Certified Lactation Specialist Site Management & Monitoring 2 — Questions and Answers
Question 1: A breastfeeding mother reports that her nipple looks wedge-shaped or lipstick-shaped after feeding. What does this indicate?
- Normal nipple elasticity
- Shallow latch causing nipple compression (Correct answer)
- Overactive let-down reflex
- Engorgement from oversupply
Correct answer: Shallow latch causing nipple compression
A wedge- or lipstick-shaped nipple after feeding indicates compression from a shallow latch, which can cause pain and poor milk transfer.
Question 2: When assessing a newborn's oral anatomy, which finding would most likely interfere with effective breastfeeding?
- Slightly asymmetrical cheeks
- High arched palate (Correct answer)
- Prominent lower lip
- Wide philtrum
Correct answer: High arched palate
A high arched palate can prevent the infant from adequately flanging the tongue and creating effective suction during breastfeeding.
Question 3: A mother calls the lactation hotline on day 3 postpartum saying her breasts feel very hard and painful. Her baby is latching poorly. What is the priority intervention?
- Advise her to stop breastfeeding temporarily
- Recommend reverse pressure softening before each feed (Correct answer)
- Suggest she pump exclusively until engorgement resolves
- Prescribe antibiotics for suspected mastitis
Correct answer: Recommend reverse pressure softening before each feed
Reverse pressure softening moves edema fluid away from the areola, making it easier for the baby to latch during physiologic engorgement.
Question 4: Which feeding cue indicates a newborn is in an ACTIVE or ready-to-feed state?
- Eyes closed, body limp
- Crying with fist clenching
- Rooting and bringing hands to mouth (Correct answer)
- Deep sleep with slow respirations
Correct answer: Rooting and bringing hands to mouth
Rooting and hand-to-mouth movements are mid-level hunger cues indicating the infant is alert and ready to feed before escalating to crying.
Question 5: A lactation consultant observes a mother breastfeeding. The baby's chin is buried in the breast but the nose is pressed flat. What should be corrected?
- Increase the angle of the nipple
- Tilt the baby's head back slightly to free the nose (Correct answer)
- Switch to a football hold immediately
- Ask the mother to push the breast away from the nose
Correct answer: Tilt the baby's head back slightly to free the nose
Tilting the infant's head back slightly keeps the chin in deep contact while naturally lifting the nose away from the breast for airway clearance.
Question 6: What is the recommended minimum number of wet diapers per day for a breastfed newborn by day 5 of life?
- 2–3 wet diapers
- 4–5 wet diapers
- 6 or more wet diapers (Correct answer)
- 8–10 wet diapers
Correct answer: 6 or more wet diapers
By day 5, a well-hydrated breastfed newborn should have at least 6 wet diapers per day, indicating adequate milk intake.
Question 7: A mother has been breastfeeding for 6 weeks and reports a sudden drop in milk supply. Which question is MOST important to ask first?
- Has she introduced a pacifier recently?
- Has she started a new medication or hormonal contraceptive? (Correct answer)
- Has she changed her nursing bra?
- Has she increased her water intake?
Correct answer: Has she started a new medication or hormonal contraceptive?
Estrogen-containing hormonal contraceptives are a leading cause of sudden milk supply drops and must be identified and addressed promptly.
Certified Lactation Specialist Site Management & Monitoring 2
A breastfeeding mother reports that her nipple looks wedge-shaped or lipstick-shaped after feeding.
What does this indicate?