Deck 7: Nutrition During Lactation: Conditions and Interventions

Question 1

Medications contraindicated during breastfeeding include all of the following EXCEPT:

A)antineoplastic agents.
B)radioactive isotopes.
C)antihistamines.
D)drugs of abuse.
E)drugs that suppress lactation.

Answer 1

C

Question 2

A breastfeeding mother asks you if alcohol can be eliminated from her breast milk by pumping immediately after drinking a few glasses of wine.What would you tell her?

A)Yes;in fact,discarding your breast milk is a good thing to do if you would like to drink while breastfeeding.
B)Yes;pumping will help,but you need to pump for the next 24 hours and discard any milk that you collect.
C)No;your breast milk will still contain alcohol;you will need to wait 1 hour per alcoholic beverage and then pump the milk and discard it to be safe.
D)No;the alcohol will still be in the breast milk and will clear from the milk as soon as it clears from the blood stream: roughly 2 to 3 hours per drink for a 120-pound woman.
E)None of the above will help eliminate alcohol from breast milk.

Answer 2

D

Question 3

Which drugs CANNOT be taken when breastfeeding?

A)Most oral contraceptives
B)Acetaminophen
C)Radioisotope drugs
D)Cold decongestants

Answer 3

C

Question 4

Which of the following would NOT be considered a simple step to manage nipple pain?

A)Air-drying breasts after nursing
B)Rubbing expressed milk or an all-purpose ointment on nipples
C)Using Vaseline to protect nipples
D)Using warm compresses

Question 5

If a 110-lb nursing woman (50 kg)wants to drink alcohol,how many cans of beer (15 g alcohol/12 oz)can this woman drink and stay within the Institute of Medicine's alcohol recommendations?

A)0
B)1
C)2
D)3

Question 6

It will take approximately _____ hour(s)to eliminate the alcohol in one glass of wine from a 120-pound nursing woman.

A)<1
B)2 to 3
C)4 to 5
D)6 to 7
E)12 or more

Question 7

When is the safest time for a nursing mom to take a drug?

A)In the morning
B)After eating a meal
C)After the infant nurses
D)Any time is safe to take a drug.
E)It is never safe for a nursing mom to take drugs.

Question 8

Which of the following herbs is considered "safe" to use during lactation?

A)Echinacea
B)St.John's wort
C)Fenugreek
D)Feverfew
E)Foxglove

Question 9

The recommendation for use of herbal teas in nursing women is:

A)choose teas using herbs for essence.
B)choose natural teas.
C)choose synthetic teas.
D)choose teas that have traditional uses dating back thousands of years.
E)choose whatever tea is preferred;all tea is safe.

Question 10

Which of the following foods has been shown to cause colicky babies?

A)Red peppers
B)Chocolate
C)Garlic
D)Tomatoes

Question 11

Which of the following would NOT be considered a common condition that is experienced by a woman who is breastfeeding?

A)Sore nipples
B)Engorgement
C)Mastitis
D)Plugged ducts
E)All of the above are common problems.

Question 12

Which of the following would NOT be a symptom of an infant suffering from an excess of caffeine?

A)Colic
B)Hyperactivity
C)Wakefulness
D)Diarrhea
E)Fussiness

Question 13

Hyperbilirubinemia in newborns is caused by _____.

A)destruction of red blood cells
B)high blood lipid levels
C)high maternal intake of vitamin A
D)labor lasting over 12 hours

Question 14

The most important step to prevent sore nipples is to _____.

A)take a prophylactic dose of antibiotics
B)make sure the baby is positioned properly
C)place cabbage leaves on your breasts before nursing
D)place herbal salve on the nipple area
E)nurse frequently

Question 15

The best way to prevent/cure a plugged duct is to:

A)use a needle to unblock the duct.
B)completely empty the breast.
C)stop nursing and use a breast pump exclusively.
D)take extra vitamin D.
E)have a glass of red wine daily.

Question 16

All of the following are recommended treatments for plugged ducts EXCEPT _____.

A)stop breastfeeding until you see a health care provider
B)gently massage the affected breast
C)apply warm compresses
D)change nursing positions
E)take one tablespoon per day of lecithin

Question 17

A mom with a newborn called a nurse practitioner to report that one of her breasts was painful,enlarged,and had a red area.In order to distinguish between two common conditions,what additional information would the practitioner want?

A)Time of onset
B)Where is the pain?
C)Do you have a fever?
D)Any flu-like symptoms?
E)All of the above

Question 18

Approximately _____ of term infants will become visibly jaundiced with their serum bilirubin levels exceeding 5 to 7 mg/dL.

A)20%
B)30%
C)40%
D)50%
E)60%

Question 19

If a breastfeeding mother needs to use a specific medication,what should you tell her?

A)If the hazards are minimal,use the medication after nursing.
B)Try an oral inhalant vs.an oral medication.
C)Take the lowest effective dose of the medication for the shortest duration.
D)All of the above

Question 20

For a woman experiencing let-down failure,good advice would include all of the following EXCEPT:

A)getting out of the house for a walk.
B)changing nursing positions.
C)playing soothing music.
D)increasing water consumption and decreasing caffeine.
E)All of the above are recommended techniques.

Question 21

The scarcity of human milk banks in North America results from all of the following EXCEPT:

A)the availability of wet nurses.
B)a resurgence of tuberculosis.
C)HIV.
D)risks related to donors who might use drugs.

Question 22

Which of the following is considered a benefit of breastfeeding a preterm infant?

A)Ease of protein digestion
B)Ease of fat absorption
C)Improved lactose digestion
D)Better visual acuity
E)All of the above

Question 23

Breast milk jaundice is believed to be caused by _____.

A)variability in the infant's ability to process bilirubin
B)a component in the mother's milk increasing bilirubin absorption
C)infrequent breastfeeding
D)All of the above

Question 24

Your best friend had a baby 3 months ago and is anxious to go "out on the town" with her friends.She is still breastfeeding,but would like to be able to have some drinks.What advice would you give her?

A)It is okay to drink while nursing because it actually helps babies sleep.
B)It is okay to drink while nursing because it increases breast milk production.
C)Pump your milk immediately after drinking and it will be eliminated from your body.
D)Pump milk before going out and use that until the alcohol has been cleared from your system.
E)Drink only beer because babies tolerate it.

Question 25

Which of the following would be considered a minor risk factor for severe hyperbilirubinemia?

A)Maternal age <25 years
B)Normal-weight infant of diabetic mother
C)Gestational age >41 weeks
D)Formula feeding an infant
E)Male gender

Question 26

Milk banks store donated milk in plastic containers because it _____.

A)expedites shipping
B)is less costly than glass
C)keeps white blood cells found in breast milk intact
D)is easier to express milk into plastic containers

Question 27

The purpose of a human milk bank is to:

A)provide a place to donate milk for women whose supply exceeds the demands of their infants.
B)provide human milk to infants who cannot be breastfed by their mothers.
C)allow women to "keep their figure" by using a pump instead of allowing the child to nurse.
D)All of the above
E)a and b only

Question 28

A lactation consultant is observing a new mom breastfeeding and notices that the baby is making smacking and clicking sounds as she sucks.This tells her that:

A)the baby is eating well and has a strong suckle.
B)the baby has a cleft palate and should be closely followed.
C)the baby is not latched on correctly and this may increase the risk of sore nipples.
D)this is just a noisy baby.
E)Noise is not an indicator of anything.

Question 29

The energy content of breast milk in women who deliver pre-term infants is _____.

A)30-37 kcal/100 mL
B)40-48 kcal/100 mL
C)58-70 kcal/100 mL
D)72-120 kcal/100 mL

Question 30

Once growth is established in preterm infants,the infants' nutritional needs exceed the content of human milk for which of the following nutrients?

A)Phosphorus
B)Calcium
C)Vitamin D
D)Vitamin C
E)All of the above

Question 31

What nutrition interventions are recommended for management of early jaundice?

A)Early and frequent breastfeeding
B)IV water feedings
C)Increased formula feedings
D)Dextrose feedings as a supplement to nursing

Question 32

A new mother goes to the mall shopping with her friends.She is gone longer than planned and is not able to nurse her baby until she returns 6 hours later.What is the most likely problem she will have?

A)A breast infection
B)Engorgement
C)Plugged ducts
D)Sore nipples
E)Mastitis

Question 33

What is a possible reason that breastfeeding may prevent allergies?

A)Influence on gut microbial flora
B)Transfer of maternal immunity
C)Transfer of maternal fatty acids and IGA in breast milk
D)Low content of allergens
E)All of the above

Question 34

Common pediatric allergens include all of the following EXCEPT:

A)cow's milk.
B)eggs.
C)peanuts.
D)soybeans
E)oats.

Question 35

What advice would be helpful for a first-time mom who would like to know how to prevent a decrease in milk production?

A)Relax and avoid stress.
B)Breastfeed or pump frequently.
C)Completely empty your breasts at each feeding,either by nursing or pumping.
D)All of the above
E)a and c only

Question 36

The total bilirubin content of an infant's meconium is _____.

A)<200 mg
B)375 mg
C)400 mg
D)450 mg

Question 37

If nursing mothers want to store expressed milk in a refrigerator,what should the temperature setting be?

A)<50 degrees F
B)<39 degrees F
C)>40 degrees F
D)78 degrees F

Question 38

Factors contributing to the rate of transmission of HIV from the mother to an infant while breastfeeding include all of the following EXCEPT:

A)strain of HIV.
B)immune status of mother.
C)viral load.
D)maternal illness.
E)All of the above are factors.

Question 39

How many hours can freshly expressed breast milk be left at room temperature and still be considered safe for a baby?

A)1-3 hr @ 78°F
B)2-4 hr @ 78°F
C)3-5 hr @ 78°F
D)4-6 hr @ 78°F
E)6-8 hr @ 78°F

Question 40

Large doses of St.John's wort decrease prolactin levels in women.This could potentially:

A)reduce oxytocin levels.
B)cause breast milk to taste like maple syrup.
C)cause a woman to become constipated.
D)reduce breast milk supply.
E)cause depression in some women.

Question 41

Physicians typically are well trained to counsel women on breastfeeding.

Question 42

You are at a nice restaurant and would like to order seafood for dinner;however,you are breastfeeding.Which of the following would have the lowest amount of mercury and be safest for you to eat?

A)Calamari
B)Swordfish
C)Shark
D)Tuna
E)King mackerel

Question 43

Medicinal herbs have been shown to be a safe alternative to drugs during lactation.

Question 44

Women should discontinue ALL medications while breastfeeding.

Question 45

Alcohol has been found to be a "galactologue" that facilitates milk let-down and helps aid milk insufficiency.

Question 46

How could the situation in question #41 be resolved?

A)Make sure mother and baby were nursing correctly and for an adequate length of time.
B)Check the mother's milk supply to make sure she is producing enough milk to feed her baby.
C)Monitor infants for stooling.
D)Initiate breastfeeding early.
E)All of the above

Question 47

What would be the best thing to do if you suspected your breastfed baby was responding adversely to milk in your diet?

A)Switch to a lactose-free formula and see if the symptoms go away.
B)Eliminate milk from your diet and monitor the baby for changes.
C)Eliminate strong-flavored vegetables,onions,and garlic from your diet because they can cause the same problems in babies.
D)All of the above would be good things to do.
E)a and c only

Question 48

It is better to smoke and breastfeed than to smoke and NOT breastfeed.

Question 49

Delayed breastfeeding can lead to jaundice because

A)it produces a state of partial starvation.
B)it can lead to decreased passage of meconium.
C)it causes an increase in bilirubin concentration.
D)All of the above

Question 50

For women with a family history of peanut allergy,exclusive breastfeeding is recommended for 4 months.

Question 51

It is necessary to STOP nursing with mastitis.

Question 52

A woman with mastitis should continue to nurse her baby.

Question 53

Drinking one cup of coffee results in hyperactivity in all infants.

Question 54

The vast majority of women experience SIGNIFICANT problems with breastfeeding.

Question 55

A nursing mom should avoid cauliflower because it has the potential to cause gas in her baby.

Question 56

Alcohol is not transferred through breast milk.

Question 57

Which of the following foods would a pediatrician recommend a nursing mother with no history of food allergies in the family restrict?

A)Peanuts and tree nuts
B)Wheat
C)Soy
D)Eggs
E)None of the above

Question 58

A friend of yours has just given birth to twins and is planning to return to work full time when they are 3 months old.She has a nanny and feels confident that she will be able to breastfeed as well as work 50 hours per week.Which of the following will present a major challenge with this plan?

A)Fatigue and sleep deprivation
B)Lack of time to nurse or pump
C)Milk production capacity
D)All of the above
E)a and b only

Question 59

Neonatal jaundice is a life-threatening condition that requires immediate medical intervention.