Question 1

Which action by the mother will initiate the milk ejection reflex (MER)?

Accepted Answer

Oxytocin,which causes the MER reflex,increases in response to nipple stimulation.A firm bra is important to support the breast; however,it will not initiate the MER reflex.Drinking plenty of fluids is necessary for adequate milk production,but adequate intake of water alone will not initiate the MER reflex.Cool packs to the breast will decrease the MER reflex.

Question 2

Which type of formula is not diluted with water,before being administered to an infant?

Accepted Answer

Ready-to-use formula can be poured directly from the can into the baby's bottle and is good (but expensive)when a proper water supply is not available.Formula should be well mixed to dissolve the powder and make it uniform in consistency.Improper dilution of concentrated formula may cause malnutrition or sodium imbalances.Cow's milk is more difficult for the infant to digest and is not recommended,even if it is diluted.

Question 3

Which statements concerning the benefits or limitations of breastfeeding are accurate?
(Select all that apply).

Accepted Answer

Breastfeeding actually decreases the risk of childhood obesity.Human milk is the perfect food for human infants.Breast milk changes over time to meet the demands of the growing infant.Scientific evidence is clear that human milk provides the best nutrients for infants with continued benefits long after weaning.Fatty acids in breast milk promote brain growth and development and may lead to enhanced cognition.Infants who are breastfed experience a reduced incidence of SIDS.

Question 4

The AAP recommends pasteurized donor milk for preterm infants if the mother's own milk in not available.Which statements regarding donor milk and milk banking are important for the nurse to understand and communicate to her client?
(Select all that apply).

Accepted Answer

Because of the antiinfective and growth promotion properties for donor milk,donor milk is highly recommended for preterm and sick infants,as well as for term newborns.Human donor milk has also been used for older children with short gut syndrome,immunodeficiencies,metabolic disorders,or congenital anomalies.Human donor milk has also been used in the adult population-posttransplant clients and for those with colitis,ulcers,or cirrhosis of the liver.Some mothers acquire milk through Internet-based or community-based milk sharing.The U.S.Food and Drug Administration (FDA)has issued a warning regarding this practice.Samples of milk from these sources are higher in contaminants and infectious disease.A milk bank that belongs to the Human Milk Banking Association of North America should always be used for donor milk.All donors are scrupulously screened,and the milk is tested to determine its safety for use.

Question 5

The breastfeeding mother should be taught a safe method to remove the breast from the baby's mouth.Which suggestion by the nurse is most appropriate?

Accepted Answer

Inserting a finger into the corner of the baby's mouth between the gums to break the suction avoids trauma to the breast.The infant who is sleeping may lose grasp on the nipple and areola,resulting in chewing on the nipple that makes it sore.A popping sound indicates improper removal of the breast from the baby's mouth and may cause cracks or fissures in the breast.Most mothers prefer the infant to continue to sleep after the feeding.Gentle wake-up techniques are recommended.

Question 6

The Baby Friendly Hospital Initiative endorsed by the World Health Organization (WHO)and the United Nations Children's Fund (UNICEF)was founded to encourage institutions to offer optimal levels of care for lactating mothers.Which actions are included in the "Ten Steps to Successful Breastfeeding for Hospitals"?
(Select all that apply).

Accepted Answer

No artificial teats or pacifiers (also called dummies or soothers)should be given to breastfeeding infants.Although pacifiers have been linked to a reduction in SIDs,they should not be introduced until the infant is 3 to 4 weeks old and breastfeeding is well established.No other food or drink should be given to the newborn unless medically indicated.The breastfeeding policy should be routinely communicated to all health care staff members.All staff should be trained in the skills necessary to maintain this policy.Breastfeeding should be initiated withn½ hour of childbirth,and all mothers need to be shown how to maintain lactation even if separated from their babies.The facility should practice rooming in and keep mothers and babies together 24 hours a day.

Question 7

As the nurse assists a new mother with breastfeeding,the client asks,"If formula is prepared to meet the nutritional needs of the newborn,what is in breast milk that makes it better?" What is the nurse's best response?

Accepted Answer

Breast milk contains immunoglobulins that protect the newborn against infection.The calorie count of formula and breast milk is approximately the same.All the essential amino acids are in both formula and breast milk; however,the concentrations may differ.Calcium levels are higher in formula than in breast milk,which can cause an excessively high renal solute load if the formula is not properly diluted.

Question 8

Nurses should be able to teach breastfeeding mothers the signs that the infant has correctly latched on.Which client statement indicates a poor latch?

Accepted Answer

The clicking or smacking sound may indicate that the baby is having difficulty keeping the tongue out over the lower gum ridge.The mother should hope to hear the sound of swallowing.The tugging sensation without pinching is a good sign.Rounded cheeks are a positive indicator of a good latch.A smoothly gliding jaw also is a good sign.

Question 9

Which instruction should the nurse provide to reduce the risk of nipple trauma?

Accepted Answer

If the infant's mouth does not cover as much of the areola as possible,the pressure during sucking will be applied to the nipple,thus causing trauma to the area.Stimulating the breast for less than 5 minutes will not produce the extra milk the infant may need and will also limit access to the higher-fat hindmilk.Assessing the nipples for trauma is important; however,this action alone will not prevent sore nipples.Soap can be drying to the nipples and should be avoided during breastfeeding.

Question 10

A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding.Which findings should the nurse include in the discussion?
(Select all that apply).

Accepted Answer

Breast tenderness,warmth in the breast,redness on the breast,and fever and flulike symptoms are commonly associated with mastitis and should be included in the nurse's discussion of mastitis.A small white blister on the tip of the nipple generally is not associated with mastitis but is commonly seen in women who have a plugged milk duct.

Question 11

In assisting the breastfeeding mother to position the baby,which information regarding positioning is important for the nurse to keep in mind?

Accepted Answer

The infant naturally faces the mother,belly to belly.The football position is usually preferred after a cesarean birth.Women with perineal pain and swelling prefer the side-lying position because they can rest while breastfeeding.The mother should never push on the back of the head.It may cause the baby to bite,hyperextend the neck,or develop an aversion to being brought near the breast.

Question 12

How many kilocalories per kilogram (kcal/kg)of body weight does a breastfed term infant require each day?

Accepted Answer

For the first 3 months,the infant needs 110 kcal/kg/day.At ages 3 to 6 months,the requirement is 100 kcal/kg/day.This level decreases slightly to 95 kcal/kg/day from 6 to 9 months and increases again to 100 kcal/kg/day until the baby reaches 12 months.

Question 13

Which actions are examples of appropriate techniques to wake a sleepy infant for breastfeeding?
(Select all that apply).

Accepted Answer

Unwrapping the infant,changing the diaper,and talking to the infant are appropriate techniques to use when trying to wake a sleepy infant.The parent can rub,never slap,the infant's hands or feet to wake the infant.Applying a cold towel to the infant's abdomen may lead to cold stress in the infant.The parent may want to apply a cool cloth to the infant's face to wake the infant.

Question 14

A new mother asks whether she should feed her newborn colostrum,because it is not "real milk." What is the nurse's most appropriate answer?

Accepted Answer

Colostrum is important because it has high levels of the nutrients needed by the neonate and helps protect against infection.Supplementation is not necessary and will decrease stimulation to the breast and decrease the production of milk.It is important for the mother to feel comfortable in this role before discharge; however,the importance of the colostrum to the infant is the top priority.Colostrum provides immunities and enzymes necessary to cleanse the gastrointestinal system,among other things.

Quiz 25: Newborn Nutrition and Feeding

Which action by the mother will initiate the milk ejection reflex (MER) ?

Which type of formula is not diluted with water,before being administered to an infant?

Which statements concerning the benefits or limitations of breastfeeding are accurate? (Select all that apply) .

The AAP recommends pasteurized donor milk for preterm infants if the mother's own milk in not available.Which statements regarding donor milk and milk banking are important for the nurse to understand and communicate to her client? (Select all that apply) .

The breastfeeding mother should be taught a safe method to remove the breast from the baby's mouth.Which suggestion by the nurse is most appropriate?

As the nurse assists a new mother with breastfeeding,the client asks,"If formula is prepared to meet the nutritional needs of the newborn,what is in breast milk that makes it better?" What is the nurse's best response?

Nurses should be able to teach breastfeeding mothers the signs that the infant has correctly latched on.Which client statement indicates a poor latch?

Which instruction should the nurse provide to reduce the risk of nipple trauma?

A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding.Which findings should the nurse include in the discussion? (Select all that apply) .

In assisting the breastfeeding mother to position the baby,which information regarding positioning is important for the nurse to keep in mind?

How many kilocalories per kilogram (kcal/kg) of body weight does a breastfed term infant require each day?

Which actions are examples of appropriate techniques to wake a sleepy infant for breastfeeding? (Select all that apply) .

A new mother asks whether she should feed her newborn colostrum,because it is not "real milk." What is the nurse's most appropriate answer?