CLE Maternal & Infant Health Considerations 2 — Questions and Answers
Question 1: A mother with gestational diabetes who is breastfeeding should be aware that lactation typically has what effect on her blood glucose levels?
- It raises blood glucose significantly
- It helps lower blood glucose and reduces insulin requirements (Correct answer)
- It has no effect on blood glucose regulation
- It causes unpredictable glucose spikes
Correct answer: It helps lower blood glucose and reduces insulin requirements
Lactation increases glucose utilization for milk production, which generally lowers maternal blood glucose and reduces insulin needs in diabetic mothers.
Question 2: Which postpartum condition is most commonly associated with delayed lactogenesis II (milk coming in after 72 hours)?
- Postpartum depression
- Retained placental fragments (Correct answer)
- Mastitis
- Engorgement
Correct answer: Retained placental fragments
Retained placental fragments maintain high progesterone levels, suppressing prolactin action and significantly delaying the onset of copious milk production.
Question 3: A mother reports her infant has been diagnosed with phenylketonuria (PKU). What is the current recommendation regarding breastfeeding?
- Breastfeeding must be stopped immediately
- Breastfeeding can continue with careful monitoring and supplementation with PKU formula (Correct answer)
- The infant should receive only PKU formula
- Breastfeeding is encouraged without any restrictions
Correct answer: Breastfeeding can continue with careful monitoring and supplementation with PKU formula
Infants with PKU can breastfeed with careful monitoring of phenylalanine blood levels, supplementing with phenylalanine-free formula to control intake.
Question 4: Which maternal medication is considered safest to use while breastfeeding for mild-to-moderate pain relief?
- Codeine
- Aspirin
- Ibuprofen (Correct answer)
- Tramadol
Correct answer: Ibuprofen
Ibuprofen is preferred for breastfeeding mothers because it has poor oral bioavailability, transfers minimally into breast milk, and is considered safe for infants.
Question 5: An infant born at 34 weeks gestation is considered:
- Extremely preterm
- Very preterm
- Late preterm (Correct answer)
- Early term
Correct answer: Late preterm
Infants born between 34 0/7 and 36 6/7 weeks gestation are classified as late preterm and have unique feeding challenges compared to term infants.
Question 6: What is the most significant risk factor for breastfeeding jaundice (starvation jaundice) in the first week of life?
- ABO incompatibility
- Inadequate milk transfer leading to insufficient caloric intake (Correct answer)
- Maternal diabetes
- Delayed cord clamping
Correct answer: Inadequate milk transfer leading to insufficient caloric intake
Breastfeeding jaundice occurs when insufficient milk intake leads to reduced stool output, causing enterohepatic recirculation of bilirubin and elevated serum bilirubin.
Question 7: A mother with hypothyroidism who is being treated with levothyroxine wishes to breastfeed. What should she be advised?
- She must stop levothyroxine while breastfeeding
- Levothyroxine is compatible with breastfeeding and treatment should continue (Correct answer)
- She should switch to a different thyroid medication while nursing
- Breastfeeding is contraindicated with any thyroid condition
Correct answer: Levothyroxine is compatible with breastfeeding and treatment should continue
Levothyroxine transfers minimally into breast milk and is considered safe; discontinuing treatment could harm the mother's health and milk supply.
CLE Maternal & Infant Health Considerations 2
A mother with gestational diabetes who is breastfeeding should be aware that lactation typically has what effect on her blood glucose levels?