CBC Milk Expression & Storage 1 — Questions and Answers
Question 1: Which hand expression technique involves placing the thumb and forefinger in a C-hold approximately 1-2 inches behind the nipple and compressing toward the chest wall?
- Marmet technique (Correct answer)
- Dancer hand position
- Football hold compression
- Cross-cradle compression
Correct answer: Marmet technique
The Marmet technique uses a C-hold with thumb and forefinger 1-2 inches behind the nipple, compressing and rolling toward the chest to mimic the infant's milking action.
Question 2: At room temperature (up to 77°F/25°C), freshly expressed breast milk can safely be stored for up to:
- 2 hours
- 4 hours (Correct answer)
- 8 hours
- 12 hours
Correct answer: 4 hours
The CDC and ABM guidelines state that freshly expressed breast milk can be kept at room temperature (up to 77°F/25°C) for up to 4 hours.
Question 3: A mother asks how long she can store freshly expressed breast milk in a standard refrigerator at 40°F (4°C). The correct answer is:
- 24 hours
- 3 days
- 4 days (Correct answer)
- 7 days
Correct answer: 4 days
According to CDC guidelines, freshly expressed breast milk can be refrigerated for up to 4 days under clean conditions, though 3 days is optimal.
Question 4: When using an electric double breast pump, which of the following practices most effectively supports milk output?
- Starting at the highest suction setting immediately
- Beginning at low suction and short cycles to stimulate letdown, then increasing suction (Correct answer)
- Pumping one breast at a time for maximum duration
- Pumping immediately after feeding without any stimulation phase
Correct answer: Beginning at low suction and short cycles to stimulate letdown, then increasing suction
Initiating with low suction and a rapid cycle rate (stimulation phase) mimics the infant's initial rapid suckling to trigger letdown before switching to a slower, higher-suction expression phase.
Question 5: A mother is exclusively pumping and notices her output is decreasing. Which counseling recommendation is most evidence-based for increasing supply?
- Switching to a manual pump for all sessions
- Increasing pumping frequency rather than duration (Correct answer)
- Doubling pump session length to 40 minutes
- Stopping night pumping sessions to improve sleep
Correct answer: Increasing pumping frequency rather than duration
Milk production is driven by frequent and effective milk removal; increasing session frequency (removing milk more often) is more effective than extending individual session length.
Question 6: Previously frozen and thawed breast milk that has been refrigerated should be used within:
- 4 hours
- 12 hours
- 24 hours (Correct answer)
- 48 hours
Correct answer: 24 hours
Thawed breast milk should be used within 24 hours of thawing (from the time it is fully thawed, not from the time it is removed from the freezer).
Question 7: When counseling a mother about breast milk storage containers, which recommendation is most appropriate?
- Use any clean glass container regardless of lid type
- Use containers specifically designed for breast milk storage that are BPA-free and seal tightly (Correct answer)
- Reuse disposable bottle liners to reduce waste
- Store milk in any airtight food storage container
Correct answer: Use containers specifically designed for breast milk storage that are BPA-free and seal tightly
BPA-free containers specifically designed for breast milk storage ensure chemical safety and an airtight seal that protects milk quality and prevents contamination.
CBC Milk Expression & Storage 1
Which hand expression technique involves placing the thumb and forefinger in a C-hold approximately 1-2 inches behind the nipple and compressing toward the chest wall?