Validation of the Nursing Diagnosis of Ineffective Breastfeeding

Objective: To test the validity of the definition, related factors, and defining characteristics of the nursing diagnosis of ineffective breastfeeding. Also, to test whether defining characteristics relevant to the interruption of breastfeeding may be included in the diagnosis of ineffective breastfeeding.
Design: A methodologic study using a two-stage Delphi process.
Participants: Sixty-six nurses in the first round of the Delphi process and 34 nurses in the second round.
Main Outcome Measures: A Likert-like scale was used to measure nurse experts' opinions as to how reflective each defining characteristic was of ineffective breastfeeding.
Results: The definition of ineffective breastfeeding was simplified, related factors were added, and defining characteristics were clarified. Two characteristics of interruption of breastfeeding were found to be relevant to ineffective breastfeeding, but were considered minor rather than major.
Conclusion: The definition, related factors, and defining characteristics of ineffective breastfeeding have been clarified and validated by nurse experts, but they need further validation by breastfeeding women.     

The Effect of Nipple Shields on Maternal Milk Volume

This study was conducted to evaluate nipple shields and determine whether altered nipple shield design would change the amount of milk obtained during breast pumping. The study also sought to determine whether milk volume would change depending on the presence or absence of a nipple shield during breast pumping. Among the 25 participants, pumping without a shield yielded statistically significantly larger milk volumes than pumping with either one of the two kinds of shields evaluated, regardless of the order of nipple shield use. The slight difference in milk volumes obtained when comparing the shields used was not statistically significant. The article includes several questions designed to alert the clinician to the risks of nipple shield use, particularly when the mother and neonate are still learning to breastfeed.     

Prevalence of Negative Birth Perception,Disaffirmation, Perinatal Trauma Symptoms,and Depression Among Postpartum Women

PURPOSE. This study documented new case and estimated annual case prevalence, and relationships among women's negative birth perceptions, provider disaffirmation, perinatal trauma symptoms, and depression at 6–7 months postpartum. DESIGN AND METHODS. An exploratory investigation of 71 White women (20.8% of the total population) was conducted. CONCLUSIONS. New case prevalence of negative birth perceptions (9.6:100), perinatal trauma symptoms (10.2:100), disaffirmation (8.6:100), and depression (15.7:100) are greater than other prominent high burden diseases. Variables were significantly correlated. PRACTICE IMPLICATIONS. Findings reinforce the need for psychiatric liaison advanced practice nurses caring for childbearing women, including roles for detection/screening, educating professionals in communication, legislative/advocacy for funding, and further research.