CBS Emergency Procedures & Response 3 — Questions and Answers
Question 1: A mother calls a lactation hotline during a power outage and states she has pumped milk stored in a refrigerator that has been without power for 6 hours. The refrigerator is still cool. What guidance should the CBS provide?
- Discard all stored milk immediately as it is no longer safe
- Use the milk within 4 hours if it still feels cold (below 40°F/4°C) (Correct answer)
- Freeze all the milk immediately once power is restored regardless of condition
- The milk is safe for 24 hours even without refrigeration
Correct answer: Use the milk within 4 hours if it still feels cold (below 40°F/4°C)
Breast milk remains safe if the refrigerator has stayed below 40°F (4°C); milk that is still cold should be used promptly or assessed based on current temperature guidelines.
Question 2: During a wildfire evacuation, a breastfeeding mother is exposed to heavy smoke for several hours. She asks if it is safe to continue breastfeeding. What is the appropriate CBS response?
- Advise her to stop breastfeeding for 48 hours after smoke exposure
- Reassure her that short-term smoke exposure does not significantly contaminate breast milk and breastfeeding should continue (Correct answer)
- Tell her to pump and discard all milk produced within 24 hours of smoke exposure
- Recommend formula until air quality returns to normal
Correct answer: Reassure her that short-term smoke exposure does not significantly contaminate breast milk and breastfeeding should continue
Short-term smoke exposure does not significantly transfer harmful levels of toxins into breast milk, and the benefits of continued breastfeeding outweigh the minimal risks.
Question 3: A postpartum mother is brought to an emergency room after a car accident. She is alert but injured and asks about breastfeeding. She received a CT scan with iodinated contrast. What guidance applies?
- She must stop breastfeeding permanently due to radiation exposure
- She can resume breastfeeding immediately; contrast agents used in CT scans are generally compatible with breastfeeding (Correct answer)
- She must pump and discard milk for 72 hours post-contrast
- She should wait 1 week before breastfeeding to allow contrast clearance
Correct answer: She can resume breastfeeding immediately; contrast agents used in CT scans are generally compatible with breastfeeding
Current evidence and guidelines from major radiology and lactation organizations indicate that iodinated contrast agents are compatible with breastfeeding and pumping/discarding is not necessary.
Question 4: A mother who is exclusively breastfeeding her 4-month-old is isolated with her infant during a flood with no access to formula for 72 hours. She is worried about her own limited food intake affecting her milk. What is the MOST accurate information to share?
- Her milk production will stop within 24 hours without adequate food
- Her body will prioritize milk production and nutritional quality is maintained even with moderate maternal caloric restriction (Correct answer)
- She should reduce feeding frequency to conserve her energy
- She should give the infant any available liquids to supplement her milk
Correct answer: Her body will prioritize milk production and nutritional quality is maintained even with moderate maternal caloric restriction
The lactating body prioritizes milk production and sustains nutritional quality during short-term food shortages, making continued breastfeeding the safest option when no alternative is available.
Question 5: In an emergency, a mother presents with sudden unilateral breast pain, localized swelling, and point tenderness without fever. What is the most likely diagnosis and immediate recommendation?
- Mastitis; begin antibiotics immediately
- Plugged duct; apply moist heat, massage, and continue frequent feeding from the affected breast (Correct answer)
- Breast abscess; refer for surgical drainage
- Engorgement; reduce feeding frequency temporarily
Correct answer: Plugged duct; apply moist heat, massage, and continue frequent feeding from the affected breast
A plugged duct typically presents with localized tenderness and swelling without fever and responds to moist heat, gentle massage, and continued nursing to clear the blockage.
Question 6: A CBS is called to assist in a community emergency center where multiple displaced mothers need breastfeeding support. Which triage priority should guide who is seen first?
- Mothers with infants who have not fed in over 6 hours and show signs of dehydration (Correct answer)
- Mothers reporting general stress and low milk supply concerns
- Mothers asking about introducing solid foods
- Mothers with older infants over 12 months who are only nursing once per day
Correct answer: Mothers with infants who have not fed in over 6 hours and show signs of dehydration
Infants showing signs of dehydration or those who have gone extended periods without feeding represent the highest clinical priority due to risk of serious harm.
Question 7: A lactating mother is advised she needs emergency general anesthesia. She asks whether she can breastfeed after waking from surgery. What is the evidence-based guidance?
- She must wait 24 hours after anesthesia before breastfeeding
- She can resume breastfeeding when she is awake and alert enough to hold the infant safely, as standard anesthetic agents are compatible with breastfeeding (Correct answer)
- She should pump and discard milk for 48 hours post-anesthesia
- General anesthesia permanently reduces milk supply and she should start supplementing
Correct answer: She can resume breastfeeding when she is awake and alert enough to hold the infant safely, as standard anesthetic agents are compatible with breastfeeding
Standard general anesthetic agents are rapidly cleared and are considered compatible with breastfeeding; the mother may resume nursing when she is alert enough to safely care for her infant.
CBS Emergency Procedures & Response 3
A mother calls a lactation hotline during a power outage and states she has pumped milk stored in a refrigerator that has been without power for 6 hours.
The refrigerator is still cool.
What guidance should the CBS provide?