Self-Assessment Questions (SAQs) for Study Session 7

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 7.1 (tests Learning Outcome 7.2 and 7.4)

You are wondering what to say to an HIV-positive mother who is particularly keen on breastfeeding. How would you advise her?


There are many ways in which you might have made notes on this difficult situation. You would have sympathised with the mother’s wish to breastfeed and probably pointed out the benefits for the baby (e.g. protection from infection, correct nutrients, reduction in risk of allergy), and the benefits for the mother (breast milk is cheaper, breastfeeding helps the uterus to contract, it is useful for birth control, etc). But you would also have told her of the risk of transmitting HIV to the baby via breastfeeding.

When you discuss formula feed as the alternative you would have explained the critical importance of clean water, and proper sterilisation of the bottles and teats, as well as the need to measure everything accurately so the baby gets the correct nourishment.

Then you would go through the AFASS criteria and the questions in Figure 7.4. If she answered ‘yes’ to them all, you would encourage her to use formula or animal milk, and also counselled her about birth control. If she answered ‘no’ and she really wants to breastfeed, you would have explained how she can reduce the risk of HIV transmission by feeding at very short intervals (no longer than three hours), and stop feeding from a breast that has a cracked nipple. You should have reminded her to check the baby’s mouth for sores, and seek urgent treatment for herself and her baby if either of them feels ill.

SAQ 7.2 (tests Learning Outcome 7.2)

Which of the following definitions is incorrect? In each case, give the correct definition.

A  Exclusive breastfeeding is only feeding one baby at a time.

B  Good positioning for breastfeeding is when the mother is sitting comfortably.

C  Good attachment means the baby has ‘a good mouthful of breast’.

D  Early breastfeeding requires the mother to get up around dawn for the first feed.

E  The principle of the warm chain means that you pay attention to keeping the baby warm at all times, so as to avoid hypothermia.


A  False: Exclusive breastfeeding is giving nothing to the baby other than breast milk for the first six months.

B  True. But look back to Section 7.1.1 and check you are clear about how to maintain the mother in good positioning.

C  True: Look back to Section 7.1.2 and check you remember precisely the four signs of good attachment.

D  False: Early breastfeeding is initiation of breastfeeding within one hour after birth.

E  True: The warm chain principle means taking action to keep the baby warm at all times.

SAQ 7.3 (tests Learning Outcome 7.5)

You are visiting a new mother and you notice that the baby feels very cold. You are worried about hypothermia. What do you do?


  • Place the baby in skin-to-skin contact with the mother, wrap them both in warm blankets, put a cap or shawl on the baby’s head and put its socks on or wrap its feet.
  • Take the baby’s temperature and if it is less than 37.5oC take it again after half an hour. If its temperature is not beginning to rise fairly soon, refer the baby urgently.
  • While you are waiting to see if the baby is getting warmer, check for a simple explanation for why the baby is cold. Ask the mother if the baby has been recently wet, or has not been recently fed, or whether she feeds it naked. Check if the room has open windows or the baby is in a cold draft of air.
  • Explain to the mother how newborns lose heat (the key ways are summarised in Section 7.4.3) and tell her why it is important always to keep the baby warm.
  • Talk her through the components of the ‘warm chain’. If you can’t remember this look again at Box 7.2.

Summary of Study Session 7