Which three (3) assessment findings indicate that the breastfeeding client has achieved a proper latch?

Choice A rationale A rhythmic sucking pattern indicates effective milk transfer. This involves an initial rapid, shallow suckling to stimulate milk ejection, followed by a slower, deeper, more sustained suck-swallow-breath pattern, which is crucial for efficient milk removal and adequate infant intake. Choice B rationale Audible swallowing confirms that the infant is effectively extracting and ingesting milk. This sound is characterized by a soft 'ka-lunk' or 'thump' sound, indicating successful transfer of milk from the breast into the infant's pharynx and esophagus, thereby signifying a proper and productive latch. Choice C rationale The infant's tongue cupping under the breast with lips flanged is a key anatomical indicator of a deep and effective latch. The flanged lips allow for maximum breast tissue inclusion, and the cupped tongue creates a vacuum, compressing the milk sinuses and facilitating efficient milk expression and transfer. Choice D rationale Smacking or clicking sounds during sucking indicate an improper or shallow latch. These noises suggest that the infant is not maintaining a sufficient vacuum seal on the breast, often due to an inadequate amount of breast tissue in the mouth, leading to air intake rather than efficient milk transfer. Choice E rationale Dimpling of the infant's cheeks while sucking is a sign of an ineffective or shallow latch. This phenomenon occurs when the infant is not adequately compressing the breast tissue and is instead relying on negative pressure from the cheek muscles, which is inefficient for milk extraction and often leads to nipple pain for the mother.