Question 1

While almost all women can breastfeed, certain conditions preclude breastfeeding. Which of the following is reason to NOT breastfeed?

Accepted Answer

A)  Maternal HIV positive status
B)  Mastitis requiring antibiotics
C)  Maternal Hepatitis C infection
D)  Mother using hormonal methods of birth control A

Question 2

Colostrum, the first milk after birth, is the perfect nutrition for a newborn baby. Which of the following is NOT a property of colostrum?

Accepted Answer

A)  It is low in fat.
B)  It is high in carbohydrates and protein.
C)  It is high in fat.
D)  It is full of antibodies. C

Question 3

A mother you are helping is positioning her baby at the breast, and you notice her hand is cupping the back of the baby's head. To help her achieve the best latch, you recommend she:

Accepted Answer

A)  Never use that position again.
B)  Doesn't know what she's doing.
C)  Lean forward to "drop" the breast into baby's mouth.
D)  Not push the back of baby's head, as the baby may resist by pushing backwards away from the breast. D

Question 4

A baby born with the help of forceps is having trouble breastfeeding. You suggest to the mother that:

Accepted Answer

A)  She contact her attorney to sue the healthcare provider.
B)  She will need to use a bottle until the baby feels better.
C)  She try different positions to find one most comfortable for baby.
D)  Her baby will likely have permanent nerve damage.

Question 5

The _________________, or milk-making glands, are secretory cells that connect to ductules.

Accepted Answer

A)  Alveoli
B)  Montgomery's tubercles
C)  Cooper's ligaments
D)  Areolae

Question 6

A breastfeeding mother is about to be discharged from the hospital two days after birth, and her care provider asks her what form of birth control she plans to use. She asks you for suggestions. You tell her:

Accepted Answer

A)  "Some moms experience a decrease in their milk supply when they start taking 'the Pill.'"
B)  "Breastfeeding cannot be used as a form of birth control."
C)  "You don't need to worry about that."
D)  "You can only use condoms or a diaphragm when you are breastfeeding."

Question 7

A pregnant mother tells you she wasn't able to nurse her first baby. She says her milk never came in. Which of the following birth circumstances might be related to a delay in milk production?

Accepted Answer

A)  Long second stage
B)  Caesarean birth
C)  Episiotomy
D)  Induction

Question 8

Lactogenesis II, when a mother's milk "comes in," usually happens:

Accepted Answer

A)  In the first 24 hours
B)  A week after birth
C)  2-5 days after birth
D)  When the placenta is delivered

Question 9

Which of the following is FALSE about human breast anatomy?

Accepted Answer

A)  Glandular tissue makes up as little as half the breast volume.
B)  On average, approximately nine milk ducts terminate at the nipple.
C)  Lactiferous sinuses can be found approximately one inch from the base of the nipple.
D)  Milk ducts can be easily found and compressed.

Question 10

A doula is creating a teaching plan for a first-time pregnant client at 12 weeks' gestation. The doula focuses on breast care once colostrum secretion begins. Which of the following teachings is not included in the teaching plan?

Accepted Answer

A)  Wash the breasts with clear tap water and mild soap daily.
B)  Wear a firm, supportive bra with wide straps.
C)  A larger bra may be needed halfway through the pregnancy.
D)  If colostrum secretion is excessive, gauze squares or commercial breast pads may be placed inside the bra.

Question 11

A mother you are helping in the early postpartum days asks what is the best way to be sure her baby is getting enough to eat when breastfeeding. Which of the following will you NOT tell her:

Accepted Answer

A)  "Your baby should have 6-8 wet diapers a day."
B)  "Your baby should nurse only 10 minutes per side."
C)  "Your baby should have at least three bowel movements per day."
D)  "Your baby should gain 4-7 ounces per week."

Question 12

Research has shown that keeping a baby skin-to-skin with his or her mother immediately following birth has many benefits. Babies will typically self-attach and breastfeed within the first hour if left skin-to-skin. All of the following common practices interfere with this process, except:

Accepted Answer

A)  There are bright lights on in the room.
B)  The baby is taken to a "warming table" to be examined.
C)  Excited relatives are getting their first chance to hold the baby.
D)  The mother had pain medications for birth.

Question 13

A doula is assisting a client and her infant a week after delivery. The infant's birth weight was 7.5 pounds. Which of the following indicates that the infant is getting enough milk?
I. The mother reports that the infant is wetting six to eight diapers a day.
II. The mother informs the doula that the infant appears content between feedings.
III. The infant's weight is 6.8 pounds.
IV. The mother reports that the infant quietly swallows during breastfeeding.

Accepted Answer

A)  I and II
B)  I, II and III
C)  I, II and IV
D)  All of the findings indicate sufficient milk intake.

Question 14

You are working with an expectant couple, and the partner is hesitant about breastfeeding. You want to help him best support the mother and baby after birth, and you know that fathers can undermine breastfeeding by:

Accepted Answer

A)  Letting mom know he supports her decisions.
B)  Suggesting getting away for a weekend without their young baby.
C)  Learning the basics of breastfeeding before the baby arrives.
D)  Helping around the house with basic tasks so mom can focus on feeding the baby.

Question 15

Newborns typically nurse how often?

Accepted Answer

A)  Every four hours, and not a moment sooner
B)  Five times
C)  Every hour
D)  8-12 times per day

Question 16

Which of the following is NOT a risk of artificial feeding?

Accepted Answer

A)  Increased risk of obesity for the baby
B)  Increased risk of otitis media for the baby
C)  Increased risk of breast cancer for the mother
D)  Decreased risk of gastrointestinal illness

Question 17

An 18-year-old client is pregnant for the first time. A few weeks before her due date, the client informs the doula that she has decided to breastfeed her baby after birth. As a part of the teaching plan, the doula informs the client that it is recommended she add some calories to her current diet to ensure sufficient milk production without compromising her own health. If the pre-pregnancy recommendation is 2,200 calories per day and the pregnancy recommendation is 2,500 calories per day, the client should consume how many calories daily during the lactation period?

Accepted Answer

A)  2,800 calories per day.
B)  3,000 calories per day.
C)  2,200 calories per day.
D)  2,700 calories per day.

Question 18

A mother tells you she plans to nurse her baby, but only for the first week because after that there's really no benefit. Your best response is:

Accepted Answer

A)  "You're crazy - how can you even think about quitting so soon after birth?"
B)  "I'm glad to hear you want to give your baby the best start. Do you have any questions about breastfeeding?"
C)  "You're right, it's all about the colostrum in those first few days."
D)  "Who told you that?"

Question 19

A mother has breast tattoos and nipple piercings. She asks you if she will be able to breastfeed. The best response is:

Accepted Answer

A)  "Why did you ever get those, anyway?"
B)  "You must not breastfeed if you've ever had any body art or adornment."
C)  "If your tattoo or piercing is healed, there is no reason for it to interfere with breastfeeding."
D)  "You should not breastfeed because you may have been exposed to HIV or hepatitis when you had the procedure done."

Question 20

A mother whose baby is two days old tells you she has sore nipples. Your best suggestion is:

Accepted Answer

A)  "Let's work on adjusting your positioning and latch to see if that helps."
B)  "Sometimes breastfeeding just plain hurts."
C)  "You should ask the nurses for a nipple shield."
D)  "Your baby is using you as a pacifier."

Exam 1: Breast-Feeding