Consider the topic you have selected to complete your evidence-based practice project. While we are not conducting research here, per se, we are considering implementing a new practice - and with any

PICOT Question

Population: Newborn babies

During the first year of the infan’ts life, the most noticeable point is physical growth. The infant’s weight should be double in first six months, and tripled in a year. During the time of growth, not only does the weight and height increases but as well the head and the chest that causes development of the heart, brain, lung and several organs used for survival (Goyal, Attanasio, & Kozhimannil, 2014). infants grow and develop at a very rapid rate during the first year of life. They grow physically, mentally, emotionally, and socially. Development is the body’s increased skill in using various body parts. Newborns rely on proper food that helps them nourish, grow and develop (Goyal, Attanasio, & Kozhimannil, 2014).

Intervention: Breastfeeding

The process of breastfeeding does more than provide important nutrition and other things to support infants’ growth and development; it also benefits mother’ health and offers an important opportunity for the pair to bond. Although breastfeeding is the gold standard, not all women breastfeed their infants. An estimate of 136.7 million babies were born worldwide each year, only 32.6% are breastfed exclusively for the first 6 months (Khan, Vesel, Bahl, & Martines, 2015). There are many research that includes efforts to understand nutritional components of breast milk, as well as its bioactive components that have an effect on cells and tissues and also how these components contribute to development and protect against disease. Breastmilk promotes sensory and cognitive development, and protects the infants against infectious and chronic diseases. It also reduces the risk of asthma and allergies (Wyness, 2014).

Comparison: Not breastfeeding

Making the decision to breastfeed is a personal matter. Some mothers make the choice not to breastfeed, but others might be unable to breastfeed because of medical condition such as HIV, or other reasons, such as problem producing milk (Khan, Vesel, Bahl, & Martines, 2015). The NICHD supports many studies on the impact of breastfeeding and breast milk on infant health. There are other options if the mother can’t breastfeed, but the benefits of breastfeeding outweighs the other options, such as formula.

Outcome: Growth and development of the baby

Studies in developing countries demonstrate that continued, frequent breastfeeding in the first six months of baby’s life is associated with greater linear growth and further protects child’s health. Breastmilk contains all the nutrients and infant needs in the first six month of life. breastfeeding protects against common childhood illnesses such as pneumonia, and may also have longer-term health benefits for the child, such as reducing the risk or overweight and obesity in childhood and adolescence.

Time: First 6 months of baby’s life.

The World Health Organization recommends that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or beyond.

Conclusion:

In newborn babies, does a breastfeeding versus to not breastfeeding affect the growth and the development of the body in the first 6 months of baby’s life?

Breast milk provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat, which are everything a baby needs to grow (Goyal, Attanasio, & Kozhimannil, 2014). More importatntly, breastmilk contains antibodies that help your baby fight off viruses and bacteria (Khan, Vesel, Bahl, & Martines, 2015). Babies who are breastfed exclusively for the first six months, without any formula, have fewer ear infections, respiratory illnesses, and fewer hospitalizations or trips to the doctor (Wyness, 2014).

Principle of Respect

Respect for person is based on two ethical convictions. The first conviction is that individuals should be treated as autonomous, which is the ability to make decisions for themselves. The second conviction related to the ethical principle of respect for persons is the recognition that persons with diminished automy are entitled to protection (Schmidt & Brown, 2019). Individuals with diminished autonomy are vulnerable people, such as, children, individual with mental disabilities, and prisoners. Nurses are obligated to show respect for the autonomy of others. Every parents in study respected with the decisions they make, and treat the patients regardless of whether they decide to participate in the study or not. Regardless of person’s character, healthcare professionals are obligated to respect every individual they care for. Respecting individual’s decision also include, getting individual’s informed consent to be do the research. Informed consent is primarily a legal and ethical concept. Subjects or patients have right to refuse to breast feed their baby, as well as right to refuse to be part of this research.

Assurance of Autonomy

Autonomy of a patient is a fundamental, yet challenging, principle of professional medical ethics. The idea that individual patients should have the freedom to make choices about their lives, including medical matters, has become increasingly prominent in currect literature (Schmidt & Brown, 2019). However, this has not always been the case, especially in the past or the history of our medical field. When conducting research, it is crucial to maintain every single subject’s autonomy. As a researcher, obligation to respect individual’s decisions should be in place regardless of how important the study is. Knowing how to respect the various facets of subject’s autonomy should be part of researcher’s professional duties, and also be reflected in his or her core research and study competencies. Selecting the subjects for the study, researchers have options to pick the subjects that are perfectly fit for the study without taking subject’s autonomy. For the persons with diminished autony, such as someone with altered mental status, the researcher is still obligated to let the subject know of the study, getting consent from proper source, and even letting the subjects know of what, why and how of the study.

Beneficence

Beneficence is the principle of doing good. Two rules of beneficence have been formulated, and they are to do no harm and to maximize possible benefits and minimize possible harm. While participating in research, individuals may face risk of harm because in order to learn what is harmful and what is helpful, subjects may risk being harmed (Schmidt & Brown, 2019). For this reason, researchers are obligated to identify and reduce any possible risk as much as possible. In addition, the risks must be justified in light of the possible benefits that may result from the research. For this study, it is important to identify if there are any harm that can happen if the babies are not breastfed versus bottle fed. If there are risks, the writer is obligated and mandated to let the subjects know of these risks. The principle of beneficence has not been upheld in many studies that has been performed many years ago. This project focuses more on benefits than harm on the baby, because regardless of whether the baby is breast fed or bottle fed, baby is still being fed and the study mainly focuses on further benefits of breastfeeding. The study result may motivate parents to follow the steps that has more benefits for their babies. The risk in this study is to identifying that bottle fed babies are more likely to have more health issues in the future, however; the parents will choose to either breastfeed or bottlefeed their babies themselves. This study will devide the parents and the babies into two groups which will be breastfeeding and bottlefeeding babies, and they will have follow up in the future to which one has more benefits.

Justice

The principle of justice is all about fairness and equity (Schmidt & Brown, 2019). In other words, treating everyone equal and with fairness in the distribution of burdens and benefits. Individuals ought to be treated equally regardless of their background, skin color, ethnic, race, religion, economic or social status, or education. Nurses and other healthcare providers are obligated to ensure that some groups of subjects, such as ethnic minorities or institutionalized individuals, are not selected for studies because they are easily available or in compromised positions. Individuals also cannot be denied treatment because they decline to participate in research. Subjects cannot receive less than the standard of care. additionally, outcomes of publicly funded research need to be reported. Unfair treatment of individuals has been a problem in the past studies. In this study, it can be tricky because physiologically, only women can breastfeed, however, there are many single dads who choose to feed their babies donated breastmilk. This study can be justified by simply stating that the ‘breast milk fed babies’ because breast milk can be donated by another female or mom. Every subject will be given equal chances in this study, and the subjects will be selected based on first come first served basis. Every client in this study will be treated fairly and equally except for the fact that there will be two different groups which will perform different tasks. Everyone will have the opportunity to benefit from the research findings when applicable. The study will also motivate future parents to make the choices that more beneficial to their babies or they will still have the right to do otherwise as well.

References

Goyal, N. K., Attanasio, L. B., & Kozhimannil, K. B. (2014). Hospital care and early breastfeeding outcomes among late preterm, early-term, and term infants. Birth: Issues in Perinatal Care, 41(4), 330-338. http://dx.doi.org:10.1111/birt.12135

Khan, J., Vesel, L., Bahl, R., & Martines, J. (2015). Timing of breastfeeding initiation and exclusivity of breastfeeding during the first six months of life: Effects on neonatal mortality and morbidity-A systematic review and meta-analysis. Maternal & Child Health Journal, 19(3), 468-479. http://dx.doi.org:10.1007/s10995-014-1526-8

Schmidt, N., Brown, J. M. (2019). Evidence-Based Practice for Nurses, 4th Edition. [Bookshelf Ambassadored]. Retrieved from https://vitalsource.com

Wyness, L. (2014). Nutrition in early life and the risk of asthma and allergic disease. British Journal of Community Nursing, S28-32. Retrieved from http://www.aanp.org/publications/jaanp

Appendix A

National Institutes of Health Protecting Human Research Participants Certificate