CBS Emergency Procedures & Response 2 — Questions and Answers
Question 1: A breastfeeding mother in a disaster shelter reports her milk supply has dropped significantly after 48 hours of stress and disrupted feeding schedules. What is the MOST important first intervention?
- Recommend formula supplementation immediately
- Encourage frequent skin-to-skin contact and increase feeding frequency (Correct answer)
- Advise the mother to pump every 4 hours only
- Suggest the mother rest and resume nursing when less stressed
Correct answer: Encourage frequent skin-to-skin contact and increase feeding frequency
Frequent skin-to-skin contact stimulates oxytocin and prolactin, helping restore milk supply even in stressful disaster conditions.
Question 2: During a mass casualty event, a newborn (3 days old) is separated from her mother who is receiving emergency care. The infant is showing hunger cues. What is the BEST action for the CBS?
- Give the infant infant formula from the emergency supply
- Locate a volunteer wet nurse or donor milk if available, prioritizing reunification (Correct answer)
- Wait for the mother to be stabilized before any feeding
- Administer glucose water to satisfy hunger temporarily
Correct answer: Locate a volunteer wet nurse or donor milk if available, prioritizing reunification
Pasteurized donor human milk or an informal wet nurse arrangement is preferred over formula for a newborn when the mother is temporarily unavailable, while working toward reunification.
Question 3: A mother who recently gave birth is evacuated to a shelter after a hurricane. She mentions her nipples are cracked and painful. In the shelter setting, without normal supplies, what is the FIRST recommendation?
- Recommend pumping exclusively until nipples heal
- Apply expressed breast milk to the nipples after each feeding (Correct answer)
- Advise the mother to stop breastfeeding temporarily
- Use petroleum jelly as a barrier to reduce friction
Correct answer: Apply expressed breast milk to the nipples after each feeding
Expressed breast milk has healing and antimicrobial properties and is readily available without needing additional supplies in an emergency shelter.
Question 4: In an emergency scenario, a CBS discovers a mother has developed a high fever (103°F/39.4°C), chills, and a hard, red, painful breast area. What condition should be suspected and what is the recommended action?
- Engorgement; recommend cold compresses and reduced feeding
- Mastitis; advise continued breastfeeding and urgent referral for antibiotic treatment (Correct answer)
- Plugged duct; recommend vigorous massage and heat only
- Breast abscess; recommend immediate cessation of breastfeeding
Correct answer: Mastitis; advise continued breastfeeding and urgent referral for antibiotic treatment
Mastitis with systemic symptoms (fever, flu-like symptoms) requires antibiotics, and breastfeeding should continue to prevent milk stasis and worsening infection.
Question 5: A mother reports her 2-week-old infant has stopped feeding effectively after a traumatic birth experience, and she is worried about jaundice in an emergency care setting. What is the most critical assessment?
- Count wet diapers and check skin color in natural light (Correct answer)
- Immediately start formula to ensure adequate caloric intake
- Advise the mother to return to the hospital for a blood draw only
- Reassure the mother that newborn jaundice always resolves on its own
Correct answer: Count wet diapers and check skin color in natural light
Assessing wet diaper output and observing skin color in natural light are the most accessible first-line tools to evaluate hydration and jaundice severity in a resource-limited emergency setting.
Question 6: During an emergency, a breastfeeding mother is prescribed a medication by an emergency physician without knowledge of her breastfeeding status. The CBS should FIRST:
- Advise the mother to stop breastfeeding until the medication course is completed
- Consult LactMed or a current drug reference to check compatibility before advising the mother (Correct answer)
- Tell the mother all emergency medications require stopping breastfeeding
- Contact the physician only if the infant shows side effects
Correct answer: Consult LactMed or a current drug reference to check compatibility before advising the mother
LactMed and similar resources provide evidence-based information on drug safety during lactation and should be consulted before advising unnecessary breastfeeding cessation.
Question 7: A premature infant (34 weeks) in a neonatal emergency is unable to breastfeed directly. The mother is distressed and her colostrum production seems minimal. What should the CBS recommend?
- Begin formula immediately as colostrum production is insufficient for premature infants
- Encourage hand expression of colostrum every 2-3 hours to stimulate and maintain supply (Correct answer)
- Wait until the infant is stable before initiating any milk expression
- Only pump once or twice per day to avoid overstimulation in early postpartum
Correct answer: Encourage hand expression of colostrum every 2-3 hours to stimulate and maintain supply
Early and frequent hand expression of colostrum, ideally beginning within 1 hour of birth, is critical to establishing milk supply for premature infants who cannot nurse directly.
CBS Emergency Procedures & Response 2
A breastfeeding mother in a disaster shelter reports her milk supply has dropped significantly after 48 hours of stress and disrupted feeding schedules.
What is the MOST important first intervention?