WorksheetsDoctor's Breastfeeding Quiz
Total questions: 30
Worksheet time: 10mins
What is the primary hormonal trigger for lactogenesis II (secretory activation) postpartum?
High levels of estrogen
Drop in progesterone after placental delivery
Increase in cortisol
Rise in prolactin during pregnancy
Which hormone directly controls milk ejection (let-down reflex)?
Prolactin
Oxytocin
Estrogen
Cortisol
What is the role of prolactin in breastfeeding?
Triggers nipple sensitivity
Stimulates alveolar milk synthesis
Regulates let-down reflex
Enhances breast engorgement
Which hormone is primarily responsible for milk ejection, and how can stress affect its action?
Prolactin; stress increases its activity
Oxytocin; stress inhibits its release
Prolactin; stress blocks its receptor
Oxytocin; stress enhances its action
Which of the following best describes the composition of breast milk in mothers of preterm infants?
Lower protein and energy content
Higher immunoglobulin A and fat content
Identical to term milk by day 5 postpartum
Decreased mineral concentration compared to term milk
In preterm human milk compared to term milk, which of the following components is typically higher during early lactation?
Casein
Immunoglobulin A
Lactose
Vitamin K
Which specific component of human milk is most directly responsible for binding and neutralizing enteric pathogens?
Lactoferrin
Secretory IgA
Lysozyme
Epidermal growth factor
What is the primary role of oligosaccharides in human milk?
Enhancing fat absorption
Promoting renal development
Serving as prebiotics to inhibit pathogen adhesion
Binding iron for infant metabolism
Which of the following human milk components provides passive immunity against enteric infections by preventing mucosal adhesion of pathogens?
Lysozyme
Secretory IgA
Lactalbumin
Vitamin A
Which human milk oligosaccharide property is most protective against infections in neonates?
Providing glucose to gut cells
Acting as competitive receptor analogs to pathogens
Increasing gastric pH
Binding iron to promote microbial growth
Which of the following is an absolute contraindication to breastfeeding?
Maternal hepatitis B infection
Use of carbamazepine
Active maternal tuberculosis untreated
CMV-seropositive mother
Which maternal infection is a clear contraindication to breastfeeding even with expressed milk?
Treated syphilis
HIV infection (in high-resource settings per CDC)
HSV infection without breast lesions
Tuberculosis under treatment
A breastfeeding mother is diagnosed with chronic hepatitis C. What is the correct breastfeeding advice per WHO and CDC guidelines?
Breastfeeding should be stopped immediately
Expressed breast milk only, not direct feeding
Breastfeeding is permitted unless nipples are cracked or bleeding
Infant must receive HCV vaccine prior to breastfeeding
What is the correct WHO recommendation on breastfeeding in the context of maternal COVID-19 infection (mild)?
Avoid breastfeeding; switch to formula
Only expressed milk should be used
Continue direct breastfeeding with hand hygiene and masking
Breastfeeding only after 7 days post-symptom resolution
Which of the following is characteristic of primary lactation failure?
Insufficient breast stimulation post-delivery
Anatomical defects or glandular hypoplasia
Maternal separation from infant
Poor infant latching
In mothers with insufficient glandular tissue (IGT), what is the hallmark clinical breast finding postpartum?
Symmetrical, firm glandular breasts
Marked engorgement on day 3
Hypoplastic, widely spaced, tubular breasts with minimal fullness
Normal areolar fullness with no milk ejection
Which of the following findings is most consistent with mammary hypoplasia (IGT)?
Areolar fullness with engorgement on Day 3
Bilateral tubular, widely spaced breasts with minimal postpartum change
Asymmetrical breast development during pregnancy
Breast tenderness and erythema
Which of the following features helps differentiate a galactocele from a breast abscess?
Erythema and systemic symptoms
Positive bacterial culture from aspirate
Milk-filled, non-tender, fluctuant cyst
Acute onset with fever and pain
A 3-day postpartum mother with delayed lactogenesis II is suspected to have Sheehan's syndrome. Which lab finding most strongly supports this diagnosis in the context of lactation failure?
Elevated TSH and prolactin
Low cortisol and low prolactin
Elevated prolactin with low ACTH
High oxytocin with low FSH
A postpartum mother presents with failure of milk secretion on Day 4. She reports no breast fullness and persistent fatigue. Which endocrine abnormality is most likely?
Elevated prolactin
Hyperthyroidism
Hypopituitarism
Hyperprolactinemia
Which clinical feature favors breast milk jaundice over pathological jaundice in an otherwise healthy infant?
Jaundice in the first 24 hours
Conjugated hyperbilirubinemia
Persistence of jaundice beyond 2 weeks without systemic illness
Infant is lethargic with poor feeding
A neonate has prolonged jaundice at 3 weeks of age and is exclusively breastfed. There is no hepatosplenomegaly, weight gain is normal, and direct bilirubin is not elevated. What is the most likely diagnosis?
Breast milk jaundice
Biliary atresia
Hypothyroidism
Galactosemia
Which antiepileptic drug is generally considered unsafe for use in breastfeeding due to risk of sedation and respiratory depression in infants?
Lamotrigine
Carbamazepine
Phenobarbital
Levetiracetam
Which maternal medication below is LEAST likely to be safely used in breastfeeding due to significant secretion into milk and infant toxicity risk?
Methotrexate
Prednisolone (low dose)
Amoxicillin
Metoprolol
Which of the following drugs is known to significantly suppress milk production?
Metoclopramide
Domperidone
Estrogen-containing contraceptives
Hydralazine
What is a key concern regarding the use of domperidone as a galactagogue?
Liver toxicity
Risk of cardiac arrhythmias and QT prolongation
Suppression of prolactin
Hyperglycemia in lactating mothers
Which galactagogue has been associated with QT prolongation and is not FDA-approved for enhancing lactation in the U.S.?
Domperidone
Metoclopramide
Fenugreek
Oxytocin spray
Which statement regarding galactagogues is most evidence-based and accurate per ABM and AAP guidelines?
Herbal galactagogues are always safe and effective
Domperidone is FDA-approved for increasing milk supply
Non-pharmacologic measures should precede galactagogues, which should be used only in confirmed hypoprolactinemia
Metoclopramide is preferred due to long-term safety profile
Maternal obesity is associated with which of the following effects on breastfeeding?
Enhanced prolactin response
Delayed onset of lactogenesis II
Increased milk production
Decreased risk of mastitis
Which breastfeeding technique modification is most beneficial for infants with cleft palate?
Cross-cradle hold with deep latch
Use of nipple shields during breastfeeding
Exclusive pumping with paced bottle feeding using specialized feeder
Cup feeding to promote palate closure
