Which of the following signs are good attachment of the breast feeding, except?

NORCET 3 - 2022 (Shift-1)

Obstetrics & Gynaecology

Medium

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

This option describes a sign of a poor or shallow latch.
For a correct and deep latch, the baby's lower lip must be turned outward (everted or flanged), not inward.
An inward-turned lip means the baby is likely sucking only on the nipple, which leads to ineffective milk transfer and can cause significant nipple pain and trauma for the mother.
All other options listed are signs of a good, effective breastfeeding attachment.

Option A: This is a sign of good attachment. The baby's chin pressing into the breast helps to stabilize the latch and ensures the nose is clear for breathing.
Option B: This is a classic sign of a good latch. A wide-open mouth allows the baby to take in a large amount of breast tissue (the areola), not just the nipple, which is essential for effective milk extraction.
Option D: This indicates a deep, asymmetrical latch, which is a sign of good attachment. More of the areola should be covered by the baby's bottom lip than the top lip.

Visual 1: Diagram - A side-by-side comparison showing the anatomy of a good (deep) latch versus a poor (shallow) latch. The good latch diagram would show the baby's mouth wide open, lips flanged out, and tongue over the lower gum, covering a large part of the areola. The poor latch diagram would show the mouth less open, lips tucked in, and the nipple being pinched.
Visual 2: Infographic - A checklist of the '4 Signs of a Good Latch' with simple icons: 1) Wide Mouth, 2) Chin Touching Breast, 3) Lips Flanged Out, 4) More Areola Seen Above.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment of effective breastfeeding attachment as background academic context rather than a clinical decision trigger.
Correctly identifying a poor latch is a critical nursing skill to prevent complications for both mother and infant.
A poor latch can lead to maternal nipple pain, cracking, bleeding, and infections like mastitis. For the infant, it can result in poor milk transfer, inadequate weight gain, and dehydration.
Nursing intervention for a poor latch involves teaching the mother to break the suction gently by inserting a finger into the corner of the baby's mouth, and then repositioning and re-latching the baby correctly.

How to Approach the Question

This is a negative-framed question, identified by the keyword 'except'.
First, recall or identify the established criteria for the main concept, which is 'good breastfeeding attachment'.
The key signs of a good latch include: mouth wide open, chin touching the breast, lower lip turned outward, and more areola visible above the mouth than below.
Evaluate each option against these criteria.
Option A, B, and D are all positive signs of a good latch.
Option C, 'The lower lip is turned inward,' directly contradicts the criterion that the lip should be turned outward.

Concept Tested & Keywords

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