International Board of Certified Lactation Consultant (IBCLC) Practice Exam

How soon after birth should hand expression or pumping be initiated if the baby is unable to feed directly?

1. Within one hour

2. Within three hours

3. Within six hours

4. Within twelve hours

The correct answer is: Within six hours

Hand expression or pumping should ideally be initiated within six hours after birth if the newborn is unable to feed directly. This timeframe is critical for several reasons. First, initiating milk expression early helps to stimulate the mother’s milk production. The early postpartum period is characterized by significant hormonal changes, particularly the increase in prolactin, which is essential for milk synthesis. By expressing milk within six hours, the mother can maximize the establishment of her milk supply. Second, human milk provides numerous immunological and nutritional benefits, which are vital for a newborn’s health, particularly in the early days when the infant is unable to latch or suckle effectively. By starting hand expression or pumping within this window, the mother can ensure that her baby receives colostrum, which is rich in antibodies and has protective properties against infections. Lastly, early milk expression can reduce the risk of engorgement and other complications associated with delayed milk expression. Timing is crucial, as the first few days after birth set the stage for successful breastfeeding later on. By prioritizing interventions within six hours, healthcare providers can enhance maternal-infant bonding and facilitate a smoother transition to direct breastfeeding when the baby is ready.