IBCLC Pharmacology and Toxicology 3

Question 1

A mother is taking metformin for type 2 diabetes and wants to breastfeed. What does the evidence show?

Accepted Answer

Metformin has very low transfer into breast milk (RID approximately 0.3-0.7%) and is considered compatible with breastfeeding

Answer

Metformin has a very low RID of approximately 0.3-0.7% and is considered compatible with breastfeeding.

Question 2

A breastfeeding mother needs general anesthesia for emergency surgery. When can she resume breastfeeding?

Accepted Answer

Once she is awake, alert, and able to safely hold and feed her infant

Answer

Modern anesthetic agents are short-acting and cleared rapidly. Breastfeeding can resume once the mother is awake and alert.

Question 3

Which herbal galactagogue has the most evidence for increasing milk supply, and what are the safety considerations?

Accepted Answer

Fenugreek has the most published evidence but can cause GI effects, hypoglycemia, and has cross-reactivity with peanut/chickpea allergies

Answer

Fenugreek is the most studied herbal galactagogue but has important safety considerations.

Question 4

A mother is prescribed ibuprofen for postpartum pain. What makes this a preferred analgesic during breastfeeding?

Accepted Answer

It has very low transfer (RID approximately 0.1-0.7%), is highly protein-bound, and is well-studied with no reported adverse effects

Answer

Ibuprofen is highly protein-bound (>99%), has minimal transfer into breast milk, and has extensive safety data.

Question 5

What is the primary concern regarding codeine use in breastfeeding mothers?

Accepted Answer

Some mothers are ultra-rapid CYP2D6 metabolizers who convert codeine to morphine at dangerously high rates, leading to infant sedation and potentially fatal respiratory depression

Answer

Ultra-rapid CYP2D6 metabolizers convert codeine to morphine at higher rates, resulting in elevated morphine levels in breast milk.

IBCLC - Certification Exam Practice Test

IBCLC - Certification Exam Practice Test

IBCLC Pharmacology and Toxicology 3