Nursing Group Research Paper
Nursing Group Research Paper
Nursing Group Research Paper
Caylin Corns, Jessica Woods, Jasmine Moses, Cody Wohlgemuth, John Massie
04/03/2017
Abstract
This research was to look at why mothers should breastfeed their infants instead of formula
feeding. There are many benefits for the mother and infant from breastfeeding. It all starts with
the correct education and initiation of breastfeeding. This research was gathered from ten
different literature reviews. There was a large amount of evidence with initiation of
of formula feeding. While some common problems with breastfeeding was discovered the
Literature Review
Introduction
To address why a mother should breastfeed information was found via google scholar,
OhioLINK database, and up to date from the hospital. Ten sources were reviewed for education,
initiation, benefits, disadvantages of formula feeding and common problems with breastfeeding.
Education
Breastfeeding education takes place during the prenatal and intrapartum periods of
can take place in an assortment of places, such as: libraries, churches, clinical setting, and
etc.. Ultimately, the CDC wants to fulfill the goals of increasing mothers knowledge and
skills, aide the mothers in viewing breastfeeding as normal, and help acquire positive
By looking at the use of breastfeeding education, many results can come array. The amount of
teaching provided, the group receiving the education, and following through with the teachings
educators made nine follow-up support telephone calls. These phone calls were checking in on
any breastfeeding problems, proposing solutions, pinpointing causes that may have inclined the
mothers verdict to initiate and remain breastfeeding, and recognizing why mothers would opt
out of breastfeeding.
Why Mothers Should Breastfeed 4
According to the study Rasheed (2000), breastfeeding is on the decline and the study
blames: knowledge deficiency, attitude of the nurses, and the practice of breastfeeding.
Shockingly the nurses were given statements with three correct statements of the failure of
lactation and none of the nurses recognized all three statements as correct. Per the study, the
three correct statements were proper latching-on, mother if not willing to breastfeed and if
breastfeeding is initiated late. This was an appalling finding of the study. If the nurses do not
have the correct knowledge about breastfeeding and formula feeding how can the nurse give the
The research showed there were four reasons why the nurses did not preach breastfeeding
to the new mothers. The top reason from both qualified and non-qualified nurses, at 62% and
65% respectively, was the low salary. The other three reasons were no time, lack of knowledge,
and it is the doctors duty to teach the patient about the benefits of breastfeeding. The lack of
education given to the mothers from the nurses led the mother to formula feed. Without knowing
the benefits of the breastfeeding the mothers are shown to choose to formula feed the infant.
Another part of the study was when the nurse should tell the mother to discontinue
breastfeeding. The most common reason the nurses said to continue breastfeeding was when the
mother had a fever. If the mother has a fever, there is an obvious problem and even a possible
infection which could be transferred to the infant if breastfeeding continued. If the child is
constipated almost ever nurse said to withhold the breastfeeding which is correct.
The results from the study led to the hospitals holding classes for both qualified and non-
qualified nurses working on maternity units. Lactation management and the benefits of
breastfeeding have to be discussed to the mother. As nurses one of the most important job is to
Why Mothers Should Breastfeed 5
correctly educate the patient. This demonstrates that proper education and training of the nurses
is essential in order for the patient to receive the best care possible.
Initiation of Breastfeeding
In the United States, the goals for Healthy People 2020 include the initiation of
month-old infants (Schanler, R., Potak D., 2016). The initiation of breastfeeding is an important
part of obtaining the beneficial attachment of baby to mother and yields many other benefits for
baby and for the mother. Breastfeeding is the optimal feeding for infants to six months of age. It
is important to initiate breastfeeding in the first hour of the newborns life where colostrum
provides vital nutrients to the baby. Lactation consultants often come and observe and even
guide the first feeding between mother and baby. Newborns should be fed breast milk unless
there is a medical problem preventing it. Babies should be encouraged to breastfeed by placing
them on the mothers chest, encouraging breastfeeding on command, and maintaining contact
human milk is superior to all other methods of infant feeding, with more beneficial outcomes in
growth, health, development, and several other outcomes in baby. Breastfed infants all have
better immune systems and improved developmental outcomes. Not only is the initiation of
breastfeeding important for baby but it benefits mother as well. It decreases postpartum bleeding
and increases uterine contractions allowing the uterine involution to be more rapid. Menstrual
blood loss decreases and most mothers have an early return to pre-pregnancy weight. Lactating
can decrease the risk of breast cancer, ovarian cancer, and osteoporosis in the postmenopausal
period.
Why Mothers Should Breastfeed 6
In addition to specific health advantages for infants and mothers, economic, family, and
environmental benefits have been described. These benefits include the potential for
decreased annual health care costs of $3.6 billion in the United States; decreased costs for
public health programs such as the Special Supplemental Nutrition Program for Women,
Infants, and Children (WIC); decreased parental employee absenteeism and associated
loss of family income; more time for attention to siblings and other family matters as a
result of decreased infant illness; decreased environmental burden for disposal of formula
cans and bottles; and decreased energy demands for production and transport of artificial
Initiating breastfeeding comes with many parts to it, involving the mechanisms of
breastfeeding such as positioning the infant, latch-on, and transfer of milk. Positioning is
important so that mother and baby are comfortably positioned. Infants should be positioned
toward the mothers body so that the mouth is near the nipple with the neck slightly extended
and the head, hips, and shoulders aligned. Latching on is also an important part of initiating
breastfeeding for baby, the lips must form a tight seal around the nipple to allow efficient milk
removal. It is important to hold the breast in one hand and allow for the infant to grasp the entire
nipple. Schanler (2016) states that an adequate latch-on includes an angle of about 120 degrees,
the lower lip turned outward, the chin and nose close to the breast, and full cheeks.
swallowing is usually a sign of successful milk transfer in most infants. However, the only
reliable way to assess infant intake is by comparing the weight before and after feeding and
keeping track of total infant growth over time. If the infant does not adequately stimulate the
breast, it is difficult to maintain the milk supply. Disorganized sucking may lead to poor infant
Why Mothers Should Breastfeed 7
growth. Signs of disorganized sucking include early release of the breast, spilling of milk from
the mouth during feeding, coughing, or gagging. (Schanler R., Potak D., 2016).
Benefits of Breastfeeding
many benefits that come with breastfeeding rather than formula-feeding. Breastfeeding plays a
huge role in numerous factors of an infants well-being including his or her gastrointestinal
system, host defense, weight, visual function, and psychological development (Schanler 2016).
Components exist in breastmilk that improve the gastrointestinal systems ability to grow and
mobilize contents (Schanler 2016). These components work by stimulating and protecting the
gastrointestinal system (Schanler 2016). Cortisol, growth factors similar to insulin, thyroid
hormone, and insulin are hormones found in breastmilk that stimulate the growth of the
gastrointestinal system and mucosal performance (Schanler 2016). White blood cells play the
biggest role in fighting infections and breastmilk contains white blood cells which then get
passed on to the infant. A huge majority, about ninety percent, of the white blood cells in
breastmilk are neutrophils and macrophages (Schanler 2016). The destruction of infectious cells
through phagocytosis is done with the help from neutrophils and macrophages, which is how
breastmilk contributes to the ability to fight infections in infants. Not only does the presence of
white blood cells help to protect the infant from infections, but the presence of antibodies in
breastmilk does so as well. An example of an infection that newborns are potentially at risk for
developing is gastroenteritis. Gastroenteritis can occur in episodes and symptoms include severe
vomiting and diarrhea that may lead to hospitalization (Schanler 2016). Symptoms of
gastroenteritis can last for forty-eight hours or more (Schanler 2016). If a mother chooses to
Why Mothers Should Breastfeed 8
breastfeed rather than bottle-feed, she can reduce her infants risk for gastroenteritis during the
According to a study performed by the Centers for Disease Control and Prevention,
white children if that child was breastfed during his or her first six to twelve weeks of life versus
never getting breastfed at all (Schanler 2016). Visual function is likely to be better in a breastfed
infant than in a formula-fed infant and this is due to the presence of docosahexaenoic acid in
human milk (Schanler 2016). Docosahexaenoic acid is found in the brain, red blood cell
membranes, and retinas of the eyes which is why the presence of this acid contributes to the
stress reduction found in breastfed infants. Oxytocin and Prolactin are lactation hormones that
cause a positive effect on an infants connection with his or her mother, meaning maternal-infant
bonding becomes stronger (Schanler 2016). This stronger bonding experience between the infant
According to The Risks of Not Breastfeeding for Mothers and Infants by Alison Stuebe,
MD, MSc, breastfeeding plays a huge role in preventing respiratory complications and SIDS in
infants. Based off of a meta-analysis of seven studies of full-term infants with no complications,
Bachrach and associates found that a 3.6-fold increased risk for lower respiratory tract infections,
like pneumonia for example, was found in infants who were formula-fed rather than breastfed
(Stuebe 2009). This study also concluded that infants who were entirely breastfed for greater
than four months did not face this high risk for lower respiratory tract infections (Stuebe 2009).
Studies suggest that if a mother chooses to formula-feed rather than breastfeed, there is a 1.6-2.1-
fold increased risk for SIDS (Stuebe 2009). It is recommended that not only should mothers of
Why Mothers Should Breastfeed 9
infants be encouraged to have their babies sleeping alone, on his or her back, in the crib, but
mothers should also be encouraged to breastfeed rather than formula-feed to decrease the infants
The original use of formula was designed for infants with difficulties in proper breast-feeding
(Palmer, 2003). In regards to the overall health of infants, studies have shown that there are
many disputes with the use of formula mixed with or without breastmilk when compared to
breastfeeding. The first six months of an infants life is very critical in relation to health; there-
fore, many research studies look at disputes during the infants first couple of months of life
(Mohsen, H., Vahid, M., & Hossein-Kargar, J., 2016). Various inquiries have noted that the use
infections, diarrhea, allergies, and other possible diseases (Mohsen, H., Vahid, M., & Hossein-
Kargar, J., 2016). With research, there are numerous explanations for the difference in health of
One of the more obvious explanations was the discovery of human milk including
hormones, growth factors, immunoglobulins, cytokines, enzymes and more. All of these
encompassing components of human milk not only help with infant growth, but passive defenses
as well. Therefore, the composition nutrients added to formula can be beneficial to infants, but
have been found to still not compensate for the natural bene- fits that are found in human milk
Although there are many stances on whether a mother should breastfeed or formula-feed
her child, the mothers own stance could be persuaded based on the health professional. The
health care provider could be lacking in support, providing unsuitable lactation consulting,
Why Mothers Should Breastfeed 10
lacking in knowledge, and/or showing a biased attitude (Chabrol, H., Walburg, V., Teissedre, F.,
Armitage, J., & Santrisse, K., 2004). This scenario could be a reason a mother would decide to
bottle-feed without being aware of the disadvantages, such as the finding that American babies
chance of death doubles when on a formula diet (Palmer, 2003). This scenario could also relate
back to the importance of proper teaching and education because the mother needs to be
Another disadvantage of formula feeding in an infant is the decreases ventilation for the
baby. According to the study Taki (2009), showed that the infant will continue to suck when
milk is being dispensed from the breast or the bottle. With a bottle the milk will continue to be
flow as long as there is formula inside the bottle. With bottle feeding it is important to be giving
the correct amount of formula. The infants were shown to be consuming more than they are
capable to while being bottle fed. With the consistent milk from the bottle it is very important to
Some mothers may be concerned that the newborn will not gain enough weight if she
breasts feeds. There was a very small difference in breastfeeding and bottle feeding. In both
cases the newborn gained a lot of weight at 6 months of age. For newborns that were breastfeed
the average amount weight gained was 7,790 grams while the bottle feed newborns had an
average of 7,986 grams. There is less than a 200-gram difference, but the bottle feed newborn
will not get all the benefits as the breastfeed newborn will.
Majority of the topics that were studied had very similar results. Total feeding time and
total length of resting time in one feeding had similar results. Total rest time for first month
newborns have the largest difference. Breastfeeding had a rest time of 230 seconds while the
bottle-feeding newborns only had an average of 50 seconds. This could lead to an issue with
Why Mothers Should Breastfeed 11
decreased ventilation to the infant. With the large rest time while breastfeeding there is a lower
chance the infant will be hypoxic. Total number of sucks per feeding decreased in the six-month
mark in breast fed infants, because their suck was stronger and got more milk with each suck.
The opposite happened in infants that were bottle fed. As the infant matured the suck became
weaker.
There are a multitude of common problems with breastfeeding seen in both the mother
and the infant. One of the most common reasons for early cessation is inadequate milk intake;
usually due to either insufficient milk production or failure of the infant to extract the milk.
Inadequate milk production can usually be correlated to some type of condition or congenital
defect such as insufficient breast development during pregnancy in which the glandular tissue is
not able to develop because of a previous breast surgery. This is commonly seen with breast
reduction procedures in which the lactation in severely impaired. There is also an endocrine
disorder called prolactinoma. Prolactinoma is a benign tumor in the pituitary gland that produces
woman because it stimulates the breast to produce milk. If stimulation is lacking, then the
production of milk needed to adequately feed the infant will also be lacking. Nipple conditions
such as sore nipples can also impede a proper feeding. Some common medications that can also
Antihistamines (Benadryl) used in high doses (Behbahan, 2008). As mentioned before hormones
come into play with breast-feeding, especially those affecting the pituitary.
After reviewing what conditions the mother can have, it is necessary to examine what
causes the infant to have inadequate milk intake. A common problem, especially in third world
Why Mothers Should Breastfeed 12
countries, is malformations with the infants lip and palate, including cleft lip and/or palate.
Basically, what happens here is the opening in the palate makes it impossible for the baby to seal
off his mouth and make the suction needed to extract milk from the breast. The baby could also
just have some type of sucking or swallowing disorder. Perhaps the infant failed to meet their
developmental milestones. This is most commonly caused by hypoxia at birth, which is basically
lack of oxygen; especially to the brain at birth (Behbahan, 2008). When this occurs, the infant
presents with neuromotor delay. Finally, the infant may simply be premature and not developed
well enough in life to be able to properly breast-feed. To improve and increase milk production
recommended. Some common positions used are the cradle position in which the mother is
sitting. If she is feeding from the left breast, the mothers left forearm support the infants head
and body. She can then use her free hand to guide her breast to the infants mouth.
Another position for a mother to breast feed is the football position. To feed from the
right breast, the infants body and legs are under the mothers right arm and the head is supported
by the mothers right hand. Much like a person would hold a football in their right arm. Again,
the free arm is used to guide the breast to the infants mouth.
An additional common intervention, one that a mother could use with a premature infant
is the use of a breast pump or a manual hand expression; which is basically massaging the breast
from the outer areas of the breast toward the nipple. Both of these techniques increase milk
promote lactation in humans. The most commonly used galactagogues medications are
infants at a dose of 10mg every eight hours, there was no difference in the amount of milk
production between mothers who received metoclopramide compared with mothers who
received placebo (Behbahan, 2008). Plus just like any medication these medications have side
References
Blat, S., Boudry, G., & Huerou-Luron, I. (2010). Breast- v. formula-feeding: impacts on the
digestive tract and immediate and long-term health effects. Retrieved March 31, 2017.
Centers for Disease Control and Prevention. Strategies to Prevent Obesity and Other Chronic
Chabrol, H., Walburg, V., Teissedre, F., Armitage, J., & Santrisse, K. (2004). Influence of
Hojat, M., Mogarab, V., & Jahromi, H. (2016). The study of growth differences of infants less
than 6 months which have used breast milk and infant formula along with breast milk.
JPMA. (n.d.). Decline in Breast Feeding, Who is to be blamed? A Study of Knowledge, Attitude
and Practice of Breast Feeding amongst Nurses. Retrieved February 20, 2017, from
http://www.jpma.org.pk/PdfDownload/2888.pdf
J. S., MD. (2016, October 28). Common problems of breastfeeding and weaning. Retrieved
breastfeeding-and-
weaning?source=search_result&search=common%2Bproblems%2Bof%2Bbreastfeeding
%2Band%2Bweaning&selectedTitle=1~150
N.P. Breastfeeding and the Use of Human Milk. (2005). Pediatrics, 115(2). Retrieved March,
Palmer, L. (2003). The Deadly Influence of Formula in America, Part 1. Part (1), 1-1. Retrieved
Schanler, R. J., MD, & Potak, D. C., RN, BSN, IBCLC. (2016). Initiation of Breastfeeding. 1-5.
https://www.uptodate.com/contents/infant-benefits-of-breastfeeding
Scott, JA and Colin, WB. Breastfeeding: reasons for starting, reasons for stopping and problems
along the way. Breastfeeding Review, Vol. 10, No. 2, 2002 Jul: 13-9. Retrieved February
http://search.informit.com.au/documentSummary;dn=441496288795946;res=IELHEA
Stuebe, A. (2009). The Risks of Not Breastfeeding for Mothers and Infants. Retrieved from
https://www.umanitoba.ca/faculties/health_sciences/medicine/units/obstetrics_gynecolog
y/media/The_risks_of_not_breastfeeding_for_mothers_and_infants.pdf
Taki, M., Mizuno, K., Murase, M., Nishida, Y., Itabashi, K., & Mukai, Y. (2009, October 15).
http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2009.01498.x/full
Why Mothers Should Breastfeed 16