Intensive Care Nursery - Lactation Education Survey

How long have you been a neonatal nurse?

< 1 year
1-2 years
3-5 years
5-10 years
> 10 years

Benefits of breastfeeding for the infant include:
(Check all that apply)

Higher developmental scores and IQ  
Decreased sepsis and NEC in the NICU  
Decreased URI’s, UTI’s, otitis media and asthma as an outpatient  

When compared to term milk, milk of mothers of premature infants has significantly higher concentrations of:
(Check all that apply)

Lipids  
Proteins  
Sodium and chloride  
Iron  
Immunoglobulins  

Normal transition from colostrum to breastmilk (“milk coming in”) begins between 3-5 days postpartum but may be as late at day 8.

True False

Transition occurs even the mother does not nurse or pump.

True False

Pumping should be initiated in the first 72 hours post-partum for the highest long-term supply.

True False

Breasts should be pumped for 10-15 minutes every 2-3 hours for a minimum of 8 times in 24 hours, ideally 10-12 times a day. Both breasts should be pumped at the same time.

True False

Pumping mothers should sleep 8-10 hours overnight without pumping so they can get their rest.

True False

Instructions for use of the breast pumps are in the breast pump kits and on the Scope under “lactation resource guide”

True False

If the pump has decreased suction, check that the connections of kit and breastpump are secure, be sure membrane is lying flat against valve head, and make sure the hard yellow ends of the tubing fit securely into breastshield connectors and the other ends into the ports on the pump connector/membrane caps.

True False

Typical expected milk volume is 10 ounces in the first few days to 1 week. Volume should slowly increase to >1000mL (over 30 ounces) per 24 hours by day 10-14.

True False

It is not common to have decreases in supply 4-6 weeks after delivery with a change in maternal hormones as well as with periods of fatigue and stress.

True False

Ways to increase milk supply are:
(Check all that apply)

More frequent pumping  
Longer sessions (45-60 minutes)  
Skin-to-skin contact and pumping at baby’s bedside  
Increasing fluid intake if insufficient (8-10 glasses of water a day)  
Get more rest and eat a nutritious diet  
Galactogogues such as reglan or domperidone  

Signs of poor “let down” include:
(Check all that apply)

Milk dripping and not spraying with pumping  
Breasts feeling soft and empty after pumping  
Sore nipples due to prolonged pumping at higher suction  

Techniques that can help with “let down” are:
(Check all that apply)

Warm moist compresses to the breast  
Breast massage and compression  
Skin-to-skin contact  
Looking at a picture of the baby  
Relaxation (soft music, massage, guided imagery).  

Questions to ask if the nipples become sore include:
(Check all that apply)

Is the flange too small or too big  
Is the nipple centered in the flange  
Is the suction too high  
Is the pumping session too long  

If the mother develops a hard, tender lump in her breast, it may be a blocked duct or the beginnings of mastitis. She should pump frequently, massaging the area and use warm compresses and ibuprofen. If it does not resolve within 24 hours or she develops and fever or flu-like symptoms, she should contact her physician.

True False

Engorgement is described as a sensation of full, firm, warm and tender breasts when the breasts become over-full.

True False

Engorgement should be treated by:
(Check all that apply)

Decreased pumping sessions  
Relaxation during pumping sessions  
Hand-expressing or warm compresses to help relieve the initial discomfort and make pumping more comfortable and efficient  
A well-fitting nursing bra  
Ibuprofen and brief use of cold compresses  

What part of the lactation process makes you the most uncomfortable?
(breast pump instructions, maternal complications, interacting with moms, etc.)

Thanks for your participation!