NSPN 7150 COMPREHENSIVE EXAM 2025/2026 QUESTIONS
WITH ANSWERS TAGGED A+
✔✔things that can help support breastfeeding for infants (7) - ✔✔young infants should
have whole torso right up against their mother, infant is best tucked in close tummy
facing the mother with their chin on the breast, the mother's hand should be placed at
the base of the infant's head (nape of the neck) to avoid pressure against the occiput
(which can cause the infant to arch away from the breast), the mother positions her
infant with the nipple directed towards the infant's nose, and cupping the breast in a C
or U shape aligning the mother's thumb with the infant's nose can be helpful. The laid-
back position may trigger the infant's innate feeding behaviors, often latching without
assistance.
✔✔3 key things about breastfeeding positions - ✔✔do not bend over (bring infant to
mother, not mother to infant), keep infant's body and head aligned straight, use pillow(s)
to support mother's arms and the infant (comfort)
✔✔signs of effective feeding for the mother (10) - ✔✔feels infant sucking strongly, milk
may leak from other breast, warm rush or tingling in breasts with milk ejection, uterine
contractions during/after feeding for the first few days postpartum, feels relaxed/drowsy
towards end of feed, breasts are full before feeding and soft after feeding (after day 3 or
4) (breasts soft all the time after several weeks despite having lots of milk), elongated
and round nipples after the feed, no cracks/blisters/bleeding/pain, feeling of milk
"coming in" (day 3 or 4), increased thirst
✔✔Signs of effective feeding for infant (15) - ✔✔chin touching breast with nose slightly
away, rapid suckling for the first few moments, rhythmic suckling as milk flows,
deep/strong sucks with occasional pauses, temple muscles move with each suck (15-20
sucks/swallows at a time), lips flanged out, mouth wide open, tongue underneath breast
and over alveolar ridge, full and round cheeks (no dimples), audible swallows ("ca"
sound), no clikcing/smacking sounds, relaxed body (no clenched hands), milk evident
in/around mouth, easily releases breast after feeding, satisfied after feed (relaxed
posture, sleepy), appropriate urine and stool output (3 BMs and 6-8 wet diapers every
24 hours after day 4)
✔✔Signs of poor feeding in newly born infant (8) - ✔✔infant falls asleep at the breast,
infant squirms or pulls off and on the breast, infant has tight/pursed lips or lower lip is
pulled in or cheeks are dimpled, infant sucks quickly but lets go of breast without
resistance if repositioned, mother experiences significant pain, nipple looks pointed at
the rip after the feed, nipples are cracked/scabbed/bleeding/blistered, infant is
experience excessive weight loss or poor weight gain
✔✔What is the LATCH tool? - ✔✔a standardized breastfeeding score tool that assesses
effective breastfeeding for mothers and infants, with a score less than 7 requiring
additional evaluation and possible lactation consultation
,✔✔What does LATCH stand for? - ✔✔latch, audible swallowing, type of nipple, comfort
(breast/nipple), and hold (positioning)
✔✔Which state is the best time for feeding - ✔✔Quiet alert
✔✔Quiet alert state hunger/feeding cues (5) - ✔✔sucking movements, sucking sounds,
hand-to-mouth movements, soft cooing, sighing sounds
✔✔how many wet diapers and meconiums should an infant have on day 2 - ✔✔The
newborn infant is expected to have two wet diapers and at least one meconium stool on
day 2.
✔✔Crying tends to increase at about _____ weeks, and increases weekly and
continues until about ____-____ months of age - ✔✔2 weeks
3-4 months of age
✔✔At the peak of early infant crying (around two months), infants cry for anywhere
between ____ minutes and _____ hours within 24 hours - ✔✔20 minutes, 6 hours
✔✔What does PURPLE crying stand for - ✔✔peak of crying, unexpected, resists
soothing, pain-like face, long lasting, and evening
✔✔Soothing methods for infant crying? (7) - ✔✔responding quickly to an infant's cues
before crying, feeding, interacting with the infant (talking, making faces, singing, cooing,
etc.), carrying the infant a lot, changing the infant's position, using movement (walking,
dancing, swaying, pushing in a stroller, going for a ride in the car, etc.), and providing
white noise or repetitive sounds (vacuums, singing, fans, noise machine, etc.)
✔✔what is the General principle for frequent feeding? - ✔✔"watch the baby, not the
clock" (on-demand feeding, meaning the infant determines the frequency of feeds)
✔✔With on-demand feeding, infants should feed at least... - ✔✔eight times in 24 hours,
if not more
✔✔Mothers of infants who do not display hunger cues as clearly and frequently (ex. late
preterm, jaundiced, etc.) should... - ✔✔put the infant skin-to-skin and attempt to feed at
least every 2-3 hours, transitioning to on-demand feeding when appropriate
✔✔Newborns breastfeed every ___-____ hours in the first weeks (watch sleep/wake
behaviors, identify quiet alert state and early feeding cues) and ____ or more times in
24 hours (no upper limit) - ✔✔1-3
, 8
✔✔duration of feeds depends on ... (5) - ✔✔infant's gestational age and ability to suck,
state of consciousness, breastfeeding position and latch, how quickly human milk lets
down, and maternal comfort
✔✔3 signs that infants are full - ✔✔when sucking and swallowing slows or stops, infants
close their mouths or push away from the breast after feeding, and infants are content
or relaxed after feeding
✔✔While infants decide how long to breastfeeding, in the early postpartum period, the
average time for feeding is... - ✔✔30-40 minutes for both breasts (approximately 15-20
minutes per breast). As infants grow, their feeding duration decreases because they get
more efficient in feeding.
✔✔Mothers can expect their infants to start gaining weight by day 5 and return to their
birth weight by... - ✔✔7-10 days, or three weeks for vulnerable infants
✔✔Steady weight gains of approximately _____ g per week are expected for infants
between the ages of 2 weeks and 3 months (after 3 months, the minimum acceptable
weight gain is lower) - ✔✔200g
✔✔Using a 24-hour baseline weight for assessing newborn weight is recommended
to.... - ✔✔rule out any effects from the birth process (ex. Fluid overload due to
excessive intrapartum fluid)
✔✔3 things to assess When infant weight gain or loss issues are identified: - ✔✔If infant
is adequately fed (supplementation may be required)
What the root cause(s) of low milk production (ex. jaundice, hydration, general health,
feeding, congenital malformation, etc.)
Present since birth? When did it become apparent? Breastfeeding management
problems? Primary factors related to the parent? Reason for infant's inability to remove
milk if milk remains in the breast after feeding?
Milk production support to address problems as soon as possible
✔✔When an infant's weight loss approaches or exceeds _____% of birth weight, health
care providers should assess what before discharge? (and the mother should be
provided with additional education and lactation support.) - ✔✔10%
adequacy of feeding (such as feeding position, latch, and swallow)
✔✔is weight loss alone an indication for automatic supplementation? - ✔✔No
WITH ANSWERS TAGGED A+
✔✔things that can help support breastfeeding for infants (7) - ✔✔young infants should
have whole torso right up against their mother, infant is best tucked in close tummy
facing the mother with their chin on the breast, the mother's hand should be placed at
the base of the infant's head (nape of the neck) to avoid pressure against the occiput
(which can cause the infant to arch away from the breast), the mother positions her
infant with the nipple directed towards the infant's nose, and cupping the breast in a C
or U shape aligning the mother's thumb with the infant's nose can be helpful. The laid-
back position may trigger the infant's innate feeding behaviors, often latching without
assistance.
✔✔3 key things about breastfeeding positions - ✔✔do not bend over (bring infant to
mother, not mother to infant), keep infant's body and head aligned straight, use pillow(s)
to support mother's arms and the infant (comfort)
✔✔signs of effective feeding for the mother (10) - ✔✔feels infant sucking strongly, milk
may leak from other breast, warm rush or tingling in breasts with milk ejection, uterine
contractions during/after feeding for the first few days postpartum, feels relaxed/drowsy
towards end of feed, breasts are full before feeding and soft after feeding (after day 3 or
4) (breasts soft all the time after several weeks despite having lots of milk), elongated
and round nipples after the feed, no cracks/blisters/bleeding/pain, feeling of milk
"coming in" (day 3 or 4), increased thirst
✔✔Signs of effective feeding for infant (15) - ✔✔chin touching breast with nose slightly
away, rapid suckling for the first few moments, rhythmic suckling as milk flows,
deep/strong sucks with occasional pauses, temple muscles move with each suck (15-20
sucks/swallows at a time), lips flanged out, mouth wide open, tongue underneath breast
and over alveolar ridge, full and round cheeks (no dimples), audible swallows ("ca"
sound), no clikcing/smacking sounds, relaxed body (no clenched hands), milk evident
in/around mouth, easily releases breast after feeding, satisfied after feed (relaxed
posture, sleepy), appropriate urine and stool output (3 BMs and 6-8 wet diapers every
24 hours after day 4)
✔✔Signs of poor feeding in newly born infant (8) - ✔✔infant falls asleep at the breast,
infant squirms or pulls off and on the breast, infant has tight/pursed lips or lower lip is
pulled in or cheeks are dimpled, infant sucks quickly but lets go of breast without
resistance if repositioned, mother experiences significant pain, nipple looks pointed at
the rip after the feed, nipples are cracked/scabbed/bleeding/blistered, infant is
experience excessive weight loss or poor weight gain
✔✔What is the LATCH tool? - ✔✔a standardized breastfeeding score tool that assesses
effective breastfeeding for mothers and infants, with a score less than 7 requiring
additional evaluation and possible lactation consultation
,✔✔What does LATCH stand for? - ✔✔latch, audible swallowing, type of nipple, comfort
(breast/nipple), and hold (positioning)
✔✔Which state is the best time for feeding - ✔✔Quiet alert
✔✔Quiet alert state hunger/feeding cues (5) - ✔✔sucking movements, sucking sounds,
hand-to-mouth movements, soft cooing, sighing sounds
✔✔how many wet diapers and meconiums should an infant have on day 2 - ✔✔The
newborn infant is expected to have two wet diapers and at least one meconium stool on
day 2.
✔✔Crying tends to increase at about _____ weeks, and increases weekly and
continues until about ____-____ months of age - ✔✔2 weeks
3-4 months of age
✔✔At the peak of early infant crying (around two months), infants cry for anywhere
between ____ minutes and _____ hours within 24 hours - ✔✔20 minutes, 6 hours
✔✔What does PURPLE crying stand for - ✔✔peak of crying, unexpected, resists
soothing, pain-like face, long lasting, and evening
✔✔Soothing methods for infant crying? (7) - ✔✔responding quickly to an infant's cues
before crying, feeding, interacting with the infant (talking, making faces, singing, cooing,
etc.), carrying the infant a lot, changing the infant's position, using movement (walking,
dancing, swaying, pushing in a stroller, going for a ride in the car, etc.), and providing
white noise or repetitive sounds (vacuums, singing, fans, noise machine, etc.)
✔✔what is the General principle for frequent feeding? - ✔✔"watch the baby, not the
clock" (on-demand feeding, meaning the infant determines the frequency of feeds)
✔✔With on-demand feeding, infants should feed at least... - ✔✔eight times in 24 hours,
if not more
✔✔Mothers of infants who do not display hunger cues as clearly and frequently (ex. late
preterm, jaundiced, etc.) should... - ✔✔put the infant skin-to-skin and attempt to feed at
least every 2-3 hours, transitioning to on-demand feeding when appropriate
✔✔Newborns breastfeed every ___-____ hours in the first weeks (watch sleep/wake
behaviors, identify quiet alert state and early feeding cues) and ____ or more times in
24 hours (no upper limit) - ✔✔1-3
, 8
✔✔duration of feeds depends on ... (5) - ✔✔infant's gestational age and ability to suck,
state of consciousness, breastfeeding position and latch, how quickly human milk lets
down, and maternal comfort
✔✔3 signs that infants are full - ✔✔when sucking and swallowing slows or stops, infants
close their mouths or push away from the breast after feeding, and infants are content
or relaxed after feeding
✔✔While infants decide how long to breastfeeding, in the early postpartum period, the
average time for feeding is... - ✔✔30-40 minutes for both breasts (approximately 15-20
minutes per breast). As infants grow, their feeding duration decreases because they get
more efficient in feeding.
✔✔Mothers can expect their infants to start gaining weight by day 5 and return to their
birth weight by... - ✔✔7-10 days, or three weeks for vulnerable infants
✔✔Steady weight gains of approximately _____ g per week are expected for infants
between the ages of 2 weeks and 3 months (after 3 months, the minimum acceptable
weight gain is lower) - ✔✔200g
✔✔Using a 24-hour baseline weight for assessing newborn weight is recommended
to.... - ✔✔rule out any effects from the birth process (ex. Fluid overload due to
excessive intrapartum fluid)
✔✔3 things to assess When infant weight gain or loss issues are identified: - ✔✔If infant
is adequately fed (supplementation may be required)
What the root cause(s) of low milk production (ex. jaundice, hydration, general health,
feeding, congenital malformation, etc.)
Present since birth? When did it become apparent? Breastfeeding management
problems? Primary factors related to the parent? Reason for infant's inability to remove
milk if milk remains in the breast after feeding?
Milk production support to address problems as soon as possible
✔✔When an infant's weight loss approaches or exceeds _____% of birth weight, health
care providers should assess what before discharge? (and the mother should be
provided with additional education and lactation support.) - ✔✔10%
adequacy of feeding (such as feeding position, latch, and swallow)
✔✔is weight loss alone an indication for automatic supplementation? - ✔✔No
