"Ineffective breastfeeding (00104)" and "Readiness for enhanced breastfeeding (00106)": Clinical validation

To clinically validate the NANDA International (NANDA-I), nursing diagnoses (ND) of "Ineffective breastfeeding (00104)" and "Readiness for enhanced breastfeeding (00106)" in postpartum women and their infants, and to determine the sensitivity, specificity, and predictive value of their elements.

Cross-sectional study was conducted from June 2023 to April 2024. Recruitment happened at a public teaching hospital, approaching dyads from the neonatology outpatient clinic and the rooming-in. The researcher applied the tool, assessed the dyad and medical records. Statistical analysis was based on accuracy measures and inferential statistics. The study was approved by the Ethics Committee.

The sample comprised 205 Brazilian dyads: 57 (27.80%) presented "Ineffective breastfeeding (00104)," whereas 203 (99.02%) presented the "Readiness for enhanced breastfeeding (00106)." "Unsustained sucking on the breast" was the most sensitive defining characteristic (DC) for the "Ineffective breastfeeding (00104)." All the DCs of "Readiness for enhanced breastfeeding (00106)" showed relevant sensitivity.

Findings validated the presence of NANDA-I ND "Ineffective breastfeeding (00104)" and "Readiness for enhanced breastfeeding (00106)" in a sample of dyads, demonstrating accuracy in such population.

This is an essential step to raise the level of evidence of the studied ND from NANDA-I terminology. Furthermore, this study has potential to contribute to improving nurse's clinical reasoning on breastfeeding, as well as to highlight that women can present simultaneously the two diagnoses, so naming them is useful to identify mothers more likely to breastfeed and those who will need more differentiated interventions.