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level: Level 1

Questions and Answers List

level questions: Level 1

QuestionAnswer
Is 39 weeks premature?No (Babies born before 37 weeks are premature.) Pg. 171
What does it mean to be exclusively breastfed?Breast milk only - no other food or drink Pg. 165
What percentage of weight loss in normal after birth?7% or less -weight loss of more than 7% indicates possible breastfeeding problems. Pg. 217 in Pocket Guide
After 2 weeks (regaining original birth weight), how much should a baby gain per day?At least 1 ounce, per day Pg. 217 in Pocket Guide
An appropriate check-up for a breastfed newborn should include:Asking additional questions and assessing a feeding. Pg. 217 in Pocket Guide
How would you calulate the daily milk requirment for a normal (within weight range) baby? (Baby is 8 lbs.)Lbs. x 2.5 = Ounces a baby should intake per day (8 x 2.5 = 20 ounces) x 2.7-3 if baby needs to catch up on weight Pg. 199 in Pocket Guide
A staff member is fond of telling mothers how expensive it is to formula feed infants and how inexpensive it is to breastfeed. What is she doing when she talks to mothers on this topic?Promoting Breastfeeding Pg. 2
If you are focusing on governmental, manufacturer, and social responsibility to assure breastfeeding's ability to compete with commercial interests, you are doing what?Protecting Breastfeeding Pg. 2
If you are focusing on the interaction of helpers with family, as well as program development and implementation, you are ding what?Supporting Breastfeeding Pg. 2
Who currently collects the most comprehensive breastfeeding statistics, in the U.S.?The CDC Pg. 6
What is prolactin?A hormone that causes milk to be made. (MAKE THE MILK - for milk - for making milk) Pg. 10-11
What is oxytocin?A hormone that causes the milk to move. (MOOVE THE MILK) Pg. 10-11
Which of the following mechanisms causes oxytocin to be released? A. Complete delivery of the placenta B. Elevated levels of gastrointestinal hormones C. Frequent feeding and milk removal D. Nipple stretching with appropriate latch-onD. Nipple stretching with appropriate latch-on Pg. 11
Lactogensis III requires which of the following to succeed? A. Frequent milk removal and nipple stimulation B. Adequate rest and alternating starting breast at each feeding C. Adequate protein and carbohydrates for the mother D. Adequate maternal hydration and lack of maternal stressA. Frequent milk removal and nipple stimulation Pg. 13
One way that fat content of milk suckled by the baby is determined is: A. The number of feedings in a 24 hour period B. The speed/efficiency with which the baby removes milk C. The amount of fat in the mother's diet D. The amount of liquid in the mother's dietB. The speed/efficiency with which the baby removes milk (Think gravy - fat sticks (thick) to the side if slow or is more liquid if fast) Pg. 15
What is Lactogensis 1?Colostrum: -derived from placenta hormones. Begins: during mid-pregnancy Pg. 13
What is Lactogensis II?Transitional Milk: Begins - after delivery of baby and placenta Ends - when colostrum is no longer created Pg. 13
What is Lactogensis III?Mature Milk: Begins: after first drop of mature milk Pg. 13
What is a paracellular transport?The milk cells have space in between them, to allow substances to pass through. (first few days after birth) O | O | O Pg. 13
What is transcellular pathway/transport?Substances have to go through the milk cell to enter the milk. (spaces have closed - closing the paracellular transport) Takes place during later breastfeeding. OOO -> Pg. 13
What does gastrin and cholecystokinin (CCK) do?The hormones promote glucose induced insulin release and exert tropic (growth promoting) effects in the gut. CCK induces satiety (fullness), postprandial sedation and sleep. (Stores energy and makes baby sleepy.) CCK = OK (non-stress) Pg. 17-18
What increases gastrin and decreases somatostatin in babies?-Sucking -Species' own milk -Decreased stress -Wellness -Touch (CCK & Gastrin = OK (non-stress)) Pg. 17-18
What does somatostatin do?Causes stress, which will slow nutrition to baby and keep baby from growing. (S = STRESS) Pg. 17-18
When undernourished mothers were supplemented with extra energy in their diet, they: A. Had babies that gained weight slightly better. B. Produced more nutritious milk. C. Had babies that gained weight significantly better. D. Responded to their infants more appropriately.D. Responded to their infants more appropriately. (Think debunking myths.) Pg. 20
Harmful bacteria have difficulty growing in the breastfed infants' gut because the composition of the breastmilk: A. Raises the pH of the gut to a basic level B. Provides too much iron for harmful bacteria to grow C. Fosters the growth of good bacteria that crowd out other organisms D. Contains limited amounts of vitamin B13C. Fosters the growth of good bacteria that crowd out other organisms (Good bacteria grow (feeds) - Starves bad bacteria) Breastfed baby should have an acidic pH. Pg. 15-16
What does bout mean?The nipple is stimulated. (baby eating) Pg. 10
What does inter-bout mean?The nipple is not stimulated. (baby is at rest - not eating) Pg. 10
What does weaning mean?Lengthening the inter-bout interval. (The time at rest - not eating.) Pg. 10
How frequent should human feedings be?Continuous - on baby's cue. Pg. 13
What happens if you have a lot of prolactin and not enough oxytocin?Engorgement (Prolactin = make the milk & Oxytocin = moove the milk) Pg. 12
What is foremilk?The milk at the beginning of the a feed. (think before) Pg. 14
What is hindmilk?The milk fromt he end of a feed. (think dessert) Pg. 14
What is a microbiome?What is living in our gut. Pg. 15
What is an example of protection?State law on breastfeeding in public. Pg. 2
What is an example of promotion?Breastfeeding costs less Pg. 2
What is an example of support?La Leche League Leader Pg. 2
What is the International Code of Marketing?It restricts formula marketing practices. Pg. 2
What are montgomery glands?They secrete lubricating fluid on the areola. (Bumps around the nipple.) Pg. 9
Elevated prolactin levels close what?Paracellular pathway O|O|O (think triangles) Pg. 13
What is the Cochrane Collaboration?They conduct systematic reviews. Pg. 3
What is a lactiferous sinus?It is not in humans. (Think lucifer - not human) Pg. 8-9
What is cholecystokinin (CCK)?A GI hormone that causes fullness/sedation. (CCK = OK) Pg. 17
Colostrum is produced by what?Pregnancy hormones. Pg. 13
What is anabolism?Storing energy for growth. Pg. 17
What are myoepithelial cells?Muscle cells around the alveolus. (Think skin muscles.) Pg. 8
What is an alveolus?A cluster of alveolar cells. Alveolar cells are milk making cells. (Think like a balloon.) Pg. 8
What are alveolar cells?Cells that make milk. (Think balloon like.) Pg. 8
What is a receptor site?Cellular "lock" for a chemical "key". (Think of the triangles.) Pg. 11
Baby hand massage is an example of what?A oxytocin releasing mechanism. (Think MOOve milk.) Pg. 11
What is a carbohydrate found only in mammal milk?Lactose Pg. 12
Cholecystokinin (CCK) helps babies feel a sense of _________ (full and sleepy).Satiety Pg. 17
Not enough water and too much stress or exercise reducing milk supply are all examples of what?Myths. Pg. 20
What is not necessarily lower in fat content?Foremilk. Pg. 14
What is the gland that secretes lactation hormones?Pituitary Gland Pg. 7
What is new born milk called?Colostrum. Pg. 13
Human milk is composed of almost 88% __________.Water Pg. 13
What hormone is responsible for milk ejection?Oxytocin (MOOve milk.) Pg.11
Breastmilk is low in this nutrient but it is almost all bioavailable?Iron. Pg. 15
Nevers that ennervate the breast 3, 4, and 5?Thoratic. (T3-5) Pg. 8
What is the number one reason mother's quite breastfeeding?Quantity/Quality of breast milk supply. Pg. 5
What hormone increases with frequent nipple stimulation?Prolactin (Make the milk.) Pg. 11
What hormone is secreted by the placenta?Progestrone Pg. 11 & 13
What promotes the release of gastrin?Touch Pg. 17-18
What is the leading cause of infant death globally?Diarrhea Pg. 15
Best practice is guided by the highest available level of ________.Evidence Pg. 3
What is complimentary feeding?Child is older than 6 months of age and receiving bf milk and solid or semi-solid foods. Pg. 4 Pocket Guide
What is supplemental feeding?Food other than breastmilk is given to an infant to replace breastmilk calories - Child is under 6 months. Pg. 173
Mothers who smoke may wean earlier because: A. Their time is consumed by smoking B. Their prolactin levels are lower C. Their babies are jittery and crabbier. D. Their milk is too full of nicotine to feed babiesB. Their prolactin levels are lower Pg. 27
Pacifier use by tube fed babies who were born prematurely may: A. Increase their NICU length of stay B. Decrease their appetite and cause them to eat less C. Increase their weight gain D. Decrease their success at breastfeedingC. Increase their weight gain Pg. 29
The FDA reports that A. Mothers in the US are routinely taught how to make formula safely B. Young mothers are less likely to make formula safely C. There is no consistent pattern of who does and does not make formula safely D. Safe formula preparation is highly overratedC. There is no consistent pattern of who does and does not make formula safely Pg. 37-38
Which of the following does not reduce the storage capacity of the breast? A. A push up bra B. Amount of tea mom drinks C. Breast implants D. EngorgementB. Amount of tea mom drinks Pg. 23
With Sheehan's Syndrome A. Pituitary function may be impaired permanently B. There are always retained placental fragments C. Symptoms begin in pregnancy D. The mother feels thirsty when her milk let down happensA. Pituitary function may be impaired permanently. Pg. 26
Wendy is a WIC nutritionist who teaches a 3-hour, comprehensive breastfeeding class. Which group of "knowers" may have the most difficulty with Wendy's class? A. Constructed knowers B. Receivers of knowledge C. Women in silence D. Procedural knowersC. Women in silence Pg. 32
Studies on childhood obesity demonstrate that: A. Breastfed babies secrete more insulin and deposit more fat than formula-fed infants B. There is a positive relationship between longer breastfeeding duration and an increased risk of childhood obesity C. Obesity is not an issue for formula fed infants; it is an issue for breastfed babies D. There is an inverse relationship between breastfeeding duration and obesity prevalence in a large populationD. There is an inverse relationship between breastfeeding duration and obesity prevalence in a large population Pg. 42
Which of the following statements is true: A. Reflux may be due to immaturity, food, or mechanics of feeding B. Reflux is only a temporary condition and causes few problems C. Breastfed babies never have reflux D. Rice cereal used to thicken formula is very effective in curing refluxA. Reflux may be due to immaturity, food, or mechanics of feeding Pg. 38
Formula contamination with organisms is: A. Not a risk for North America B. A greater problem with powder than liquid C. A greater problem with liquid than powder D. An issue for women in resource inadequate homesB. A greater problem with powder than liquid Pg. 37
Babies who are fed formula are more likely to have which of the following outcomes? A. Less obesity B. Higher IQs C. Less diabetes D. Higher rate of SIDSD. Higher rate of SIDS
It is best to use few words with this kind of "knower".Women in Silence Pg. 32
There are concerns with preparation, especially if powdered...Formula Pg. 37
These "knowers" like to be helped by women who have had similar experiences.Subjective Knowers P. 33
This affects up to 20% of postpartum women:Anemia Pg. 26
Negative breastfeeding support can increase with this....Depression Pg. 31
Acronym for Secretory Immunoglobulin A:SigA Pg. 16
Can implants reduce breast storage capacities?Yes Pg. 23
Acronym for Polycystic Ovarian Syndrome:PCOS Pg. 27
These nipples can be drawn out easily by the baby.Flat - Grade 1 Pg. 25
What may cause a lower rise in prolactin?Smoking P. 27
These "knowers" seek information from a variety of sources.Procedural Knowers Pgs. 33
Acronym for Human Milk Banking Association of North America:HMBANA Pg. 36
Not breastfeeding increases the risk of these types of cancers:Breast and ovarian Pg. 27
Only infant contraindication for breastfeedingGalactosemia Pg. 43
Can engorgement reduce storage capacity?Yes Pg. 23
What may delay onset of Lactogenesis II (transition milk)?Maternal Obesity
What is the 3rd infant feeding hierarchy?Banked Donor Human Milk Pg. 37
What is a mother contraindication for breastfeeding?HIV infection Pg. 43
Type II inverted nipples do not retain _______.Projection Pg. 25
What is a physiologic reason for low milk supply?Hypothyroidism Pg. 26
What is a maternal benefit of BF for >1 year?Reduction in risk of hypertension.
Buying milk on the internet is an example of what?Risky behavior Pg. 37
These types of "knowers" believe all authorities tell the truth.Receivers of Knowledge Pg. 33
What may alter the pattern of postpartum bleeding?Retained Placental Fragments
Nipple shields are frequently used __________.Inappropriately Pg. 13
Who can make enough milk for 2,3, or more babies?Mothers of multiples. Pg. 41
This behavior may lead to low milk supply.Cigarette Smoking Pg. 27
The periareolar incision is often associated with ___________.Milk insufficiency Pg. 23
Cronobacter Sakazakii is a what?Formula Contaminant Pg. 37-38
What is the best technique for dealing with engorgement?Prevention
What is a maternal contradiction to breastfeeding?If the mother is HIV positive - she may NOT breastfeed in the U.S.
Is a pacifier an indicator of sore nipples?Yes.
The TJC (Joint Commission) Perinatal Core Measure Outcomes ____________ exclusive breastmilk feeding.Increase.
What is the minimum angel of the mouth corners for proper bf latch?140 degrees
When is not a good time to attempt to breastfeed?Deep sleep and when baby is crying
Hand to mouth is an example of what?A feeding cue
A person who provides perinatal support is called?A doula
What do babies do naturally if left alone after birth?Self-attachment
Placing the nipple in the top of baby's mouth does what?Allows for nipple stretching and oxytocin release
Limp hands and body are a sign of ________.Satiety
Having the baby with mom 24 hrs/day is called what?Rooming-in
What do you call the up and down chewing motion?Piston
Soft body tone and relaxed hands are signs of ________.Satiety
What is a technique for calming babies?Skin to Skin
What is a key component of counseling?Listening
Epidural anesthesia is associated with what?Latch difficulty.
When is the ideal state to attempt feeding a newborn?Light sleep with REM
What creates changes in breast appearance?Pregnancy
A vacuum does what?Creates negative pressure.
____________ is a late stage of hunger.Crying
Don't command, do __________.Suggest
What do you call a baby's jaw that moves forward and back in this motion?Rocker
Nose to ___________ to start the latch process.Nipple
What should be 140 degrees or more?The angle of the bf baby's mouth.
What helps the baby transition to extrauterine life?Skin to skin
What do you call a wide open mouth as baby approaches the breast?A gape
The first and last step in effective counseling is to ______________ to mothers.Listen
The use of labor __________ may impact the baby's ability to orient to the breast.Drugs or medicines
Tummy to mummy, nose to nips, _________ the hips to open the lips.Flex
What does a doula do?Provides professional labor support
Which of the following is an advantage of being skin to skin for the infant? A. babies cry less B. babies have higher IQs C. babies exercise their lungs more with crying D. babies heart rates become more rapid and unevenA. babies cry less
Pregnant women choose formula because they: A. Think it will be more economical B. Believe that they will be unable to find breastfeeding help C. Think their diet lacks adequate quality D. Feel more comfortable with the idea of formula feedingD. Feel more comfortable with the idea of formula feeding
Smell is: A. The only sense that is available to the newborn immediately after birth B. The only sense that is available in utero C. A sense that helps guides babies to the breast D. Not available to the newborn immediately after birthC. A sense that helps guides babies to the breast
Studies about mother's hospital experience indicate that of mothers who intended to breastfeed: A. That they are at risk of not exclusively breastfeeding if given a formula pack at discharge. B. Most reported their baby had not been given a pacifier. C. Most reported that hospitals are very helpful to new mothers according to the mPINC survey. D. Most reported that formula packs at discharge helped them breastfeed longer.A. That they are at risk of not exclusively breastfeeding if given a formula pack at discharge.
When latching the baby to the breast: A. Guide the baby to the breast with pressure to the back of the head B. Start with the baby's nose at the level of the nipple C. Start with the baby's lips stroking the nipple D. Be sure that the baby is first wide awake and ready to feedB. Start with the baby's nose at the level of the nipple
Helping a mother to learn about correctly latching the baby on involves: A. Observation of prefeeding and readiness behaviors B. Starting with the nipple pointing at the baby's chin C. Waiting until the baby starts crying D. Shaping the mother's breast like a wedge before putting it into the baby's mouthA. Observation of prefeeding and readiness behaviors
One of the advantages of having babies room-in with their mothers is that: A. Grandparents can have more contact with the baby B. There is reduced risk of enzymes in the milk C. Mothers can feed when feeding cues are given D. Medical records staff can find the babyC. Mothers can feed when feeding cues are given
An optimal state for breastfeeding is when the baby is A. Crying B. REM Sleeping C. Fussy and pulling up legs D. Deep SleepB. REM Sleeping
Susie Suckles is 2 Days old and she is not living up to her name. What is one possible reason for her incorrect/unsuccessful breastfeeding? A. A two-hour delay in initiating feeding B. Immediate suckling within the first hour of life C. Rooming in 24 hours a day in the hospital D. The hospital's hearing test policyA. A two-hour delay in initiating feeding
What is the most effective strategy in breastfeeding counseling? A. Talking B. Giving advice C. Listening D. Making referralsC. Listening
What is the latching process?Nose opposite nipple to start . Gape response. Head tilts back. Bottom lip and tongue reach the breast first.
What is the ideal baby's body position for latching-on?Turned toward mother (Tummy to Tummy). Shoulders/hips aligned. Arms/hands around breast.
What is the ideal facial proximity during feeding?Nose and chin close to breast.
What is the ideal mouth seal for feeding?Top and bottom lip sealed. Rounded cheek line. Not dimpled cheek.
What is the ideal rhythm for feeding?Bursts of 2:1 or 1:1
What is the ideal latch type?Asymetric latch
What is an asymmetric latch?When the baby latches onto the lower half of the areola. This is ideal. You do NOT way a "bulls-eye".
What is the ideal latch jaw motion?Rocker
What is the ideal ending to a feed?Baby releases the nipple.
What is the ideal baby's tone after feeding?Soft tone and relaxed hands
What is the ideal mother's comfort level during feeding?Tugging feeling
What is the ideal look of the mother's nipple after feeding?Similar to pre-feeding
How many baby states of transition are there?9: Birth Cry, Relaxation, Awakening, Activity, Rest, Crawling/Sliding, Familiarization, Suckling, Sleeping
When a supplement has been ordered, which of the following is MOST important when considering using an at-breast supplementer? A. Whether the supplement is medically necessary B. Whether the supplement device is made in the US C. Whether the baby is able to be positioned and transfer adequately at the breast. D. Whether the mother is a smokerA. Whether the supplement is medically necessary ? C. Whether the baby is able to be positioned and transfer adequately at the breast. ?
One plausible suggestion that might help a mother to increase the volume of milk is to A. Use two flanges and pump both breasts at the same time B. Pump in a quiet room away from the baby C. Pump both breasts at the same time using the highest possible vaccum setting D. Pump one breast, then wait 5 minutes, and then pump the other breastA. Use two flanges and pump both breasts at the same time
Raynaud's of the nipple is characterized by A. Fever B. Blanching (whitening) of the nipple C. Itchy flaky skin D. Deep fissuresB. Blanching (whitening) of the nipple
The best advise for a mother suffering from mastitis is to? A. Keep breastfeeding frequently on both sides B. Breastfeed on the unaffected side only C. Stop breastfeeding entirely D. Stop taking the antibiotics as soon as she feels betterA. Keep breastfeeding frequently on both sides
Which of the following has been found to be a significant risk factor for mastitis? A. Poor maternal nutrition B. Inadequate rest for the mother C. Return to work D. Hurried, infrequent feedingsD. Hurried, infrequent feedings
The 2010 Health Care Reform Act A. Provides paid time off to express milk B. Provides for company sponsored lactation support C. Provides for time for milk expression during the work day D. Provides for a safe place to store expressed milkC. Provides for time for milk expression during the work day
Peggy Poop is 4 months old and exclusively breastfed. She has been having visible blood in her stools. What is the most likely breastfeeding related reason for this blood? A. Too much fiber in the mother's diet B. Too much spicy food in the mother's diet C. Not enough vitamin supplementation for the infant D. Cow milk protein in the mother's dietD. Cow milk protein in the mother's diet
Alcohol consumption by the mother may result in A. Having to pump and dump her milk for 24 hours B. Lower milk consumption by the baby after the alcohol is consumed C. Slower weight gain for the baby D. An inebriated babyB. Lower milk consumption by the baby after the alcohol is consumed
Which of the following is NOT a question that is important to the success of the Lactational Amenorrhea Method (LAM) A. Exclusive breastfeeding of baby under 6 months of age B. No return of menses C. No pacifier use D. Adequate nutrition of the motherD. Adequate nutrition of the mother
What do you call inflammation in the breast causing localized tenderness, redness, and heat?Mastitis
What do you call vasoconstriction and reduced blood flow to an extremity of the body in response to cold stress?Raynaud's Syndrome
The 2010 Health Care Reform Act allows for ____________ employees breaks during the day to express milk and a ________.Hourly; private room other than a bathroom to pump
Environmental contaminants in breastmilk are A. a concern for every mother B. minimal compared to uterine exposure C. never a problem D. the #1 reason mothers stop breastfeedingB. minimal compared to uterine exposure
Most babies don't like the taste of it...Alcohol in milk
Means of acculturating babies to ethnic cuisine...Food flavors in mother's diet
Nursing babies from 2 different pregnancies is called?Tandem nursing
This symptom is usually due to sepsis or blood incompatibility:Jaundice in the first 24 hours
A condition that results when red blood cells break down faster than the liver can handle, causing a yellow color of the skin. In the newborn, normal physiologic jaundice is caused by the immaturity of the liverJaundice
What can be helpful in milk collection?Guided imagery
What is the injected progestin-only contraceptive called?Depoprovera
This causes vasospasm of the nipple causing pain:Raynaud's Syndrome
What is the protocol for candidiasis (yeast infections)?Treat both mother and baby
What is caused by compression of the duct?Clog
What is usually seen in bilateral mastitis?Streptococcus (two t's = 2 breasts)
What is seen in a single breast mastitis?Staph (one t = one breast)
What do you call food or drinks given to the mother that are believed to increase milk production?Galactogogue
What is a non-evidence-based galactogogue?Metaclopramide
What is the preferred method of supplementation?Cup feeding
What is associated with a poor latch?Nipple pain
What do you call pumping in short frequent intervals?Power pumping
What form of birth control uses breastfeeding for family planning?Lactational Amenorrhea Method (LAM)
Environmental contamination are largely _______ exposure.uterine
What is a technique for draining an abscess?Needle aspiration
What does not need to be checked routinely in healthy, term, asymptomatic babies?Blood sugar
What is a metabolic disorder of the baby, which makes breast milk contraindicated?Galactosemia
Sore nipples are often associated with what?A poor latch
Women lose bone ________ during lactation, but gain back more after weaning.Density
_________ Mother Care (KMC) helps premies thrive.Kangaroo