IBCLC - Certification Lactation Management Techniques Questions and Answers

Question 1

A mother on postpartum day 3 has severe, pitting edema causing her breasts to be very firm and her areolae to be taut and swollen, preventing her infant from latching.
Which of the following techniques should the IBCLC teach the mother to use immediately before attempting to feed?

Accepted Answer

Performing Reverse Pressure Softening (RPS) on the areola.

Answer

Applying warm compresses for 10 minutes to encourage let-down.

Answer

Using a breast pump on the highest setting to draw out the nipple.

Answer

Suggesting immediate, temporary formula supplementation to allow the swelling to resolve.

Question 2

When assessing for proper breast pump flange fit, which of the following is the primary indicator of a correct size?

Accepted Answer

The nipple moves freely in the flange tunnel without excessive rubbing, and only a minimal amount of areolar tissue is drawn in.

Answer

A significant portion of the areola is drawn into the flange tunnel with each suction cycle.

Answer

The flange size is 2-3 mm larger than the mother's bra cup size designation.

Answer

The flange creates a very tight seal that leaves a deep red ring on the breast after pumping.

Question 3

An IBCLC is creating a care plan for a mother and her 36-week gestation infant. The infant is sleepy at the breast, feeds for only 5-10 minutes before falling asleep, and has had only two wet diapers in the last 12 hours. The mother's milk is beginning to increase in volume. Which management plan is MOST appropriate for this dyad?

Accepted Answer

Suggest the mother breastfeed first, then pump to protect her supply and provide any expressed milk to the infant, while waking the infant to feed at least every 2-3 hours.

Answer

Advise the mother to let the infant sleep and feed on demand, as sleepiness is normal for newborns.

Answer

Recommend supplementing with 2 ounces of formula after each breastfeeding attempt to ensure hydration.

Answer

Encourage the use of a nipple shield as the primary intervention to help the infant stay awake and transfer milk more efficiently.

Question 4

Which of the following is a core principle of paced bottle-feeding for a breastfed infant?

Accepted Answer

Keeping the bottle mostly horizontal to the floor and allowing the infant to take pauses to control the milk flow.

Answer

Holding the infant in a reclined position with the bottle held vertically to ensure a continuous, rapid flow.

Answer

Encouraging the infant to finish the entire bottle within 10 minutes to mimic an efficient breastfeeding session.

Answer

Using a fast-flow nipple to reduce the infant's frustration and work of feeding.

Question 5

A client who had breast reduction surgery five years ago is breastfeeding her 2-week-old infant. The infant nurses 10-12 times a day with an apparently good latch but is showing signs of slow weight gain. What is the MOST important initial step in managing this situation?

Accepted Answer

Perform pre- and post-feeding weights to accurately assess milk transfer and determine the need for supplementation.

Answer

Reassure the mother that slow weight gain is common and to continue her current routine.

Answer

Recommend herbal galactagogues as the first step to increase her milk supply.

Answer

Advise immediate and permanent cessation of breastfeeding and switching to formula.

Question 6

When teaching a mother hand expression using the Marmet technique, what is the correct sequence of actions?

Accepted Answer

Placing the fingers behind the areola, pressing back toward the chest wall, then compressing and rolling forward.

Answer

Sliding the fingers from the outer breast down toward the nipple to push the milk out.

Answer

Squeezing the nipple tip directly to express the milk stored there.

Answer

Using the whole hand to cup and firmly squeeze the entire breast in a rhythmic pattern.