IBCLC 2013 Missed Practice Questions with 100% correct answers

Which of the following maternal perinatal factors is MOST LIKELY to interfere with initiation of breastfeeding? Cesarean surgery A mother complains of incision pain following her cesarean birth and requests pain relief medication, but she is worried about the effect on her baby. Your FIRST response to her should be: We will monitor you and your baby closely after you have received pain medication Which components of human milk are MOST STABLE to pasteurization and freezing? Minerals Which of the following is the MOST APPROPRIATE complementary food for a 10-month-old breastfed baby? Strips of lightly cooked pork Nutrient-dense and iron-rich foods are the most important complementary foods for the breastfed child between 6 and 12 months. A mother asks about sources of vitamin D for her 16-month-old breastfeeding child. Your FIRST recommendation should be: Continue breastfeeding, and ask your doctors to test you both for vitamin D levels Which of the following foods is the BEST source of calcium for a partly breastfeeding 16-month-old who cannot tolerate dairy products? Sesame seed paste a hospital nurse told her "if he nurses longer than that, he's only using you as a pacifier and you'll get sore." Your FIRST statement to her should be: Let's see what he can do with nursing at breast at his own pace. You are working to implement the Baby-Friendly Hospital Initiative in your facility, where scheduled feeds are often recommended for outdated and incorrect reasons. Your FIRST strategy should be to: during Step 2 training, explore and correct all the reasons that are given for scheduling feeds. What is the MOST IMPORTANT reason for continuing to breastfeed into the second year of life and beyond? Immune protection tailored to the child's environment A mother with epilepsy wants to breastfeed her third baby, after formula-feeding her first two. Which aspect of breastfeeding should you spend MOST time discussing with her? Increased infant alertness Breastfed infants are more alert and responsive compared to formula-fed babies mother kept her 4-year-old daughter and 7-month-old baby alive while snowbound in their car 9 days. Which component of breastmilk at this stage was HIGHER than at previous stages of lactation? Lysozyme Lysozyme increases over the early months of lactation and is higher at 3 months than 1 month. A first-time mother and her 5-day-old infant called you for help. The baby is neither voiding nor stooling regularly and appears yellow. While the mother's breasts were engorged, all attempts at latching the baby onto the breast failed. She expressed 2 oz of milk total (60 ml). What is the NEXT action she should take? Place the baby skin-to-skin on her chest, and see if he will self-attach. You are helping a mother 3 days after a surgical procedure to drain a breast abscess. Her breast is firm and milk is leaking from the incision, which is on the lateral side of the breast near her chest wall. What is the FIRST action she should take? Put the baby to breast on the affected side to relieve milk stasis. How many stages are described in Tanner's phases of breast development? Five A pregnant woman with many allergies asks about infant feeding. Your BEST response is: A baby is never allergic to its mothers' milk, but he may be sensitive to foods in the mother's diet. A breastfeeding mother is also pregnant. She asks the lactation consultant if she needs special dietary considerations to "eat for three" while she's pregnant. Which suggestion is irrelevant? Double your protein intake. A cesarean birth is more likely to affect breastfeeding in all of the following ways EXCEPT: delayed lactogenesis II.? It WILL cause: increased maternal pain. b. a need for maternal medications, more separation of mother and infant Pooling or collection of fluid between the skin and cranial bones of the infant's head is called: caput succedaneum. Which statement regarding the timing of lactogenesis II is FALSE? Timing is dependent on breast stimulation by the baby. TRUE STATEMENTS: Begins 30-40 hours after delivery of the placenta b. May initially go unnoticed by mother c. May be delayed 10-20 hours if mother has diabetes Which of the following maternal perinatal factors is MOST LIKELY to interfere with initiation of breastfeeding? Cesarean surgery Which mineral is particularly difficult for the premature (preterm) infant to absorb? Iron At what gestational age does the swallowing reflex first appear? 16 weeks Which nutrient is most difficult for premature babies to digest? Fats All of the following developmental processes are interrupted by premature birth EXCEPT: hearing and taste. ARE INTERRUPTED: bone mineralization. b. gut maturation. c. deposition of fat. Which component of human milk is LEAST important in preventing neonatal septicemia? Lysozyme in colostrum ARE PREVENTATIVE: Secretory IgA antibodies c. Oligosaccaride receptor analogues d. Lactoferrin protein Which feeding device is MOST APPROPRIATE if a preterm baby cannot yet breastfeed but can tolerate oral feeds? Cup: most researched You are working with a late preterm infant (born at 34 to 36 weeks gestation) who had been in the hospital NICU since birth 10 days ago. The baby falls readily asleep at breast each time you assist mom to latch. Her milk supply is plentiful because of pumping. What is the MOST LIKELY cause for this infant to be unable to sustain his latch at breast? His suck has low intraoral pressure (vacuum) due to gestational age. You are counseling the mother of baby born at 36 weeks gestation who says her infant is quite sleepy. She calls her infant a snacker, which she describes as her infant waking up to feed approximately every 1-2 hours and promptly falling asleep at the breast. What should be your NEXT suggestion for this mother Keep the baby skin-to-skin, without swaddling blankets, to maintain his temperature during feeds. Late preterm infants may fall asleep if they are slightly chilled, due to inherent thermal instability. Skin-to-skin contact is the best way to maintain thermal stability and maintain alertness. You are helping a breastfeeding mother of a preterm infant with positioning to optimize her infant's ability to latch and sustain feeding at breast. Which of the following is MOST LIKELY to result in effective breastfeeding for this mother and infant? The "football" or cross-cradle hold with the mother's hand behind the baby's shoulders When are the levels of secretory IgA (sIgA) highest in human milk? During the first 24 hours after birth A woman who received intravenous magnesium sulfate during labor to control her blood pressure is having trouble initiating breastfeeding The MOST LIKELY explanation for this is: this medication can cause maternal lethargy, confusion, and muscle relaxation An 18-hour-old baby has not yet successfully breastfed. He cues to feed, but cannot stay on breast. To help him suck better, which would be the LEAST effective strategy? Use a supplementer at breast so his suck increases milk volume. A lactating mother noticed two raised bumps on her areola that drip milk when her baby is nursing on the other breast. These bumps are MOST LIKELY: milk duct pores. A mother birthed by cesarean surgery after a 36-hour labor with pitocin and intravenous fluid support. At the 6-day visit, the baby is still losing weight. The baby is urinating adequately, stooling adequately. The pediatrician asks that the baby be supplemented. The LC's FIRST action is to: ask about medications and IV fluids during labor.