Deck 7: Nutrition During Lactation: Conditions and Interventions

Question 1

Infants who are diagnosed with galactosemia should not be breastfed.

Answer 1

True

Question 2

Treatment for plugged ducts would least likely include _____.

A) stopping breastfeeding until a health care provider is consulted
B) massaging the affected breast
C) applying a warm compress
D) changing nursing positions
E) taking one tablespoon of lecithin per day

Answer 2

A

Question 3

Human immunodeficiency virus can be transmitted from the mother to the infant through breastfeeding.

Answer 3

True

Question 4

A woman experiencing letdown failure may be prescribed a(n) _____ nasal spray.

A) oxytocin
B) estrogen
C) prolactin
D) lactogen
E) progesterone

Question 5

The best way to prevent sore nipples is to _____.

A) take a prophylactic dose of antibiotics
B) make sure the baby is positioned properly
C) place cabbage leaves on the breasts before nursing
D) place herbal salve on the nipple area
E) nurse frequently

Question 6

The Rush Mothers' Milk Club program uses a team approach to feeding very low-birthweight infants their own mothers' milk.

Question 7

Alcohol has been found to be a galactogogue that facilitates milk letdown and rectifies milk insufficiency.

Question 8

Any skin-to-skin contact with a premature infant in the neonatal intensive-care unit should be avoided.

Question 9

Severe nipple pain, the presence of nipple fissures, and pain that persists throughout a feeding are normal and do not require medical attention.

Question 10

The condition characterized by milk streaming from the breast as feeding begins is called _____.

A) mastitis
B) hyperactive letdown
C) hyperlactation
D) engorgement
E) letdown failure

Question 11

The highest-calorie portion of milk is usually produced during the last 10 minutes of pumping.

Question 12

Alcohol is transferred from the mother to the infant through her breast milk.

Question 13

The BPPOP mission was to improve the ability of AAP members to support new mothers and their breastfeeding infants.

Question 14

Which of the following is least likely to cause persistent nipple pain?

A) poor latch
B) improper release of suction after a feed
C) infection
D) pumping with excess suction
E) using a warm compress on nipples

Question 15

A nursing mom should avoid cabbage and legumes because they have the potential to cause gas in the baby.

Question 16

A woman with mastitis should continue to nurse her baby.

Question 17

Which of the following is true of hyperlactation?

A) It is a localized blockage of milk resulting from milk stasis.
B) It is a condition in which breast milk contains excess quantities of alcohol or other drugs.
C) It occurs when the milk volume produced by the mother exceeds the intake of the baby.
D) It is an inflammation of the breast.
E) It occurs when the milk volume produced by the mother is insufficient for the infant.

Question 18

The vast majority of women experience significant problems with breastfeeding.

Question 19

One effective treatment for a plugged duct is to _____.

A) use cabbage leaves
B) completely empty the breast
C) stop nursing and use a breast pump exclusively
D) take extra vitamin D
E) have a glass of red wine daily

Question 20

Medicinal herbs are regulated as dietary supplements and are tested for safety and efficacy.

Question 21

The recommendation by Lawrence and Lawrence for the use of herbal teas by nursing women is to choose _____.

A) teas using only herbs for essence
B) teas containing herbs with active principles
C) teas prepared with medicinal herbs
D) teas that have traditional uses dating back thousands of years
E) their tea of preference because all types of tea are safe

Question 22

Which of the following statements is true of opioids?

A) They are a group of synthetic medications that help promote milk production.
B) They are a group of herbal galactogogues.
C) They are a group of pain-relieving medications.
D) They are a group of medications that help women who suffer from letdown failure.
E) They are a group of medications that prevent the transmission of HIV from the mother to the fetus.

Question 23

Large doses of St. John's wort decrease prolactin levels in women. This could potentially _____.

A) reduce oxytocin levels
B) cause breast milk to taste like maple syrup
C) cause a woman to become constipated
D) reduce breast milk supply
E) cause depression in some women

Question 24

Which of the following is true of St. John's Wort?

A) It is used to provide artificial flavor in maple syrup and in teas.
B) It is used to increase capacity for mental work and physical activity.
C) It is widely used as a mood stabilizer and as an antidepressant.
D) It is reported to have estrogen-like effects in some women.
E) It increases prolactin levels, which cause an increase in breast milk supply.

Question 25

Management of early jaundice is best achieved by _____.

A) early and frequent breastfeeding
B) IV water feedings
C) increased formula feedings
D) dextrose feedings as a supplement to nursing
E) breastfeeding supplemented with formula feedings

Question 26

The ultimate test of drug safety for an infant is the _____ and any side effects on the infant.

A) infant's age
B) duration of dosing
C) measurement of the infant's plasma drug concentration
D) drug's exposure index
E) infant's feeding pattern

Question 27

_____ is known to inhibit lactation.

A) Oxytocin
B) Progesterone
C) Estrogen
D) Metoclopramide
E) Domperidone

Question 28

The brain and brain cells, if destroyed by bilirubin deposits, will _____.

A) regenerate in nearly all cases
B) regenerate in roughly half the cases
C) regenerate haphazardly, leading to brain cancer
D) not regenerate
E) regenerate immediately

Question 29

Breastfeeding women should avoid eating swordfish, shark, and tuna because they have high _____ levels.

A) mercury
B) iron
C) folate
D) calcium
E) nitrogen

Question 30

The American Academy of Pediatrics classifies _____ as a substance that is contraindicated during lactation.

A) alcohol
B) caffeine
C) THC
D) nicotine
E) sugar

Question 31

A breastfeeding mother asks you if alcohol can be eliminated from her breast milk by pumping immediately after drinking a few glasses of wine. What would you tell her?

A) Yes; in fact, discarding your breast milk is a good thing to do if you would like to drink while breastfeeding.
B) Yes; pumping will help, but you need to pump for the next 24 hours and discard any milk that you collect.
C) No; your breast milk will still contain alcohol; you will need to wait 1 hour per alcoholic beverage and then pump the milk and discard it to be safe.
D) No; the alcohol will still be in the breast milk and will clear from the milk as soon as it clears from the bloodstream: roughly 2 to 3 hours per drink for a 120-pound woman.
E) No; alcohol cannot be removed from breast milk; if she wishes to breastfeed, she must stop consuming alcohol.

Question 32

In the United States, the most frequent cause of hospital readmission during the first two weeks of life is _____.

A) hyperbilirubinemia
B) diabetes
C) Rh sensitization
D) hemolytic disease
E) kernicterus

Question 33

A lactating woman suffers from nausea, morning sickness, and flatulence. Which herbal tea would you recommend to her to ease her symptoms?

A) rose hips tea
B) peppermint tea
C) red bush tea
D) chicory tea
E) orange spice tea

Question 34

Alcohol may _____ milk letdown by _____ levels.

A) increase; increasing oxytocin
B) increase; decreasing oxytocin
C) increase; increasing prolactin
D) decrease; increasing oxytocin
E) decrease; decreasing oxytocin

Question 35

Symptoms of mastitis and plugged ducts are similar; however, _____ is/are accompanied by _____.

A) mastitis; migraines
B) mastitis; fever and flu-like symptoms
C) plugged ducts; migraines
D) plugged ducts; fever and flu-like symptoms
E) plugged ducts; weight gain

Question 36

Which contraceptive method does the World Health Organization advise women to avoid in the first six weeks postpartum?

A) condoms
B) progestin-only oral contraceptives
C) abstinence from sex
D) progestin-only implants
E) combined oral contraceptives

Question 37

_____ is an active ingredient in marijuana.

A) Domperidone
B) Delta-9-tetrahydrocannabinol
C) Coumarin
D) Pseudoephedrine
E) Metoclopramide

Question 38

Which of the following is a cause of low milk supply?

A) excessive breastfeeding
B) excessive pumping
C) inefficient emptying of the breast caused by a poor latch
D) complete emptying of the breast
E) small breast size

Question 39

Your friend had a baby 3 months ago and is anxious to go out with her friends. She is still breastfeeding but would like to have a few drinks. What would you suggest to your friend?

A) It is okay to drink alcohol while nursing because alcohol actually helps babies sleep.
B) It is okay to drink alcohol while nursing because alcohol increases breast milk production.
C) Pump the milk immediately after drinking alcohol, and it will be eliminated from the body.
D) Pump milk before going out and use that until the alcohol has been cleared from the system.
E) She should drink only beer because babies can tolerate it.

Question 40

A new mother was away from her infant longer than planned and could not nurse her baby until she returned 6 hours later. Which of the following problems is she most likely to experience?

A) a breast infection
B) engorgement
C) plugged ducts
D) sore nipples
E) mastitis

Question 41

A food allergy is an immunologic response, typically immunoglobulin _____ mediated, to a specific food protein.

A) A
B) D
C) E
D) G
E) M

Question 42

Mothers of multiples should _____.

A) feed formula to all their infants because their milk supply will not be enough to feed more than one infant
B) drink high amounts of water to increase their milk supply
C) eat food high in fats to ensure their milk has enough fat to nourish all their infants
D) obtain their nutrients from a well-balanced diet to ensure their milk can adequately nourish all their infants
E) take vitamin and mineral supplements to ensure their milk has adequate amounts to meet all of their infants' nutritional needs

Question 43

Which of the following are the most important biologically active compounds found in St. John's Wort?

A) steroid-like glycosides
B) delta-9-tetrahydrocannabinol and pyridoxine
C) codeine and tramadol
D) coumarins and flavonoids
E) hypericin and hyperforin

Question 44

Which statement correctly describes food allergy or food intolerance?

A) Food intolerance is mediated by the immune system.
B) A food allergy involves an adverse reaction to food mediated by metabolism or digestion but not the immune system.
C) A food allergy is mediated by high levels of immunoglobin A, which can be transferred from the mother to the infant through breastfeeding.
D) Food intolerance occurs only with nuts or nut products.
E) A food allergy is an exaggerated immunologic response.

Question 45

Which food is least likely to cause colic in breastfed infants?

A) garlic
B) chocolate
C) broccoli
D) apricots
E) cabbage

Question 46

The composition of milk from mothers who deliver preterm infants is higher in _____ and slightly lower in _____ content compared to the milk of mothers who deliver full-term infants.

A) protein and energy; lactose
B) lactose; protein and energy
C) lactose and protein; energy
D) energy; protein and lactose
E) protein; energy and lactose

Question 47

A full milk supply is considered _____ ounces per day.

A) 5-8
B) 10-15
C) 15-25
D) 25-35
E) 40-50

Question 48

Infants born between _____ weeks are considered late-preterm.

A) 28 and 30
B) 30 and 33
C) 34 and 37
D) 39 and 42
E) 42 and 45

Question 49

Breast milk that has been expressed and stored in a refrigerator can be kept safely for _____.

A) 2-3 days
B) 5-7 days
C) 2-3 weeks
D) 8-10 hours
E) 3-6 months

Question 50

To achieve breast milk banking production goals, mothers should try to begin pumping _____ post-delivery.

A) 1 hour
B) 6 hours
C) 1 day
D) 2-3 days
E) 3-4 days

Question 51

What is typically the main obstacle in nursing multiples?

A) insufficient nutrients in the milk
B) sleep deprivation
C) milk production capacity
D) time and fatigue
E) fatigue and milk production

Question 52

Bilirubin is a byproduct of the normal physiologic degradation of _____.

A) leukocytes
B) plasma
C) hemoglobin
D) lactose
E) glucose

Question 53

The total bilirubin content in the intestinal tract meconium of the average newborn is _____ mg.

A) 200
B) 375
C) 400
D) 450
E) 550

Question 54

Freshly expressed breast milk left at room temperature can be considered safe for a baby for up to _____ hours.

A) 1-3
B) 2-4
C) 3-5
D) 4-6
E) 6-8

Question 55

Which food item is least likely to be considered a common pediatric food allergen?

A) cow's milk
B) eggs
C) peanuts
D) soybeans
E) oats

Question 56

A lactating woman experiences localized pain in a red, hot, swollen area on the right breast and has a tender lump. She also experiences fever and flu-like symptoms. Which of the following conditions is she suffering from?

A) plugged ducts
B) breast abscess
C) engorgement
D) mastitis
E) sore nipples

Question 57

Breastfeeding should be strictly avoided if the mother _____.

A) smokes cigarettes daily
B) is consuming antihistamines
C) consumes more than 3 cups of coffee per day
D) is infected with HIV
E) is suffering from mastitis

Question 58

In most cases, symptoms of an infant's adverse reaction to an offending food will improve after the food has been removed from the mother's diet for _____.

A) 3 to 5 days
B) 5 to 7 days
C) 2 to 3 weeks
D) a month
E) 5 to 6 weeks

Question 59

The energy content of breast milk in women who deliver preterm infants is _____ kcal/100 mL.

A) 15-25
B) 30-37
C) 40-48
D) 58-70
E) 72-120

Question 60

Suboptimal breastfeeding can lead to jaundice because it can _____.

A) increase the intestinal absorption of bilirubin
B) lead to increased passage of meconium
C) cause a decrease in bilirubin concentration
D) decrease the hepatic circulation of bilirubin
E) increase fecal weight

Question 62

Milk banks store donated milk in plastic containers because _____.

A) they expedite shipping
B) they are less costly than glass
C) they keep white blood cells found in breast milk intact
D) it is easier to express milk into plastic containers
E) they inhibit the growth of any bacteria in the milk

Question 63

Discuss the prevention and treatment of severe jaundice.

Question 64

A woman with low milk supply visits her physician. She believes that she needs to switch from breastfeeding to feeding her infant with human milk supplement. What should the doctor explain to her about the causes of low milk supply, and what should be recommended to increase the woman's milk supply?

Question 65

Describe the purpose of milk banks and how they select women to provide milk.

Question 66

The mother of a late-preterm infant visits her physician because she is concerned she does not have adequate milk supply. How does her infant affect her milk supply, and what is the recommended course of action to help increase her supply of milk?

Question 67

List at least four major program components of the Rush Mothers' Milk Club.

Question 68

Which factor is least likely to be considered a cause for the scarcity of human milk banks in North America?

A) the availability of wet nurses as an alternative to banked milk
B) a resurgence of tuberculosis
C) HIV
D) risks related to donors who might use drugs
E) increasing demand

Question 69

Your friend is considering feeding her preterm infant formula rather than breastfeeding the infant because she is a working mom and believes that feeding the infant formula would be more convenient and supply sufficient nutrients. What would you tell her about the nutritional, health, and developmental benefits of breastfeeding preterm infants to persuade her to consider breastfeeding as the better option?

Question 70

Discuss the factors that influence the rate of transmission of HIV from the mother to the child through breastfeeding.