A nurse is teaching a new mother about the signs of effective breastfeeding of her newborn. Which of the following information should the nurse include in the teaching?

Choice A rationale: While adequate rest and sleep are essential postpartum, the client's symptoms of feeling down and sad may be indicative of postpartum depression and should be further evaluated.
Choice B rationale: Counseling may be helpful, but the priority is to first assess and screen for postpartum depression before making additional recommendations.
Choice C rationale: While antidepressant medications might be necessary for postpartum depression, the initial step should be to assess and screen for depression using the appropriate tool.
Choice D rationale: The client's statement and symptoms raise concerns about possible postpartum depression. Using a postpartum depression screening tool will help the nurse assess the severity of the client's symptoms and determine the appropriate course of action.

The correct answer is Choice B, the nipple line.

Choice A rationale: The axillae, or underarms, are not used to measure chest circumference in a newborn. This area does not provide an accurate or consistent measurement of chest size due to the positioning and movement of the baby’s arms.

Choice B rationale: The nipple line is the correct anatomical landmark to use when measuring chest circumference in a newborn. This line is typically used because it provides a consistent and accurate measurement. It is located at the level of the nipples, which is approximately at the mid-chest level. This location allows for a measurement that is representative of the chest size, as it is at the broadest part of the chest.

Choice C rationale: The lower ribcage border is not the correct landmark for measuring chest circumference in a newborn. This area is too low and would not provide an accurate representation of the chest size. The measurement taken at this location would be smaller than the actual chest size, as it is below the broadest part of the chest.

Choice D rationale: The sternal notch is not an appropriate landmark for measuring chest circumference in a newborn. The sternal notch is located at the top of the sternum, near the base of the neck. A measurement taken at this location would not accurately represent the size of the chest, as it is above the broadest part of the chest.