Quantum Units Education®

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.

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:

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.

Environmental Effects

4. 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.

Endorsement of Breastfeeding as the Best Nutrition for Infants

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

Rates of Breastfeeding

6. 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.

Disparities in Breastfeeding Practices

7. 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.

8. 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.

Lactation Problems

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

Employment and Child Care

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

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

12. 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.

13. 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.

Breastfeeding from the Public Health Perspective: Mothers and Their Families

14. In 2009, half of all mothers with children under the age of one year were employed, which could impact breastfeeding rates.

15. 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.

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

17. 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.

18. 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.

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

20. 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.

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

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

23. 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).

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

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

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

27. 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.

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

29. 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.

30. 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.

31. 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.

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

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

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

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

Action 5: Create a National Campaign to Promote Breastfeeding

35. 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.

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

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

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

37. 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.

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

38. 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.

Action 15: Expand the Use of Programs in the Workplace

39. 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.

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

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