IBCLC Trivia 5 — Questions and Answers
Question 1: The term 'laid-back breastfeeding' (biological nurturing) refers to which positioning approach?
- Having the infant lie flat on a feeding pillow while the mother sits upright
- The mother reclining at 45° or more with the infant prone on her chest, using gravity for latch support (Correct answer)
- Side-lying breastfeeding in bed
- The football hold with the mother leaning backward
Correct answer: The mother reclining at 45° or more with the infant prone on her chest, using gravity for latch support
Biological nurturing (Suzanne Colson) uses a semi-reclined maternal posture so the infant lies prone on the mother's body, activating feeding reflexes and reducing latch difficulty.
Question 2: Which immunoglobulin is most abundant in human breast milk and provides mucosal immunity to the infant?
- IgG
- IgM
- IgE
- Secretory IgA (sIgA) (Correct answer)
Correct answer: Secretory IgA (sIgA)
Secretory IgA is the predominant immunoglobulin in breast milk; it lines mucosal surfaces of the infant's GI tract and respiratory system, providing passive immune protection.
Question 3: A mother produces significantly more milk than her infant requires, leading to discomfort, leaking, and infant gagging. This condition is called:
- Hypogalactia
- Agalactia
- Hyperlactation syndrome (Correct answer)
- Engorgement
Correct answer: Hyperlactation syndrome
Hyperlactation syndrome (oversupply) is characterized by an excessive milk production rate that exceeds infant demand, causing maternal discomfort and potentially causing the infant to struggle with fast flow.
Question 4: According to the IBLCE Code of Professional Conduct, IBCLCs must maintain client confidentiality EXCEPT when:
- The client requests information be shared with a specific healthcare provider
- Disclosure is required by law or is necessary to prevent serious harm (Correct answer)
- The IBCLC disagrees with the client's feeding choices
- Another IBCLC requests the records for peer review
Correct answer: Disclosure is required by law or is necessary to prevent serious harm
Confidentiality may be breached when legally mandated (e.g., mandatory reporting) or when necessary to prevent serious, imminent harm, consistent with healthcare ethics standards.
Question 5: Which of the following best describes 'transitional milk'?
- The milk produced when switching from breastfeeding to formula
- The milk produced between days 2–5 and about day 14 postpartum as colostrum shifts to mature milk (Correct answer)
- Milk expressed at the beginning of a pump session
- Milk produced after 12 months of lactation
Correct answer: The milk produced between days 2–5 and about day 14 postpartum as colostrum shifts to mature milk
Transitional milk appears after colostrum and before mature milk (roughly days 5–14), increasing in volume and shifting in composition with rising lactose and fat and declining protein and immunoglobulins.
Question 6: What does the term 'galactopoiesis' refer to in lactation physiology?
- The initiation of lactation at birth
- The maintenance and ongoing production of milk after lactation is established (Correct answer)
- The cessation of milk production at weaning
- The let-down or milk ejection reflex
Correct answer: The maintenance and ongoing production of milk after lactation is established
Galactopoiesis refers to the maintenance of established milk production; it depends on continued prolactin secretion driven by frequent, effective milk removal.
Question 7: Which of the following is considered a contraindication to breastfeeding in the United States?
- Maternal hepatitis B surface antigen positive status
- Maternal untreated active tuberculosis with infant not yet treated (Correct answer)
- Maternal cytomegalovirus (CMV) seropositivity
- Maternal mild postpartum depression
Correct answer: Maternal untreated active tuberculosis with infant not yet treated
Untreated active maternal TB is a CDC-listed contraindication to breastfeeding until the mother is no longer infectious, as respiratory transmission (not milk) is the primary risk.
IBCLC Trivia 5
The term 'laid-back breastfeeding' (biological nurturing) refers to which positioning approach?