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Concept analysis is an essential tool in nursing. It is useful in the development of new nursing theories and practices that help in improving the health care standards and the quality of the care given. Basically, in concept analysis, a nursing concept is selected. Such a concept must be relative to nursing theory. A further analysis on associated attributes is then done to find out the strengths and weaknesses of concept. In this paper, the concept of effectiveness of breastfeeding will be discussed extensively; especially its importance in meeting the maternal and infants’ needs. This write up will, thus, consider a review of a number of scholarly articles to help it in examining the effectiveness of breast feeding and discussing three defining attributes about the concept. It also gives two models of cases and two other alternative cases as well as the analysis on one antecedent and consequence.
According to Walker & Avant (2010), concept analysis normally is a process that not only identifies various unique attributes associated with the concept but also provides a precise defining of the concept in question. This would ensure that health care professionals construct or develop a new nursing theory, and clinic or research tools in improving the quality of health care. Engaging the concept analysis in nursing would ensure that the existing health care tools are being effectively determined to help understanding whether their characteristics reflect those of the being measured concepts.
As pointed out by Weimers, Svensson & Naver (2006), most midwives and neonatal nurses lack the important knowledge in breastfeeding. The scholars note that based on Orem’s self-care theory, empowering parents, especially women, to act as self-care agents for their new born babies would help them in creating self-knowledge and confidence. This would ensure that there is an acceptable understanding that is manifested on the effectiveness of breastfeeding.
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The purpose of study is to analyze the concept of effectiveness of breast feeding. As pointed out by Mulder (2006), the concept analysis on the effectiveness of breastfeeding has been contributed by the need to not only examine the quality of breast feeding, but also by the definition associated attributes. He notes that the lack of consistency in identifying attributes and defining breastfeeding has made it difficult for comparing breastfeeding studies with the nursing theory. This has resulted into an ambiguous definition on the success of breastfeeding.
According to Mulder (2006), the clinical problems such as an excessive weight loss, dehydration or kernicterus have been contributed by the failure to identify and assess ineffective breastfeeding practices or behaviors. The consequences of these deficiencies can impact negatively on the life of an infant causing the development of complications in hearing due to developed kernicterus symptoms. This would lead to re-hospitalization of the affected mothers and babies.
Various authors have described breastfeeding differently as “the process where the infant receives breast milk” (Mulder, 2006) or “a complex and interactive process which results into mutual satisfaction of maternal and infant needs” (Weimers, Svensson & Naver, 2006). Breastfeeding, thus, tends to be associated with the process of transferring milk from maternal breast to the infant. This displays breast feeding as a dynamic interaction which promotes a symbiotic relationship between the mother and the infant.
Consequently, the concept of effectiveness of breastfeeding has been used by Mulder (2006) in describing an individual’s breastfeeding session, the characteristics associated with it including the duration for which breastfeeding is administered. However, in this paper, the concept of effective breastfeeding has been reviewed to denote it as the interactive process during the individual breastfeeding session. Therefore, effective breastfeeding has been defined as a mutually interactive process between the mother and the infant in a manner that quantifiably allows a direct transfer of breast milk from the mother to the infant.
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The concept of effectiveness of breastfeeding is useful in helping the mother of re-hospitalized babies in addressing paternal conditions which might have arose from their inability to participate in breastfeeding. According to Weimers, Svensson & Naver (2006), this may result from the lack of information on the importance of breastfeeding or due to the incoherency between the present babies’ complication and the initial breastfeeding practices.
On the other hand, the concept of effectiveness of breastfeeding entails the use of variables that are essential for the future theory development in addressing issues related to breastfeeding. As pointed out by Walker & Avant, the failure from the concept analysis to produce useful theoretical based denote the process as inconsequential. Therefore, the analysis on the concept of effectiveness of breastfeeding is not based on only the contextual format, but rather more on the ontological and epistemological foundation.
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Definition Attributes of the Concept of the Effectiveness of Breastfeeding
According to Walker & Avant (2010), defining attributes are the basic characteristics that single out a concept and, thus, help in distinguishing the concept of others which are similar or related to it. Based on the above literature review, the identifiable characteristics associated with the concept of effective breastfeeding include: milk transfer, positioning, maternal state, and latch. To essentially account for the attributes that can ensure the interactive process in effective breast feeding, the paper discusses three defining attributes, which include milk transfer, latch, and positioning.
As pointed out by Moyet (2008), positioning is basically a relative placement of both the mother and the infant in order to enable the process of breastfeeding to be comfortable to both parties. Mulder (2006) notes that by engaging in good positioning, the common problems associated with breastfeeding such as ineffective feeding and sore nipples can be prevented. On the other hand, Mulder (2006) points out that latch normally denotes the placement of lips, a tongue, and gums of the infant relatively to the maternal breast and nipple. A good latch, thus, creates a formidable seal between the mother’s breast and the infant’s mouth which helps in ensuring the adequate sucking of milk from the mother’s breast. Finally, Weimers, Svensson & Naver (2006) describe milk transfer as a process of audible swallowing due to cumulative results associated with breastfeeding such as suckling, positioning, and latching. They note that the adequate milk transfer is based on the existence of an adequate glandular tissue and hormone that can enable the mother to have a good milk production process.
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Model Cases of Effectiveness of Breastfeeding and the Alternative Cases
According to Walker & Avant (2010), identifying model cases that not only define attributes but also provide a borderline case that contains most of the associated attributes related to the concept being studied and which is important for the concept analysis. Mulder (2006) points out that as the mother places her nipple into the mouth of her baby, which is waiting anxiously open; she should ensure that the head of the baby is effectively positioned closely to her breast. This allows the baby to latch to mother’s areola, thus, cupping her breast and nipple with his tongue. This allows the baby to suck in adequate breast milk which is then followed by swallowing.
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However, the borderline case arises from the point where the mother is not able to sufficiently produce enough milk that adequately satisfies the maternal and infant’s needs. Mulder (2006) noted that the inability of mother to produce enough breast milk could be as a result of the historical breast surgery or trauma that suppressed the mammary tissue. This may result into the production of little milk or even no production at all. The affected infants require a supplementary feeding such as an effective bottle-feeding. This is realized through effective positioning and good latching which together enable the baby to suck in and swallow adequate milk.
Walker & Avant (2010) define antecedent as an incident that is prior to the inclusion of the concept but does not define attributes. While various characteristics associated with breastfeeding have been discussed, Mulder (2006) identifies the state of the infant receptive to breastfeeding as the antecedent for effective breastfeeding. She points out that the infant’s state is important. For example, even though those infants in a sleep might feel hungry, they require the stimulation by the mother to transit them into a wakeful state before they can be able to eat.
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On the other hand, Walker & Avant (2010) define a consequence as an event which results from the occurrence of concept. As an outcome of effective breastfeeding, Mulder (2006) notes that infants demonstrate their satisfaction when they release the breast willingly, when they fail to root back when stimulated, and, more significantly, when they feel relaxed. She adds that mothers who effectively breastfeed their babies should feel comfortable and free from pain, which may be inflicted at their nipple or breast due to the baby’s dissatisfaction with the process.
Walker & Avant (2010) define empirical referents as the categories of actual occurrence that denote the existence of the concept itself. In this literature, the empirical referents have been related to various attributes such as positioning, milk transfer, and latch. For positioning, empirical referents included the alignment of the infant’s head, trunk, and mouth in the manner that allows it to face the mother’s breast (Mulder, 2006). This is not only to prevent the traction but also to enhance the process of milk swallowing by the baby. On the other hand, the empirical referent for the milk transfer is based on a visual evidence of swallowing as displayed by the infant. More significant is the observation of milk in the mouth of baby. This allows the mother to observe the rate, at which sucking and swallowing occurs (Mulder, 2006).
In conclusion, effective breastfeeding is an essential component in meeting both the maternal and infant’s needs. There is, thus, the need for the additional research not only to clarify the concept and its value, but rather to offer a precise definition on the attributes associated with effectiveness of breastfeeding. Equally, the laxity to empower women to engage in self-care nursing must also be addressed, since it may inhibit the importance of effective breastfeeding. Moreover, it is imperative for mothers and health care providers to have the understanding of the need to effectively engage the defining attributes in order to apply the same in the alternative cases associated with the concept.
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