Common Clinical Challenges Flashcards

A mother who had a cesarean birth under general anesthesia wants to breastfeed. She is now awake and alert 4 hours postpartum. What is the priority?

Answer: Facilitate skin-to-skin contact and a breastfeeding attempt as soon as the mother is alert

Once the mother is awake and alert, skin-to-skin contact and breastfeeding should be facilitated as soon as possible regardless of the type of anesthesia used.

A mother notices blood in her expressed breast milk. She is 5 days postpartum and this is her first pregnancy. What is the most likely cause?

Answer: Rusty pipe syndrome due to increased vascularity

Rusty pipe syndrome is caused by increased blood flow to the breasts during pregnancy, resulting in pinkish or rust-colored colostrum or milk in the early postpartum period.

A 4-week-old infant with an upper lip tie is having difficulty flanging the upper lip during breastfeeding. The mother reports nipple pain. What should the IBCLC recommend first?

Answer: Positional adjustments and manual lip flanging before considering surgical intervention

Conservative measures including positional changes and manually flanging the lip should be attempted before surgical referral.

A mother reports her 6-week-old has been refusing the breast and arching away during feeding. The infant was previously feeding well. What condition should the IBCLC suspect?

Answer: Gastroesophageal reflux causing feeding aversion

Breast refusal with arching in a previously well-feeding infant is a classic presentation of gastroesophageal reflux.

A mother with previously well-established breastfeeding notices a sudden decrease in milk supply at 3 months postpartum. She has recently started hormonal birth control. Which type is most likely responsible?

Answer: Combined estrogen-progestin oral contraceptive

Combined oral contraceptives containing estrogen are known to decrease milk supply, especially when started before 6 months postpartum.

A mother with bilateral breast reduction surgery performed 5 years ago wants to breastfeed. What is the most important factor in predicting her lactation potential?

Answer: Whether the nipple-areolar complex was detached and reattached during surgery

The status of the nipple-areolar complex during surgery is the most significant predictor of lactation potential.