CBS Maternal & Infant Health 2 — Questions and Answers
Question 1: A mother at 3 weeks postpartum reports her breasts feel soft and no longer engorged. She worries her milk supply has dropped. What is the most appropriate response?
- Refer her immediately to a physician for hormonal testing
- Reassure her that this is normal as supply regulates to infant demand (Correct answer)
- Recommend supplementing with formula to ensure adequate intake
- Suggest pumping after every feed to stimulate more production
Correct answer: Reassure her that this is normal as supply regulates to infant demand
Breast softening around 3-6 weeks postpartum indicates milk supply has regulated to match the baby's needs, not that supply has decreased.
Question 2: Which maternal condition is MOST associated with delayed lactogenesis II (milk coming in)?
- Gestational hypertension
- Retained placental fragments (Correct answer)
- Iron-deficiency anemia
- Hypothyroidism
Correct answer: Retained placental fragments
Retained placental fragments maintain high progesterone levels, directly inhibiting prolactin action and delaying milk onset.
Question 3: An infant born at 35 weeks gestation is breastfeeding. Compared to a term infant, this late preterm infant is at higher risk for:
- Overfeeding at the breast
- Hyperbilirubinemia and poor weight gain (Correct answer)
- Early introduction of solid foods
- Maternal nipple trauma due to strong suck
Correct answer: Hyperbilirubinemia and poor weight gain
Late preterm infants have immature suck-swallow-breathe coordination and limited glycogen stores, increasing risk for jaundice and inadequate intake.
Question 4: A CBS is counseling a mother with polycystic ovary syndrome (PCOS) who is concerned about milk supply. Which statement is accurate?
- PCOS has no effect on milk supply
- PCOS is associated with insufficient glandular tissue and may reduce supply (Correct answer)
- PCOS always causes complete lactation failure
- PCOS only affects milk supply if insulin levels are normal
Correct answer: PCOS is associated with insufficient glandular tissue and may reduce supply
PCOS is linked to hormonal imbalances and insufficient glandular tissue (IGT), which can lead to primary low milk supply in some women.
Question 5: What is the recommended maximum safe level of alcohol intake before breastfeeding, and how long should a mother wait before nursing after one standard drink?
- No alcohol is safe; abstain completely during breastfeeding
- One standard drink; wait at least 2 hours per drink (Correct answer)
- Two standard drinks; wait 30 minutes
- One standard drink; wait 30 minutes
Correct answer: One standard drink; wait at least 2 hours per drink
Current evidence supports waiting approximately 2 hours per standard drink for alcohol to clear breast milk before nursing.
Question 6: A mother asks about breastfeeding during a subsequent pregnancy. Which statement reflects current evidence-based guidance?
- Breastfeeding must stop immediately upon confirmed pregnancy
- Breastfeeding during uncomplicated pregnancy is generally safe (Correct answer)
- Milk supply automatically ceases at conception
- Tandem nursing (breastfeeding during pregnancy) causes fetal harm
Correct answer: Breastfeeding during uncomplicated pregnancy is generally safe
For low-risk pregnancies, breastfeeding can continue safely, though nipple sensitivity and milk supply changes are common.
Question 7: Which finding during a breastfeeding assessment would MOST indicate the infant is receiving adequate milk transfer?
- Infant nurses for exactly 20 minutes per side
- Audible swallowing and 6-8 wet diapers per day after day 4 (Correct answer)
- Infant falls asleep within 5 minutes of latching
- Mother reports feeling a let-down reflex every feed
Correct answer: Audible swallowing and 6-8 wet diapers per day after day 4
Audible swallowing combined with adequate wet diaper output after day 4 are the most reliable indicators of sufficient milk intake.
CBS Maternal & Infant Health 2
A mother at 3 weeks postpartum reports her breasts feel soft and no longer engorged.
She worries her milk supply has dropped.
What is the most appropriate response?