P-IBCLC BFHL-18

P-IBCLC BFHL-18-P01 “Reverse-cycle” nursing refers to:

An electric breast pump’s adjustment of the vacuum-and-release cycle.
A pattern of feeding more at night and sleeping more during the day.
Breastfeeding on the weekend in the same pattern used during the work week.
Breastfeeding on the weekend just to the point of comfort, to avoid the need to express additional milk at work early in the following week.

P-IBCLC BFHL-18-P02 Thawed breastmilk should not be bottle-fed to a healthy infant at which of the following temperatures?

Body temperature.
10 degrees above body temperature.
Room temperature.
Refrigerator temperature.

P-IBCLC BFHL-18-P03 A mother wants to freeze her breastmilk. Which of the following is best practice?

Refreeze any remaining thawed milk that was not used at the feeding.
Use thawed milk within 48 hours.
If frozen in a freezer maintained at negative 4 degrees Fahrenheit, the milk can be used within 12 months.
Do not shake the breastmilk after it has thawed.

P-IBCLC BFHL-18-P04 In addition to cost, a mother considering buying any breast pump should first consider:

The availability of replacement parts.
How easy it can be cleaned.
The color.
Where it was manufactured.

P-IBCLC BFHL-18-P05 Which of the following actions may compromise the safety of human milk? The breastmilk is:

Used between 8 and 12 days after it was refrigerated.
Stored at room temperature no more than 8 hours before it is refrigerated.
Expressed after the mother carefully washed her hands.
Collected in a clean glass or plastic container that can be capped.

P-IBCLC BFHL-18-P06 When mothers begin expressing milk to create a stockpile before returning to work, very small quantities are commonly obtained at first principally because:

Her body has not learned to respond to the pump or to hand expression.
The mother is using an ineffective pump.
Her hand-expression technique is poor.
Her milk-ejection reflex requires the presence of her infant.

P-IBCLC BFHL-18-P07 Heating frozen breastmilk in a microwave oven is not recommended because microwave heating is likely to:

Heat unevenly and create hotspots that risk injuring the infant.
Make the milk smell unpalatable.
Reduce concentrations of IgA.
Reduce vitamin B1.

P-IBCLC BFHL-18-P08 Which of the following is a sign of a good breast pump for a particular mother?

It is comfortable for her to use.
Disassembling and reassembling the pump kit requires great dexterity.
Her breasts feel harder after a pumping session.
The longer she uses the pump, the less milk she tends to obtain at each pumping session.

P-IBCLC BFHL-18-P09 Milk that is frozen at home (in a refrigerator freezer with a separate door):

Can be safely used for at least 6 months.
Has a composition that best nourishes the infant if it is used as soon as possible.
Should be stored near the door, so access to the milk does not unduly warm the freezer.
Once warmed and used for a feeding can again be refrigerated for 24 hours if any remains.

P-IBCLC BFHL-18-P10 Problems of the early postpartum (the first 3 or 4 weeks), such as engorgement, leaking, and frequent and irregular feedings, typically have resolved or diminished by the time the baby is around _____ weeks old.

5.
13.
17.
9.

P-IBCLC BFHL-18-P11 As compared with breastfeeding mothers employed part time or not at all, research finds that breastfeeding mothers employed full time:

Are less likely to initiate breastfeeding.
Are more likely to initiate breastfeeding.
Tend to continue breastfeeding longer, the older the infant is when the mother returns to work.
Have about the same rate of breastfeeding at 6 months postpartum.

P-IBCLC BFHL-18-P12 By using a large hospital-grade breast pump as compared with pumping each breast sequentially, pumping both breasts simultaneously yields:

Less milk ejections.
Smaller volumes of milk.
A larger proportion of the milk remaining in the breast.
Higher cream content in the milk expressed.

P-IBCLC BFHL-18-P13 The breastfeeding mother who travels in the United States can fly with human milk in her carry-on luggage if the containers:

Cannot be opened except by breaking a seal applied to the cap.
Happen to contain more than 3 ounces of breastmilk.
Hold 3 ounces or less of breastmilk.
Cannot be opened except by breaking a seal applied to the cap and hold 3 ounces or less of breastmilk.

P-IBCLC BFHL-18-P14 To prepare chilled or frozen milk for a feeding:

Handle it carefully to maintain the cream portion separately.
Heat in a microwave oven.
Heat in a container of warm water or warm at room temperature.
Heat in a carefully monitored pan on the stove.

P-IBCLC BFHL-18-P15 A portion of thawed and warmed breastmilk that remains after a bottle feeding:

May be layered on top of still-frozen milk and refrozen.
May be left at room temperature if the next feeding will be within 3 hours.
Should be immediately discarded.
May be refrigerated and used at the next feeding.

P-IBCLC BFHL-18-P16 If a mother’s milk supply diminishes after she returns to employment, she can increase it again by:

Increasing the number of times she expresses milk at work.
Decreasing feedings before and after work.
Asking the daycare provider to feed the baby within the hour before she will return to the center.
Getting a full night’s sleep by decreasing night feeds.

P-IBCLC BFHL-18-P17 The Affordable Care Act of 2010 requires employers with more than 50 employees to:

Provide 1 breaktime per day for the mother to express breast milk.
Provide a bathroom for expressing milk.
Qualify breastfeeding mothers for “time and space” provisions until their infants are 12 months old.
Provide hospital-grade breast pumps for the mother's use.

P-IBCLC BFHL-18-P18 Expressing milk while she is at work helps the mother to:

Maintain her milk supply.
Prevent mastitis.
Take much needed breaks during the work day.
Lose weight.

P-IBCLC BFHL-18-P19 The best daycare providers for breastfeeding infants are those who ________ so that ________.

Teach a supine baby to hold his or her own bottle / the baby can end a feeding at will.
Offer a bottle only after observing feeding cues / the baby is fed when he or she is hungry.
Hold a baby while offering a bottle with the base considerably elevated / milk will flow steadily.
Maintain a feeding schedule / to help the provider and the mother be most efficient.

P-IBCLC BFHL-18-P20 As compared with immediate freezing, refrigeration of expressed milk for as much as 8 days is recommended to better retain ________.

Vitamins C and K.
Antimicrobial factors.
Sodium-transport proteins.
Short-chain fatty acids.

P-IBCLC BFHL-18-P21 The earlier in the postpartum period that the mother returns to full-time work:

The more frequently she will need to pump or express her breasts.
The less frequently she will need to pump or express her breasts.
The more likely it is that she will develop mastitis.
The less likely she will be able to pump enough milk for her baby.

P-IBCLC BFHL-18-P22 Another reason for a returning-to-work mother to continue breastfeeding her infant is that infants placed in group child care are more likely to develop:

Diarrhea.
Candida (thrush).
Infections related to teething.
Lower respiratory infections.

P-IBCLC BFHL-18-P23 As a rule of thumb, a working mother should express milk at least:

Twice during an 8-hour workday.
Three times during an 8-hour workday.
For 20 minutes, using a double-pump kit at each pumping session.
For 10 minutes, using a double-pump kit at each pumping session.
For 10 minutes, using a double-pump kit at each pumping session.

P-IBCLC BFHL-18-P24 An employed breastfeeding mother typically affects her workplace by:

Taking more work-at-home days.
Missing more days of work due to infant illness.
Making less use of a company health plan to pay for infant illness.
Being less productive because she misses her infant more.

P-IBCLC BFHL-18-P25 What is the main reason that employed mothers tend to wean early?

Insufficient or diminishing milk supply.
Workplace facilities that support breastfeeding.
Lack of time to express milk.
Returning to work.

P-IBCLC BFHL-18-P26 The bacterial concentration in expressed human milk:

Falls during the first few hours after expression, but only if it is immediately refrigerated.
Rises gradually beginning about an hour after the milk was expressed, if it remains at room temperature.
Rises sharply beginning about an hour after the milk was expressed, if it remains at room temperature.
Falls during the first several hours after expression, even if it remains at room temperature.

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P-IBCLC BFHL-18

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