Question Title

* 1. On the day after delivery, a breastfeeding mother reports that she is having difficulty getting her infant to breastfeed. Your best response to this situation would be to:

Question Title

* 2. A 4 day old comes to your office for his newborn follow-up visit.  He was the first child born to a 28 year old G1 mother at 38 weeks gestational age by spontaneous vaginal delivery weighing 3400 grams. He was able to go skin-to-skin after delivery and latch within the first hour. The mother noted some pain with latching in the hospital and was discharged home with continued and exclusive direct breastfeeding. At your office, the mother reports that the newborn is crying frequently despite being fed every 2-3 hours on both breasts. He is having 4 wet diapers and 1 black, tarry stool per day. Mother complains that her nipples are very tender and sometimes bleed. Her breasts are starting to feel fuller and more painful. The baby now weighs 2950 grams.

Question Title

* 3. A one-week old term infant presents to the primary care clinic for a weight check. The mother is a first-time exclusively breastfeeding mother, and wants to know whether her baby is getting enough milk. Which of the following would be most reassuring regarding adequate intake in a breastfeeding infant during the first week of life?

Question Title

* 4. A term infant is born to a mother who has been stable in a methadone treatment program for the past 5 years. Her routine serologies, including HIV, Hep B, and Hep C, were negative at the beginning of her pregnancy. She wants to know whether she can breastfeed her baby while continuing to take daily doses of methadone.

Question Title

* 5. You are using the AAP Breastfeeding Action plan to help a new mother assess how breastfeeding is going.

Which of the following is a reassuring sign regarding adequate breastfeeding?

Question Title

* 6. An exclusively breastfed 5-month-old infant of a first-time mother presents to the primary care provider with increased frequency of loose stools, about 6 times per day, and more spitting up than usual.  The mother reported a “stomach bug” in the family that lasted  about 24 hours one week prior to evaluation. The mother notes that the infant is feeding well. In the office, the exam shows an infant who is well-appearing, smiling, and interactive. The mouth is moist and skin turgor is good. The abdominal exam is benign. The infant was noted to go from the 50th percentile in weight to the 25th percentile. The infant’s stools were guaiac negative in the office. What would be the most appropriate recommendation at this time?

T