IBCLC Common Clinical Challenges 2

Question 1

A mother reports that her 3-week-old infant has been cluster feeding every evening for several hours. What is the most appropriate guidance?

Accepted Answer

Reassure the mother that cluster feeding is normal and does not indicate low supply

Answer

Cluster feeding is a normal newborn behavior, especially in the evening hours, and does not indicate insufficient milk supply.

Question 2

A mother with flat nipples is having difficulty achieving a deep latch. Which intervention should the lactation consultant try first?

Accepted Answer

Teach reverse pressure softening before latching

Answer

Reverse pressure softening helps move edema away from the areola and can help flat nipples become more protractile for latching.

Question 3

An infant born at 35 weeks gestation is having difficulty coordinating suck-swallow-breathe during breastfeeding. What is the most appropriate first step?

Accepted Answer

Use paced feeding at the breast with frequent breaks

Answer

Paced feeding at the breast allows the late preterm infant to coordinate suck-swallow-breathe at their own pace while maintaining the breastfeeding relationship.

Question 4

A mother presents with a white spot on her nipple that causes sharp pain during feeding. The area is firm to palpation. What is this most likely?

Accepted Answer

A milk bleb (blister) blocking a nipple pore

Answer

A milk bleb appears as a white or yellow spot on the nipple, is often painful during feeding, and results from a thin layer of skin growing over a milk duct opening.

Question 5

A mother with type 1 diabetes reports that her milk production seems delayed. Her infant is 4 days old. What is the most likely explanation?

Accepted Answer

Insulin-dependent diabetes can delay lactogenesis II onset

Answer

Insulin plays a role in lactogenesis II, and mothers with type 1 diabetes may experience a delay of 24-48 hours in the onset of copious milk production.

IBCLC - Certification Exam Practice Test

IBCLC - Certification Exam Practice Test

IBCLC Common Clinical Challenges 2