Case Scenarios

The Lactation QBank Canvas site is the platform from which learners can access remote, on-demand simulation-based training in maternal-child care!

We have designed cases to teach healthcare professionals and trainees how to provide lactation support in telehealth and in-person settings.

Cases in the Lactation QBank:

  • Case 1Breast engorgement in the setting of delayed onset of lactogenesis II
  • Case 2. Bloody nipple discharge in a lactating patient
  • Case 3. Breast milk production and maternal mental health
  • Case 4. Effective breast pump use and management of breast pump-induced trauma
  • Case 5. Advocating for breastfeeding education and lactation support in the hospital
  • Case 6. Providing anticipatory guidance and supporting inclusive breastfeeding after breast surgery
  • Case 7. Sudden-onset breast pain in a lactating patient
  • Case 8. Providing anticipatory breastfeeding guidance to a pregnant patient with a breast lesion (Available soon!)
  • Case 9. Recurrent plugged ducts in an exclusively pumping patient (Available soon!)
  • Case 10. Low milk production despite “trying everything” with worsening nipple rash (Available soon!)
  • Case 3. Breast milk production and maternal mental health
  • Case 8. Providing anticipatory breastfeeding guidance to a pregnant patient with a breast lesion (Available soon!)
  • Case 2. Bloody nipple discharge in a lactating patient
  • Case 6. Providing anticipatory guidance and supporting inclusive breastfeeding after breast surgery 
  • Case 8. Providing anticipatory breastfeeding guidance to a pregnant patient with a breast lesion (Available soon!)
  • Case 8. Providing anticipatory breastfeeding guidance to a pregnant patient with a breast lesion (Available soon!)
  • Case 1. Breast engorgement in the setting of delayed onset of lactogenesis II
  • Case 4. Effective breast pump use and management of breast pump-induced trauma
  • Case 6. Providing anticipatory guidance and supporting inclusive breastfeeding after breast surgery
  • Case 7. Sudden-onset breast pain in a lactating patient

What to Expect

Learners can access the case scenarios on the Lactation QBank Canvas platform using code JBPJLT.

Sign-up using code JBPJLT

Case 1. Breast engorgement in the setting of delayed onset of lactogenesis II

Learning objectives  

  1. Obtain a pregnancy, peripartum, and breastfeeding history of a lactating patient presenting with breast engorgement
  2. Obtain a focused medical history of a neonate whose mother has delayed lactogenesis II
  3. Perform a focused breast examination
  4. Create a management plan based on the history and physical assessment
  5. Teach a patient appropriate breast massage and hand expression techniques to resolve breast engorgement
  6. Communicate the management plan to patient

Topics: clinical lactation, pediatrics

Sign-up using code JBPJLT.

Case 2. Bloody nipple discharge in a lactating woman

Learning objectives  

  1. Obtain a pregnancy, peripartum, and breastfeeding history of a lactating patient presenting with bloody nipple discharge
  2. Obtain a focused medical history of a neonate whose mother has bloody nipple discharge
  3. Perform a breast assessment
  4. Instruct the patient to elicit discharge from the nipple
  5. Create a management plan based on the history and physical assessment
  6. Communicate the management plan to the patient

Topics: clinical lactation, breast surgery

Sign-up using code JBPJLT.

Case 3. Breast milk production and maternal mental health

Learning objectives  

  1. Obtain a pregnancy, peripartum, and breastfeeding history from the patient
  2. Obtain the infant’s medical history from the patient
  3. Communicate the potential negative health consequences of breast milk oversupply to the patient
  4. Communicate a concise management strategy for breast milk oversupply
  5. Screen the patient for clinical signs of maternal perinatal mood and anxiety disorder
  6. Provide recommendations for a breastfeeding patient with perinatal mood and anxiety disorder

Topics: clinical lactation, maternal mental health

Sign-up using code JBPJLT.

Case 4. Effective breast pump use and management of breast pump-induced trauma

Learning objectives  

  1. Counsel the new mother regarding expectations of breast milk provision to a NICU baby 
  2. Teach a breastfeeding mother how to hand express colostrum
  3. Teach a breastfeeding mother how to use  a double-electric, hospital-grade breast pump and a wearable breast pump 
  4. Teach a breastfeeding mother “hands-on” pumping techniques  
  5. Identify and propose solutions for breast pump-induced trauma to the nipple-areolar complex
  6. Teach a breastfeeding mother how to store expressed breast milk

Topics: clinical lactation, pediatrics

Sign-up using code JBPJLT.

Case 5. Quality improvement in the hospital through breastfeeding education and support

Learning Objectives:

Learning Objectives for Scenario 1 (First 15 minutes)

  1. List the neonatal and maternal health complications associated with suboptimal breastfeeding. 
  2. Explain how much it costs to train hospital staff in clinical lactation.
  3. Elaborate how hospital staff training in clinical lactation will improve patient safety and care.
  4. Describe what the return on investment for the hospital would be if hospital staff were trained in clinical lactation

Learning Objectives for Scenario 2 (Last 15 minutes)

  1. Describe federal laws and regulations that employers must follow when a lactating mother returns to work.
  2. List why employee lactation support would affect employee satisfaction and employee turnover.
  3. Outline how to implement accessible lactation spaces throughout the hospital for hospital staff use.
  4. Explain why supporting hospital staff with their lactation needs will translate to better patient care.

Topics: clinical lactation

Sign-up using code JBPJLT.

Case 6. Providing anticipatory guidance and supporting inclusive breastfeeding after breast surgery


Learning Objectives:

  1. Obtain a comprehensive maternal history 
  2. Describe normal infant behavior and development during the first week of life
  3. Recognize maternal risk factors for low milk production
  4. Provide education regarding the clinical changes associated with lactogenesis II
  5. Teach the patient how to relieve breast engorgement
  6. Employ shared decision-making strategies for inclusive breast milk feeding

Topics: clinical lactation, breast surgery, breast health, pediatrics

Sign-up using code JBPJLT.

Case 7. Sudden-onset breast pain after the newborn sleeps through the night


Learning Objectives:

  1. Obtain a comprehensive history of the lactating patient and her infant 
  2. Perform a breast assessment
  3. Describe normal sleep patterns for infants between 0 and 6 months of age
  4. Describe conservative management strategies for inflammatory mastitis
  5. List clinical signs associated with infectious mastitis 
  6. Describe when it is necessary to avoid breastfeeding or to “pump and dump” following medication, recreational drug, tobacco, and alcohol use
  7. Propose a management and follow up plan

Topics: clinical lactation, pediatrics

Sign-up using code JBPJLT.