Dear friends,
Not every mother with an incorrect positioned baby will get nipple pain. Every LC and every LLLL has seen babies at breast that made their own nipples hurt by proxy with the mom having no pain or discomfort at all. So nipple pain is not ''what everyone gets'' from incorrect positioning. Nipple pain can result from incorrect positioning and from a number of other causes. Every kitten is a cat, but not every cat is a kitten.
There is no one result that every woman will get from incorrect positioning. There are however results that only come from incorrect positioning or rather in-adequate latch and that is a compression stripe on the nipple.
This question is an example of incorrect phrasing leading to incorrect reasoning. Exam questions should be phrased with ultimate precision and be very clear and not open for multiple interpretation. This is even more so for exams that are taken by people from such a diversity in cultures and languages as IBCLCs2B
Warmly,
Gonneke, IBCLC, retired LLLL, MOM -with not a single picture of herself with correctly latched on babies and never a painfull nipple in 12 years of breastfeeding other than 1 round of candida- in southern Netherlands
--- On Sun, 7/26/09, Phyllis Adamson IBCLC <[log in to unmask]> wrote:
From: Phyllis Adamson IBCLC <[log in to unmask]>
Subject: Re: [LACTNET] exam practice questions
To: [log in to unmask]
Date: Sunday, July 26, 2009, 10:15 AM
I'll take a stab at this one by saying I agree with the Board's statement: A Nipple Pain is the correct answer.
You are looking for a "definitive symptom of incorrect positioning".
What is it that "defines" incorrect positioning?
Something that happens to everyone who does that.
Using incorrect positioning, everyone gets:
A. sore nipples
Not everyone who uses incorrect positioning gets:
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
Many do, but "not everyone", so none of these others would be considered "definitive" of incorrect positioning.
Just my own reasoning, and I've taken the exam twice.
Take each question exactly and only as written.
Don't add anything that isn't there. (over-analysis)
Don't ignore a word that is there. (read carefully - you have the time)
Phyllis
--
Phyllis Adamson, IBCLC, RLC
Glendale, AZ.
[log in to unmask]
---- Karin de Graaf <[log in to unmask]> wrote:
=============
First of all thanks everybody for giving encouragement and sharing
experiences. Thanks everybody for your concern and your friendly words.
Still, I do want to come back to my original topic, which is that in my mind
some questions are not correct or erratic.
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.
In my thought option A is not specific for positioning, because there are
many more causes for nipple pain then positioning. B can be candida,
allergy, so not the answer. C can be related to candida or other conditions,
so not the answer. D is in my mind definitely a sign of incorrect
positioning. E is vasospasm which can also be a complication of other
painful conditions of the nipple like candida. In my opinion the right
answer should be D. If this question was put to me on the exam I wouldn't
write a comment on this question because I find it a clear question, en
answer D is in my mind a clear answer. But I got it wrong according to the
IBCLE, because the correct answer is A.
I want to know if my line of thinking is incorrect. Please let me know your
opinion on this matter.
(PS: I'm not at all worried or nervous. I just have a professional interest
in comparing my way of thinking with colleagues. J J )
Greetings,
Karin de Graaf IBCLC
Private practice
The Netherlands
<http://www.borstvoedinghulp.nl> www.borstvoedinghulp.nl
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