CLC Breastfeeding Challenges & Clinical Solutions 2 — Questions and Answers
Question 1: What is the recommended position for breastfeeding a baby with gastroesophageal reflux?
- An upright or semi-upright position to reduce reflux episodes (Correct answer)
- A flat, lying-down position
- A head-down position to aid digestion
- Position does not affect reflux
Correct answer: An upright or semi-upright position to reduce reflux episodes
Keeping the baby more upright during and after feeding helps reduce reflux by using gravity to keep milk in the stomach. The laid-back or upright positions minimize the flow of milk back up the esophagus.
Question 2: What is a galactagogue and when might a lactation counselor discuss it?
- A substance believed to increase breast milk production, discussed when other supply-building strategies have been tried first (Correct answer)
- A medication to stop lactation
- A type of breast pump
- A formula supplement for low-weight infants
Correct answer: A substance believed to increase breast milk production, discussed when other supply-building strategies have been tried first
Galactagogues are foods, herbs, or medications believed to increase milk supply. Lactation counselors may discuss them after addressing latch, feeding frequency, and other evidence-based supply management strategies.
Question 3: What is the proper storage duration for expressed breast milk at room temperature (77°F/25°C)?
- Up to 4 hours (Correct answer)
- Up to 8 hours
- Up to 24 hours
- Up to 1 hour
Correct answer: Up to 4 hours
According to CDC guidelines, freshly expressed breast milk can be stored at room temperature (up to 77°F/25°C) for up to 4 hours. After that, it should be refrigerated or discarded.
Question 4: What role does skin-to-skin contact play in establishing breastfeeding?
- It triggers the baby's innate feeding reflexes, regulates temperature, and promotes bonding and milk production (Correct answer)
- It is only important for premature babies
- It has no effect on breastfeeding outcomes
- It should be limited to 5 minutes after birth
Correct answer: It triggers the baby's innate feeding reflexes, regulates temperature, and promotes bonding and milk production
Immediate skin-to-skin contact after birth activates the baby's instinctive feeding behaviors, stabilizes temperature and heart rate, promotes oxytocin release in the mother, and significantly improves breastfeeding initiation and duration.
Question 5: When should a lactation counselor recommend a mother seek medical evaluation rather than continuing lactation counseling alone?
- When there are signs of infection (fever, red streaks), significant infant weight loss, or jaundice (Correct answer)
- Only when the mother requests a referral
- Never, as lactation counselors handle all breastfeeding issues
- Only after six weeks of unsuccessful breastfeeding
Correct answer: When there are signs of infection (fever, red streaks), significant infant weight loss, or jaundice
Lactation counselors must recognize when issues exceed their scope of practice. Medical referral is indicated for signs of infection, significant infant weight loss (>10% of birth weight), jaundice, or other clinical concerns.
Question 6: What is the WHO recommendation for exclusive breastfeeding duration?
- 6 months of exclusive breastfeeding, with continued breastfeeding alongside complementary foods up to 2 years or beyond (Correct answer)
- 3 months of exclusive breastfeeding
- 12 months of exclusive breastfeeding
- Until the baby's first tooth appears
Correct answer: 6 months of exclusive breastfeeding, with continued breastfeeding alongside complementary foods up to 2 years or beyond
The World Health Organization recommends exclusive breastfeeding for the first 6 months of life, followed by nutritionally adequate and safe complementary foods with continued breastfeeding up to 2 years of age or beyond.
CLC Breastfeeding Challenges & Clinical Solutions 2
What is the recommended position for breastfeeding a baby with gastroesophageal reflux?