Breastfeeding Made Simple

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. The term that neuroscientists use to refer to reflexes and instincts that are built into your baby’s body and brain is:

a) competence
b) hardwiring
c) ability
d) instinct

2. The rooting reflex is a stepping action that babies use to push their way up to the breast after birth.

a) True
b) False

3. The La Leche League is:

a) a group of expert physicians who study instincts
b) a support group for mothers who have high-risk babies
c) for teenage mothers who want to breastfeed
d) a mother-to-mother breastfeeding organization

4. The highly instructionalized ________ -brain approach can leave some mothers feeling________.

a) right, secure
b) right, overwhelmed
c) left, knowledgeable
d) left, incompetent

5. Breastfeeding should be initiated when a baby is:

a) calm and alert
b) hungry and crying
c) smacking her lips and asleep
d) rooting and fussy

6. When babies get ready to feed, they throw their head back and thrust their chin forward.

a) True
b) False

7. According to Righard and Alade, which of the following temporarily decrease a baby’s urge to self attach:
  1. the mother receiving an epidural during labor
  2. the mother receiving Demerol, a narcotic, during labor
  3. the baby being taken for

a) all the above
b) 1 and 4
c) 2 and 3
d) all but 4

8. “Kangaroo Mother Care” described by Dr. Bergman, used ____________ to improve infant survival of the smallest preemies in Zimbabwe from 10 percent to 50 percent.

a) high calorie formula
b) incubators
c) skin-to-skin wrapping
d) warmth

9. When separation occurs, a baby goes into a defense mode to:

a) conserve energy
b) increase the odds of survival
c) lower stress hormones
d) increase hunger

10. Which of the following are positive effects of skin-to–skin contact after birth:
  1. babies are more likely to breastfeed
  2. babies are more likely to breastfeed well
  3. babies cry up to ten times less
  4. babies have a healthier and more

a) all the above
b) 1 and 2
c) all but 3
d) 4 only

11. All of the following are roles of oxytocin except:

a) it is released during orgasm in men and women
b) it causes contractions of the uterus during labor
c) it is responsible for the “letdown” reflex
d) it increases the “nesting” syndrome

12. The “befriend” part of the tend-and-befriend response refers to the tendency of females to seek relationships with males when under stress.

a) True
b) False

13. Breastfeeding is a _______ activity

a) left-brained
b) simple
c) right-brained
d) complex

14. One reason you want your nipple to reach your baby’s comfort zone during breast-feeding is to protect your nipple from friction and compression.

a) True
b) False

15. All of the following are comfortable and effective latch-on techniques except:

a) align nose to nipple with the baby’s head tilted slightly back
b) allow the baby’s feet to push against a hard surface
c) make sure the baby’s mouth is wide open
d) help baby onto the breast

16. Nipple pain is often resolved by:

a) Allowing nipples to “toughen up”
b) waiting four to six weeks for them to heal
c) having a better latch
d) applying warm packs prior to feeding

17. The sandwich analogy is best described as:
  1. avoiding a “wrong-direction sandwich”
  2. getting into a “sniff position”
  3. using a rolling motion
  4. focusing on the underside

a) all the above
b) 1 and 2
c) all but 3
d) all but 4

18. When baby’s flailing hands become a challenge, the baby can be swaddled and dressed in a diaper to prevent overheating.

a) True
b) False

19. During the first day, a newborn’s stomach is:

a) easily stretched
b) able to digest two ounces of milk
c) the size of a marble
d) contains digestive enzymes

20. A newborn may lose up to ten percent of his birth weight a few days after birth because he:

a) was born waterlogged
b) hasn’t been fed enough
c) is not able to digest his milk
d) was not fed for twenty-four hours after birth

21. All of the following are early feeding cues except:

a) rooting
b) crying
c) putting his hand to his mouth
d) fussing

22. __________ is low fat milk, like 1 percent milk, and __________ is like cream.

a) foremilk, hindmilk
b) hindmilk, foremilk

23. On day four, a newborn should have:

a) several wet diapers
b) only one wet diaper
c) four wet diapers
d) it varies with every baby

24. ___________ stools are black, tarry, and sticky and __________ stools occur by day three or four and are greenish.

a) transitional, normal
b) normal, meconium
c) transitional, meconium
d) meconium, transitional

25. A baby should breastfeed:

a) when hungry
b) on a schedule
c) eight to twelve times in twenty-four hours
d) when weight loss occurs after the first four days

26. An average weight gain for a fully breastfed baby is about______ a week, starting at the low weight at day three or four.

a) two ounces
b) six ounces
c) fourteen ounces
d) one pound

27. A fully breastfed baby not passing enough stools is a red flag for:

a) underfeeding
b) constipation
c) an intestinal blockage
d) dehydration

28. Newborn jaundice, the normal yellowing of the skin, is caused by:

a) too many white blood cells
b) high levels of oxygen
c) toxins in the blood
d) bilirubin

29. The “lying-in” period is from colonial America and is comparable to postpartum in modern times.

a) True
b) False

30. All of the following are true about a doula except:

a) it is from a Greek word meaning servant
b) provides help before, during and after delivery
c) care is provided by a professional
d) can be a friend or family member

31. The hormone related to milk production is highest in the middle of the night and is called:

a) estrogen
b) prolactin
c) progesterone
d) oxytocin

32. Humans are definitely _______ mammals.

a) Cache
b) follow
c) nest
d) carry

33. The most common time for babies to cluster their feeding is:

a) morning
b) noon
c) evening
d) night

34. Always position babies on their back or side for sleeping.

a) True
b) False

35. Which of the following is true about formula-fed babies?

a) stools are more frequent
b) weight gain is more rapid
c) they require less use of a pacifier
d) 7 to 8 percent of babies have had a bad reaction to formula

36. The American Academy of Pediatrics recommends breast feeding for at least ______ _______ with the addition of solid foods at 6 months.

a) 6 months
b) one year
c) 18 months
d) 10 months

37. As the amount of milk increases in the breasts, the amount of feedback inhibitor of lactation:

a) remains the same
b) decreases
c) increases
d) varies from mother to mother

38. A mother with a large storage capacity can comfortably hold ______ _______ in each breast.

a) one cup
b) one-half cup
c) 150 ml
d) 100 cc

39. A baby may want to breastfeed to:
  1. satisfy thirst by taking foremilk
  2. satisfy hunger long enough to get hind milk
  3. ease feelings of fear and loneliness
  4. establish closeness

a) all the above
b) 3 and 4
c) all but 1
d) 1 and 2 only

40. In general, milk:

a) is released faster from the breast
b) comes faster from a bottle, due to continuous flow
c) flow varies from mother to mother
d) flow depends on the baby’s sucking ability

41. One reason to delay the start of solid foods is the risk of allergies.

a) True
b) False

42. Which of the following reasons indicate the time has come to wean:
  1. you’ve decided the time is right
  2. the baby has teeth
  3. your child is ready
  4. the mother is receiving chemotherapy or radiation

a) all the above
b) 3 and 4
c) all but 1
d) all but 2

43. One method used by mothers to breastfeed in a less-than-friendly environment would be the use of a “code word” that won’t be obvious to others.

a) True
b) False

44. When abrupt weaning is inevitable, the mother should:

a) wear a smaller size bra
b) reduce salt intake
c) increase calories
d) pump the breasts frequently

45. Signs of readiness in a baby for solid foods is:

a) fussiness
b) having teeth
c) sitting up alone
d) having doubled her birth weight

46. The best treatment for mastitis and engorgement is breastfeeding.

a) True
b) False

47. In research by Bates et al, mothers who were immediately responsive to crying babies, had babies who would cry less.

a) True
b) False

48. In the U.S. today, it is a rare baby who does not receive some type of infant formula.

a) True
b) False

49. All of the following are true breastfeeding goals when the mother is returning to work except:

a) supply only mother’s milk for feedings when you and your baby are apart
b) supply as much mother’s milk as is convenient
c) supplement as much as possible with formula
d) supplement with formula while away and breastfeed when together

50. Which of the following will help stop leaks:
  1. use nursing pads
  2. regular pumping while at work
  3. apply pressure discreetly to nipples with forearms
  4. decrease fluids

a) all the above
b) 1 only
c) all but 3
d) all but 4

51. Freshly expressed mature milk can be at room temperature (less than 79 degrees F.) for:

a) less than one hour
b) no more than two hours
c) 4-6 hours
d) 12 hours

52. Which hormonal contraceptive can lower your milk supply sometimes dramatically:

a) progesterone
b) estrogen
c) prolactin
d) oxytocin

53. One cause of engorgement is increased circulation which may be relieved with warmth or cold.

a) True
b) False

54. The most common cause of nipple pain is:

a) not breaking the baby’s suction
b) overzealous cleaning of the nipples
c) mastitis
d) a shallow latch

55. Thrush, a yeast infection of the baby’s mouth, can be treated with nystatin suspension which has become__________ effective in recent years.

a) more
b) less
c) very

56. Milk production may be increased by the use of Reglan, which also has the side effect of:

a) constipation
b) diarrhea
c) headaches
d) depression

57. Silicon and forms of silicon are considered:
  1. inert
  2. a heavy metal
  3. a treatment for colic
  4. dangerous

a) all the above
b) 4 only
c) 1 and 3
d) 1 only

58. One method to increase a baby’s milk intake when she has a cold or flu is to breastfeed:

a) in a room with high humidity
b) after the baby sneezes
c) when she is fussy
d) after suctioning their nose