Breastfeeding is essential as it provided infants with ideal nutrition. Breastmilk has a mixture of vitamins, fat, proteins, and all the essential nutrients. Moreover, breastmilk contains the necessary antibodies that can help a baby’s body fight off bacteria, viruses, allergies and asthma. However, very many factors affect a mother’s ability to breastfeed a baby. One of these factors is the breast’s anatomy. Inverted nipples have been linked with reduced lactation abilities. The outcomes of not breastfeeding a baby include weak immune systems, low birth weights, and increased neonatal mortality rates.
Background of Study
Vazirinejad, Darakhshan & Hadadian (2009) carried out a study to ascertain the impacts of breast anatomical differences in weight gain among neonatal during the first week after birth. The researchers classified the breasts as large nipples/large breasts, inverted nipples, and flat nipples. According to the study, little research has been carried out to determine the impacts of a mother’s breast anatomy on breastfeeding outcomes. Vazirinejad, Darakhshan & Hadadian (2009) noted that very few mothers have an awareness of the effects of breast anatomy on their born children. This mostly affects first-time mothers. Breastfeeding is an essential undertaking. Every mother should make sure that an infant breastfeeds as per the required timetable. Breastfeeding helps with weight gain and overall body development. The significance of this study is that it gives nurse awareness of the impacts of breast differences on infant weight gain. The nurses will be able to explain to first-time mothers how they can ensure that breast variations do not affect breastfeeding.
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Dewey et al. (2003) carried a study to determine the risk factors for neonatal weight loss, delayed onset of breastfeeding, and suboptimal infant lactation behavior among highly motivated and educated mothers. The study objectives included determining the risk factors and incidence of factors linked to poor breastfeeding outcomes in the nonexistence of socio-cultural obstacles to exclusive lactation. Dewey et al. (2003) sought to fill a gap in knowledge, as there has been no study that has recognized all significant breastfeeding outcomes at the same time during the first week postpartum. The significance of this study is that it highlights two crucial issues; parity has a vital role to play towards early breastfeeding among mothers. However, factors such as maternal overweight, the use of pacifiers, and labor medications can affect lactation. This study is important to nurses as the primipara mothers require health education and appropriate interventions to ensure they achieve and establish efficacious breastfeeding. The information from the research will ensure the nurses have the right knowledge when assisting primipara mothers.
How do these two articles support the nurse practice issue you chose?
The two articles provide information on the consequence of inverted nipples on lactation. Breastfeeding is an important activity that every mother should take seriously. However, for a mother to fruitfully breastfed a baby, there must be a proper attachment of the newborn at the breast. Various breast anatomies affect an infant’s capability to clasp on the breast such as inverted nipples effectively. I will use the two articles in understanding the impact of breast anatomy on child growth and development. The articles will also provide me with information on the various techniques mother can use to correct inverted nipples.
When comparing the groups used in the study by Vazirinejad, Darakhshan & Hadadian (2009), they are close to what I had initially identified in my PICOT question. The researchers found out that infants born to moms with at least one form of breast difference had a low birth weight one week after birth. On the other hand, infants of mothers who did to have breast differences had a significantly higher weight.
Method of Study
The primary data collection method used in the study by Vazirinejad, Darakhshan & Hadadian (2009) was observation to gather data from a cohort of 100 mothers. The participants were divided into two groups consisting of 50 participants each. Group-A had antenatal moms with breast differences while Group-B consisted of mothers lacking breast differences.
Dewey et al. (2009) used two data-gathering methodologies, interviews and observation. Interviews were used in gathering data from the 280 eligible mothers regarding their infant feeding patterns, the ability to breastfeed the infant, previous breastfeeding experience, and availability of support systems during delivery and labor. The observation was used to gather data during breastfeeding. This method allowed the researcher to determine whether the nipple is normal, inverted or flat. Infant suckling behavior, infant and maternal positioning during breastfeeding and mother's behavior was also determined.
The main advantage of interviews is that they allow a researcher to get detailed information on the study. However, costs are a significant setback for interviews. It requires one to employ staff to carry out the interviews. The main advantage of the observational data gathering technique is that it allows a researcher to gather accurate and reliable data. The researcher has no control over the study sample hence eliminating bias. The primary setback related to the data methodology is that in case of controlled observations such as that by Bagal et al. (2017), it requires the use of special tools or instruments to get reliable data, and they are costly.
Results of Study
In the article by Vazirinejad, Darakhshan & Hadadian (2009), the findings showed that there was significant weight variation in infants born to mothers with one form of breast variation on the seventh day. The infants born to mothers without breast variations had a significantly higher mean weight. Additionally, the study also found out that the different breast variations identified, such as inverted nipples, large breasts/large nipples, and flat nipples, had a role to play in weight gain. Without considering these breast variations, it forces mothers to start using artificial formulas that result in adverse outcomes. Vazirinejad, Darakhshan & Hadadian (2009) found out that the mothers’ breast variations play a significant role in infant weight gain in the future hence affecting overall growth, and development. The study identified that during the first week of infant growth, colostrum is vital and breast variations prevent them from accessing it. The first few months after birth are essential as the infants grow rapidly, and thus without breast milk, they are likely to suffer.
Dewey et al. (2003) found out that excess weight loss on the third and seventh days after infant birth was associated with the nipple anatomies (flat and inverted). According to the study, women with flat and inverted nipples face challenges during breastfeeding, and this leads to a delayed onset of lactation. The women should receive specialized assistance until the infants have the ability to of latching on the nipples effectively. Mothers with flat and inverted nipples tend to use pacifiers and NBM fluids and thus make them develop suboptimal infant breastfeeding behavior, which leads to low infant birth weight.
The nursing practice implications arising from the two studies can be seen from the fact that pediatric nurses working in health centers follow child development from birth up to about six years. These nurses must support breastfeeding practices among mothers by having regular meetings within the centers. The studies highlight how breast anatomical structures can prevent successful breastfeeding. The nurse can use this information in teaching the mothers how to avoid breastfeeding problems, maintaining lactation, and seeking medical attention to correct the defects. A multi-faceted and cooperative approach is essential for attaining and maintaining effective breastfeeding.
Ethical Considerations
All researchers must consider ethics when carrying out a study. One of the primary ethical considerations every researcher must meet is informed consent. This refers to the willingness of a participant to intelligently and voluntarily approve to become part of a study. Through informed consent, the researcher can show the participants that they are free from any attacks on their liberty, openness, and integrity. A researcher must ensure that the informed consent form provides the participants with information about a study, and procedures to be followed throughout the entire process. Another crucial ethical facet is privacy and confidentiality. The participants’ data should be treated as private and confidential. This indicates that the identifiability of the participants should not be made public by the researcher when publishing a study.
Boskabadi et al. (2014), Vazirinejad, Darakhsgan & Hadadian (2009), Bagal et al. (2017), and Dewey et al. (2003) ensured that all their participants had signed an informed consent form and given information about the research before its commencement. This was to ensure that each participant was fully aware of the research objectives and procedures. Moreover, the studies fulfilled the privacy and confidentiality of ethical considerations. None of the researchers has published identifiable information such as names, social security numbers, pictures, or medical record numbers of the participants. This makes it hard for one to identify the respondents used in the study.
Outcomes Comparison
The anticipated outcome of my PICOT question is that infants who are not breastfed as required by their mothers because of inverted nipples will have a higher neonatal mortality rate. On the other hand, infants’ breastfed as needed will have zero or meager neonatal mortality rates within the first six years after birth. According to the findings by Boskabadi et al. (2014), Vazirinejad, Darakhsgan & Hadadian (2009), Bagal et al. (2017), and Dewey et al. (2003), inverted nipples lead to low infant birth weight during the first seven days after birth. Low birth weight is associated with high infant mortality rates. Therefore, the four studies' outcomes are somehow similar to my PICOT outcomes.
References
Bagal, S. U., Salunkhe, J. A., Salunkhe, A. H., Kakade, S. V., & Mohite, V. R. (2017). A comparative study to assess the problem of the inverted nipple and its relationship to successful breastfeeding among antenatal mothers. International Journal of Health Sciences & Research. 7(4), 280-288. Retrieved from https://www.ijhsr.org/IJHSR_Vol.7_Issue.4_April2017/42.pdf
Boskabadi, H., Ramazanzadeh, M., Zakerihamidi, M., & Rezagholizade Omran, F. (2014). Risk factors of breast problems in mothers and their effects on newborns. Iranian Red Crescent medical journal, 16(6), 1-6. doi:10.5812/ircmj.8582.Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103000/
Vazirinejad, R., Darakhshan, S., Esmaeili, A., & Hadadian, S. (2009). The effect of maternal breast variations on neonatal weight gain in the first seven days of life. International Breastfeeding Journal, 4 , 1-16. Doi: 10.1186/1746-4358-4-13. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785755/
