Which of the following is NOT the correct sign of good attachment during breastfeeding?

Appeared in: UPUMS Nsg officer-2023

Explanation

The baby's lower lip being curled inwards is a sign of a shallow or poor latch, not a good one.
For effective milk transfer and to prevent maternal nipple pain, the baby's lower lip should be flanged or everted (turned outwards).
An inward-curled lip prevents the baby from taking enough areola into their mouth, leading to 'nipple feeding' instead of 'breast feeding,' which is inefficient and painful.

Option A: This is a sign of a good, deep, asymmetrical latch. It indicates the baby has taken more of the lower part of the areola into their mouth, which is the correct technique.
Option B: A wide-open mouth is a fundamental requirement for a good latch, allowing the baby to draw a large amount of breast tissue into their mouth for effective suckling.
Option D: The baby's chin touching the breast is a sign of a close, stable latch. This position helps the baby's tongue massage the milk sinuses effectively and keeps the nose clear for breathing.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment of Breastfeeding Attachment as background academic context rather than a clinical decision trigger.
Nurses must be able to quickly and accurately assess breastfeeding attachment to prevent complications like maternal nipple trauma, breast engorgement, mastitis, and inadequate infant nutrition.
Teaching and reinforcing the signs of good attachment with new mothers is a primary nursing intervention to promote breastfeeding success, infant health, and maternal confidence.
What if? If a mother reports severe nipple pain but the latch appears correct on the surface, the nurse should investigate further for issues like a posterior tongue-tie (ankyloglossia) or an overly strong suck, which can cause pain despite seemingly good positioning.

How to Approach the Question

This is a negative-framed question, asking you to identify the option that is NOT a sign of good attachment.
First, recall the key indicators of a successful breastfeeding latch. Think about the four main points: Mouth wide open, lower lip flanged out, chin touching breast, and more areola visible above the lip.
Evaluate each option against these criteria for a 'good' latch.
Option A, 'More areola visible above,' is a known sign of a good asymmetrical latch.
Option B, 'Mouth wide open,' is a fundamental requirement for a deep latch.
Option D, 'Chin touching the breast,' confirms close positioning.

Concept Tested & Keywords

Concept Tested: Assessment of Breastfeeding Attachment
Stem keywords: breastfeeding, good attachment, sign
Lead-in keywords: NOT
Negative lead-in flag: Question asks to identify the incorrect statement (the sign that is NOT indicative of good attachment).

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 143-145

E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) p. 102-104

Practise the full UPUMS Nsg officer-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.