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

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.

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

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.

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

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

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

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

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

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

IBCLC - Certification Exam Practice Test

IBCLC - Certification Exam Practice Test

IBCLC Common Clinical Challenges 3