NSPN 7150 EVALUATION EXAM 2025/2026 QUESTIONS
WITH ANSWERS TAGGED A+
✔✔Is leptin and adiponectic present in formula - ✔✔No, just human milk
✔✔The early development of the infant microbiota is believed to be important as it... -
✔✔maintains homeostasis with the host's immune system and has an impact on health
later in life
✔✔Ventura et al. (2019) claimed that the early microbiome was... - ✔✔the key
determinant of human health - although the gut microbiome consistently changes until
the age of 2-3, the initial gut microbiome colonization is very important as it is the solid
foundation for immune development, which helps subsequent creation and conservation
of the homeostasis of the host-microbiome during infancy
✔✔Suckling triggers the production of what two main hormones? - ✔✔Suckling →
anterior pituitary → prolactin → stimulate alveoli (secretory cells) to secrete milk
Suckling → posterior pituitary → oxytocin → stimulate alveoli (myoepithelial cells) to
eject milk into ducts
✔✔What blocks prolactins role in milk production during pregnancy? - ✔✔Progesterone
(so once the placenta is delivered, the inhibiting influence of progesterone is gone,
causing prolactin to cause copious production of milk)
✔✔When do prolactin levels increase (2) - ✔✔suckling and with sleep
✔✔Why is breastfeeding at night important - ✔✔More prolactin hormone is produced at
night
✔✔Levels fall to baseline levels within ____ weeks if a woman does not breastfeed -
✔✔2 weeks
✔✔it is important for mothers to frequently nurse their infants in the first couple of
weeks? - ✔✔this is the window of time to increase the number of prolactin receptors to
ensure solid milk production.
✔✔where is oxytocin produced & secreted - ✔✔in the hypothalamus and secreted into
the bloodstream by the posterior pituitary gland
✔✔Explain what is meant by oxytocin is controlled by a positive feedback mechanism: -
✔✔the release of the hormone causes an action that stimulates more of its own release
,✔✔What is oxytocin release triggered by (5) - ✔✔nipple stimulation, touch, smell, sight,
and sounds.
✔✔Oxytocin causes contraction of the myoepithelial cells around the alveoli, causing
what? - ✔✔milk to flow down from the ducts, called letdown or the milk ejection reflex
(responsible for milk ejection)
✔✔What does oxytocin do in terms of stress (4) - ✔✔It helps calm the mother,
decreases stress, raises pain threshold, and enhances the mother's ability to interact
with her infant
✔✔Explain why oxytocin is the love hormone - ✔✔increases positive social behaviors
and interactions, induces caring behaviors, and induces aggression and defensive
responses when needed
✔✔What control is galactopoiesis under? What does this mean? - ✔✔Autocrine (or
local) control takes over from the initial endocrine control of milk production in the early
days of postpartum. The rate of milk production (galactopoiesis) is related to the degree
of emptiness of the breast.
✔✔What is the feedback inhibitor of lactation - ✔✔as the alveolar lumen fills,
components of the retained milk itself (such as peptides and fatty acids) signal the
secretory cells to slow down milk synthesis
✔✔If suckling or other stimulation does not occur, prolactin levels will return to pre-
pregnancy levels in about ____ days. - ✔✔7
✔✔What are the 3 e's that keep prolactin levels high? - ✔✔Early and often: skin-to-skin
contact immediately after birth and continuing, frequent feeds including night feeds
Effective feeding: effective latch, active sucking, infant completes feeds
Exclusive breastfeeding: no artificial nipples, no artificial milk (unless medically
indicated)
✔✔Treatment for mother with high blood pressure after birth? - ✔✔skin-to-skin contact
and breastfeeding her infant, as this triggers the secretion of oxytocin, which has a
calming effect, lowers maternal blood pressure and cortisol levels, decreases anxiety
and aggressive behavior, and permeates the areas of the brain associated with
mothering and bonding behaviors
✔✔explain Primary insufficiency - ✔✔women with mammary hypoplasia have
insufficient glandular tissue, which is the primary condition that causes failed
lactogenesis II.
Breasts rarely develop sufficient tissue to sustain milk production
Women may not notice any breast changes during pregnancy
,Reason for condition is unknown
Physical symptoms: widely spaced and tubular shaped breasts, large areola, frequently
asymmetric breasts
✔✔Explain nipple conditions - ✔✔nipples that do not protrude may be inverted, so
infants may need time and support to learn to latch effectively (usually doesnt affect milk
production)
✔✔Explain anemia in terms of breastfeeding - ✔✔one study found that a postpartum
hemoglobin of <10g/dL was associated with insufficient milk supply. Further research
needed.
✔✔name 4 hormonal issues related to breastfeeding - ✔✔Retained placental products:
may alter the normal hormonal shifts that occur when the complete placenta is delivered
(decreased progesterone and increased prolactin). Milk supply can increase once the
retained products of the placenta are removed.
Polycystic ovarian syndrome (PCOS): may be associated with the abnormal release of
pituitary hormones, potentially leading to difficulty achieving full milk production
Low thyroid: may decrease milk supply without treatment (medication to regulate thyroid
levels corrects this)
Sheehan syndrome: occurs when the pituitary gland is damaged during childbirth due to
postpartum hemorrhage so severe that it causes pituitary infarct and necrosis (occurs in
0.01%-0.02% of postpartum women). This permanent condition causes lactation failure
in addition to other hormonal problems.
✔✔Explain how implants and reduction mammoplasty affect breastfeeding -
✔✔Implants: implants inserted through the axilla or under the breasts are lease likely to
impair breast function, whereas surgery through the areola or nipple is much more likely
to damage nerve pathways and ductal connections.
Reduction mammoplasty: often leads to failure of full milk production, depending on how
much of the breast was removed and the patency of the ductal structures and nerves.
Infants should do as much breastfeeding as possible, but supplemental feedings should
be offered if the infant shows signs of insufficient intake.
✔✔what is "The one intervention above any other that would improve neonatal and
maternal outcomes is Zero Separation for the first day of every newborn's life." - ✔✔skin
to skin contact
, ✔✔how to do ssc? - ✔✔the mother places the dried and naked infant (maybe in diaper)
in chest-to-chest position with nothing between them, such as blankets or clothing. The
infant's shoulders should be touching the mother's chest, and the infant's head should
be turned to the side, so the nose is not blocked. The infant's arms should be free on
the sides of the body to move as they wish. Mothers should be in a reclined position, not
flat. Blankets should cover both the mother and infant until temperature stability is
achieved.
✔✔True or false: For the first 12 hours after birth, skin-to-skin contact supports and may
shorten the transition period for infants because they reach physiological stability more
quickly. - ✔✔True
✔✔name 5 maternal benefits of ssc - ✔✔Promotes bonding and attachment: SSC and
early suckling in the first hour releases oxytocin, leading to a feeling of confidence and
comfort when caring for their infant
May prevent maternal depression: mothers who regularly engage in SSC in the
postpartum period report lower levels of depression, have a more significant reduction
of maternal salivary cortisol levels (which is an indication of less physiological stress),
and report less anxiety when caring for their infants
Increases interactions: one of the potent stressors for infants in their early life is the loss
of parental proximity, so mother-infant togetherness and parent-infant interaction
through SSC are vital as they increase bonding and attachment
Improves breastfeeding: infants who experience SSC with their mothers immediately
after birth are more likely to latch effectively, and immediate and uninterrupted SSC for
"the sacred hour" (at least one hour after birth) is the most effective way to promote
exclusive breastfeeding. SSC also significantly increases human milk volume and it
enhances maternal breastfeeding self-efficacy, which increases exclusive breastfeeding
duration
Operating rooms: women with no SSC after cesarean section surgery were 2.29x more
likely to use analgesic medication, and women who experienced SSC in the operating
room were 9.4x more likely to breastfeed and 3.25x more likely to exclusively
breastfeed
✔✔name 4 infant benefits of ssc - ✔✔Supports transition: SSC helps the infant to stay
warmer, have better temperature control in the postpartum period, maintain blood
glucose level, maintain regular breathing patterns, experience more efficient postnatal
metabolic adjustments, have improved cardio-respiratory stability, cry less at birth, have
lower cortisol levels, attain longer sleep periods and longer periods of alertness,
experience less caloric expenditure, gain weight faster, have improved brain
development, and have improved breastfeeding duration
Enhances brain development: SSC accelerates maturation and increases complexity in
infants' brain development
Decreases pain during painful procedures: SSC acts as non-pharmacological analgesia
for newborns and helps them cope with pain, including procedures such as vitamin K
injection and blood dot screening
WITH ANSWERS TAGGED A+
✔✔Is leptin and adiponectic present in formula - ✔✔No, just human milk
✔✔The early development of the infant microbiota is believed to be important as it... -
✔✔maintains homeostasis with the host's immune system and has an impact on health
later in life
✔✔Ventura et al. (2019) claimed that the early microbiome was... - ✔✔the key
determinant of human health - although the gut microbiome consistently changes until
the age of 2-3, the initial gut microbiome colonization is very important as it is the solid
foundation for immune development, which helps subsequent creation and conservation
of the homeostasis of the host-microbiome during infancy
✔✔Suckling triggers the production of what two main hormones? - ✔✔Suckling →
anterior pituitary → prolactin → stimulate alveoli (secretory cells) to secrete milk
Suckling → posterior pituitary → oxytocin → stimulate alveoli (myoepithelial cells) to
eject milk into ducts
✔✔What blocks prolactins role in milk production during pregnancy? - ✔✔Progesterone
(so once the placenta is delivered, the inhibiting influence of progesterone is gone,
causing prolactin to cause copious production of milk)
✔✔When do prolactin levels increase (2) - ✔✔suckling and with sleep
✔✔Why is breastfeeding at night important - ✔✔More prolactin hormone is produced at
night
✔✔Levels fall to baseline levels within ____ weeks if a woman does not breastfeed -
✔✔2 weeks
✔✔it is important for mothers to frequently nurse their infants in the first couple of
weeks? - ✔✔this is the window of time to increase the number of prolactin receptors to
ensure solid milk production.
✔✔where is oxytocin produced & secreted - ✔✔in the hypothalamus and secreted into
the bloodstream by the posterior pituitary gland
✔✔Explain what is meant by oxytocin is controlled by a positive feedback mechanism: -
✔✔the release of the hormone causes an action that stimulates more of its own release
,✔✔What is oxytocin release triggered by (5) - ✔✔nipple stimulation, touch, smell, sight,
and sounds.
✔✔Oxytocin causes contraction of the myoepithelial cells around the alveoli, causing
what? - ✔✔milk to flow down from the ducts, called letdown or the milk ejection reflex
(responsible for milk ejection)
✔✔What does oxytocin do in terms of stress (4) - ✔✔It helps calm the mother,
decreases stress, raises pain threshold, and enhances the mother's ability to interact
with her infant
✔✔Explain why oxytocin is the love hormone - ✔✔increases positive social behaviors
and interactions, induces caring behaviors, and induces aggression and defensive
responses when needed
✔✔What control is galactopoiesis under? What does this mean? - ✔✔Autocrine (or
local) control takes over from the initial endocrine control of milk production in the early
days of postpartum. The rate of milk production (galactopoiesis) is related to the degree
of emptiness of the breast.
✔✔What is the feedback inhibitor of lactation - ✔✔as the alveolar lumen fills,
components of the retained milk itself (such as peptides and fatty acids) signal the
secretory cells to slow down milk synthesis
✔✔If suckling or other stimulation does not occur, prolactin levels will return to pre-
pregnancy levels in about ____ days. - ✔✔7
✔✔What are the 3 e's that keep prolactin levels high? - ✔✔Early and often: skin-to-skin
contact immediately after birth and continuing, frequent feeds including night feeds
Effective feeding: effective latch, active sucking, infant completes feeds
Exclusive breastfeeding: no artificial nipples, no artificial milk (unless medically
indicated)
✔✔Treatment for mother with high blood pressure after birth? - ✔✔skin-to-skin contact
and breastfeeding her infant, as this triggers the secretion of oxytocin, which has a
calming effect, lowers maternal blood pressure and cortisol levels, decreases anxiety
and aggressive behavior, and permeates the areas of the brain associated with
mothering and bonding behaviors
✔✔explain Primary insufficiency - ✔✔women with mammary hypoplasia have
insufficient glandular tissue, which is the primary condition that causes failed
lactogenesis II.
Breasts rarely develop sufficient tissue to sustain milk production
Women may not notice any breast changes during pregnancy
,Reason for condition is unknown
Physical symptoms: widely spaced and tubular shaped breasts, large areola, frequently
asymmetric breasts
✔✔Explain nipple conditions - ✔✔nipples that do not protrude may be inverted, so
infants may need time and support to learn to latch effectively (usually doesnt affect milk
production)
✔✔Explain anemia in terms of breastfeeding - ✔✔one study found that a postpartum
hemoglobin of <10g/dL was associated with insufficient milk supply. Further research
needed.
✔✔name 4 hormonal issues related to breastfeeding - ✔✔Retained placental products:
may alter the normal hormonal shifts that occur when the complete placenta is delivered
(decreased progesterone and increased prolactin). Milk supply can increase once the
retained products of the placenta are removed.
Polycystic ovarian syndrome (PCOS): may be associated with the abnormal release of
pituitary hormones, potentially leading to difficulty achieving full milk production
Low thyroid: may decrease milk supply without treatment (medication to regulate thyroid
levels corrects this)
Sheehan syndrome: occurs when the pituitary gland is damaged during childbirth due to
postpartum hemorrhage so severe that it causes pituitary infarct and necrosis (occurs in
0.01%-0.02% of postpartum women). This permanent condition causes lactation failure
in addition to other hormonal problems.
✔✔Explain how implants and reduction mammoplasty affect breastfeeding -
✔✔Implants: implants inserted through the axilla or under the breasts are lease likely to
impair breast function, whereas surgery through the areola or nipple is much more likely
to damage nerve pathways and ductal connections.
Reduction mammoplasty: often leads to failure of full milk production, depending on how
much of the breast was removed and the patency of the ductal structures and nerves.
Infants should do as much breastfeeding as possible, but supplemental feedings should
be offered if the infant shows signs of insufficient intake.
✔✔what is "The one intervention above any other that would improve neonatal and
maternal outcomes is Zero Separation for the first day of every newborn's life." - ✔✔skin
to skin contact
, ✔✔how to do ssc? - ✔✔the mother places the dried and naked infant (maybe in diaper)
in chest-to-chest position with nothing between them, such as blankets or clothing. The
infant's shoulders should be touching the mother's chest, and the infant's head should
be turned to the side, so the nose is not blocked. The infant's arms should be free on
the sides of the body to move as they wish. Mothers should be in a reclined position, not
flat. Blankets should cover both the mother and infant until temperature stability is
achieved.
✔✔True or false: For the first 12 hours after birth, skin-to-skin contact supports and may
shorten the transition period for infants because they reach physiological stability more
quickly. - ✔✔True
✔✔name 5 maternal benefits of ssc - ✔✔Promotes bonding and attachment: SSC and
early suckling in the first hour releases oxytocin, leading to a feeling of confidence and
comfort when caring for their infant
May prevent maternal depression: mothers who regularly engage in SSC in the
postpartum period report lower levels of depression, have a more significant reduction
of maternal salivary cortisol levels (which is an indication of less physiological stress),
and report less anxiety when caring for their infants
Increases interactions: one of the potent stressors for infants in their early life is the loss
of parental proximity, so mother-infant togetherness and parent-infant interaction
through SSC are vital as they increase bonding and attachment
Improves breastfeeding: infants who experience SSC with their mothers immediately
after birth are more likely to latch effectively, and immediate and uninterrupted SSC for
"the sacred hour" (at least one hour after birth) is the most effective way to promote
exclusive breastfeeding. SSC also significantly increases human milk volume and it
enhances maternal breastfeeding self-efficacy, which increases exclusive breastfeeding
duration
Operating rooms: women with no SSC after cesarean section surgery were 2.29x more
likely to use analgesic medication, and women who experienced SSC in the operating
room were 9.4x more likely to breastfeed and 3.25x more likely to exclusively
breastfeed
✔✔name 4 infant benefits of ssc - ✔✔Supports transition: SSC helps the infant to stay
warmer, have better temperature control in the postpartum period, maintain blood
glucose level, maintain regular breathing patterns, experience more efficient postnatal
metabolic adjustments, have improved cardio-respiratory stability, cry less at birth, have
lower cortisol levels, attain longer sleep periods and longer periods of alertness,
experience less caloric expenditure, gain weight faster, have improved brain
development, and have improved breastfeeding duration
Enhances brain development: SSC accelerates maturation and increases complexity in
infants' brain development
Decreases pain during painful procedures: SSC acts as non-pharmacological analgesia
for newborns and helps them cope with pain, including procedures such as vitamin K
injection and blood dot screening
