IBCLC - Certification Pharmacology and Toxicology Questions and Answers

Question 1

A breastfeeding mother of a 3-week-old infant is diagnosed with mastitis and prescribed dicloxacillin.
She is concerned about the medication's safety for her infant.
What is the most appropriate information for the IBCLC to provide?

Accepted Answer

Reassure her that dicloxacillin is generally considered compatible with breastfeeding and to continue nursing frequently, as this helps resolve the mastitis.

Answer

Advise her to "pump and dump" for 24 hours after each dose to minimize infant exposure.

Answer

Suggest she ask her physician to switch to a tetracycline antibiotic instead.

Answer

Inform her that any antibiotic use requires temporary cessation of breastfeeding.

Question 2

A mother who is breastfeeding her 4-month-old infant reports a sudden and significant decrease in her milk supply. She mentions she recently started taking an over-the-counter medication for cold symptoms. Which of the following active ingredients is the MOST likely cause of her reduced milk production?

Accepted Answer

Pseudoephedrine

Answer

Guaifenesin

Answer

Dextromethorphan

Answer

Acetaminophen

Question 3

When evaluating a medication's safety for a breastfed infant, the Relative Infant Dose (RID) is a key parameter. What does the RID represent?

Accepted Answer

The infant's dose via milk (in mg/kg/day) as a percentage of the mother's dose (in mg/kg/day).

Answer

The total milligrams of the drug the infant receives in 24 hours.

Answer

The ratio of the drug's concentration in breast milk compared to the mother's plasma.

Answer

The time it takes for half of the drug to be eliminated from the mother's milk.

Question 4

A client with postpartum depression is breastfeeding her 6-week-old infant. Her physician is considering prescribing a selective serotonin reuptake inhibitor (SSRI). Which of the following SSRIs is generally preferred for lactating individuals due to its low transfer into breast milk and extensive safety data?

Accepted Answer

Sertraline

Answer

Fluoxetine

Answer

Citalopram

Answer

Paroxetine

Question 5

A mother reports daily use of cannabis (marijuana) and wants to know if it is safe to continue breastfeeding her 2-month-old infant. Which of the following statements provides the most accurate information?

Accepted Answer

THC is fat-soluble, concentrates in breast milk, and has a very long half-life, posing potential risks to infant neurodevelopment.

Answer

Pumping and discarding milk for 12 hours after use will eliminate any risk to the infant.

Answer

As long as the mother does not feel impaired, there is no risk of exposure to the infant through her milk.

Answer

Occasional use is considered safe, but daily use should be avoided.

Question 6

A breastfeeding mother requires a diagnostic V/Q scan (ventilation/perfusion scan), which uses Technetium-99m macroaggregated albumin (99mTc-MAA). What is the most current, evidence-based recommendation regarding breastfeeding after this procedure?

Accepted Answer

No interruption of breastfeeding is required.

Answer

She must pump and discard her milk for at least 24 hours.

Answer

Breastfeeding must be permanently discontinued.

Answer

A temporary interruption of 12 hours is required for safety.