CLE Site Management & Monitoring 3 — Questions and Answers
Question 1: During a lactation education class, a mother asks about 'breast refusal' — her 3-week-old baby turns away from the breast. Which scenario is LEAST likely to cause this behavior?
- Nipple confusion from frequent pacifier use
- Mother's abundant milk letdown causing flow preference
- Infant receiving adequate milk volume at breast (Correct answer)
- Ear infection causing pain when the infant turns his head to latch
Correct answer: Infant receiving adequate milk volume at breast
Adequate milk transfer is not a cause of breast refusal; it is actually the goal of breastfeeding management.
Question 2: A CLE educator is monitoring a support group for mothers returning to work. Which strategy BEST supports sustained milk supply during maternal employment?
- Pump once daily during work hours to save time
- Maintain a pumping schedule that mirrors the infant's feeding frequency (Correct answer)
- Switch entirely to formula during work hours and breastfeed at night
- Use only manual pumping without any double electric pump option
Correct answer: Maintain a pumping schedule that mirrors the infant's feeding frequency
Pumping at intervals matching the infant's feeding frequency maintains the stimulation needed to sustain milk supply.
Question 3: What is the recommended minimum internal temperature for storing freshly expressed breast milk in a standard refrigerator to maximize safety?
- 50°F (10°C)
- 40°F (4°C) or below (Correct answer)
- 45°F (7°C)
- 35°F (2°C)
Correct answer: 40°F (4°C) or below
Breast milk should be stored at or below 40°F (4°C) in a refrigerator for up to 4 days.
Question 4: A CLE is monitoring a mother who complains of nipple pain rated 8/10 throughout the entire feeding. The FIRST assessment priority is:
- Recommend nipple shields without observing a feeding
- Observe a complete feeding to assess latch, positioning, and infant oral function (Correct answer)
- Prescribe an antifungal cream empirically
- Advise pumping exclusively until pain resolves
Correct answer: Observe a complete feeding to assess latch, positioning, and infant oral function
Observing a complete feeding is the essential first step to identify the root cause of persistent nipple pain.
Question 5: Which document would a CLE use to systematically record observations from a breastfeeding assessment session for continuity of care?
- Incident report form
- Lactation assessment or SOAP note (Correct answer)
- Pediatric APGAR record
- Hospital discharge summary only
Correct answer: Lactation assessment or SOAP note
A SOAP note or structured lactation assessment form documents subjective, objective, assessment, and plan information for continuity of care.
Question 6: When a CLE identifies that a breastfed infant has jaundice on day 4, the most critical monitoring parameter related to breastfeeding is:
- Number of formula supplements given
- Stool color and frequency as indicators of bilirubin excretion and milk intake (Correct answer)
- Duration of each sleep period
- Whether the mother has inverted nipples
Correct answer: Stool color and frequency as indicators of bilirubin excretion and milk intake
Stool frequency reflects milk intake and bilirubin excretion; frequent, yellow stools after day 4 indicate adequate feeding and bilirubin clearance.
Question 7: A CLE at a community health center notices a mother's documentation shows four missed follow-up visits. The most person-centered approach is to:
- Discharge the client for non-compliance
- Contact the client to identify and address barriers to attendance (Correct answer)
- Refer to child protective services immediately
- Schedule a punitive counseling session about missed appointments
Correct answer: Contact the client to identify and address barriers to attendance
Reaching out to identify barriers (transportation, work, childcare) reflects client-centered care and supports breastfeeding continuation.
CLE Site Management & Monitoring 3
During a lactation education class, a mother asks about 'breast refusal' — her 3-week-old baby turns away from the breast.
Which scenario is LEAST likely to cause this behavior?