IBCLC Pharmacology and Toxicology 2

Question 1

Which resource is considered the gold standard for evaluating medication safety during lactation?

Accepted Answer

LactMed database and Hale's Medications and Mothers' Milk

Answer

LactMed and Hale's are the most authoritative, evidence-based resources for evaluating drug safety during lactation.

Question 2

A breastfeeding mother needs a diagnostic procedure using gadolinium-based contrast for an MRI. What is the recommendation?

Accepted Answer

Breastfeeding can continue without interruption as less than 0.04% of gadolinium is excreted in breast milk

Answer

The amount of gadolinium excreted into breast milk is extremely small, making it safe to continue breastfeeding.

Question 3

Which class of antidepressants is generally considered most compatible with breastfeeding?

Accepted Answer

Selective serotonin reuptake inhibitors (SSRIs), particularly sertraline and paroxetine

Answer

SSRIs, particularly sertraline and paroxetine, have the most extensive safety data during breastfeeding.

Question 4

A mother who is a regular cannabis user asks about the safety of breastfeeding. What should the IBCLC advise?

Accepted Answer

THC is lipophilic, concentrates in breast milk, is stored in infant fat tissue, and may affect neurodevelopment; abstaining is recommended

Answer

THC is highly lipophilic, concentrates in breast milk at levels up to 8 times maternal plasma, and may affect neurodevelopment.

Question 5

What is the relative infant dose (RID) and what threshold is generally considered acceptable?

Accepted Answer

RID is the percentage of the maternal weight-adjusted dose received by the infant through breast milk; less than 10% is generally acceptable

Answer

The RID expresses the infant's dose as a percentage of the mother's weight-adjusted dose, with less than 10% generally considered acceptable.

IBCLC - Certification Exam Practice Test