Breastfeeding is a widely known way of obtaining good
nutrition for babies. It is known to be cost-effective, healthy for the baby,
and reduces the risk of disease in both the infant and the woman; however,
there are a few reasons to think that breastfeeding would not be in some
populations that can turn away from such a highly beneficial, nutritional
source for the baby. Barriers exist in all aspects in caring for an infant and
the method of feeding is highest in that outlook. Reasons for not choosing to
breastfeed and choosing to bottle feed instead include environmental,
physiological, and informational factors. In efforts to increase the number of
women that breastfeed, medical and nursing staff have pushed for breastfeeding
by using interventions already used in the hospital but there are factors as
previously mentioned that can impede implementing breastfeeding.

is the start for making wise decisions based on strong knowledge of the methods
for breastfeeding available. Because “women access information about
breastfeeding from many non medical sources: media, social groups, family
members, and cultural practices” (as cited in Sriraman & Kellams, 2016, p.

716), it is important for women to receive proper education so that they do not
turn away at the first sign of discomfort or failure of the infant to latch on
to the nipple. Although certain populations such as Hispanics have chosen to
breastfeed based on culture, it still pays to learn because there has been a
shift in how many Hispanics choose to breastfeed rather than bottle feed due to
difference in culture when some Hispanics immigrated to the United States
(Hohl, Thompson, Escareño, & Duggan, 2016, p. 1549). Sometimes when mothers
follow a custom without an evidenced-based explanation, the custom can take the
place of a source with proper information or the custom can be easily abandoned
and use formula based on new circumstances. As a woman in a study stated in
Hohl et al. (2017), “We (Hispanics) don’t know much about baby bottles and
stuff like that. What do I know, right? Nobody ever showed me baby bottles.

Only breast from my mother” (1551). Although the choice seems safe and a mother
can breastfeed her child based on this rationale, it can be short-term as
“Hispanic women in the United States faced economic pressure to work” (Hohl et
al., 2017, p.1554) and can lose sight of the reason for breastfeeding. When
more information is provided to a mother in the postpartum period, the better
she can lead in her decisions.

            Interventions are
included in the plan of care with breastfeeding to avoid problems and for whenever
complications occur. Engorgement is a common discomfort and can be relieved by
using practical corrective measures. One of them includes using a warm shower
in order to decrease discomfort right before breastfeeding occurs (Ricci, Kyle,
& Carman, 2017, p. 544). One of the main treatments is completely emptying
the breasts thereby putting the baby on the breast to feed the baby or using
some kind of breast pump to release the pressure that’s built up from the milk
supply (Ricci et al., 2017, p. 544-545). The baby will need some help in
finding the nipple as sometimes it can become inverted. One standard action
that can be taken is to use breast shells in order to try to reverse the nipple
back into place as to protrude (Ricci et al., 2017, p.428). Preventative
measures can be taken to prevent a lot of what occurs during pregnancy involves
proper mechanics both by the mother and the baby. Nurses can play a key role in
the hospital by teaching the mother to make sure “the infant to latch on by
bringing the infant rapidly to the breast with a wide-open mouth” (Ricci et
al., 2017, p.578). If this is done properly, the mother will recognize that the
baby covers as much of the areola as possible to prevent soreness. If
prevention can take place before discomfort occurs in the breastfeeding mother,
then more breastfeeding can take place; however, even interventions used for
breastfeeding discomfort can be troublesome in the experience.

When there are physical
barriers involved in breastfeeding, it can be challenging for mothers to use
this method of feeding because it goes against what popular belief about breastfeeding.

There are already existing comfort measures that breastfeeding mothers can take
in order to relieve discomforts but still have flaws in the complete process. A
few obstacles that come with breastfeeding are nipple soreness, inverted
nipples, engorgement (breasts filled with excessive amounts of breast milk),
among others and interventions exist that help the breastfeeding mother as
mentioned in Hohl et al. (2016), “…difficulties were surmountable for most
women, especially with support and instruction from health workers and family
members” (1554). Nipple shields have been used to resolve inverted nipples. In
some cases, however, nipple shields have stood in the way of the breastfeeding
experience as argued in Flacking and Dykes (2017) with preterm infants that
have used nipple shields to help them latch on and have later turned out to
fail because by discharge breastfeeding was no longer used as the parents main
feeding method (8). Some mothers have complained about nipple shields being
used in the hospital as a normal interventions and described it by saying,
“They staff went and got a nipple shield. It wasn’t a suggestion; she just
got it as it was the most natural thing to have…You don’t feel that close…

It’s something in between us” (Flacking & Dyke, 2017, p. 4). The
suggestions and perceptions of the mother are supposed to be incorporated into
the plan of care in order to have successful outcomes. Among these problems
have brought difficulties in helping the mother continue breastfeeding because
they have encountered physical barriers.

Breastfeeding was the core of
the method of feeding an infant but the number of women that do have fluctuated
due to several factors. Breastfeeding remains the best option solely when
referring to the benefits, however, there are still reasons that overpower the
benefits where some can be changed. Nipple shields have been implemented to no
avail in some women that have used them due to varying factors and
individualized approaches. Education with appropriate information that are
evidence-based provide women with the best possible decisions based on the
knowledge they receive. Interventions such as instructing mothers during the
times where breasts become engorged has not changed in the sense that when women’s
breasts become engorged for example, are to continue to breastfeed, take a warm
shower, and to use cold compresses during exacerbations (Ricci, Kyle, &
Carman, 2017, p. 544).  

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