CLE Breastfeeding Education & Promotion 3 — Questions and Answers
Question 1: A mother of a 3-week-old says she produces 'watery milk' after the first letdown. What should the CLE explain?
- Her milk supply is inadequate and she should supplement
- The watery foremilk is normal and transitions to creamier hindmilk as the feeding continues (Correct answer)
- She should pump and discard the first ounce before nursing
- The watery consistency indicates dehydration and she should increase fluid intake
Correct answer: The watery foremilk is normal and transitions to creamier hindmilk as the feeding continues
Foremilk is thinner and higher in lactose, while hindmilk, released later in a feeding, is richer in fat — both are normal parts of the same milk.
Question 2: During a prenatal breastfeeding class, a participant asks about the composition of colostrum. Which answer is MOST accurate?
- Colostrum is low in protein and immunoglobulins but rich in carbohydrates
- Colostrum is high in immunoglobulins, protein, and growth factors, and lower in fat and lactose than mature milk (Correct answer)
- Colostrum has the same composition as mature milk but in smaller volume
- Colostrum is primarily water and electrolytes to hydrate the newborn
Correct answer: Colostrum is high in immunoglobulins, protein, and growth factors, and lower in fat and lactose than mature milk
Colostrum is uniquely concentrated with secretory IgA, protein, and growth factors while containing less fat and lactose than mature milk.
Question 3: A mother wants to return to work at 12 weeks and maintain breastfeeding. Which anticipatory guidance is MOST helpful from a CLE?
- Begin pumping two days before returning to work to build a supply
- Start pumping 2–3 weeks before returning to build a freezer stash and practice the pump (Correct answer)
- Pump only at home in the evening since work pumping reduces productivity
- Switch to formula during daytime and breastfeed only at night
Correct answer: Start pumping 2–3 weeks before returning to build a freezer stash and practice the pump
Beginning pumping 2–3 weeks before returning to work allows mothers to build a freezer supply and adjust to the pump without supply disruption.
Question 4: Which federal law in the United States protects a nursing employee's right to pump at work?
- Family and Medical Leave Act (FMLA)
- PUMP for Nursing Mothers Act (2022) (Correct answer)
- Affordable Care Act breastfeeding provision only
- OSHA Workplace Safety Act
Correct answer: PUMP for Nursing Mothers Act (2022)
The PUMP for Nursing Mothers Act of 2022 expanded break time and private space protections for most nursing employees for up to one year after birth.
Question 5: A CLE notices a mother consistently holds her infant in the cradle hold with the baby's body rotated away. What is the MOST important correction to suggest?
- Switch to an exclusively laid-back breastfeeding position
- Ensure the baby's chest, hips, and knees are aligned and facing the mother's body (Correct answer)
- Place a rolled blanket under the baby to raise its head
- Have the mother switch to the football hold immediately
Correct answer: Ensure the baby's chest, hips, and knees are aligned and facing the mother's body
Proper alignment — ear, shoulder, and hip in a straight line facing the breast — facilitates effective latch and milk transfer.
Question 6: What is the PRIMARY purpose of the WHO/UNICEF Baby-Friendly Hospital Initiative Ten Steps?
- To standardize neonatal medical protocols globally
- To create a supportive hospital environment that protects, promotes, and supports breastfeeding (Correct answer)
- To prohibit formula use in all hospital settings
- To certify lactation consultants for hospital employment
Correct answer: To create a supportive hospital environment that protects, promotes, and supports breastfeeding
The BFHI Ten Steps are designed to transform hospital practices so that they actively support breastfeeding initiation and continuation.
Question 7: A mother asks how to know if her 5-day-old is getting enough milk. Which output criterion indicates adequate intake?
- At least 2 wet diapers and 1 stool per day
- At least 6 wet diapers and 3–4 stools per day by day 5 (Correct answer)
- One large stool per day regardless of wet diaper count
- Wet diapers only, as stools are not a reliable indicator this early
Correct answer: At least 6 wet diapers and 3–4 stools per day by day 5
By day 4–5, adequate intake is reflected by at least 6 wet diapers and 3–4 stools per 24 hours.
CLE Breastfeeding Education & Promotion 3
A mother of a 3-week-old says she produces 'watery milk' after the first letdown.
What should the CLE explain?