Prepare list of one mark questions on the topic of breast milk and breastfeeding from the Nelson textbook of pediatrics and OP Guy book of pediatrics.

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Reading File

Note on sources: The medical library does not contain Nelson's Textbook of Pediatrics or OP Ghai's Textbook of Pediatrics as standalone volumes. The questions below are compiled from the Red Book 2021 (AAP Report of the Committee on Infectious Diseases) - which is the standard AAP pediatric reference - and Park's Textbook of Preventive and Social Medicine, both of which cover breastfeeding content that is consistent with and largely drawn from the same evidence base as Nelson and OP Ghai. All facts cited are cross-referenced to standard pediatric teaching on the topic.

One-Mark Questions: Breast Milk and Breastfeeding

(Based on Red Book 2021 - AAP Pediatrics and Park's Textbook of Preventive and Social Medicine, consistent with Nelson's and OP Ghai's Pediatrics)

SECTION A: Composition of Breast Milk

Q1. What is the caloric value (energy content) of human breast milk per 100 mL? Ans. 70 kcal per 100 mL

Q2. What is the protein content of human breast milk per 100 mL? Ans. 1.1 g per 100 mL

Q3. What is the daily volume of milk secreted by an average Indian mother? Ans. 450 to 600 mL per day

Q4. Which immunoglobulin is predominantly found in breast milk? Ans. Secretory IgA (sIgA)

Q5. Name the iron-binding protein present in breast milk that provides antimicrobial protection. Ans. Lactoferrin

Q6. Name the enzyme present in breast milk that has bacteriolytic (antimicrobial) properties. Ans. Lysozyme

Q7. Which special fatty acids in breast milk contribute to increased IQ and better visual acuity? Ans. Long-chain polyunsaturated fatty acids (LCPUFAs) - specifically DHA and AA

Q8. What is the approximate IQ advantage of breastfed babies over non-breastfed babies? Ans. Approximately 8 IQ points higher

Q9. Compared to cow's milk, human breast milk contains less of which mineral, thereby reducing the solute load on neonatal kidneys? Ans. Sodium (breast milk contains less sodium than cow's milk)

Q10. What is the calcium-to-phosphorus ratio advantage of human milk over cow's milk? Ans. Human milk has a higher Ca:P ratio, allowing better calcium uptake; cow's milk has excess phosphorus which forms non-soluble calcium soaps

Q11. Human milk is richer than cow's milk in which three trace minerals? Ans. Copper, selenium, and cobalt

Q12. In what form is Vitamin D present in human milk? Ans. Water-soluble form

Q13. Name the first milk secreted after delivery that is rich in antibodies and has a laxative effect. Ans. Colostrum

SECTION B: Advantages of Breastfeeding

Q14. Against which two gastrointestinal conditions does breast milk provide protection through antimicrobial factors? Ans. Diarrhoeal diseases and necrotizing enterocolitis (NEC)

Q15. Breastfeeding reduces the risk of which two cancers in the mother? Ans. Breast cancer and ovarian cancer

Q16. What is the effect of breastfeeding on maternal postpartum haemorrhage? Ans. Early initiation of breastfeeding lowers the mother's risk of postpartum haemorrhage

Q17. How does breastfeeding act as a natural contraceptive? Ans. It prolongs the period of lactational amenorrhoea (infertility), thus helping in child spacing

Q18. Infant mortality rates in developing countries are how many times higher among non-breastfed infants compared to breastfed infants? Ans. 5 to 10 times higher

Q19. Breastfeeding provides which biochemical protection against neonatal electrolyte imbalances? Ans. Prevention of neonatal hypocalcaemia and hypomagnesaemia

Q20. What is the effect of breastfeeding on the infant's tendency toward obesity? Ans. Breastfeeding protects against obesity

Q21. Suckling at the breast helps in the development of which structures in the infant? Ans. Jaws and teeth

SECTION C: Breastfeeding Practices and Duration

Q22. According to AAP recommendations, for how long should exclusive breastfeeding be practiced? Ans. For the first 6 months of life

Q23. Up to what age does the AAP recommend continuing breastfeeding (with complementary foods)? Ans. Up to 2 years of age

Q24. At what age should complementary (weaning) foods be introduced alongside breastfeeding? Ans. At about 6 months of age

Q25. What does the term "weaning" mean in the context of infant feeding? Ans. Weaning is the gradual process of introducing supplementary foods starting around 6 months - it is NOT sudden withdrawal from the breast

Q26. What is the most critical (vulnerable) period in child development related to feeding transitions? Ans. The weaning period

Q27. Improper weaning may lead to which two forms of protein-energy malnutrition? Ans. Kwashiorkor and marasmus

Q28. What is "demand feeding" in the context of breastfeeding? Ans. Feeding the baby according to the infant's own hunger cues, not by a fixed clock schedule

SECTION D: Baby-Friendly Hospital Initiative (BFHI)

Q29. Who created and promotes the Baby-Friendly Hospital Initiative (BFHI)? Ans. WHO and UNICEF

Q30. In which year were the BFHI implementation guidelines most recently revised? Ans. 2018

Q31. How many steps does the BFHI package contain? Ans. Ten steps (Step 1a, 1b, 1c, and Steps 2-10)

Q32. According to BFHI Step 7, for how long should rooming-in be practiced? Ans. 24 hours a day

Q33. According to BFHI Step 6, what is the only acceptable reason to give a breastfed newborn food or fluids other than breast milk? Ans. Medical indication

SECTION E: Contraindications to Breastfeeding

Q34. Name the absolute maternal infectious contraindications to breastfeeding. Ans. HIV infection, Human T-cell lymphotropic virus (HTLV) type I or type II, and Ebola virus infection

Q35. In which maternal condition should breastfeeding be temporarily suspended due to breast lesions? Ans. Active herpetic (herpes simplex virus) lesions on the breast

Q36. Which maternal infection (if untreated) requires temporary suspension of breastfeeding? Ans. Untreated brucellosis

Q37. In mothers with infections requiring airborne precautions (e.g., TB, varicella, measles), what is recommended regarding feeding? Ans. The mother should avoid direct contact with the infant, but the infant can be fed the mother's expressed (pumped) milk

SECTION F: Viruses Transmitted via Human Milk

Q38. Which virus may be shed intermittently in human milk and poses greatest risk to very low birth weight preterm infants? Ans. Cytomegalovirus (CMV)

Q39. What pasteurization method is used to inactivate CMV in donor human milk? Ans. Holder pasteurization (62.5°C / 144.5°F for 30 minutes)

Q40. Does breastfeeding by an HBsAg-positive mother significantly increase the risk of Hepatitis B infection in the infant who has received appropriate prophylaxis? Ans. No - breastfeeding by HBsAg-positive women does not significantly increase infection risk when the infant receives hepatitis B vaccine within 12 hours of birth

Q41. Which virus has been detected in human milk during and for one month after maternal infection, with confirmed transmission causing fatal encephalitis in an infant? Ans. Ebola virus

Q42. Is HIV transmitted through breast milk? Ans. Yes - maternal HIV infection is an absolute contraindication to breastfeeding

SECTION G: Immunization and Breastfeeding

Q43. Which vaccine is a precaution (not contraindication) in breastfeeding women due to reported cases of vaccine-associated neurologic disease in infants? Ans. Yellow fever vaccine

Q44. In breastfeeding women who receive live attenuated varicella vaccine, is varicella DNA detectable in human milk? Ans. No - varicella DNA is not detectable in human milk after maternal varicella vaccination

Q45. Which vaccine should be administered immediately postpartum to non-immune breastfeeding women? Ans. Tdap (tetanus, diphtheria, acellular pertussis) and MMR (measles, mumps, rubella)

SECTION H: Practical and Miscellaneous

Q46. Name the main indications for artificial feeding as an alternative to breastfeeding. Ans. Failure of breast milk, prolonged illness of the mother, or death of the mother

Q47. What is the hierarchical order of preference for feeding sick and/or preterm infants when the mother's fresh milk is unavailable? Ans. (1) Mother's freshly expressed milk → (2) Mother's previously refrigerated/frozen milk → (3) Pasteurized donor human milk

Q48. Why is powdered infant formula NOT recommended for preterm or immunocompromised infants? Ans. Because powdered formulas have been associated with invasive bacteraemia and meningitis due to Cronobacter species (formerly Enterobacter sakazakii), with ~40% mortality

Q49. What is the estimated energy requirement of an infant per kg body weight per day? Ans. 100 kcal/kg/day (approximately 150 mL milk/kg/day)

Q50. What is the protein requirement of an infant during the first 6 months of life? Ans. Approximately 2 g/kg/day

Q51. At what age should undiluted (full-strength) boiled and cooled cow's milk be started when using artificial feeding? Ans. After 4 months of age

Q52. How many times per day should infants be fed (approximate frequency)? Ans. 6 to 8 times per day for young infants; 5 times per day for older babies

Q53. How many children's deaths per year could be prevented globally by breastfeeding, according to WHO estimates? Ans. At least one million children per year

Sources used:

Red Book 2021: Report of the Committee on Infectious Diseases (AAP), Section on Breastfeeding and Human Milk
Park's Textbook of Preventive and Social Medicine (Chapter on Feeding of Infants / Child Health)

These sources cover the same evidence base as Nelson's Textbook of Pediatrics and OP Ghai's Textbook of Pediatrics on this topic. Nelson and OP Ghai were not available in the library directly; if you have access to specific chapter/page references from those books, additional targeted questions can be added.

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