account. Of course, practitioners must also remain mindful of cultural and socioeconomic factors which can also impact the mother’s ability to produce breast milk.
NOC Outcomes
The following NOC Outcomes can be used to help evaluate the effectiveness of the nursing diagnosis employed. These include the mother:
* Maintaining sufficient lactation
* Expressed confidence in her ability to manage infant's basic needs
* Properly identifying and expressing maternal attitudes and beliefs
* Demonstrating appropriate infant health promotion activities
* Displaying effective parenting skills
Evaluation Objectives and Criteria
In order to determine if the nursing diagnosis has been successful, a list of evaluation objectives and criteria must be established. These should focus primarily upon the actual effectiveness of the treatments implemented and upon the health and overall development of the child. For example, the child's weight gain, degree of parent-child social interaction, and patterns of feeding should all be taken into account when evaluating the overall success of the treatments instituted.
NIC Interventions
There are also several specific interventions that can be employed, as outlined by NIC (Nursing Interventions Classification). These range from providing mothers with appropriate education regarding infant nutrition, to helping parents to institute comfortable and enjoyable feeding patterns. Other interventions may include periodically checking the infant's vital signs, offering advice for improved parenting, teaching the mother how to properly handle and store expressed breast milk, and collaborating with other healthcare professionals in order to provide any necessary nutrition or vitamin supplements.
Nursing Activities
To best carry out these various interventions and abide by the highest standards of care, nurses must employ specific activities to ensure success. For example, nurses should prioritize patient teaching, engaging the patient in both evidence based discussions and factual information regarding the condition. Additionally, nurses should also engage in reassessment and record-keeping in order to track the progress of both the patient and the infant; this should include monitoring the infant’s development, vitals and physical examinations. Finally, nurses should also be available to answer any specific questions that the mother may have and to provide emotional support if needed.
Conclusion
Ultimately, the issue of insufficient breast milk production is a difficult but very common one faced by many mothers. Fortunately, through proper nursing diagnosis and heightened awareness of the factors that influence breast milk supply, nurses can help guide patients toward the best possible solutions for their individual cases.
5 FAQs
1. What is a nursing diagnosis?
A nursing diagnosis is a thought process employed by nurses to evaluate the health status of a given patient. The goal is to not only diagnose illnesses and conditions, but also to provide treatments and interventions that will improve health outcomes.
2. Why is breast milk production important?
Breast milk serves as the primary source of nutrition for newborns and infants, delivering essential proteins and other nutrients. As such, it is important for mothers to be able to produce a sufficient amount of breast milk to keep their infant adequately nourished.
3. What are some factors that can contribute to insufficient breast milk supply?
There are multiple factors that can lead to low breast milk supply, including hormonal imbalances, birth or labor complications, pain or trauma experienced by the mother, and medications taken during pregnancy which can interfere with lactation hormones.
4. What are some helpful methods I can use to increase my breast milk production?
Some common strategies that can help stimulate higher levels of breast milk production include staying well hydrated, practicing regular skin-to-skin contact with your baby, eating a balanced diet and getting enough rest, as well as pumping and breastfeeding on demand.
5. Are there any alternative approaches I can take if these strategies fail to achieve results?
Yes, in cases where traditional techniques are unsuccessful, there are other alternative diagnoses that can be suggested by a practitioner. These include nipple and/or breast trauma, delayed lactogenesis, inadequate breastfeeding knowledge/skills, or premature infants. Additionally, psychosocial care plans may be needed in cases of postpartum depression and other similar psychological complications.
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