Bundle
CERTIFIED LACTATION COUNSELOR (CLC) TEST COMPILATION BUNDLE
6 Items
Certified Lactation Consultant Exam UPDATED 2022
Certified Lactation Consultant Exam 1 breast or 2? ans: There is no difference in baby's net fat intake according to the number of breasts suckled per f... [Show More] eeding or the breastfeeding frequency Offer the 1st breast 1st and the 2nd breast 2nd it really doesn't matter 1 breast or 2 whatever they want 1+ year of lactation ans: After one year of lactation the milk expressed has significantly increased fat and energy contents, compared with milk expressed by women who have been lactation for a shorter time. The volume of milk does not have to change as the baby gets older/bigger because the composition of the milk changes Anemia and breastfeeding ans: Postpartum hemorrhage can cause sheehans syndrome which in turn causes hormonal issues including milk making hormones Retained placenta fragments prevents the shift from lactogenesis stage 1 to stage 2 which can affect your mature milk coming in Breast milk composition changes... ans: Over the course of lactation Within the day there are variations on the composition of milk Within a feeding By the way it is taken during a feeding and also between feedings Canabis use and breastfeeding ans: Exposure of infant to any kind of passive smoke is a concern. There is no safe threshold limit for cannabis use in pregnancy. Among pregnant women cannabis use was significantly associated with an increased risk of preterm birth and low birth weight The high fat solubility of cannabinoids make them difficult to analyze in breast milk. THC (delta-9-tetrahydrocannabinol) is measurable in milk 6 days after maternal use Colic ans: An easily identifiable childhood problem that has no clearly identified treatment Does not seem to be associated with GERD Colicky babies had more than double the abundance of microbia in the gut Constructed Knowing ans: The position at which truth is understood to be contextual, knowledge is tentative, and it is understood that the knower is part of the known Have abandoned either/or thinking Have learned to live with conflict and have high tolerance for internal contradiction and ambiguity Believe all knowledge is constructed and the knower is an intimate part of the known Want to avoid compartmentalizing thought and feeling, home and work, self and other Want to embrace all the pieces of the self in some ultimate sense of the whole: mother-daughter-wife-artist Aspire to work that contributes to the empowerment and improvement in the quality of life of others Believe that ideas and values must be nurtured Have a unique and authentic voice Engorgement ans: Breasts hard, hot, and shiny Temp above normal Feels discomfort in the breast Nipple difficult to grasp, makes difficult for baby to latch Occurs most commonly day 3-5 As the pressure builds up inside the breast milk production decreases, this is natures early dry up mechanism Failure to effectively resolve prolonged symptomatic engorgement may have a negative impact on continued adequate milk supply Placing breasts in a bowl of warm water will stimulate the milk to flow out to relieve some pressure so you can then feed Fat content in breast milk ans: Longer times in between feedings made for a lower fat content but faster feedings made for a higher fat content where as feedings lasting longer than 30 mins made for a lower fat content Breastfed babies can regulate fat intake quickly and thus mothers should be encouraged to practice baby led feeding Maximum fat levels were obtained 30 mins post-feed Focuses on advantages of breastfeeding on a personal (personal connection), community, country (amount spent on healthcare), or global level (waste from formula & formula products) Focuses on the good "advantages" of breastfeeding ans: Breastfeeding Promotion Focuses on government, manufacturer, and social responsibility to assure breast feeding's ability to compete with commercial interests. Includes addressing improper marketing practices Addressing breastfeeding in public, at work, jury duty, family law, mothers in prison, etc.. ans: Breastfeeding Protection Focuses on the interaction of "helpers" with family as well as program development and implementation ans: Breastfeeding Support Formula preparation and storing ans: Formula needs to be mix with water that is at least 70ºC or 158ºF in order to kill Enerobacter Sakazakii Formula made with hot water need to be cooled quickly to body temperature if it is being fed to the baby immediately If the formula is not being fed immediately, refrigerate it right away and keep refrigerated until feeling Hierarchy of infant feeding choices ans: 1. Baby at mothers breast 2. Mother's own expressed milk 3. Milk from a milk bank 4. Cows milk forumla 5. Soy formula How do I know my baby is getting enough milk? ans: One wet diaper for how old the baby is (however this can be skewed by the diuresing process and is not a good indicator of adequate hydration) 4 wets on day 4 and each day after Multiple poops each day that change in consistency and color How do we assure an adequate milk supply? ans: Universal understanding of how breastfeeding works Early initiation and adequate breastfeeding (10-12x per day) Appropriate breastfeeding assessment Improved and early breastfeeding support Appropriate HCP and LCP follow-up in the postpartum period Admitting there is no magic bullet More nursing= more milk How does iron effect baby's gut ans: Low iron in the gut is good, breastmilk has relativly low iron content Tons of different bacteria thrives on excess iron so having to much can cause issues How does pH of the gut effect babies ans: Gut pH of breastfed babies is higher than those who are formula fed or even mixed fed. Higher pH means less harmful bacteria is able to grow which helps have less issues with diarrhea How does the presence of lactobacillus bifidus affect baby's gut ans: Presence of bifidus factor in breast milk promotes the growth of lactobacillus bifidus which helps maintain the low pH and crowd out the harmful bacteria How does the presence of SIgA antibodies effect baby's gut ans: Antibodies such as SIgA bind to microbes in the baby's intestinal tract and prevent them from being absorbed into the rest of the body. Mothers IgA has been found to protect against the development of necrotizing enterocolitis in preterm infants How in prolactin produced? ans: Breast stimulation Nipple stimulation (makes the most) How much milk do moms make on average? ans: 750-1000mL per day How much weight should my baby be gaining ans: Approximently 1 ounce per day is expected in the early months by more may be needed for babies with metabolic or respiratory distress because they tend to burn more calories breathing, keeping warm, etc.. How to support exclusive breastfeeding ans: Increase hospital and health system capacity including revitalizing, expanding, and institutionalizing the baby-friendly hospital initiative in health systems Provide community based strategies including communication campaigns tailored to the local context Strengthen the monitoring, enforcement, and legislation related to "The Code" and subsequent resolutions. Enact at least 6 months paid maternity leave Invest in training and capacity building in breastfeeding protection, promotion, and support If baby is diagnosed with Galactosemia ans: recessive genetic disorder; characterized by body's inability to tolerate galactose Can be rapidly fatal is lactose is not completely removed from the infants diet Breastfeeding is contraindicated If mother has active chicken pox that developed within the 5 days prior to delivery to the 2 days following delivery ans: Mother should temporarily not breastfeed but can feed expressed breast milk If mother has active TB ans: Mother should temporarily not breastfeed but can feed expressed breast milk If mother has an active herpes lesion on the breast ans: Can breastfeed from unaffected side if affected side is completely covered If both sides are affected mother should temporarily not breastfeed or feed expressed breastmilk If mother is infected with HIV ans: Breastfeeding or feeding at the breast is not advisable If mother is infected with T-cell lymphotopic virus ans: Breastfeeding or feeding at the breast is not advisable If mother is infected with untreated brucellosis ans: Mothers should temporarily not breastfeed or feed expressed breast milk If mother is suspected or confirmed of having Ebola ans: Breastfeeding or feeding at the breast is not advisable If mother is taking certain medications (medications and decrease cells proliferation: cancer drugs) ans: Mothers should temporarily not breastfeed or feed expressed breast milk If mother is undergoing diagnostic imaging with radiopharmaceuticals ans: Mothers should temporarily not breastfeed of feed expressed breast milk If mother is using illicit street drugs such as PCP or cocaine ans: Breastfeeding or feeding at the breast is not advisable Exceptions being narcotic dependent mothers who are enrolled in a supervised methadone program and have a negative screening for HIV infection Increased worry of stress my diminish milk supply ans: Not necessarily, worry/stress may alter behavior which could alter supply but not nursing enough or removing milk often enough Inverted Nipples ans: Grade 1: are easily pulled out with a breast pump or infant nursing (look inverted with rest but evert with use) Grade 2: can be pulled out but don't maintain their projection (may invert as soon as baby comes off breast) Grade 3: difficult or impossible to pull out Classification is about function during feeding not about how inverted or flat the nipple looks at rest Does the nipple ever evert? Look over the mothers shoulder to see what the nipple looks like immediately following feeding Is nursing during pregnancy safe? ans: It is safe as long as you are not at risk for preterm delivery, however the composition of your milk might change due to placental hormones being on board and your toddler may not want to feed anymore Lactogenesis 1/Secretory Differentiation ans: Production of colostrum from the placental hormones (progesterone) When placenta delivers the progesterone levels drop to allow for prolactin to take its place in the milk making cells Lactogenesis 2/Secretory Activation ans: Begins when progesterone leaves the cells and prolactin enters the receptor sites Milk will be a mix of colostrum and mature milk Lactogenesis 3/Galactopoesis ans: Long term production of mature milk Need frequent removal of milk and frequent nipple stimulation to continuously produce milk Less engorgement is associated with ans: More time spent in the first 48 hours Maternal exercise is related to infant weight gain growth ans: No!! Need to drink a lot of fluids to produce a lot of milk ans: No!! There is not enough evidence to support increasing fluid intake beyond what breastfeeding mothers are likely to require to meet their needs Negative influences on milk production ans: Long spaced between feedings Long, slow feedings-can effect prolactin production Negative influences on milk production: Breast surgery or injury ans: With surgery concern centers on damage to nerves which makes stimulation difficult or impossible, and damage to ducts which makes milk flowing out of breasts difficult or impossible Counseling implication after breast surgery: Likelyhood of full breastfeeding is unknown The hormonal exposure of pregnancy and lactation may mitigate some effects of surgery Assessment and close follow-up are the keys Assure adequate nutrition for the infant Negative influences on milk production: Excessive pressure in the breast ans: Pressure on the milk making cells causes less milk to be made Pressure can result from: vascular, lymphatic, and third spacing forces Too much milk in the breast (engorgement) Missed feedings Restrictive bras and clothing Brest implants: decrease storage and capacity and also increase the pressure on the milk cells Negative influences on milk production: Physical objects ans: Pacifier use may be an indicator that parents need extra breastfeeding teaching *Ask questions* Nipple shields Negative influences on milk production: Sub-optimal breast anatomy ans: Anatomical concerns Absence of breast changes in pregnancy or early days postpartum No postpartum breast fullness or signs of abundant milk production Hypoplastic breast(s) (underdeveloped, tubular, or inadequate glandular tissue) Discrepant breast size (Unilateral underdeveloped breasts) Negative influences on milk production: Sub-optimal or altered physiology ans: Iron deficiency Anemia: Physiologic (poor O2 to milk making cells) or due to exhaustion or depression altering mothers coping behavior Hemorrhage: Sheehan's syndrome (the pituitary gland is deprived of blood and its functions are impaired) Hormone imbalance: Thyroid, obesity, GDM PCOS Certain drugs: Pseudoephdrines & corticosteroids (betamethasone) Postpartum depression ans: Women who are more likely to wean early are those who have experienced depression either in pregnancy or postpartum Among women with breastfeeding difficulties, women who had a negative experience with breastfeeding support had a significantly higher risk of postpartum depression and more likely to show symptoms at 2 months Preterm milk ans: Appears to have different composition for the first 5-7 weeks after delivery independent of gestational age Preterm milk appears to be higher in protein, fat, and electrolytes than mature milk This is determined by being preterm not just having a small baby therefor it does not matter if the baby is SGA or LGA only dependent of gestational age Procedural Knowing ans: The position at which techniques and procedures for acquiring, validating, and evaluating knowledge claims are developed and honored Invested learning, constantly taking in new information Interested in obtaining and applying knowledge Want to understand other people's points of view Assume that every one including themselves can be wrong Will read a variety of books with different points of view May attend several classes and change health care providers easily May be viewed as inconsistent by others May want very technical information about breastfeeding To develop a relationship with Procedural knowers: Be prepared to back up statements with evidence Be knowledgeable about multiple sources of reference Limit personal stories Understand that options and change are part of the process Reason #1 why women do not exclusively breastfeed ans: Unrealistic expectations from society about motherhood. Along with lack of preparation for what the newborn period would be like. Reason #2 why women do not exclusively breastfeed ans: Lack of timely interventions. Mother's problems at 3-7 days posed the greatest risk for stopping which is when they are home from the hospital and alone with no support. The fastest drop-off is in the first 10 days following discharge from the hospital Receivers of knowledge ans: Believe that all authorities tell the truth Like to learn the right answer and repeat it to the teacher Can not tolerate ambiguity Submit to the command of authority-not inner voice Sense of self is embedded in external definitions and roles Live at the behest of those around them To develop a relationship with Receivers of knowledge: Teacher or counselor must project authority Never be ambiguous Advantages must be concrete and appropriate for her Teaching should be centered on the right way and include return demo Silence learner ans: A position of not knowing in which the person feels voiceless, powerless, and mindless Afraid of words See themselves as relatively powerless and dependent on others for survial Do not trust their ability to understand or remember Have little awareness of their intellectual capabilities Live at the behest of those around them To develop a relationship with Women in Silence: Few words Familiar words Short, easy, comfortable Nothing to remember You may need to be an advocate Size of the breast relates to the amount of milk produced ans: No!! the proportion of glandular and fat tissue and the number and size of the ducts are not related to milk production Smoking and breastfeeding ans: Smoking mothers make less milk Smoking mothers may have lower prolactin levels because prolactin doesn't rise like it should Babies tended to nap less when fed milk from mothers who smoked vs those who did not smoke Quiting smoking during pregnancy resulted in a lower chance of preterm birth 22% of SIDS cases can be directly attributed to maternal smoking during pregnancy Storing breast milk that is leftover from a feeding ans: Use within 2 hours after the baby is done feeding Storing fresh expressed or pumped breast milk ans: Up to 4 hours on the countertop Up to 4 days in the refrigerator Within 6 months but up to 12 months in the freezer Storing thawed, previously frozen breast milk ans: Up to 1-2 hours on the countertop Up to 24 hours in the refrigerator Never re-freeze previously thawed milk Subjective knowing ans: Believes knowing is personal, private, and based on intuition and/or feeling states, rather than on thought and articulated ideas that are defended with evidence Sense of self is embedded in external definitions and roles Sense of authority arises primarily from the power of a group Trust their own intuition Inner voice helps guide them Distrust male authority figures "Experts don't know what they are talking about" Trust other women with similar experiences Find female support groups helpful Attracted to natural things, like breastfeeding Want to be helped by someone who has breastfed Interested in breastfeeding from her own point of view To develop a relationship with Subjective knowers: Create time for them to talk about themselves and what they think about breastfeeding Offer help with possible misconceptions about breastfeeding Offer to make contacts and referrals Tandem Nursing ans: The practice of breastfeeding 2 babies not from the same pregnancy at the same time Milk volumes increase faster but less engorgement is experienced with two nurslings May require specific teaching to manage faster flow Help parents respond to different needs of each child Nurse newborns frequently Find time for non-nursing interactions with older babies The Global Strategy for Infant & Young Child Feeding ans: Is intended as a guide for action; it identifies interventions with a proven positive impact, it emphasizes providing mothers and families the support they need to carry out their crucial roles, and it explicitly defines the obligations and responsibilities in this regard of governments, international organizations, and other concerned parties. The International Code of Marketing of Breast milk Substitutions ans: An international health policy framework to regulate the marketing of breast milk substitutes in order to protect breastfeeding. It was written in response to the marketing activities of the infant feeding industry which were promoting formula feeding over breastfeeding, which in turn was leading to a dramatic increase in maternal and infant morbidity and mortality. The World Health Organization and UNICEF have set out three strategies needed for increasing breastfeeding initiation and duration in every country. What are the 3 strategies? ans: Breastfeeding Promotion Breastfeeding Protection Breastfeeding Support Weight loss in breastfed infant ans: No more than 7% weight loss from with birth weight and no more weight loss by day 5 and should be back to birth weight by 2 weeks Weight loss greater than 7% from birth weight indicates a possible breastfeeding problem and requires more intensive evaluation of breastfeeding and possibly intervention (not supplementation!) to correct problems and improve milk production and transfer What causes infants to lose weight in the first postpartum days ans: Labor medications More intrapartum fluids are given, they have more fluid to loss which is a normal process No labor prior to a c-section, maybe they weren't ready to be born What contributes to low rates of exclusive breastfeeding globally? ans: Caregiver and societal beliefs favoring mixed feedings (believing that breast milk is not enough or that babies actions/issues are related to the breast milk/breastfeeding) Hospital and healthcare practices and policies that are not supportive of breastfeeding Lack of adequate skilled support Aggressive promotion of infant formula and other breast milk substitutes rather than promoting support for breastfeeding Inadequate maternity and paternity leave legislation and other workplace policies Lack of knowledge about the dangers of not exclusively breastfeeding and of proper breastfeeding techniques What does "The Code" do? ans: Regulates the marketing of breast milk substitutes which includes infant formulas and any other food or drink, together with feeding bottles, and teats, intended for babies and young children. Sets standards for the labeling and quality of products and for how the law should be implemented and monitored within countries. Aims to make sure that parental choices on feeding are based on full, impartial information, rather than misleading, inaccurate or biased marketing claims. What does oxytocin do? ans: Allows for the milk to move from the milk making cells and through the nipple with "contractions" that squeeze the cells and the ducts. What does prolactin do? ans: Enters receptor sites in the milk making cells and helps produce breastmilk What is a third way oxytocin can be triggered? ans: Baby hand massage What is the first way oxytocin can be triggered? ans: Conditioned response/Conditioned Milk Ejection Reflex (Let down). Automatic response that comes with the association of smell, touch, sounds of baby at the breast. Also occurs on babies end with knowing what to do when placed at the breast. What is the role of the pituitary glade in milk making? ans: Messages from certain stimulation travels through the breast to the pituitary gland which triggers it to produce prolactin and oxytocin which are two hormones needed to make milk. What is the second way oxytocin can be triggered? ans: Nipple stretching that occurs with a proper latch Women how do not breastfeed are at a greater risk for what diseases? ans: Myocardial infarction Metabolic syndrome Coronary artery disease Stroke DMII HTN Hyperlipidemia Cardiovascular disease Breast, endometrial, and ovarian cancer [Show Less]
- Answers
- $16.45
- 1
- 310
Certified Lactation Consultant Exam QUESTIONS AND ANSWERS ALL CORRECT
Certified Lactation Consultant Exam QUESTIONS AND ANSWERS ALL CORRECT The World Health Organization and UNICEF have set out three strategies needed for ... [Show More] increasing breastfeeding initiation and duration in every country. What are the 3 strategies? Correct answerBreastfeeding Promotion Breastfeeding Protection Breastfeeding Support Focuses on advantages of breastfeeding on a personal (personal connection), community, country (amount spent on healthcare), or global level (waste from formula & formula products) Focuses on the good "advantages" of breastfeeding Correct answerBreastfeeding Promotion Focuses on government, manufacturer, and social responsibility to assure breast feeding's ability to compete with commercial interests. Includes addressing improper marketing practices Addressing breastfeeding in public, at work, jury duty, family law, mothers in prison, etc.. Correct answerBreastfeeding Protection Focuses on the interaction of "helpers" with family as well as program development and implementation Correct answerBreastfeeding Support Women how do not breastfeed are at a greater risk for what diseases? Correct answerMyocardial infarction Metabolic syndrome Coronary artery disease Stroke DMII HTN Hyperlipidemia Cardiovascular disease Breast, endometrial, and ovarian cancer Reason #1 why women do not exclusively breastfeed Correct answerUnrealistic expectations from society about motherhood. Along with lack of preparation for what the newborn period would be like. Reason #2 why women do not exclusively breastfeed Correct answerLack of timely interventions. Mother's problems at 3-7 days posed the greatest risk for stopping which is when they are home from the hospital and alone with no support. The fastest drop-off is in the first 10 days following discharge from the hospital The International Code of Marketing of Breast milk Substitutions Correct answerAn international health policy framework to regulate the marketing of breast milk substitutes in order to protect breastfeeding. It was written in response to the marketing activities of the infant feeding industry which were promoting formula feeding over breastfeeding, which in turn was leading to a dramatic increase in maternal and infant morbidity and mortality. What does "The Code" do? Correct answerRegulates the marketing of breast milk substitutes which includes infant formulas and any other food or drink, together with feeding bottles, and teats, intended for babies and young children. Sets standards for the labeling and quality of products and for how the law should be implemented and monitored within countries. Aims to make sure that parental choices on feeding are based on full, impartial information, rather than misleading, inaccurate or biased marketing claims. The Global Strategy for Infant & Young Child Feeding Correct answerIs intended as a guide for action; it identifies interventions with a proven positive impact, it emphasizes providing mothers and families the support they need to carry out their crucial roles, and it explicitly defines the obligations and responsibilities in this regard of governments, international organizations, and other concerned parties. What contributes to low rates of exclusive breastfeeding globally? Correct answerCaregiver and societal beliefs favoring mixed feedings (believing that breast milk is not enough or that babies actions/issues are related to the breast milk/breastfeeding) Hospital and healthcare practices and policies that are not supportive of breastfeeding Lack of adequate skilled support Aggressive promotion of infant formula and other breast milk substitutes rather than promoting support for breastfeeding Inadequate maternity and paternity leave legislation and other workplace policies Lack of knowledge about the dangers of not exclusively breastfeeding and of proper breastfeeding techniques How to support exclusive breastfeeding Correct answerIncrease hospital and health system capacity including revitalizing, expanding, and institutionalizing the baby-friendly hospital initiative in health systems Provide community based strategies including communication campaigns tailored to the local context Strengthen the monitoring, enforcement, and legislation related to "The Code" and subsequent resolutions. Enact at least 6 months paid maternity leave Invest in training and capacity building in breastfeeding protection, promotion, and support What is the role of the pituitary glade in milk making? Correct answerMessages from certain stimulation travels through the breast to the pituitary gland which triggers it to produce prolactin and oxytocin which are two hormones needed to make milk. How in prolactin produced? Correct answerBreast stimulation Nipple stimulation (makes the most) What is the first way oxytocin can be triggered? Correct answerConditioned response/Conditioned Milk Ejection Reflex (Let down). Automatic response that comes with the association of smell, touch, sounds of baby at the breast. Also occurs on babies end with knowing what to do when placed at the breast. What is the second way oxytocin can be triggered? Correct answerNipple stretching that occurs with a proper latch What is a third way oxytocin can be triggered? Correct answerBaby hand massage What does prolactin do? Correct answerEnters receptor sites in the milk making cells and helps produce breastmilk What does oxytocin do? Correct answerAllows for the milk to move from the milk making cells and through the nipple with "contractions" that squeeze the cells and the ducts. Preterm milk Correct answerAppears to [Show Less]
- Exam
- $15.45
- 2
- 288
Certified Lactation Course Exam QUESTIONS AND ANSWERS
weaning the addition of adding other foods to a diet, but not completely stopping or ceasing breastfeeding when did breastfeeding rates start to init... [Show More] ially decline (i.e. in Britain), particularly among the wealthy population? 16th-17th century and through the 18th century which month did women historically think was the most important to breastfeed during? the summer (due to food spoilage) what three ingredients made up the first commercial formula? (early 1800's/19th century) -wheat flour -cows milk -sugar what was, and still is today, one of the biggest reasons why mothers quit breastfeeding? mothers report not producing enough milk when did bottle feeding become the "new norm", thus, causing breastfeeding rates to continue to decline? 20th century (particularly, mid 1900's) (1950's-1970's) what is the WHO code? an attempt to prevent excessive marketing of ABM (artificial baby milk) and to bring awareness of benefits of breastfeeding (although this code is not law in many countries as it interferes with marketing & freedom) breastfeeding education to pubic is critical! what are some other breastfeeding barriers mothers have? -sexual vs functional aspects of breasts -women in the workplace -"im not producing enough milk" -lack of support from medical profession where are the breasts specifically located on the body? -between 2nd & 6th rib -from sternum to mid axillary line -only gland in not fully functioning at birth *may contain hair, sweat, and oil glands hypoplastic breasts -insufficient glandular tissues -usually only extend from 3rd to 5th rib -typically have more spacing between breasts (1.5 inches or more) montgomery glands/tubercles "small bumps" located around areola that become more prominent (hypertrophy) during pregnancy & are thought to secrete substance during pregnancy/lactation & contain scent glands to help guide infant to nipple, while also helping kill pathogens that try to enter the body areola vary in shape & color; usually circular; become darker during pregnancy and do not return to pre-pregnancy color nipple contain smooth muscle fibers for erectness and graspability; normally found at 4th intercostal space that typically contain between 4-18 openings (9 on average) for milk to be expressed through during lactation nipple/areola complex thought of as one entity; both elongate up to 2-3 times resting length during breastfeeding; areola = most sensitive part of breast nipples = least sensitive everted nipples most common type of nipples; protrudes slightly at rest & everts well with stimulation flat nipples soft, but pliable & graspable pseudo-inverted nipples appear to be inverted but will evert with stimulation or compression retracted nipples type of inverted nipples that appear to be graspable but retracts, rather than everts, with compression inverted nipples/nipple inversion retracted nipples that occur with retracted both with rest and stimualtion what are some techniques for flat/inverted nipples that may help to evert nipples? -inverted syringe -supple cups -breast shells -avent nipplette -"pinch test" in last trimester of pregnancy supernumerary nipples "3rd nipple" or "accessory nipple" found along line of glandular tissue what is breast tissue composed of? 2/3 glandular tissue 1/3 adipose tissue suspensory ligaments aka cooper's ligaments; heavy fibrous bands that divide adipose and glandular tissue of breasts into segments describe breast innervation breasts and areola are high innervated by 4th-6th intercostal nerves (greatest amount of innervation from 4th intercostal nerve) to bring sensation from behind from spine along ribs to chest and breasts how to properly perform breast assessment: -examine bilaterally at same time -observe shape, size, symmetry, elasticity -look for bumps, edema, engorgement, scars, anything abnormal what are the internal features of the breasts? -4 sections called quadrants -lactocytes (cells that make milk) fill each alveoli --> alveoli fill lobes of breasts --> lobes surround areola of breasts --> breast milk secreted into lumen of alveolus --> from center of alveolus, milk moves into small channel (ductile) (many of these, delicate) --> each ductile drains into large lactiferous or mammary duct --> ducts terminate at the nipple **AKA: lactocytes --> alevoli --> small ductile --> mammary duct --> larger mammary ducts --> nipple opening what is the "foundation" of milk production? lactocytes (milk producing cells) what is witch's milk? breast buds/neonatal engorgement in full term infants that may be mistaken for baby acne; self resolve by 4 weeks pp why is it critical to ask mothers about breast changes during pregnancy when completing an assessment different hormones cause breast changes during pregnancy which are critical in assisting with breastfeeding in the pp period; examples: -estrogen: cause ductile system to proliferate -progesterone: promotes and increases the size of breast lobes and alveoli -serum prolactin: nipple growth -serum placental lactogen: areolar growth Lactogenesis I occurs between 16-20 weeks of pregnancy until milk surges, or comes in, after birth breast size increases differentiation between alveolar cells into secretory cells occur hormone prolactin stimulates mammary secretory epithelial cells to produce milk endocrine (hormonal) control Lactogenesis II occurs between PP day 3-8 where there is a rapid increase in milk volume for 2-5 days, then abruptly levels off; this is the onset of copious milk supply triggered by rapid drop in progesterone levels after placenta is delivered will feel fullness and warmth in breasts now switches from endocrine to autocrine control galactopoiesis maintenance of the established milk production under autocrine control works on a supply & demand basis breasts will decrease slightly by 6-9 months pp involution the process of weaning slowly over 3 months or longer when FIL (feedback inhibitors of lactation) in breastmilk suppress lactation if milk is not removed from the breasts describe colostrum -"first milk" -starts about 16-20 weeks gestation and mom may or may not leak this during pregnancy (which is normal, nothing to worry about); -clear to golden yellow in color, but may be greenish or brownish due to old blood -very dense and thick, gel-like; present in small aounts -acts as "gut primer" or "closure"; helps block out pathogens and clear meconium out of gut -physiologic capacity of stomach: only 20 mls at birth (note: anatomic capacity is much larger, do not go by this) [Show Less]
- Exam
- $15.45
- 0
- 206
Lactation Consultant QUESTIONS AND ANSWERS
what does the AAP recommend? -that infants be breastfed exclusively for the first 6 months of life but should continue for at least 12 months. -if infant... [Show More] s are weaned before 12 months, they should receive iron-fortified infant formula women most likely to breastfeed women over 30, caucasian and well educated benefits of breast-feeding -contains growth factors that promote development of the brain and GI system -bacteriologically safe -has nutrients that are more easily absorbed than in formula contraindications of breastfeeding -galactosemia in infant -active TB -HIV -T-cell lymphotropic virus I or II -maternal chemotherapy or therapeutic radioactive isotopes -maternal use of "street drugs" Galactosemia not able to digest galactose- baby will die. people who have immigrated from poorer countries think that: formula is better US-born hispanic women: are less likely to initiate breast-feeding muslim and jewish cultures: value breastfeeding anatomy of breast -composed of 15 to 20 segments (lobes) embedded in fat and connective tissues -well supplied with blood what are in each lobe of the breast? alveoli, the milk-producing cells, surrounded by myoepithelial cells How many pores does each nipple have? 15 to 20 what is it that triggers the release of prolactin decrease in estrogen and progesterone after delivery of placenta When are prolactin levels the highest? during the first 10 days after birth and gradually decline but remain above baseline levels for duration of lactation oxytocin -other hormone essential to lactation -also responsible for contracting uterus after birth what produces oxytocin? the posterior pituitary prompted by the hypothalamus what reflexes is oxytocin responsible for -milk-ejection reflex -let-down reflex synthetic oxytocin pitocin what does human milk contain -digestive enzymes -the proteins Whey and Casein When does stage 1 of lactogenesis happen begins at 16 to 18 weeks of pregnancy what is produced in stage 1 of lactogenesis -colostrum -rich in immune globulins -high concentration of proteins and minerals -less fat than mature milk When does stage 2 of lactogenesis occur by day 3 to 5 when copious amounts of milk comes in to breast At the beginning of nursing what is released? -foremilk -60% skim milk -35% whole milk -provides lactose, protein, and water-soluble vitamins Hindmilk -(cream) -5% -increases after initial "let-down" rooting reflex head will turn towards finger if brushed against side of cheek *Frequency of feedings at least q 3h **how many times should a woman breastfeed in 24 hours? 8 to 12 times skin to skin -helps regulate baby's blood glucose -regulates baby's breathing how do you know a full-term infant is getting enough milk -feeds 8 to 12 times in 24 hours -has burst of sucking and swallowing -enough wet and soiled diapers -regains birth weight in 10 to 14 days what does prolactin cause for mom? vaginal dryness when is it best to breast-feed? within one hour of birth when does breast milk change in composition? -with each stage of lactation -during each feeding -as the infant grows breast milk production is based on a _______ principle -"supply meets demand" -more the infant needs the more abundant the milk supply when should solid food be started? after age 4 to 6 months [Show Less]
- Exam
- $10.45
- 0
- 169
Certified Lactation Counselor QUESTIONS AND ANSWERS| GRADED A
Certified Lactation Counselor QUESTIONS AND ANSWERS| GRADED A Predominant Breastfeeding Correct Answer: Babies who receive breastmilk and other liquids... [Show More] (e.g. water, minerals, vitamins, oral meds). Breastfeeding Correct Answer: Baby receives human milk, as well as other foods or fluids, including formula. Complementary Feeding Correct Answer: Process starts when BM alone or infant formula alone is no longer sufficient to meet nutritional requirements of infants, therefore other foods or liquids are introduced. Typically child is between 6-23 months 3 strategies for increasing BF initiation and duration Correct Answer: Promotion, Protection, Support Promotion Correct Answer: Focuses on advantages of BF on a personal, community, country, or global level. BF to the community. Protection Correct Answer: Focuses on government, manufacturer, and social responsibility to assure BF ability to compete with commercial interests. Includes state, local, an national laws regarding BF. International Code of Marketing of Breast-milk Subsitutes Correct Answer: Addresses improper marketing practices by formula companies. It is not currently a law in the US. What does the International Code Prohibit? Correct Answer: Distributing free formula Giving coupons for formula What did the AAP resolution state in regards to the International Code? Correct Answer: No distributing formula, discharge bags, industry written handouts. Support Correct Answer: Focuses on interaction of helpers with family, as well as program development and implementation. 10 steps to successful BF Correct Answer: 1. Written BF policy. Skin to Skin immediately after birth. 2. Train healthcare staff 3. Inform pregnant women about benefits and management of BF 4. Help all mothers initiate BF within 1 hour after birth 5. Show mother's how to BF and maintain lactation 6. Exclusive breast milk only 7. Practice rooming in 24 hours a day 8. Encourage BF on demand 9. No artificial teats or pacifiers 10. Establishment of BF support groups Healthcare staff responsibility for working with lactating mothers include what? Correct Answer: 1. Training 2. Minimum of 20 hours of training 3. 3 hours of competency verification What are the indications for providing supplementation other than breast milk? Correct Answer: 1. Medical condition 2. Parents request after being informed of consequences Protocol for calculating Baby's daily needs Correct Answer: Baby's weight x 2.5 (2.7 or 3.0 if Baby needs to catch up weight) = daily ounces. PCP decides what the multiplier is!!! What should be assessed 3-5 days after birth by PCP? Correct Answer: Hydration (elimination patterns) Body weight (no more than 7% loss) Observe Feeding Maternal or infant issues What is a CLC? Correct Answer: Nationally recognized designation awarded by the ALPP. Practice parameters are designated by professional scope of practice. How many stools per day should a breast fed newborn have? Correct Answer: 4, some yellow by day 4. When should a baby be back to birth weight? Correct Answer: 12-14 days post birth How much weight should a baby gain daily? Correct Answer: Approximately 1 ounce Why do women supplement with formula when there is no medical need? Correct Answer: 1. Lack of preparation for what the newborn period would be like. 2. Lack of timely interventions Alveoli Correct Answer: Small glands in the breast that produce milk At-Breast Supplementer Correct Answer: a device that allows a supplement to be given while a baby is actively nursing at the breast, ex: Supplement Nursing System Atopy Correct Answer: hypersensitive or allergic state involving an inherited predisposition What is the BFHI Baby Friendly Hospital Initiative Correct Answer: Initiative by UNICEF and WHO (1991) to support breastfeeding in hospitals and maternity centers. "The 10 Steps". Unicef. Baby-Friendly Hospital Initiative. Available online: http://www.unicef.org/programme/breastfeeding/baby.htm. Bilirubin Correct Answer: an orange-yellow pigment formed in the liver by the breakdown of hemoglobin and excreted in bile. CCK (cholecystokinin) Correct Answer: Hormone that regulates the emptying of the gallbladder and secretion of enzymes by the pancreas. Colostrum Correct Answer: Thick, milky fluid secreted by the breast during pregnancy and during the first days after birth before lactation begins. Causes a laxative effect which helps the baby pass meconium. Coryllos type Correct Answer: Classification system for anklyloglossia (tongue-tie) Dancer Hand Position Correct Answer: Technique used to support Baby's chin and mother's breast. Use Thumb and index finger under chin, remaining 3 fingers to support breast. Alveolar Cells Correct Answer: found in the walls of the alveoli, simple squamous epithelial cells, main sites of gas exchange myoepithelial cells Correct Answer: contract in response to stimulation by sympathetic nervous system and squeeze milk up the duct Montgomery glands Correct Answer: Bumps on breasts (Look like goosebumps) Produce a unique blend of milk and sebum (skin oil) Modern study of the structure of the breast reveals what? Correct Answer: -Fat is mixed throughout the breast -Uneven spacing of the ducts -3-5 functioning nipple pores (May have 5-9, but not all work) -No lactiferous sinus What are the 2 hormones pathways that control lactation? Correct Answer: Prolactin and Oxytocin Prolactin (4 details related to milk production) Correct Answer: 1. is triggered by touch (pregnant and non pregnant women). Higher levels when stimulating breast/nipples vs breast alone. 2. Lengthening time between feeding leads to lower baseline levels. (Weaning) 3. levels go down between nursings and rise during nursing. 4. Infrequent nursing leads to lowering of this hormone Average number of feeds in a day? Correct Answer: 8-12 What produces colostrum? Correct Answer: Progesterone in the receptor sites What produces more mature milk? Correct Answer: Prolactin in the receptor sites What happened when infants suckled in the first 2 hours of birth? Correct Answer: Ingested significantly more milk on day 4 What happened to mother of preemies who initiated milk expression within 1 hour of birth? Correct Answer: Had significantly more milk when measured on days 7 and 42. Better to stimulate breasts throughout the day right after birth to continue to stimulate production. Oxytocin Correct Answer: A hormone released by the posterior pituitary that stimulates uterine contractions during childbirth and milk ejection during breastfeeding. What 3 things can trigger Oxytocin? Correct Answer: 1. Conditioned response 2. Nipple stretching 3. Hand massage Conditioned Response from Milk Ejection (Let down) Correct Answer: -Example- Mother lets down when not near baby, but hears a baby cry. -Conditioned over time -Faster for women who have BF in the past -To condition the response can use any sense-smell, touch, sound Nipple stretching Correct Answer: Only happens with a proper latch Hand massage: Baby Correct Answer: When we allow babies to be more hands on they can help control flow rate by how they massage the breast. How many triggers does Oxytocin have? Can it be triggered by stress. Correct Answer: 3 triggers. Yes. What is hormone is triggered by stimulation? [Show Less]
- Exam
- $16.45
- 0
- 285
CLC Practice Exam QUESTIONS AND ANSWERS A GRADED
According to the 2015 U.S. Department of Health and Human Service guidelines, how long can breast milk be stored in the refrigerator? a) 24 hours b) 72 h... [Show More] ours c) 5 days d) 8 days c) 5 days Crying is more frequent in infants who are: a) Not held for at least 90 minutes immediately after birth b) Picked up immediately when they start crying c) Between birth and 6 weeks of age d) Between 6 weeks and 3 months of age c) Between birth and 6 weeks of age Which of the following would be perceived as a conflict of interest for an IBCLC) a) Working as a lactation consultant for a non-Baby Friendly Hospital b) Suggesting the use of formula to supplement a low weight gaining baby c) Including her name on a list of private practice IBCLCs given out at the hospital d) Speaking at a conference where her honoria is paid by a formula company d) Speaking at a conference where her honoria is paid by a formula company The most important reason to provide breast milk to infants during a disaster is: a) Unavailability of ready-to-feed formula b) Prevention of GI diseases such as diarrhea c) Breast milk will be at the correct temperature d) Water for reconstitution of formula may not be available or safe b) Prevention of GI diseases such as diarrhea Slade is able to stick his tongue out over his lower gum because of which nerve? a) Trigeminal b) Hypoglossal c) Facial d) Glossopharyngeal b) Hypoglossal A pregnant woman who attended your breastfeeding class calls to tell you that she has found out that she is HIV positive and she has been told she can't breastfeed. What is the first thing you would say to her? a) As long as you take the AZT, you can go ahead and breastfeed b) It's a good thing you live in the U.S. where you can bottle-feed without any problems c) If you determine that you will exclusively breastfeed without giving any supplements, you can go ahead and breastfeed d) I'm so sorry to hear that. You must be devastated. I know how much you were looking forward to breastfeeding your baby d) I'm so sorry to hear that. You must be devastated. I know how much you were looking forward to breastfeeding your baby Christie comes in for a breastfeeding assessment, and it's evident that her baby is getting too much milk at a feeding. Which of the following would be the best advice to give her? a) Feed on just one side per feeding and let the infant nurse for several feedings on that side before switching sides b) Pump off some of the breast milk before you put the baby to the breast to lessen the let-down c) Stop breastfeeding for a couple of days to let some of your supply decrease naturally d) Drink two cups of sage tea per day to decrease your milk supply a) Feed on just one side per feeding and let the infant nurse for several feedings on that side before switching sides The amount of weight a mother gains during her pregnancy may have an impact on breastfeeding because: a) A large weight gain during the pregnancy may encourage the mother to try to diet while lactating b) Fat stored during pregnancy is more easily mobilized for breast milk content than the fat stored before the pregnancy c) A low weight gain may indicate an eating disordeer d) A weight gain of over 38 lbs. may decrease the protein in her breast milk b) Fat stored during pregnancy is more easily mobilized for breast milk content than the fat stored before the pregnancy Of the following, which is the most important issue for the lactation consultant to address with the mother in the first few days postpartum? a) Teach the mother how to prevent sore nipples b) Teach the mother how to treat her engorgement once she goes home c) Teach the mother ways of coping with a crying baby d) Teach the mother how to determine if the infant is getting enough breast milk d) Teach the mother how to determine if the infant is getting enough milk The FIL (Feedback Inhibitor of Lactation) is: a) Required for increasing milk production b) Is only stimulated during engorgement c) A suppressor peptide that signals the brain to make less milk d) An integral part of the endocrine control of milk production c) A suppressor peptide that signals the brain to make less milk Women of childbearing age should consume at least 400 mcg of folate per day in order to reduce the incidence of: a) Tetrology of Fallot b) Neural tube defects c) Bilateral club feet d) Cleft lip and/or palate b) Neural tube defects [Show Less]
- Exam
- $13.95
- 2
- 768
Purchase the bundle to get the full access instantly
- 3 Million+ Study Documents
- 100% Money Back Guarantee
- Immediate Download Access
Add To Cart
Reviews 0
Bundle Details
$27.45
- Trusted by 800,000+ Students
- 24/7 Money Back Guarantee
- Download is directly available
627
2
Seller Details
Beginner
Reviews received
