IBCLC Common Clinical Challenges 3

Question 1

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?

Accepted Answer

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

Answer

Wait 24 hours for all anesthesia to clear before breastfeeding

Answer

Begin pumping immediately but delay direct breastfeeding

Answer

Administer a galactagogue to prevent delayed lactation

Question 2

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?

Accepted Answer

Rusty pipe syndrome due to increased vascularity

Answer

Cracked nipples from poor latch

Answer

Breast cancer requiring immediate evaluation

Answer

Intraductal papilloma

Question 3

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?

Accepted Answer

Positional adjustments and manual lip flanging before considering surgical intervention

Answer

Immediate referral for frenectomy

Answer

Switch to bottle feeding to avoid further nipple damage

Answer

Apply nipple cream and continue with current latch

Question 4

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?

Accepted Answer

Gastroesophageal reflux causing feeding aversion

Answer

The infant is self-weaning

Answer

The mother's milk supply has suddenly decreased

Answer

Normal developmental feeding behavior

Question 5

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?

Accepted Answer

Combined estrogen-progestin oral contraceptive

Answer

Progestin-only pill

Answer

Progestin-releasing IUD

Answer

Progestin implant

Question 6

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?

Accepted Answer

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

Answer

The total amount of breast tissue removed

Answer

The size of her breasts before surgery

Answer

The number of years since the surgery was performed