NSPN 7150 FINAL PAPER 2025/2026 QUESTIONS WITH
ANSWERS TAGGED A+
✔✔Are print and audiovisual educational materials effective on their own? - ✔✔No, but
they are used to support one-on-one education
✔✔HCPs that take a neutral view of breastfeeding are perceived by mothers as having
a preference for... - ✔✔bottle feeding
✔✔Human milk changes according to what 6 things? - ✔✔gestational and infant age,
stages of lactation, time of day of the feed, maternal diet, volume of human milk, and
infant health
✔✔Human milk has both _______________ components and is
_______________________ - ✔✔nutritional, bacteriostatic (inhibits bacteria from
growing and reproducing)
✔✔Oligosaccharides in human milk do what? - ✔✔They inhibit the proliferation of fungal
and viral pathogens, as well as bacteria, by indirectly modifying the cellular responses
of the infant's epithelial and immune cells (hence why human milk may safely be stored
at room temperature for up to 4-6 hours)
✔✔True or false: The quality of the milk for the infant does not change. - ✔✔True
✔✔How does gestational age affect human milk composition? - ✔✔preterm milk is
higher in protein and anti-infective properties to meet the needs of preterm infants
✔✔Explain the 3 stages of lactation - ✔✔Stage I: most women begin to produce
colostrum in the last trimester of pregnancy and for about 2-4 days after birth.
Colostrum has higher concentration of protein, minerals, and immunoglobulins, but has
less fat than mature milk.
Stage II: the onset of copious milk secretion after birth (days 2-3 to 8 postpartum)
Stage III: secretion of mature milk
✔✔What is colostrum? What is it very high in? What is it considered? What does it
contain (5)? What happens since colostrum is produced in small amounts? - ✔✔the first
milk available to the infant that is high density and low volume, which is perfect for
newborn stomach capacity. It is very high in immunoglobulins (especially IgA), and is
considered the "first immunization". Preterm colostrum has even higher
immunoglobulins and other anti-infective properties.
,Contains lactose (prevents hypoglycemia, facilitates meconium passage to help excrete
bilirubin), laxatives (soft stooling), whey/casein ratio of 80/20 (aids disgestion), all 10
amino acids (low renal solute load for immature kidneys), and a high level of stem cells
(50,000 stem cells/mL, amounting to 5 million stem cells/kg body weight per day during
the first five days of breastfeeding)
Because colostrum is produced in small amounts, infants will nurse frequently and this
will help to establish a good milk supply.
✔✔How does time of day affect human milk composition? - ✔✔in the night, human milk
tends to be higher in fat content and lower in volume, which helps the infant to have
more extended periods of sleep throughout the night
✔✔How does the stage of the feed affect human milk composition? Why is the maternal
diet relevant? - ✔✔foremilk (95% of volume) and hindmilk (5% of volume)
Level of lactose is relatively stable throughout the feed
Increase in fat concentration throughout the feed
Mothers who are not always able to eat proper food still produce nutritious milk, but a
proper diet is the best way to ensure that the mother has energy to care for herself and
her infant
✔✔How does the maternal diet (particularly fat intake) affect human milk consumption?
- ✔✔the total amount of fat in the mother's diet does not affect the amount of fat in
human milk (but the types of fat in her diet influence the fatty acids in her human milk)
✔✔How does the age of the infant affect human milk consumption? What do the infant's
salivary amylase do? - ✔✔each mother's milk continually changes to meet the needs of
her infant from neonate to toddler. The infant's salivary amylase fine-tunes what is in the
breast milk to provide exactly what the infant needs.
✔✔How does tandem nursing affect human milk? - ✔✔when tandem nursing
(breastfeeding two siblings of different ages), the body always compensates to meet the
needs of the infant and the colostrum quickly changes to milk. Since each breast
produces milk independently of the other, the breast milk will adapt to feeding two
children with different needs if each nurses only on one breast.
✔✔How does illness in mother or infant affect human milk consumption? - ✔✔The
mother's immune system will create antibodies in response to pathogens her infant is
exposed to. These specific anti-infective factors go into her milk to help protect her
infant.
✔✔Should mothers breastfeed their infants even when they have the flu or a cold? -
✔✔Yes, mothers should breastfeed their infants even when they have the flu or a cold.
,Explain that her immune system is more mature than her infant's and will provide more
protection to her infant since she has probably already been exposed.
✔✔What is stage 1 of lactation called? What happens? - ✔✔Mammogenesis (growth
and development of the mammary gland) → causes the rapid development of additional
glandular tissue and ducts and darkening of areolar pigments
✔✔When does breast development begin - ✔✔About 5 weeks of fetal life
✔✔What happens to breast development during puberty - ✔✔during each menstrual
cycle, estrogen causes further arborization of the ducts (fine branching structures at the
end of nerve fibers which greatly increase during pregnancy and lactation) and
progesterone causes the proliferation of glandular tissue.
✔✔When do breasts fully develop? What happens at the age of 30? - ✔✔breasts
usually fully develop by age 20. During each menstrual cycle, further growth and
development occurs during the follicular and ovulatory phase then regresses. However,
until age 30, changes occurring with each cycle are advantageous as the post-
menstrual cycle regression isn't complete.
✔✔What happens to breast development during pregnancy? - ✔✔mammogenesis
causes the rapid development of additional glandular tissue and ducts and darkening of
areola pigments.
✔✔What is lactogenesis II (lactating) - ✔✔full secretory activity of alveolar cells and the
production of milk
✔✔What is stage 2 of lactation? What happens? - ✔✔Lactogenesis -> the functional
change of the breasts to produce milk
✔✔What is lactogenesis I - ✔✔the onset of milk secretion and begins because of the
changes in the breast during pregnancy and continues until full milk production occurs
in the first few days of the postpartum period
prepares breast tissue for milk synthesis through colostrum production → prolactin
hormone prepares breast tissue for milk synthesis during the second half of pregnancy
and produces colostrum
✔✔What is lactogenesis II - ✔✔copious milk production beginning approximately 2 days
after birth → occurs 2-3 days postpartum and is the onset of copious milk production
✔✔What is lactogenesis stage II triggered by? - ✔✔by the hormonal shift that occurs
with the delivery of the placenta and occurs whether or not a woman breastfeeds.
, ✔✔What is stage 3 of lactation? What happens? - ✔✔Galactopoiesis (maintaining the
production of milk - lactogenesis III) → the process of continued secretion of copious
milk (mature milk) and requires regular milk removal)
✔✔What does breast milk production mainly depends on? (2) - ✔✔adequate oxytocin
and prolactin levels & adequate milk removal from breasts.
✔✔By day 10, the composition of milk is called what? - ✔✔Mature Milk
✔✔What is stage 4 of lactation? What happens? - ✔✔Involution (termination of milk
production)
✔✔Involution or termination of milk production takes how many days after the last
feeding? - ✔✔40 days
✔✔True or false: During involution, the experience for the mother and the composition
of her milk will be the same whether the process of involution is abrupt or gradual. -
✔✔False. The process can be abrupt or gradual, and it affects mother's experience and
milk composition
✔✔The ducts in lactating breasts widen as they fill with milk, acting more like
________________________ rather than _____________________________ -
✔✔transport systems
storage systems
✔✔True or false: The size and shape of the breast are not accurate indicators of its
ability to produce milk. - ✔✔true
✔✔True or false: The lactiferous sinuses behind the nipples often need to be
compressed to hand express milk. - ✔✔False
✔✔True or false: As soon as the placenta delivers, the spaces between the alveolar
cells close due to the hormonal changes. - ✔✔False
✔✔True or false: The breast size increases during pregnancy to correspond to growth
of glandular and adipose tissue, and the nipples become more flattened. - ✔✔False
✔✔What is polymastia and how often does it occur? how is it treated? - ✔✔accessory
mammary tissue
Extra breast tissue which can occur anywhere along the primitive milk line
ANSWERS TAGGED A+
✔✔Are print and audiovisual educational materials effective on their own? - ✔✔No, but
they are used to support one-on-one education
✔✔HCPs that take a neutral view of breastfeeding are perceived by mothers as having
a preference for... - ✔✔bottle feeding
✔✔Human milk changes according to what 6 things? - ✔✔gestational and infant age,
stages of lactation, time of day of the feed, maternal diet, volume of human milk, and
infant health
✔✔Human milk has both _______________ components and is
_______________________ - ✔✔nutritional, bacteriostatic (inhibits bacteria from
growing and reproducing)
✔✔Oligosaccharides in human milk do what? - ✔✔They inhibit the proliferation of fungal
and viral pathogens, as well as bacteria, by indirectly modifying the cellular responses
of the infant's epithelial and immune cells (hence why human milk may safely be stored
at room temperature for up to 4-6 hours)
✔✔True or false: The quality of the milk for the infant does not change. - ✔✔True
✔✔How does gestational age affect human milk composition? - ✔✔preterm milk is
higher in protein and anti-infective properties to meet the needs of preterm infants
✔✔Explain the 3 stages of lactation - ✔✔Stage I: most women begin to produce
colostrum in the last trimester of pregnancy and for about 2-4 days after birth.
Colostrum has higher concentration of protein, minerals, and immunoglobulins, but has
less fat than mature milk.
Stage II: the onset of copious milk secretion after birth (days 2-3 to 8 postpartum)
Stage III: secretion of mature milk
✔✔What is colostrum? What is it very high in? What is it considered? What does it
contain (5)? What happens since colostrum is produced in small amounts? - ✔✔the first
milk available to the infant that is high density and low volume, which is perfect for
newborn stomach capacity. It is very high in immunoglobulins (especially IgA), and is
considered the "first immunization". Preterm colostrum has even higher
immunoglobulins and other anti-infective properties.
,Contains lactose (prevents hypoglycemia, facilitates meconium passage to help excrete
bilirubin), laxatives (soft stooling), whey/casein ratio of 80/20 (aids disgestion), all 10
amino acids (low renal solute load for immature kidneys), and a high level of stem cells
(50,000 stem cells/mL, amounting to 5 million stem cells/kg body weight per day during
the first five days of breastfeeding)
Because colostrum is produced in small amounts, infants will nurse frequently and this
will help to establish a good milk supply.
✔✔How does time of day affect human milk composition? - ✔✔in the night, human milk
tends to be higher in fat content and lower in volume, which helps the infant to have
more extended periods of sleep throughout the night
✔✔How does the stage of the feed affect human milk composition? Why is the maternal
diet relevant? - ✔✔foremilk (95% of volume) and hindmilk (5% of volume)
Level of lactose is relatively stable throughout the feed
Increase in fat concentration throughout the feed
Mothers who are not always able to eat proper food still produce nutritious milk, but a
proper diet is the best way to ensure that the mother has energy to care for herself and
her infant
✔✔How does the maternal diet (particularly fat intake) affect human milk consumption?
- ✔✔the total amount of fat in the mother's diet does not affect the amount of fat in
human milk (but the types of fat in her diet influence the fatty acids in her human milk)
✔✔How does the age of the infant affect human milk consumption? What do the infant's
salivary amylase do? - ✔✔each mother's milk continually changes to meet the needs of
her infant from neonate to toddler. The infant's salivary amylase fine-tunes what is in the
breast milk to provide exactly what the infant needs.
✔✔How does tandem nursing affect human milk? - ✔✔when tandem nursing
(breastfeeding two siblings of different ages), the body always compensates to meet the
needs of the infant and the colostrum quickly changes to milk. Since each breast
produces milk independently of the other, the breast milk will adapt to feeding two
children with different needs if each nurses only on one breast.
✔✔How does illness in mother or infant affect human milk consumption? - ✔✔The
mother's immune system will create antibodies in response to pathogens her infant is
exposed to. These specific anti-infective factors go into her milk to help protect her
infant.
✔✔Should mothers breastfeed their infants even when they have the flu or a cold? -
✔✔Yes, mothers should breastfeed their infants even when they have the flu or a cold.
,Explain that her immune system is more mature than her infant's and will provide more
protection to her infant since she has probably already been exposed.
✔✔What is stage 1 of lactation called? What happens? - ✔✔Mammogenesis (growth
and development of the mammary gland) → causes the rapid development of additional
glandular tissue and ducts and darkening of areolar pigments
✔✔When does breast development begin - ✔✔About 5 weeks of fetal life
✔✔What happens to breast development during puberty - ✔✔during each menstrual
cycle, estrogen causes further arborization of the ducts (fine branching structures at the
end of nerve fibers which greatly increase during pregnancy and lactation) and
progesterone causes the proliferation of glandular tissue.
✔✔When do breasts fully develop? What happens at the age of 30? - ✔✔breasts
usually fully develop by age 20. During each menstrual cycle, further growth and
development occurs during the follicular and ovulatory phase then regresses. However,
until age 30, changes occurring with each cycle are advantageous as the post-
menstrual cycle regression isn't complete.
✔✔What happens to breast development during pregnancy? - ✔✔mammogenesis
causes the rapid development of additional glandular tissue and ducts and darkening of
areola pigments.
✔✔What is lactogenesis II (lactating) - ✔✔full secretory activity of alveolar cells and the
production of milk
✔✔What is stage 2 of lactation? What happens? - ✔✔Lactogenesis -> the functional
change of the breasts to produce milk
✔✔What is lactogenesis I - ✔✔the onset of milk secretion and begins because of the
changes in the breast during pregnancy and continues until full milk production occurs
in the first few days of the postpartum period
prepares breast tissue for milk synthesis through colostrum production → prolactin
hormone prepares breast tissue for milk synthesis during the second half of pregnancy
and produces colostrum
✔✔What is lactogenesis II - ✔✔copious milk production beginning approximately 2 days
after birth → occurs 2-3 days postpartum and is the onset of copious milk production
✔✔What is lactogenesis stage II triggered by? - ✔✔by the hormonal shift that occurs
with the delivery of the placenta and occurs whether or not a woman breastfeeds.
, ✔✔What is stage 3 of lactation? What happens? - ✔✔Galactopoiesis (maintaining the
production of milk - lactogenesis III) → the process of continued secretion of copious
milk (mature milk) and requires regular milk removal)
✔✔What does breast milk production mainly depends on? (2) - ✔✔adequate oxytocin
and prolactin levels & adequate milk removal from breasts.
✔✔By day 10, the composition of milk is called what? - ✔✔Mature Milk
✔✔What is stage 4 of lactation? What happens? - ✔✔Involution (termination of milk
production)
✔✔Involution or termination of milk production takes how many days after the last
feeding? - ✔✔40 days
✔✔True or false: During involution, the experience for the mother and the composition
of her milk will be the same whether the process of involution is abrupt or gradual. -
✔✔False. The process can be abrupt or gradual, and it affects mother's experience and
milk composition
✔✔The ducts in lactating breasts widen as they fill with milk, acting more like
________________________ rather than _____________________________ -
✔✔transport systems
storage systems
✔✔True or false: The size and shape of the breast are not accurate indicators of its
ability to produce milk. - ✔✔true
✔✔True or false: The lactiferous sinuses behind the nipples often need to be
compressed to hand express milk. - ✔✔False
✔✔True or false: As soon as the placenta delivers, the spaces between the alveolar
cells close due to the hormonal changes. - ✔✔False
✔✔True or false: The breast size increases during pregnancy to correspond to growth
of glandular and adipose tissue, and the nipples become more flattened. - ✔✔False
✔✔What is polymastia and how often does it occur? how is it treated? - ✔✔accessory
mammary tissue
Extra breast tissue which can occur anywhere along the primitive milk line
