UPDATED IBCLC Exam QUESTIONS AND ANSWERS

What is the first question to consider when helping a breastfeeding mother with a medication question? A) What is the relative infant dose of the medication? B) What is the protein binding of the medication? C) What is the molecular weight of the medication? D) Is the medication really necessary to take now? - ANSWER D Which drug property results in more transfer of the drug into the mother's milk? A) Molecular weight 800 Daltons B) High protein binding C) High lipid solubility D) Low maternal plasma concentration - ANSWER C When it comes to medications and breastfeeding, drugs with a shorter half-life are preferred. How many half-lives until it is generally considered that the drug is eliminated from the system? A) 3 B) 5 C) 7 D) 9 - ANSWER B If a woman is given 80 mg of a drug to treat a urinary tract infection - and the drug has a half-life of 3 hours - how much will be left in her system after 3 half-lives? A) 40 mg B) 20 mg C) 10 mg D) 5 mg - ANSWER C What is considered a high enough molecular weight that the medication will be too big to easily get into the breast milk compartment? A) 200 Daltons B) 300 Daltons C) 400 Daltons D) More than 800 Daltons - ANSWER D Drugs can be highly bound to albumin, a large protein in the blood circulation, and therefore too big to get into the breast milk space. What percentage of protein binding is considered high and therefore preferred? A) 40% B) 60% C) 80% D) 90% - ANSWER D While most drugs are compatible with breastfeeding, a few are not. Which type of drug is usually contraindicated for breastfeeding? A) Antibiotic B) Antidepressant C) Chemotherapy D) Diabetic therapy - ANSWER C A Relative Infant Dose (RID) of _____ indicates compatibility with breastfeeding. A) 10% ANSWER A) 10% B) 10% - A good resource to use to figure out if a medicine is compatible with breastfeeding is: A) The Physician Desk Reference (PDR) B) The medicine package insert C) Google D) LactMed - ANSWER D) LactMed In Hale's Medications and Mothers' Milk, which lactation risk category is the safest? A) L1 B) L2 C) L4 D) L5 - ANSWER A In Hale's Medications and Mothers' Milk, what lactation risk category does a medication go into if there is absolutely no published data about the medication, even if it is considered safe? A) L2 B) L3 C) L4 D) L5 - ANSWER B In which lactation risk category in Medications and Mothers' Milk is this the recommendation: "The drug is contraindicated in women who are breastfeeding an infant." A) L2 B) L3 C) L4 D) L5 - ANSWER D) L5 Many antibiotics are safe for the breastfeeding mother to take. However, caution needs to be taken with this antibiotic, ________, about which Hale's Medications and Mothers' Milk says, "This antibiotic can be extremely toxic, particularly in neonates, and should not be used for trivial infections." A) Ampicillin B) Chloramphenicol C) Gentamicin D) Metronidazole - ANSWER B) Chloramphenicol Plasma levels of most topical and ophthalmic preparations are virtually nil and are not likely to produce milk levels at all. A) True B) False - ANSWER A) True Some drug pumping systems exist in the alveolar cell (the cells that line the milk sac). For example, iodine is readily pumped into the milk compartment. Therefore, any form of radioactive iodine should be avoided while breastfeeding. A) True B) False - ANSWER A) True Although there are many exceptions, in general, _______ of the maternal dose finds its way into the milk and, subsequently, to the baby. ***(Do not confuse this with Relative Infant Dose) A) 1% B) 5% C) 10% D) 12.5% - ANSWER A What is the AVERAGE volume of milk consumed per 24 hours by a breastfed baby around age 2-4 weeks? A) 550-600ml (18-20oz) B) 650-700ml (21.5-23oz) C) 750-800 ml (25-26.5oz) D) 850-900ml (28-30oz) - ANSWER C Which statement about the effect of human milk on the child's immune system would be MOST important to medical students? A)Human milk stimulates the baby to begin making his own SIgA and other antibodies.