BREASTFEEDME

Which of the following would a breastfeeding mother expect during the postpartum period?

Increased postpartum bleeding.

Slow uterine involution.

Difficulty returning to pre-pregnancy weight.

Delayed return of menstruation and fertility.

Which of the following would a breastfeeding mother expect during the postpartum period?

Increased postpartum bleeding.

Slow uterine involution.

Difficulty returning to pre-pregnancy weight.

Delayed return of menstruation and fertility.

Delayed return of menstruation and fertility.

Which of the following gastrointestinal diseases is NOT associated with artificial feeding?

Crohn's disease.

Inflammatory bowel disease.

Celiac disease.

Duodenal ulcers.

Duodenal ulcers.

Which of the following is a non-verbal communication skill that builds confidence in the mother?

Standing over the mother while talking to her.

Sitting in a relaxed manner near the mother.

Frequent checking of time to make sure you are not late for your next appointment.

Touching the mother's breast.

Sitting in a relaxed manner near the mother.

Which of the following is NOT important in a prenatal clinical assessment of a mother intending to breastfeed?

Exploration of the grandmother's breastfeeding experience and beliefs.

Exploration of the mother's beliefs and feelings about breastfeeding.

Physical examination of the breasts for inverted nipples, surgical scars, and unusual shapes.

Complete history of previous pregnancies and breastfeeding experiences.

Exploration of the grandmother's breastfeeding experience and beliefs.

Domestic violence, both sexual abuse and assault, affects a greater percentage of pregnant women than non-pregnant women. What is the increased risk for assault, battery, and rape for a woman who is pregnant?

60%.

20%.

40%.

80%.

60%.

Women who have been sexually abused may experience which of the following during pregnancy?

Exhibitionist behavior during examinations.

Reluctance to seek prenatal and health care.

Lack of concern about the baby.

Euphoria over the upcoming birth of the baby.

Reluctance to seek prenatal and health care.

Collaboration with new mothers and families for best breastfeeding outcomes requires use of the following EXCEPT:

Provision of access to community resources and educational materials.

Assessment of the mother's strengths and weaknesses through open-ended interviewing techniques.

Formulation of a plan and informing the mother that she must follow the plan rigorously.

Formulation of a follow-up plan with the mother that is acceptable and feasible.

Formulation of a plan and informing the mother that she must follow the plan rigorously.

Which of the following is an example of the Ten Steps to Successful Breastfeeding?

Practice rooming in 12 hours a day.

Give all newborn infants only breast milk.

Give no artificial nipples or pacifiers to breastfed infants.

Breastfeed on a schedule.

Give no artificial nipples or pacifiers to breastfed infants.

Economic benefits of breastfeeding include all the following EXCEPT:

Increased costs for special breastfeeding garments.

Reduced health care costs.

Reduced employee absenteeism to care for sick infants.

Reduced expenses for infant formula in the WIC program.

Increased costs for special breastfeeding garments.

Which of the following statements about breastfeeding patterns is TRUE?

Exclusive breastfeeding is required to see any benefits.

Benefits are conferred to the infant in a dose-response relationship.

Complete protection of the infant is conferred by token breastfeeding.

The breastfeeding pattern makes no difference in research studies.

Benefits are conferred to the infant in a dose-response relationship.

Your state legislator has decided that she will sponsor a bill that allows women to breastfeed in public without being afraid that they will be arrested for indecent exposure. This is an example of:

Breastfeeding promotion.

Breastfeeding support.

Breastfeeding protection.

Breastfeeding fundamentalism.

Breastfeeding protection.

Experiences of hospitals who achieve Baby-Friendly status show:

Increased initiation rates and decreased duration rates.

Decreased initiation rates and increased duration rates.

Increased initiation rates and increased duration rates.

Decreased initiation rates and decreased duration rates.

Increased initiation rates and increased duration rates.

The 2020 Healthy People Objective sets which of following rates as targets for breastfeeding?

75.% initiation, 50% breastfeeding at 6 months, and 25% breastfeeding at 1 year.

81.9% initiation, 60.5% breastfeeding at 6 months, 34.1% breastfeeding at 1 year,44.3% exclusive for 3 months and 23.7% exclusive for 6 months.

50% initiation, 40% breastfeeding at 6 months, and 30% breastfeeding at 1 year,100% exclusive for 3 months and 50% exclusive for 6 months

25% initiation, 50% breastfeeding at 6 months, 75% breastfeeding at 1 year,50% exclusive for 3 months and 30% exclusive for 6 months.

81.9% initiation, 60.5% breastfeeding at 6 months, 34.1% breastfeeding at 1 year,44.3% exclusive for 3 months and 23.7% exclusive for 6 months.

Which of the following is NOT a goal of the Innocenti Declaration?

Imaginative legislation relating to breastfeeding women in the workforce.

Enacting and implementing the International Code of Marketing of Breast milk Substitutes.

Establishing a multisectoral national breastfeeding committee to set breastfeeding policy.

Implementing the Baby-Friendly Hospital Initiative in all large city hospitals.

Implementing the Baby-Friendly Hospital Initiative in all large city hospitals.

The purpose of the International Code of Marketing Breast-Milk Substitutes is:

To restrict hospital use of formula.

To address inappropriate marketing practices to mothers and health care providers.

To prevent mothers from undermining their own breastfeeding efforts.

To outlaw the use of infant formula.

To address inappropriate marketing practices to mothers and health care providers.

Which of the following would be a disadvantage of formula use in an emergency situation?

Ease of accessibility

Ease of contamination

Ease of distribution

Ease of preparation

Ease of contamination

Feeding difficulties were NOT associated with which of the following labor and immediate postpartum events?

Vacuum extraction delivery

Aggressive oral and nasal suctioning.

Forceps and vacuum deliveries

Vitamin K shot.

Vitamin K shot.

Which of the following statements about labor analgesia is TRUE?

Use of analgesia during labor had no impact on effectiveness of suckling at 2 hours of age.

Babies whose mothers received epidural anesthesia had significantly more breastfeeding problems.

Babies whose mothers had received epidurals were no more likely to receive supplements in the hospital.

Epidural anesthesia had no impact on the infant's physical state.

Babies whose mothers received epidural anesthesia had significantly more breastfeeding problems.

The use of trained labor support personnel has been shown to have the following effect:

The mother's perception of pain was increased.

The behaviors promoting breastfeeding were decreased.

Mothers were more likely to report breastfeeding problems.

Mothers were more likely to be exclusively breastfeeding on demand at 6 weeks.

Mothers were more likely to be exclusively breastfeeding on demand at 6 weeks.

In hospitals where infant formula is marketed through the distribution of formula samples in discharge bags for breastfeeding mothers, the most likely outcome is:

Mothers were less likely to achieve breastfeeding for 6 months.

Mothers were less likely to continue breastfeeding for a year.

Mothers were less likely to achieve exclusive breastfeeding goals.

Mothers were less likely to breastfeed at all.

Mothers were less likely to achieve exclusive breastfeeding goals.

Frequent milk removal from the breast is important because:

It will prevent overproduction of milk.

It will prevent engorgement.

It will slow down the rate of milk synthesis.

It will make the infant sleepy.

It will prevent engorgement.

After cesarean section birth, skin to skin contact with mother should begin:

Only after the infant tolerates a bottle feeding

After mother is moved out of the recovery room

As soon as mother and infant can comfortably respond

After mother has pumped her breasts

As soon as mother and infant can comfortably respond

Jane Doe has very sore nipples on Day 3. Because breastfeeding is so painful, she is limiting the number of feedings, delaying them during the day and shortening the length of time she feeds at each feeding. Her husband gives the baby a bottle during the night so Jane can recuperate and because the baby does not seem to be adequately fed. How many examples of inadequate sucking stimulation can be found in this case?

1.

4.

6.

8.

4

Which hospital practice falls under the category of "unfair marketing practices"?

Use of pacifiers during gavage feeding.

Distribution of the hospital's own educational materials to all new mothers.

Coupons for diaper services.

Distribution of formula samples in discharge packs to all new mothers.

Distribution of formula samples in discharge packs to all new mothers.

Skin to skin contact is associated with all of the following EXCEPT:

More organized feeding

Enhanced maternal-infant bonding

Delay in latching on to the breast

Analgesic effect during painful procedures

Delay in latching on to the breast

The primary function of prolactin in the new mother is:

Making milk.

Moving milk

Involution of the uterus.

Growth of breast tissue.

Making milk.

Oxytocin release is influenced by all the factors below EXCEPT:

Infant hand massage on the breast.

Conditioned response to the baby's crying

Blood flow to the breast.

Nipple stretching

Blood flow to the breast.

As a young adult, Mary Smith had breast reduction surgery in which the nipple was removed and then replaced in a cosmetically appropriate position during reconstruction. What is the most likely thing that Mary will experience when attempting to breastfeed?

Lack of innervation of the nipple impacting messages sent to the brain to either make milk or release milk.

Reanastomosis of the milk ducts and flow of copious amounts of milk.

Production of adequate amounts of milk but no way to release the milk.

Excess milk production.

Lack of innervation of the nipple impacting messages sent to the brain to either make milk or release milk.

What is a major difference between sucking on a bottle and sucking on the breast?
Bottle teat delivers milk continuously.
Teat of the bottle is often larger.
Breast delivers milk continuously.
Teat of the bottle expands more in the baby's mouth

Bottle teat delivers milk continuously.

which of the following factors is NOT associated with an adequate milk supply?

Mismanagement of feeding routines.

Complete delivery of the placenta.

Frequent suckling.

Adequate removal of milk from the breast.

Mismanagement of feeding routines.

Which of the following is NOT considered an early feeding cue?

Tongue protrusion and mouthing motions.

Sucking on hands, fingers.

Rooting.

Crying.

Crying.

Which of the following is a sign of a possible inadequate milk supply problem?

Weight loss of more than 7% in the first 72 hours of life.

Sleepiness in the infant during the first 48 hours.
No signs of Lactogenesis II by 36 hours postpartum.
Breasts are bluish in color from venous circulatory pattern

Weight loss of more than 7% in the first 72 hours of life.

Mary wants to assess whether her baby's latch is correct. Which of the following hallmarks should she look for in a CORRECT latch?

In-drawing of the cheeks.

Baby's mouth centered on the nipple.

Nipple in the upper half of the baby's mouth.

Baby's lower lip folded in.

Nipple in the upper half of the baby's mouth.

The benefits of rooming in include all of these EXCEPT:

Mothers learn their infant's feeding cues.

Facilitates mother-infant bonding.

Rates of infant abandonment are reduced.

Mothers and infants sleep less frequently and less soundly.

Mothers and infants sleep less frequently and less soundly.

Rooming in should:

Begin immediately after birth.

Be practiced for at least 12 hours per day.
Begin after the baby has been weighed and measured in the nursery.
Be practiced just for breastfeeding mothers.

Begin immediately after birth.

What is baby-led feeding?

Following the baby's cues for feeding.

Letting the baby hold its own bottle.

Feeding the baby at the beginning of the hour every 3 hours.
Not feeding the baby for the first time until it cries.

Following the baby's cues for feeding.

Research indicates that incorrect latch at hospital discharge contributes to many problems. Which of the following breastfeeding problems is NOT related to a poor latch?

Sore nipples.

Engorgement.

Mastitis.

Inverted nipples.

Inverted nipples.

John is not latching on well and has yet to effectively suck. His mother had labor analgesia and John was separated from her at birth for weighing and measuring, Apgar scores and Vitamin K injection. He is 12 hours old. What procedure could be instituted in the hospital that might help John latch on and nurse more effectively?

Continuous skin-to-skin contact between mother and baby.

Rooming in for day-time hours only.

Suck-training.
Scheduling feedings every three hours.

Continuous skin-to-skin contact between mother and baby.

Signs of milk ejection (let down) include which of the following?

Change in the rhythm of the baby's suck/swallow pattern.

Increased urge to urinate in the mother.

Baby falling asleep at the breast.

Maternal weight loss.

Change in the rhythm of the baby's suck/swallow pattern.

One of the consequences of NOT rooming in 24 hours a day in the hospital is:

Mothers lack adequate opportunity to learn feeding cues.

Mothers become overtired and do not sleep as well.
Infants do not get bathed as frequently as necessary.
Infants sleep less because they are upset.

Mothers lack adequate opportunity to learn feeding cues.

Mary has a low milk supply and her baby is not gaining weight adequately. Which of the following would be the BEST FIRST step in correcting Mary's low milk supply?

Have her begin pumping around the clock.

Observe a feeding at the breast to see if there is a mechanical reason for the low milk supply.

Recommend that Mary increase her intake of dietary iron by eating more red meat.

Feed the baby a bottle of formula to make sure that the baby remains hydrated.

Observe a feeding at the breast to see if there is a mechanical reason for the low milk supply.

According to Brazelton, which of the following is not an infant behavioral state?

Active alert.

Deep sleep.

Active sleep.

Active alert.

Deep sleep.

Mothers who think they have a low milk supply are more likely to:

Have made their decision to breastfeed early in pregnancy.

Intended to breastfeed for at least a year.

Use digital scales to verify weight gain before and after feedings.

Lack confidence in their bodies' ability to produce adequate milk.

Lack confidence in their bodies' ability to produce adequate milk.

Increasing a milk supply can be best accomplished by:

Stimulating both breasts simultaneously for an increase in prolactin.

Decreasing pumping during the night.

Decreasing the cumulative 24-hour pumping to less than 100 minutes.

Increasing the amount of fluids the mother consumes.

Stimulating both breasts simultaneously for an increase in prolactin.

Function of Ocytocin

The two main actions of oxytocin in the body are contraction of the womb (uterus) during childbirth and lactation.

Mary has a premature infant in the NICU. She wants to express milk. Which of the following techniques may assist her in extracting milk?

Washing her hands with warm soapy water before beginning.

Sitting in a comfortable chair.

Smelling a blanket or piece of clothing that her baby has used/worn.

Looking at a picture of any baby before she starts pumping.

Smelling a blanket or piece of clothing that her baby has used/worn.

Which of the following pieces of advice is appropriate for the lactation support person to give a nursing mother experiencing a plugged duct?

"Stop nursing on that side so that the plug will reabsorb."

"Wear loose clothing and go braless until the plug resolves."

"Nurse frequently on the affected side to facilitate drainage of the area."

"Increase the intake of dietary calcium intake."

"Nurse frequently on the affected side to facilitate drainage of the area."

Which of the following protocols should the mother of a hospitalized premature or sick infant use to establish an optimal milk supply with a breast pump?

Pump every three hours during daylight hours, 15 minutes per side.

Accomplish five expressions in a 24-hour period for 100 minutes a day.

Imitate what a healthy infant would be doing at the breast, pumping frequently 8-12 times in a 24 hour period.

Pump every four hours around the clock, for 100 minutes total of double pumping.

Imitate what a healthy infant would be doing at the breast, pumping frequently 8-12 times in a 24 hour period.

Advantages of human milk for low birth weight infants include which of the following?

Digestion of fats equivalent to that of fat in formula.

Lower iron content.

Amino acid profile that mirrors that of formula.

Enzymes in human milk that supplement the immature digestive capacity.

Enzymes in human milk that supplement the immature digestive capacity.

Which of the following sources of breast pumps is the LEAST satisfactory?

A manufacturer
A pharmacy.

A rental station.

A garage sale.

garage

Examples of non-evidence based interventions for breast problems in this chapter include:

Use of cabbage leaves to prevent engorgement.

Use of breast shells to correct inverted nipples prenatally.

Use of Vitamin E to heal sore nipples.

All of the above.

All of the above.

Milk may be safely stored in the refrigerator for the healthy term infant for which of the following durations?

1 day.

8 days.

3 days.

2 days.

3 days.

Skin-to-skin care is beneficial for the premature infant because:

It delays hospital interventions that are unnecessary.

It stimulates maturation and development in the infant.

It decreases the infant's need for food.

It decreases the amount of gagging that the infant does.

It stimulates maturation and development in the infant.

The most important element of management of a yeast infection of the breast/nipple is:

Shampooing the family dog.

Treatment of the mother with Nystatin mouthwash.

Simultaneous treatment of both mother and baby.

Treatment of the mother for Raynaud's phenomenon.

Simultaneous treatment of both mother and baby.

Breastfeeding the premature infant has advantages over bottle-feeding. Which of the following can you document as evidence based when a colleague disagrees with you?

More apneic episodes when breastfeeding.

Better oxygen saturation rates.

Heart rates above normal.

Better transfer of milk.

Better oxygen saturation rates.

Which of the following is the most significantly related factor in developing mastitis?

A short lingual frenulum.

Anemia.

Resumption of carpool duties.

Blocked ducts.

Blocked ducts.

For infants born with a cleft lip mothers have found that a useful technique to help the infant maintain a seal at the breast is to:

Hold the breast in the infant's mouth with the thumb covering the cleft.

Use a nipple shield to encourage suckling.

Bottle-feed until repair of the lip has been made and then breastfeed.

Tape the edges of the cleft lip together.

Hold the breast in the infant's mouth with the thumb covering the cleft.

Which of the following symptoms occurs ONLY with an abscess?

Presence of pus.

Maternal fever.

Redness of the breast.

Pain.

Presence of pus.

Which of the following would be an acceptable medical indication for giving formula to a breastfed infant in the hospital?

Mothers who plan to take birth control pills.

Infants with inborn errors of metabolism.

Infants who have not fed in the last three hours.

Infants whose mothers wish to sleep through a feeding.

Infants with inborn errors of metabolism.

According to the American Academy of Pediatrics, all breastfeeding newborns should be seen by a pediatrician or other knowledgeable health care provider at:

3-5 days of age.

3-5 days after hospital discharge.

Within one week of hospital discharge.

2 weeks of age.

3-5 days of age.

Benefits to employers of supporting breastfeeding in the workplace include which of the following?

More health care claims.

Reduced absenteeism.

Greater turnover of workers.

Lower employee loyalty.

Reduced absenteeism.

Recommended Daily Allowance for lactating women is:

500 calories additional to pre-pregnant requirement

700 calories additional to pre-pregnant requirement

800 calories additional to pre-pregnant requirement

1000 calories additional to pre-pregnant requirement

500 calories additional to pre-pregnant requirement

Complementary foods for the exclusively breastfed baby should be rich in which of the following components?

Protein.

Fat.

Selenium.

Calcium.

Protein.

The health care system can help provide support for nursing mothers in the work place by implementing which of the following?

Providing each employee with a personal cooler for storing her expressed milk.

Providing breaks for employees to express their milk.

Providing unpaid maternity leave to their employees.

Providing electrical outlets in women's bathrooms for expressing.

Providing breaks for employees to express their milk.

Which of the following is NOT part of the 4-D process to become a Baby-Friendly Hospital?

Dissemination.

Direction.

Discovery.

Designation.

Direction.

The ONLY infant contraindication to breastfeeding is:

HIV.

PKU.

Polio.

Galactosemia

Galactosemia - cannot metabolize sugar properly

For which of the following maternal diseases is breastfeeding permissible AFTER the mother has been treated?

Hepatitis C.

Tuberculosis.

HIV.

Giardia.

Tuberculosis.

When should the introduction of complementary foods ideally begin?

At 4 months of age.

Around 6 months of age.

By 9 months of age.

1-2 years and beyond as mother and baby wish.

Around 6 months of age.

Mary has been diagnosed with Human T-cell Leukemia Virus Type 1 (HTLV).Which of the following is the recommended method of feeding her baby?

Exclusive formula feeding.

Equal breastfeeding and formula feeding.

Exclusive breastfeeding.

More breastfeeding than formula feeding.

Exclusive formula feeding.

Pacifier use is allowed in the hospital for which of the following reasons according to step 9?

Pain relief during circumcision.

When the baby cries.

As a substitute for a feeding.

To prevent SIDS.

Pain relief during circumcision.

What is the recommended duration of breastfeeding according to health authorities?

12 months.

18 months.

6 months.

No upper limit beyond 12 months.

No upper limit beyond 12 months.

In Step 6 the expectation is that:

Pay retail prices for nipples and bottles.

Negotiate for free formula with the formula companies.

Purchase formula in a competitive manner.

Continue to offer formula company discharge packs which they have paid for.

Purchase formula in a competitive manner.

The Ten Steps to Successful Breastfeeding require which of the following labor and birth practices?

No epidural pain medication.

Uninterrupted skin to skin starting within 5 mins of birth.

Transport to the nursery while the mother is recovering.

Delay of Vitamin K and eye ointment delivery for 24 hours.

Uninterrupted skin to skin starting within 5 mins of birth.

the efficacy for LAM as a contraceptive method is

67%

>98%

<50%

100%

>98%

Lactational Amenorrhea Method