CBS Treatment Planning & Management 3 — Questions and Answers
Question 1: A mother develops a firm, red, wedge-shaped area on one breast with flu-like symptoms and fever 3 weeks postpartum. What is the MOST appropriate initial management?
- Immediately wean the infant
- Continue breastfeeding or pumping, apply warm compresses, rest, and refer for antibiotic evaluation (Correct answer)
- Apply ice packs and restrict fluid intake
- Immediately refer for surgical drainage
Correct answer: Continue breastfeeding or pumping, apply warm compresses, rest, and refer for antibiotic evaluation
Mastitis management includes continued milk removal (breastfeeding or pumping), warm compresses, rest, hydration, and antibiotic evaluation to prevent abscess formation.
Question 2: A CBS is counseling a mother who wants to relactate after stopping breastfeeding 4 weeks ago. Which factor MOST improves the likelihood of successful relactation?
- The mother's age
- The shorter the time since cessation and the more frequent breast stimulation provided (Correct answer)
- The infant's current age and weight
- The mother's diet and fluid intake
Correct answer: The shorter the time since cessation and the more frequent breast stimulation provided
The shorter the time since weaning and the more frequently the breast is stimulated, the greater the likelihood of successfully reestablishing milk production.
Question 3: When a breastfed infant is diagnosed with hyperbilirubinemia (jaundice) at 4 days old, what is the recommended breastfeeding management if the bilirubin is at a treatable but non-critical level?
- Stop breastfeeding and switch to formula for one week
- Supplement with water between feedings to flush bilirubin
- Increase breastfeeding frequency to 8–12 times per 24 hours to enhance bilirubin excretion (Correct answer)
- Temporarily stop breastfeeding and substitute with donor milk
Correct answer: Increase breastfeeding frequency to 8–12 times per 24 hours to enhance bilirubin excretion
Frequent breastfeeding promotes stooling which is the primary route of bilirubin excretion, and ensures adequate caloric intake to support the infant's ability to clear bilirubin.
Question 4: A mother is preparing to return to work at 8 weeks postpartum and wants to continue breastfeeding. Which pumping schedule should the CBS recommend to maintain supply?
- Pump once in the morning before work only
- Pump every 3–4 hours during work hours to replace missed feedings (Correct answer)
- Pump only when feeling full at work
- Pump twice daily at home to compensate for missed feedings
Correct answer: Pump every 3–4 hours during work hours to replace missed feedings
Pumping every 3–4 hours at work replaces the frequency of missed breastfeedings, maintaining the milk removal signal needed to sustain supply.
Question 5: A mother's infant has a posterior tongue-tie (Type IV) confirmed by assessment. The mother is experiencing nipple pain and the infant is gaining weight slowly. What is the recommended course of action?
- Continue current feeding without intervention and reassess in 2 weeks
- Refer to a knowledgeable provider for frenotomy evaluation while providing interim latch support (Correct answer)
- Immediately wean to bottle feeding
- Apply nipple shields permanently as the sole solution
Correct answer: Refer to a knowledgeable provider for frenotomy evaluation while providing interim latch support
A confirmed posterior tongue-tie causing pain and poor weight gain warrants referral for frenotomy evaluation, with interim latch optimization support from the CBS.
Question 6: A CBS is working with a mother who has diabetes and is breastfeeding. Which guidance is MOST important regarding her insulin requirements postpartum?
- Insulin requirements typically increase significantly while breastfeeding
- Insulin requirements often decrease while breastfeeding due to glucose utilization for milk production (Correct answer)
- Breastfeeding has no effect on insulin requirements
- She should stop breastfeeding to stabilize blood sugar levels
Correct answer: Insulin requirements often decrease while breastfeeding due to glucose utilization for milk production
Breastfeeding utilizes glucose for lactose synthesis, which can reduce insulin requirements in diabetic mothers, requiring careful blood sugar monitoring and medication adjustment.
Question 7: When a mother reports her milk supply has decreased after her menstrual period returned, what is the MOST appropriate explanation and management?
- The milk is no longer nutritious and supplementation is required
- Hormonal fluctuations around menstruation can temporarily reduce supply, which typically rebounds after the period ends (Correct answer)
- The mother should wean immediately as this signals natural supply decline
- The infant should be fed more formula permanently to account for reduced supply
Correct answer: Hormonal fluctuations around menstruation can temporarily reduce supply, which typically rebounds after the period ends
Hormonal changes associated with menstruation can cause a temporary dip in milk supply around days 1–3 of the period, which typically resolves naturally as hormones normalize.
CBS Treatment Planning & Management 3
A mother develops a firm, red, wedge-shaped area on one breast with flu-like symptoms and fever 3 weeks postpartum.
What is the MOST appropriate initial management?