Karin writes:
Let me give an example now from the IBCLE candidate information guide.
Question 5: the definitive symptom of incorrect positioning of a baby at
the breast is A nipple pain B irritated inflamed nipple epithelium C
stabbing pain when the baby latches on D a compression stripe across the
nipple E blanching of the whole nipple after feeding.
Karin,
I think the exam's trying to get at the point that one need not have a
compression stripe, but mom can still be in pain from poor positioning - that
compression stripe can be an indicator of poor positioning, but nipple
pain in the absence of a compression stripe ( nipple elongated a lot, or
compressed but not to an actual stripe) would still indicate a poor alignment.
SO by their thinking it is the pain for the mom, whether or not her skin is
misshapen down to a compression stripe, that would alert about incorrect
positioning. Perhaps one could make a case for compression stripe also being
noted when baby can't handle flow so they clamp down, or can't latch well
due to tongue-tie, then the positioning would not be incorrect, but some
other aspect of the situation. That said, I can figure out WHY they might go
with D but I guarantee I would make a note on the critique sheet about that
one, and might have gotten it wrong myself on the exam. A real problem, as
Phyllis said, is "over-analysis." When actually sitting with a real mom
and baby, the wording of this question means nothing, and we would be able to
help this dyad just fine... ;0
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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