A nurse at a clinic is preparing the immunizations for a 6-month-old baby. The mother says, “My baby is afraid of strangers and afraid of separating from me. My mother-in-law is upset and thinks I am

causing it.” Which response by the nurse is most appropriate?

Secure parent-infant attachmentinfluences feeding patterns and the infant’s emotional readiness to eat, both of which affect nutritional intake and growth. A strong attachment relationship ensures responsive feeding, reduces stress during meals, and supports healthy development.

Rationale for correct answers:

A.Physical closeness such as skin-to-skin, rocking, and gentle touchfosters emotional bonding and signals a secure attachment.

B.Cuddlingis a sign of nurturing and emotional connection. This physical closeness helps the infant feel safe, calm, and secure, which is key in attachment.

C.Observing how the parent soothes a crying or distressed baby reflects sensitivity and responsiveness, which are fundamental components of healthy attachment.

D.A parent who appears relaxed and confidentduring interactions is likely forming a positive attachment. Tension or avoidance may suggest bonding difficulties.

Rationale for incorrect answer:

E.Crying alone isnot a direct indicatorof attachment quality. All infants cry as a form of communication. What’s more important is how the caregiver respondsto the crying such as comforting, picking up, and soothing.

Take home points

• Healthy attachment behaviors include responsive touch, holding, eye contact, and soothing efforts.
• Nurses should assess not just the infant’s behavior, but also the parent’s sensitivity, consistency, and emotional presence.
• Strong attachment supports optimal nutrition, immune development, and emotional resilience.
• Early identification of bonding concerns allows for timely intervention and support, promoting better long-term outcomes for both infant and caregiver.

Developmental milestonesare age-specific tasks and behaviors most children can do within a certain age range. They guide parents and healthcare professionals in monitoring a child's development and identifyingpotential developmental delays. The milestones are categorized into different areas, such as motor skills, sensory development, language, and social skills.

Rationale for correct answer:

C. The infant turning and looking for the mother when she walks out of his viewdemonstrates object permanence, the understanding that people and objects continue to exist even when out of sight. This milestone typically begins to emerge around 6 to 8 months of ageand is a key component of cognitive development during the sensorimotor stageas described by Piaget.

Rationale for incorrect answers:

A. The infant smiling at the mother when she talks to himreflects social developmentand bonding, not object permanence. It shows recognition and responsiveness, usually emerging around 6 weeks of age.

B. The infant repeatedly flexing and extending his arms and legs when the mother picks him upindicates excitement or physical reactionto familiar handling, not a cognitive understanding of presence or absence.

D. The infant crying when the mother hands him to a babysitteris a sign of separation anxiety, which also develops around 6 to 9 months but is emotionally driven, not a direct measure of object permanence.

Take home points

• Object permanence is the ability to understand that people and things exist even when unseen.
• This milestone is typically observed when an infant looks for or searches for a hidden person or object.
• It is a key developmental step that reflects cognitive growth in the first year.
• Supportive communication helps parents recognize and value such milestones, fostering a sense of progress and connection.