Case Scenarios

The On-Demand Telesimulation™ Lactation QBank Canvas site is the platform from which learners can access remote, on-demand simulation-based training in maternal-child care! Through unfolding case scenarios and telesimulations, the platform is a convenient training tool for a variety of learners:

  • Lactation consultant clinical hours
  • Virtual OSCE simulation training
  • Baby-Friendly Hospital Staff training
  • WIC staff training
  • …and more!

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

On-Demand Telesimulation™ Case Scenarios:

Case 1.

Learning objectives  

  1. Obtain a focused history relevant to the presenting concerns (eg. medical, surgical, family, social, pregnancy, peripartum, breastfeeding)
  2. Obtain a focused medical history of a neonate whose mother has delayed lactogenesis II
  3. Perform a focused breast examination for a lactating patient presenting with breast engorgement (Note: the standardized patient will be wearing a realistic breast model)
  4. Teach a lactating patient appropriate breast massage techniques to resolve breast engorgement
  5. Teach a lactating patient how to hand express her breast milk
  6. Communicate a management plan to lactating patient with breast engorgement caused by lactogenesis II

Topics: clinical lactation, pediatrics, breast pump use, out-patient setting, telehealth, urgent and emergency care

Case 2.

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, exclusive pumping, out-patient setting, telehealth

Case 3. 

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, breast pump use, NICU, out-patient setting, telehealth

Case 4. 

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, exclusive pumping, hospital-based care, NICU

Case 5. 

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, hospital-based care, public health and policy

Case 6.


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,  in-patient setting

Case 7.


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, in-patient setting, urgent and emergency care

Case 8.


Learning Objectives:

  1. Obtain a comprehensive history of the pregnant patient
  2. Describe characteristics of benign and malignant lesions on the nipple-areolar complex that present during the peripartum period
  3. Discuss a follow up plan for a rapidly enlarging lesion on the nipple of a pregnant patient
  4. Provide anticipatory guidance regarding breastfeeding and lactation for a pregnant patient 
  5. Practice building a trusting patient-provider relationship that ensures the pregnant patient will seek continued care from you

Topics: clinical lactation, breast/chest surgery, health, and cancer, breast pump use/exclusive pumping, maternal mental health, out-patient/ambulatory/clinic setting, pregnancy/prenatal, telehealth

Case 9.


Learning Objectives:

  1. Obtain a comprehensive history of the lactating patient and her infant
  2. Describe a safe weaning plan for a lactating patient who is exclusively pumping
  3. Counsel a lactating, heterosexual female person about options for improving physical intimacy with her male partner
  4. Provide a management plan for dyspareunia secondary to hypoestrogenism of lactation

Topics: clinical lactation, breast pump use/exclusive pumping, telehealth

What to Expect

Learners can access the case scenarios on the On-Demand Telesimulation™ Canvas platform using code JBPJLT.

Sign-up using code JBPJLT

Cases by Topic:

  • Case 2. Bloody nipple discharge in a lactating patient
  • Case 6. Providing anticipatory guidance and supporting inclusive breastfeeding after breast surgery
  • Case 8. Anticipatory breastfeeding guidance for a pregnant woman with a growth on her nipple
  • 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 8. Anticipatory breastfeeding guidance for a pregnant woman with a growth on her nipple
  • Case 9. Exclusively pumping patient with pain during sexual intercourse is ready to wean 
  • Case 10. Low milk production despite “trying everything” with worsening nipple rash (Available soon!)
  • 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 after the newborn sleeps through the night
  • Case 8. Anticipatory breastfeeding guidance for a pregnant woman with a growth on her nipple
  • Case 9. Exclusively pumping patient with pain during sexual intercourse is ready to wean 
  • Case 10. Low milk production despite “trying everything” with worsening nipple rash (Available soon!)
  • 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 after the newborn sleeps through the night
  • Case 3. Breast milk production and maternal mental health
  • Case 8.Anticipatory breastfeeding guidance for a pregnant woman with a growth on her nipple
  • Case 3. Breast milk production and maternal mental health
  • Case 4. Effective breast pump use and management of breast pump-induced trauma
  • 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 8.Anticipatory breastfeeding guidance for a pregnant woman with a growth on her nipple
  • 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 1Breast 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
  • Case 5. Advocating for breastfeeding education and lactation support in the hospital
  • Case 8. Anticipatory breastfeeding guidance for a pregnant woman with a growth on her nipple
  • 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 9. Exclusively pumping patient with pain during sexual intercourse is ready to wean 
  • Case 10. Low milk production despite “trying everything” with worsening nipple rash (Available soon!)
  • Case 1Breast engorgement in the setting of delayed onset of lactogenesis II
  • Case 7. Sudden-onset breast pain after the newborn sleeps through the night