STUDY GUIDE SOLVED QUESTIONS
◉ When does transitional milk occur? Answer: Days 3-10
◉ When does mature milk occur? Answer: After day 10
◉ What are the signs of a good latch? Answer: Chin touching breast,
wide mouth, audible swallowing, tugging not pain
◉ What does LATCH stand for? Answer: Latch, Audible swallow,
Type of nipple, Comfort, Hold
◉ When is formula feeding preferred? Answer: Maternal infection
(HIV), medications unsafe for BF, preference
◉ What are the safe formula feeding teachings? Answer: Never
dilute, don't microwave, discard after 1 hour after feeding starts
◉ What are the maternal adjustment phases according to Rubin?
Answer: Taking-In → Taking-Hold → Letting-Go
,◉ What does engrossment refer to? Answer: Father/partner's
intense interest in newborn
◉ What is the difference between bonding and attachment? Answer:
Bonding = parent to infant; Attachment = mutual relationship
◉ What are the signs of poor bonding? Answer: Not touching baby,
avoiding eye contact, ignoring baby cues
◉ When should a provider be called postpartum? Answer: Heavy
bleeding, fever > 100.4 after 24 hrs, severe pain, DVT signs
◉ What is the contraindication for Hemabate (carboprost)? Answer:
Asthma
◉ What is the contraindication for Methergine? Answer:
Hypertension
◉ What is the purpose of oxytocin postpartum? Answer: Contracts
uterus → prevents hemorrhage
◉ What are the best pain medications for postpartum? Answer:
Ibuprofen + acetaminophen first-line; opioids only PRN
,◉ Why are stool softeners important postpartum? Answer: Prevents
straining, especially after tears or C-section
◉ When can sex be resumed postpartum? Answer: When healed and
lochia stops (usually ~6 weeks)
◉ Why is breastfeeding protective against pregnancy but not
reliable birth control? Answer: Ovulation can return before first
period
◉ What is diastasis recti? Answer: Separation of abdominal muscles
postpartum
◉ What is the normal postpartum temperature? Answer: < 100.4°F
first 24 hrs is OK; > 100.4 after 24 hrs = infection
◉ What is the best position for breastfeeding? Answer: Tummy-to-
tummy, ear-shoulder-hip aligned
◉ What causes afterpains? Answer: Uterine contractions; worse in
multiparas & breastfeeding
◉ What are the signs of postpartum hemorrhage? Answer:
Saturating pad < 15 min, boggy uterus, low BP, tachycardia
, ◉ What is the first intervention for postpartum hemorrhage?
Answer: Fundal massage
◉ What is a key reason to suppress lactation in non-breastfeeding
moms? Answer: Avoid nipple stimulation (raises prolactin)
◉ What hormone drop triggers milk production postpartum?
Answer: Estrogen and progesterone decrease → prolactin rises
◉ How can you tell if the uterus is displaced by a full bladder?
Answer: Fundus is high and deviated to the right
◉ What are normal afterpains caused by? Answer: Uterine
contractions as it returns to prepregnancy size
◉ What happens to pulse postpartum? Answer: Slightly decreases
(bradycardia normal)
◉ What is lochia rubra composed of? Answer: Blood, decidua, and
trophoblastic tissue
◉ What does foul-smelling lochia indicate? Answer: Infection