Breast feeding is contraindicated except - - RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Obstetrics & Gynaecology

Medium

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

The question asks to identify the condition among the options that is not a contraindication for breastfeeding.
Breastfeeding is highly recommended for an infant with diarrhea. It is a primary intervention to prevent dehydration, a major risk in diarrheal illness.
Breast milk provides easily digestible nutrients and fluids, which are crucial for a sick infant.
Human milk contains protective substances like secretory IgA and other antibacterial factors that help the infant fight gastrointestinal infections and recover more quickly.

Option A: Chemotherapeutic drugs are cytotoxic and are excreted in breast milk. They can cause severe adverse effects in the infant, including immune suppression, neutropenia, and impaired growth.
Option B: HIV can be transmitted from mother to infant through breast milk. In countries where safe and reliable access to formula is available, breastfeeding by an HIV-positive mother is contraindicated to prevent vertical transmission of the virus.
Option C: Phenylketonuria (PKU) is an inborn error of metabolism where the infant cannot break down the amino acid phenylalanine. Breast milk contains phenylalanine, and its accumulation is toxic to the infant's developing brain. Therefore, exclusive breastfeeding is contraindicated, and the infant requires a special low-phenylalanine formula.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Contraindications to breastfeeding as background academic context rather than a clinical decision trigger.
Nurses play a critical role in educating and supporting mothers about breastfeeding. Knowing the true contraindications versus common myths is essential for providing accurate patient education and ensuring the health of both mother and infant.
Incorrectly advising a mother to stop breastfeeding during a common illness like diarrhea can lead to severe dehydration in the infant, requiring hospitalization. Correct advice promotes faster recovery and prevents complications.
A key nursing responsibility is to identify situations that require consultation with a lactation specialist or physician, such as when a mother is on specific medications or has a condition like HIV.

How to Approach the Question

First, identify the keywords in the question. The key terms are "breastfeeding," "contraindicated," and "except."
The word "except" is crucial. It turns the question around, asking you to find the option that is NOT a contraindication, meaning the situation where breastfeeding is permissible or even recommended.
Evaluate each option to determine if it is a valid reason to stop breastfeeding.
Option A (Chemotherapy): Recall that these are powerful drugs that can harm the baby. This is a contraindication.
Option B (HIV): Recall the risk of mother-to-child transmission. This is a contraindication.
Option C (PKU): Recall this is a metabolic disorder where a component of breast milk is harmful. This is a contraindication.

Concept Tested & Keywords

Concept Tested: Contraindications to breastfeeding
Stem keywords: Breast feeding, contraindicated
Lead-in keywords: except
Negative lead-in flag: Question asks for the exception where breastfeeding is NOT contraindicated.

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 455-457

E6 Obstetrics Williams p. 49-70