CMS Breastfeeding & Lactation Support 3

Question 1

A mother of premature twins at 30 weeks gestation asks about providing breast milk. What should the midwife advise?

Accepted Answer

Mother's own milk is optimal for premature infants and pumping should begin within 6 hours of birth

Answer

Preterm infants cannot digest breast milk and require specialized formula only

Answer

Donor breast milk or premature formula is always preferred over mother's own milk

Answer

Breastfeeding attempts should wait until both infants reach 36 weeks corrected gestational age

Question 2

Which newborn condition most significantly interferes with effective breastfeeding by restricting tongue movement?

Accepted Answer

Ankyloglossia (tongue-tie)

Answer

Mild physiologic jaundice on day 2

Answer

Physiologic weight loss of 5% in the first 48 hours

Answer

Normal transitional sleepiness during the first 24 hours

Question 3

A breastfeeding mother asks about alcohol consumption. What should the midwife advise regarding safe timing?

Accepted Answer

Waiting approximately 2 hours per standard drink before breastfeeding reduces infant alcohol exposure

Answer

Alcohol does not transfer into breast milk and no precautions are needed

Answer

Any alcohol consumption requires permanent cessation of breastfeeding

Answer

One alcoholic drink daily is safe and has no measurable effect on milk composition or infant

Question 4

An HIV-positive mother asks whether she can breastfeed her newborn. According to US CDC guidelines, the midwife should advise:

Accepted Answer

Breastfeeding is not recommended in the US because safe formula alternatives are readily available

Answer

Breastfeeding is safe if the mother maintains undetectable viral load on antiretroviral therapy

Answer

Breastfeeding may continue for the first 3 months only, then must be discontinued

Answer

The decision is entirely the mother's choice with no clinical recommendation either way

Question 5

A breastfeeding mother describes bilateral nipple pain with color changes (white, then blue, then red) immediately after feedings, worsened by cold air. This presentation is most consistent with:

Accepted Answer

Raynaud's phenomenon of the nipple causing vasospasm

Answer

Persistent mastitis causing bilateral nipple erythema and warmth

Answer

Bilateral nipple discharge unrelated to feeding

Answer

Candidal (thrush) infection of the nipple surface

Question 6

A breastfeeding mother is returning to work in 3 weeks. What is the best approach to support continued breastfeeding?

Accepted Answer

Start pumping and storing breast milk now to build a supply and establish a workplace pumping routine

Answer

Begin formula supplementation immediately to reduce dependence on breastfeeding

Answer

Only pump at home in the morning and evening once back at work

Answer

Switch to exclusive formula feeding upon returning to work to simplify scheduling

Question 7

When a breastfeeding newborn develops jaundice on day 4, what is the midwife's most appropriate initial action?

Accepted Answer

Assess feeding frequency, latch adequacy, milk transfer, and obtain serum bilirubin levels

Answer

Advise immediate and complete cessation of breastfeeding

Answer

Recommend phototherapy without further clinical assessment

Answer

Switch the infant immediately to formula to treat the jaundice