CLE Milk Expression & Storage 2 — Questions and Answers
Question 1: What is the primary purpose of breast massage and hand expression performed immediately before or during pumping?
- To sterilize the breast surface before milk contact with the pump
- To stimulate the let-down reflex and maximize milk output (Correct answer)
- To increase the fat content of the milk collected
- To prevent mastitis by clearing blocked ducts
Correct answer: To stimulate the let-down reflex and maximize milk output
Hands-on pumping techniques—breast massage and hand expression—trigger the let-down reflex and improve milk removal efficiency, resulting in greater output.
Question 2: A hospital-grade double electric breast pump is most appropriately recommended for which situation?
- A mother who occasionally misses one feeding per day
- A mother with severe oversupply wanting to reduce production
- A mother of a premature or hospitalized infant who cannot feed at the breast (Correct answer)
- A mother who has been exclusively breastfeeding for more than 6 months
Correct answer: A mother of a premature or hospitalized infant who cannot feed at the breast
Hospital-grade pumps provide superior suction and cycling frequencies to effectively stimulate and maintain milk supply when a baby is unable to nurse directly.
Question 3: The correct breast shield (flange) size for pumping is primarily determined by:
- The mother's bra cup size
- The diameter of the mother's nipple (Correct answer)
- The volume of milk produced per session
- The age and weight of the infant
Correct answer: The diameter of the mother's nipple
The flange opening should allow the nipple to move freely with approximately 1–2 mm of space around it; an incorrect size reduces output and can cause nipple pain or damage.
Question 4: According to CDC guidelines, how should breast pump parts that contact milk be cleaned after each use?
- Wipe with a dry cloth and allow to air dry completely
- Rinse with cold water only to preserve residual milk proteins
- Wash with hot soapy water, rinse thoroughly, and allow to air dry or use a dishwasher (Correct answer)
- Soak in a 1:10 bleach-water solution for at least 30 minutes
Correct answer: Wash with hot soapy water, rinse thoroughly, and allow to air dry or use a dishwasher
CDC guidelines recommend washing pump parts that contact milk with hot soapy water and rinsing well, or running them through the dishwasher if the parts are dishwasher-safe.
Question 5: A mother reports that her refrigerated and frozen breast milk has a soapy or metallic taste and smell. The most likely cause is:
- Bacterial contamination, and the milk should be discarded immediately
- Elevated lipase activity breaking down milk fats during storage (Correct answer)
- Improper storage temperature causing chemical changes
- The mother consuming strongly flavored foods such as onions or garlic
Correct answer: Elevated lipase activity breaking down milk fats during storage
Elevated lipase activity naturally breaks down milk fats during refrigeration or freezing, producing a soapy or rancid smell and taste; scalding milk before storage inactivates the enzyme.
Question 6: When a clean water source is unavailable at a workplace, the CDC recommends storing unwashed pump parts between sessions on the same day by:
- Keeping them in a sealed paper bag at room temperature
- Wiping them with alcohol wipes between each use
- Placing them in a sealed bag or container in the refrigerator until the next session (Correct answer)
- Replacing all parts with new disposable parts for each session
Correct answer: Placing them in a sealed bag or container in the refrigerator until the next session
When washing between sessions is not possible, storing pump parts in a sealed bag in the refrigerator between same-day sessions limits bacterial growth until thorough washing can occur.
Question 7: What volume of breast milk per feeding is typically appropriate for a healthy 2-month-old infant?
- 1–2 oz (30–60 mL)
- 3–4 oz (90–120 mL) (Correct answer)
- 5–6 oz (150–180 mL)
- 7–8 oz (210–240 mL)
Correct answer: 3–4 oz (90–120 mL)
Most 2-month-old infants take approximately 3–4 oz (90–120 mL) per feeding, and breastfed babies' intake per feeding remains relatively stable from 1 to 6 months.
CLE Milk Expression & Storage 2
What is the primary purpose of breast massage and hand expression performed immediately before or during pumping?