CSP Breastfeeding & Infant Feeding Practices 2 — Questions and Answers
Question 1: The hormone primarily responsible for milk ejection (let-down reflex) during breastfeeding is:
- Prolactin
- Estrogen
- Oxytocin (Correct answer)
- Progesterone
Correct answer: Oxytocin
Oxytocin, released from the posterior pituitary in response to nipple stimulation, causes myoepithelial cells to contract and eject milk from the alveoli.
Question 2: Donor human milk used in NICUs for preterm infants is most commonly pasteurized using which method?
- Flash pasteurization (72°C for 15 seconds)
- Holder pasteurization (62.5°C for 30 minutes) (Correct answer)
- Ultra-high temperature (UHT) processing
- Retort sterilization
Correct answer: Holder pasteurization (62.5°C for 30 minutes)
Holder pasteurization (62.5°C for 30 minutes) is the standard method used by human milk banks to inactivate pathogens while preserving most bioactive components.
Question 3: The Ten Steps to Successful Breastfeeding are a core component of which internationally recognized program?
- La Leche League International Protocol
- Baby-Friendly Hospital Initiative (BFHI) (Correct answer)
- WHO/UNICEF Breastfeeding Promotion Campaign
- Academy of Breastfeeding Medicine Protocol
Correct answer: Baby-Friendly Hospital Initiative (BFHI)
The Baby-Friendly Hospital Initiative (BFHI), launched by WHO and UNICEF, uses the Ten Steps to Successful Breastfeeding as evidence-based practices hospitals must implement to receive certification.
Question 4: In a breastfed infant, which growth chart is recommended by the WHO and AAP for monitoring growth from birth to 24 months?
- CDC 2000 growth charts
- WHO 2006 Child Growth Standards (Correct answer)
- Fenton preterm growth charts
- INTERGROWTH-21st standards
Correct answer: WHO 2006 Child Growth Standards
The WHO 2006 Child Growth Standards were developed using data from breastfed infants in 6 countries and represent the international standard for healthy growth in children 0–24 months.
Question 5: Which sign most reliably indicates adequate milk transfer and intake in a breastfeeding newborn?
- Infant sleeps for 4+ hours between feedings
- Infant has at least 6 wet diapers and 3–4 stools per day by day 4–5 (Correct answer)
- Maternal breasts feel soft after each feeding
- Infant feeds for at least 30 minutes per session
Correct answer: Infant has at least 6 wet diapers and 3–4 stools per day by day 4–5
By day 4–5, a well-fed newborn typically produces at least 6 wet diapers and 3–4 stools daily, reflecting adequate hydration and milk intake.
Question 6: Galactagogues are substances used to increase milk supply. Which of the following is considered a pharmacologic galactagogue sometimes used in lactating women?
- Fenugreek
- Domperidone (Correct answer)
- Blessed thistle
- Oatmeal
Correct answer: Domperidone
Domperidone is a dopamine antagonist that increases prolactin levels and is used as a pharmacologic galactagogue, though it is not FDA-approved in the US for this purpose.
Question 7: Absolute or relative contraindications to breastfeeding for the INFANT include which of the following conditions?
- Phenylketonuria (PKU) (Correct answer)
- Neonatal jaundice requiring phototherapy
- Neonatal hypoglycemia
- Down syndrome
Correct answer: Phenylketonuria (PKU)
Classic PKU is a contraindication to breastfeeding because breast milk contains phenylalanine, which infants with PKU cannot metabolize, leading to neurotoxic accumulation.
CSP Breastfeeding & Infant Feeding Practices 2
The hormone primarily responsible for milk ejection (let-down reflex) during breastfeeding is: