IBCLC Breastfeeding 2 — Questions and Answers
Question 1: What are the WHO's recommendations for breastfeeding duration?
- Breastfeed exclusively for 3 months, then switch to formula
- Exclusive breastfeeding for the first 6 months with continued breastfeeding alongside complementary foods up to 2 years or beyond (Correct answer)
- Breastfeed for 12 months maximum
- There is no specific recommendation for breastfeeding duration
Correct answer: Exclusive breastfeeding for the first 6 months with continued breastfeeding alongside complementary foods up to 2 years or beyond
WHO recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary foods for up to 2 years or beyond.
This recommendation is based on extensive evidence showing that exclusive breastfeeding for 6 months provides optimal nutrition, immune protection, and developmental benefits. Continued breastfeeding beyond 6 months provides ongoing benefits alongside complementary foods.
Question 2: What is the recommended minimum number of breastfeeding sessions per day for a newborn in the first week?
- 4-6 times per day
- 8-12 times per day (Correct answer)
- Every 4 hours on a schedule
- Only when the baby cries
Correct answer: 8-12 times per day
Newborns should breastfeed a minimum of 8-12 times per 24 hours.
Frequent feeding ensures adequate caloric intake for the infant and establishes prolactin receptor sites for the mother. Feeding should be guided by infant hunger cues rather than rigid schedules. Crying is a late hunger cue.
Question 3: Which is a reliable indicator of adequate milk intake in a breastfed newborn?
- The infant sleeps for long stretches
- The infant produces at least 6 wet diapers and 3-4 yellow stools per day by day 4-5 (Correct answer)
- The infant feeds for exactly 20 minutes per breast
- The mother does not experience breast fullness
Correct answer: The infant produces at least 6 wet diapers and 3-4 yellow stools per day by day 4-5
Adequate diaper output is a reliable indicator of sufficient milk intake.
By days 4-5, a well-fed newborn should produce at least 6 wet diapers and 3-4 yellow, seedy stools per day. After initial physiological weight loss (up to 7-10%), infants should regain birth weight by 10-14 days and gain approximately 20-35 grams per day.
Question 4: What is paced bottle feeding and when is it recommended for breastfed infants?
- It means feeding the infant as quickly as possible
- It is a technique where the bottle is held horizontally, the infant controls the pace, and frequent pauses are introduced to prevent overfeeding and support return to the breast (Correct answer)
- It means offering the bottle only at scheduled times
- It is only used for premature infants
Correct answer: It is a technique where the bottle is held horizontally, the infant controls the pace, and frequent pauses are introduced to prevent overfeeding and support return to the breast
Paced bottle feeding mimics breastfeeding flow dynamics, helping prevent flow preference and overfeeding.
Key elements include holding the infant upright, holding the bottle horizontally, allowing the infant to draw the nipple in, introducing pauses, and stopping when the infant shows satiety cues rather than encouraging them to finish a set amount.
Question 5: What is the difference between foremilk and hindmilk?
- They are produced by different parts of the breast
- Foremilk is the lower-fat milk at the start of a feeding, while hindmilk is the higher-fat milk that becomes available as the breast is progressively emptied (Correct answer)
- Hindmilk is always better than foremilk
- Foremilk is colostrum and hindmilk is mature milk
Correct answer: Foremilk is the lower-fat milk at the start of a feeding, while hindmilk is the higher-fat milk that becomes available as the breast is progressively emptied
Foremilk and hindmilk represent a continuous gradient of increasing fat content during a feeding.
Between feedings, milk fat globules adhere to the alveolar epithelium. At the beginning of a feeding, the foremilk is lower in fat. As feeding progresses, fat globules are dislodged, increasing fat content. The degree of variation depends on breast fullness.
Question 6: A mother has been told she should stop breastfeeding because she is taking a commonly prescribed medication. What should the IBCLC do first?
- Agree with the recommendation and help the mother wean
- Verify the medication's safety using a reliable lactation pharmacology resource such as LactMed or Hale's (Correct answer)
- Tell the mother to ignore medical advice
- Recommend she stop the medication without consulting her prescriber
Correct answer: Verify the medication's safety using a reliable lactation pharmacology resource such as LactMed or Hale's
The IBCLC should verify medication safety using evidence-based lactation pharmacology resources.
Many medications that are actually compatible with breastfeeding are erroneously labeled as contraindicated based on pharmaceutical company liability concerns. The IBCLC should verify using LactMed, Hale's, or the InfantRisk Center, then share evidence with the mother and prescriber.
IBCLC Breastfeeding 2
What are the WHO's recommendations for breastfeeding duration?