CERTIFIED LACTATION COUNSELOR EVALUATION EXAM
QUESTIONS AND ANSWERS SURE A+
✔✔How to help mother's with Raynaud's Syndrome - ✔✔-Medication
-Prevent or decrease cold exposure
-If still pain, check if Baby's sucking strength is too strong. May need nipple shield!
✔✔What types of breast problems can occur? - ✔✔-Clogs or plugs
-Blebs (clogged pore)
-Mastitis
-Abscess
✔✔What are clogs or plugs? - ✔✔-Palpable lumps of milk
-Localized
-May come out as a string or blob
-Typically disappear in 24-48 hours
✔✔Blebs - ✔✔-Small white spots on the face of the nipple (looks like a milk filled blister)
-One duct opening is covered
-Stabbing pin point pen
-May exit when treated as clogs
-May require lancing
✔✔Mastitis - ✔✔-Issue with tissues of the breast
-Needs intervention (NSAIDS), antibiotics
-Keep milk flowing, breasts soft and comfortable to avoid abscess development.
✔✔What other diseases can look like Mastitis? - ✔✔-Strep
-Sepsis
-MRSA
✔✔Neonatal hypoglycemia - ✔✔Low blood sugar in neonate (40mg/dL)
✔✔Symptoms of Neonatal Hypoglycemia - ✔✔-Jittery
-Cyanosis
-Apnea
-Hypothermia
-Poor tone
-Poor feeding
-Seizures
✔✔How to treat hypoglycemia - ✔✔Dextrose Gel
✔✔What is jaundice? - ✔✔-Yellow coloration of skin and eyes
,-Caused by unconjugated bilirubin
-Jaundice is a recycling problem
✔✔How is jaundice measured? - ✔✔Bhutani curve determines when bilirubin levels
require treatment
✔✔Is jaundice normal for neonates? - ✔✔Yes. 50-70% of all newborns have some level
of jaundice
More common in BF babies vs formula fed babies
✔✔Types of Jaundice in Newborns? - ✔✔1. Pathologic
2. Early Onset
3. Late Onset
✔✔What is Pathologic Jaundice? - ✔✔Jaundice that occurs within the first 24 hours.
likely ABO incompatibility or RH factor
✔✔Late Onset or Breast Milk Jaundice - ✔✔-Benign
-Visible 10-14 days or later out
✔✔What can occur if jaundice is untreated? - ✔✔-Bilirubin encepathlopathy can cause
cerebral palsy, hearing loss, visual impairment, dental problems, MR, death (rarely)
-Because it crosses the blood-brain barrier, it can cause damage to the brain, spinal
cord, and nerve cells.
✔✔What can best influence the state, organization, and motor system modulation of the
newborn? - ✔✔Skin to Skin
✔✔What is kangaroo mother care? - ✔✔-Special kind of S2S for preemies and fragile
babies.
-Mother upright
-Can last for hours
-Improves cerebral blood flow
-Improves weight gain
-Better long term physiologic organization and cognitive control
-Shorter NICU stays
-Decreases Sepsis/ Mortality
-Found babies stayed warmer in KMC vs incubator
-Can be done 24 hours a day
✔✔What is on the Preterm Infant BF Behavior (PIBBS) test? - ✔✔-Rooting
-Areolar grasp
-Latched on
-Sucking
-Longest sucking burst
, -Swallowing
✔✔What could cause Goldsmith's sign? - ✔✔-R/O ear infections, teething, and birth
trauma
-Breast cancer is a possibility. Recognition of this early on can lead to early diagnosis
✔✔Hand Expression - ✔✔-Increases milk volume
-Increased fat and energy content
✔✔Pumps - ✔✔-Need appropriate pump for situation (e.g. preemie's need hospital
grade pumps)
-CDC cleaning guidelines
-Pumps can cause damage do follow manufacturers recommendations.
✔✔What is power pumping? - ✔✔Pump 5 min, pause, pump 5 min, pause, pump 5 min.
✔✔What are Galactogogues? - ✔✔-Substances believed to increase milk production.
-No research that supports
-Not within scope for LC's or CLC's
-Could have side effects)
✔✔Does Fenugreek work to increase supply? - ✔✔No evidence
✔✔Does Reglan (Metoclopramide) increase supply? - ✔✔No, no research.
✔✔Does Motilium (Domperidone) increase supply? - ✔✔-No studies support.
-Not legal in US
-Rare, but serious risks. Including death.
✔✔What is induced lactation? - ✔✔-Occurs when there is no prior pregnancy.
-Lots of time
-Rarely results in full milk supply
-Works when focus is on experience, not on milk produced.
✔✔Relactation - ✔✔Follows pregnancy. Mother may have lost a baby before BF, or
could have BF for a week and then stopped. Wants to restart 6 months later.
✔✔Relactation Variables - ✔✔1. How much milk did she make in the past?
2. Baby's willingness to nurse
3. Length of time it will take to produce milk. (Don't know how long that will take)
✔✔What do you need to keep in mind when you recommend a supplemental feeding
device? - ✔✔-Cost/Availability
-Ease of cleaning/use
QUESTIONS AND ANSWERS SURE A+
✔✔How to help mother's with Raynaud's Syndrome - ✔✔-Medication
-Prevent or decrease cold exposure
-If still pain, check if Baby's sucking strength is too strong. May need nipple shield!
✔✔What types of breast problems can occur? - ✔✔-Clogs or plugs
-Blebs (clogged pore)
-Mastitis
-Abscess
✔✔What are clogs or plugs? - ✔✔-Palpable lumps of milk
-Localized
-May come out as a string or blob
-Typically disappear in 24-48 hours
✔✔Blebs - ✔✔-Small white spots on the face of the nipple (looks like a milk filled blister)
-One duct opening is covered
-Stabbing pin point pen
-May exit when treated as clogs
-May require lancing
✔✔Mastitis - ✔✔-Issue with tissues of the breast
-Needs intervention (NSAIDS), antibiotics
-Keep milk flowing, breasts soft and comfortable to avoid abscess development.
✔✔What other diseases can look like Mastitis? - ✔✔-Strep
-Sepsis
-MRSA
✔✔Neonatal hypoglycemia - ✔✔Low blood sugar in neonate (40mg/dL)
✔✔Symptoms of Neonatal Hypoglycemia - ✔✔-Jittery
-Cyanosis
-Apnea
-Hypothermia
-Poor tone
-Poor feeding
-Seizures
✔✔How to treat hypoglycemia - ✔✔Dextrose Gel
✔✔What is jaundice? - ✔✔-Yellow coloration of skin and eyes
,-Caused by unconjugated bilirubin
-Jaundice is a recycling problem
✔✔How is jaundice measured? - ✔✔Bhutani curve determines when bilirubin levels
require treatment
✔✔Is jaundice normal for neonates? - ✔✔Yes. 50-70% of all newborns have some level
of jaundice
More common in BF babies vs formula fed babies
✔✔Types of Jaundice in Newborns? - ✔✔1. Pathologic
2. Early Onset
3. Late Onset
✔✔What is Pathologic Jaundice? - ✔✔Jaundice that occurs within the first 24 hours.
likely ABO incompatibility or RH factor
✔✔Late Onset or Breast Milk Jaundice - ✔✔-Benign
-Visible 10-14 days or later out
✔✔What can occur if jaundice is untreated? - ✔✔-Bilirubin encepathlopathy can cause
cerebral palsy, hearing loss, visual impairment, dental problems, MR, death (rarely)
-Because it crosses the blood-brain barrier, it can cause damage to the brain, spinal
cord, and nerve cells.
✔✔What can best influence the state, organization, and motor system modulation of the
newborn? - ✔✔Skin to Skin
✔✔What is kangaroo mother care? - ✔✔-Special kind of S2S for preemies and fragile
babies.
-Mother upright
-Can last for hours
-Improves cerebral blood flow
-Improves weight gain
-Better long term physiologic organization and cognitive control
-Shorter NICU stays
-Decreases Sepsis/ Mortality
-Found babies stayed warmer in KMC vs incubator
-Can be done 24 hours a day
✔✔What is on the Preterm Infant BF Behavior (PIBBS) test? - ✔✔-Rooting
-Areolar grasp
-Latched on
-Sucking
-Longest sucking burst
, -Swallowing
✔✔What could cause Goldsmith's sign? - ✔✔-R/O ear infections, teething, and birth
trauma
-Breast cancer is a possibility. Recognition of this early on can lead to early diagnosis
✔✔Hand Expression - ✔✔-Increases milk volume
-Increased fat and energy content
✔✔Pumps - ✔✔-Need appropriate pump for situation (e.g. preemie's need hospital
grade pumps)
-CDC cleaning guidelines
-Pumps can cause damage do follow manufacturers recommendations.
✔✔What is power pumping? - ✔✔Pump 5 min, pause, pump 5 min, pause, pump 5 min.
✔✔What are Galactogogues? - ✔✔-Substances believed to increase milk production.
-No research that supports
-Not within scope for LC's or CLC's
-Could have side effects)
✔✔Does Fenugreek work to increase supply? - ✔✔No evidence
✔✔Does Reglan (Metoclopramide) increase supply? - ✔✔No, no research.
✔✔Does Motilium (Domperidone) increase supply? - ✔✔-No studies support.
-Not legal in US
-Rare, but serious risks. Including death.
✔✔What is induced lactation? - ✔✔-Occurs when there is no prior pregnancy.
-Lots of time
-Rarely results in full milk supply
-Works when focus is on experience, not on milk produced.
✔✔Relactation - ✔✔Follows pregnancy. Mother may have lost a baby before BF, or
could have BF for a week and then stopped. Wants to restart 6 months later.
✔✔Relactation Variables - ✔✔1. How much milk did she make in the past?
2. Baby's willingness to nurse
3. Length of time it will take to produce milk. (Don't know how long that will take)
✔✔What do you need to keep in mind when you recommend a supplemental feeding
device? - ✔✔-Cost/Availability
-Ease of cleaning/use
