TeachME Professional Development

Breastfeeding Support and Promotion

Message from the Secretary, U.S. Department of Health and Human Services

1. ____ percent of all newborns in America now begin their lives breastfeeding, and breastfeeding has regained its rightful place in our nation as the norm.

A. 50 B. 75 C. 66 D. 80

The Importance of Breastfeeding: Health Effects

2. An Agency for Healthcare Research and Quality (AHRQ) report shows the health risks associated with formula feeding and early weaning from breastfeeding include all of the following EXCEPT:

A. Diarrhea B. Ear infections C. Leukemia D. Diaper rash

3. The risk of hospitalization for lower respiratory tract disease in the first year of life is more than 250 percent higher among babies who are formula fed than in those who are exclusively breastfed for at least four months.

A. True B. False

4. The risk of sudden infant death syndrome is ____ percent higher among infants who are never breastfed.

A. 51 B. 56 C. 61 D. 66

Psychosocial Effects

5. The literature is conclusive that breastfeeding helps to lower the risk of postpartum depression, a serious condition that almost 17 percent of mothers experience.

A. True B. False

Environmental Effects

6. Although breastfeeding requires mothers to consume a small amount of additional calories, it generally requires no containers, no paper, no fuel to prepare, and no transportation to deliver, and it reduces the carbon footprint by saving precious global resources and energy.

A. True B. False

Endorsement of Breastfeeding as the Best Nutrition for Infants

7. Which of the following is NOT one of the organizations that has recommended breastfeeding:

A. American Academy of Pediatrics (AAP) B. American Academy of Family Physicians C. American Association of Breastfeeding Advocates D. American Dietetic Association

Rates of Breastfeeding

8. National objectives for Healthy People 2010 called for 75 percent of mothers to initiate breastfeeding, 50 percent to continue breastfeeding for three months and 25 percent to continue breastfeeding for six months.

A. True B. False

Disparities in Breastfeeding Practices

9. Breastfeeding rates for black infants are about ___ percent lower than those for white infants at birth, age six months, and age 12 months, even when controlling for the family's income or educational level.

A. 50 B. 25 C. 40 D. 35

10. A recent national sample of women enrolled in The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) reported that only 36 percent of participants thought that breastfeeding would protect the baby against ______________.

A. Respiratory infections B. Colic C. Diarrhea D. Sudden Infant Death Syndrome

11. Many people, including health professionals, are under the incorrect assumption that because commercially prepared formula has been enhanced in recent years, infant formula is equivalent to breast milk in terms of its health benefits.

A. True B. False

Poor Family and Social Support

12. Experts believe that __________ play(s) a significant role in a mother's decision of whether or not to breastfeed.

A. The baby's father B. Friends C. Health care providers D. A and B

Lactation Problems

13. Frequently cited problems with breastfeeding include all of the following EXCEPT:

A. Sore Nipples B. Fatigue C. Engorged breasts D. Pain

14. One national study on feeding practices found that about 50 percent of mothers cited sore nipples as their reason for stopping breastfeeding.

A. True B. False

Employment and Child Care

15. Which of the following is NOT a significant barrier to breastfeeding for the working mom?

A. Inflexibility in work hours and locations B. Lack of privacy for breastfeeding or expressing milk C. Lack of maternity leave D. Insecurity about overexposure in the workplace

16. In a survey of 712 mothers, participants reported that each week of maternity leave increased the duration of breastfeeding by at least one week.

A. True B. False

Barriers Related to Health Services

17. Separating mothers from their babies during their hospital stay has a negative impact on the initiation and duration of breastfeeding, and yet one study reported that only ___ percent of U.S. hospitals and birth centers allowed newborns to stay in the same room as their mothers.

A. 57 B. 61 C. 65 D. 69

18. Cesarean delivery is associated with delayed skin-to-skin contact between mother and baby, increased supplemental feeding, and separation of mother and baby, all of which lead to suboptimal breastfeeding practices.

A. True B. False

Breastfeeding from the Public Health Perspective: Mothers and Their Families

19. In 2009, half of all mothers with children under the age of one year were employed.

A. True B. False

Communities

20. Which of the following is NOT one of the ways WIC has rewarded breastfeeding mothers:

A. Providing a food package with a higher monetary value for breastfeeding participants than for participants who do not breastfeed B. Offering small cash incentives C. Giving a food package that consists of higher quantities of complementary foods for breastfed babies who are at least six months old D. Offering breast pumps

21. The American Medical Association (AMA) uses a social marketing approach to encourage and support breastfeeding that began with the campaign Loving Support Makes Breastfeeding Work.

A. True B. False

22. Peer counselors may be effective breastfeeding success in part because they are seen as role models and also because they often provide:

A. Coaching during the childbirth B. Counseling for mothers having emotional issues C. Assistance through phone calls or home visits D. None of the above

23. The WHO International Code of Marketing of Breast-milk Substitutes declares that substitutes for breast milk should not be marketed in ways that can interfere with breastfeeding.

A. True B. False

24. Since family members, such as fathers and babies' grandmothers, are important parts of a mother's life, it may be important for community-based groups to include them in education and support programs for breastfeeding.

A. True B. False

Health Care

25. The promotion and support for breastfeeding is highly recommended throughout the encounters women have with health professionals during prenatal and postpartum care, and as a result most clinicians are adequately prepared to support mothers who wish to breastfeed.

A. True B. False

26. All of the following are examples of barriers to breastfeeding newborns EXCEPT:

A. Non-private hospital rooms B. Placement of stable, healthy full-term newborn on infant warmer immediately upon delivery C. Provision of infant formula or water without medical indication D. Removal of newborn from mother's room at night

27. The Baby-Friendly Hospital Initiative, established by WHO and UNICEF, includes a set of maternity care practices known as the Twelve Steps to Successful Breastfeeding, that, when implemented together, result in better breastfeeding outcomes.

A. True B. False

28. Which of the following is NOT one of the practices of the Baby-Friendly Hospital Initiative?

A. Have a written breastfeeding policy that is routinely communicated to all health care staff B. Inform all pregnant women about the benefits and management of breastfeeding C. Help mothers initiate breastfeeding within two hours of birth D. Give newborn infants no food or drink other than breastmillk, unless medically indicated

29. Baby-Friendly hospitals do not allow pacifiers or artificial nipples for breastfeeding infants.

A. True B. False

30. In 2006, an estimated ____ percent of all U.S. births were preterm (less than 37 completed weeks of gestation), and ____ percent of infants had a low birth weight (less than 2,500 grams).

A. 13.9; 9.2 B. 11.7; 10.1 C. 10.5; 7.2 D. 12.8; 8.3

31. Which of the following is NOT an accurate statement about NEC (necrotizing enterocolitis)?

A. Formula feeding is a risk factor B. About 20% of preterm infants weighing less than 2500 grams will suffer from NEC infection C. Hospitalization for all surgical NEC averages 62 days and $300,000 per patient D. NEC treatment accounts for 19% of all newborn health care costs

32. Although there are currently only 16 donor milk banks operating across the United States and Canada that collect, pasteurize, store, and distribute the human milk that has been donated, experts are pushing for additional facilities since they are beneficial and generally operate with very few challenges.

A. True B. False

33. Breast milk is a means of viral transmission, and thus it is essential that donors are screened for significant viral diseases, such as:

A. HIV B. Human T-cell leukemia virus C. Hepatitis C D. All of the above

34. Although heat treatment can destroy most infectious pathogens in milk, excessive heat will destroy some of the nutritional components of the milk as well.

A. True B. False

35. The skin-to-skin closeness that occurs during breastfeeding promotes bonding and attachment between mother and infant, increases the efficiency of breastfeeding, and enhances the neurological and _________ development of the infant.

A. Physical B. Interpersonal C. Psychosocial D. Behavioral

36. Currently, among 173 countries, only four are without a national policy requiring paid maternity leave. These countries include all of the following EXCEPT:

A. Swaziland B. Russia C. Papua New Guinea D. United States

37. The 2010 Affordable Care Act included a provision requiring employers to a provide reasonable, though unpaid, break time for a mother to express milk and a place, other than a restroom, that is private and clean where she can express her milk.

A. True B. False

38. The 2005-2007 Infant Feeding Practices Study II found that among mothers who worked and breastfed, 28 percent kept the infant at work and breastfed during the workday, 17 percent went to the infant to breastfeed, and 5 percent had the baby brought to them at the work site in order to breastfeed.

A. True B. False

Research and Surveillance

39. Because of ethical considerations, research on the health outcomes of different modes of infant feeding is limited to randomized controlled studies, the results of which can only provide inferences on the association between feeding type and outcomes.

A. True B. False

40. The USDA operates the WIC program, which serves more than ____ of the infants born in the United States.

A. 30% B. 40% C. 50% D. 60%

41. Forty-seven states have now formed breastfeeding coalitions, and there are many local, tribal, and territorial coalitions as well.

A. True B. False

A Call to Action-Action 2: Develop Programs to Educate Fathers and Grandmothers About Breastfeeding

42. When a mother is thinking about how to feed her baby, she values the advice of her______ the most.

A. Partner B. Mother C. Friends D. Health care provider

Action 4: Use Community-Based Organizations to Promote and Support Breastfeeding

43. Difficulties with breastfeeding can occur at any time of the day or night, so mothers are encouraged to use _________ to provide needed assistance.

A. Telephone triage B. Hotlines C. Online networks D. All of the above

Action 5: Create a National Campaign to Promote Breastfeeding .

44. Social marketing, which engages members of the community with each other, is a promising way of ensuring that new generations understand the value of breastfeeding and can make well-informed decisions about infant feeding.

A. True B. False

Action 6. Ensure That the Marketing of Infant Formula is Conducted in a Way That Minimizes its Negative Impacts on Exclusive Breastfeeding

45. Each of the following helps endorse formula feeding EXCEPT:

A. Free formula samples B. Notepads and growth charts with formula logo C. Advertisements promoting supplementation when medically necessary D. Posters advertising formula in health care provider's office

Action 7: Ensure that Maternity Care Practices Throughout the United States are Fully Supportive of Breastfeeding

46. Maternity care practices often reflect clinicians' personal experiences with breastfeeding and may be based on misinformation that interferes with successful breastfeeding.

A. True B. False

Action 10. Include Basic Support for Breastfeeding as a Standard of Care

47. International Board Certified Lactation Consultants carry certification by the International Board of Lactation Consultant Examiners (IBLCE) and are the only health care professionals certified in lactation management.

A. True B. False

Action 13: Work Toward Establishing Paid Maternity Leave for all Employed Mothers

48. The International Labor Organization, an arm of the United Nations, recommends a paid maternity leave of 12 weeks and also recommends that employers not be solely responsible for funding maternity leave, as this could create a disincentive to hire women.

A. True B. False

Action 15: Expand the Use of Programs in the Workplace

49. Providing reasonable break times during the workday is the most effective strategy of combining employment and breastfeeding because it allows for the increased duration and intensity of breastfeeding.

A. True B. False

Action 19: Develop a National Monitoring System to Improve the Tracking of Breastfeeding Rates

50. Although the Centers for Disease Control and Prevention (CDC) tracks breastfeeding rates, few systems exist to track changes in breastfeeding behavior and attitudes.

A. True B. False


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