IBCLC Questions and Answers.

IBCLC Questions and Answers. Food allergy is defined as an adverse reaction to a foreign substance or antigen. This causes an immunological change, a rise in _______ IgE [p657] When considering the effect of breastfeeding in the development of infant allergies, breastmilk: prevents/limits the infant's exposure to non human proteins [p759-760] Amy is concerned that her 3 month old may have lactose intolerance and is wondering about trying a lactose free formula instead of breastfeeding. You inquire what symptoms led her to this conclusion. Amy relates that her mother said she was lactose intolerant as an infant. Her baby is gassy and has loose stools. You best response to this mother would be: Babies under 3 y/o rarely have lactose intolerance. Tell me more about your baby's behavior. [p 658-659] A breastfeeding mother tells yo u that she is lactose intolerant. You inform her that _____ primary lactose intolerance is rare in newborns & that she should continue to breastfeed [p 658-659] This mother notices something white on her nipple tip. This most probably is: a nipple bleb [p.295] The structure represented in this image is a: Alveoli, which is the milk producing unit in the breast, lined with lactocytes which produce breastmilk [p 50] When, in the various stages of lactation, does the switch from endocrine to autocrine control occur: Lactogenesis II [p.55] During a prenatal breast exam, the expectant mother presents with widely spaced small breasts with mark asymmetry. This anatomical "red flag" is often associated with: Insufficient lactation [p. 338] During pregnancy, high circulating plasma levels of progesterone will: After breastfeeding this mother complains of extreme pain in both of her nipples. You may discuss with her the following causes: she likely has Raynaud's syndrome A breastfeeding mother comes into your office with a lump in her right breast. She reports that she has a hx of plugged ducts. Her doctor diagnosed a galactocele by US. You explain to her that a galactocele is a benign cyst in the ducts of the breast and can be aspirated and refilled with milk [p301] which nerve supplies the greatest amount of sensation to the areola? 4th intercostal nerve [p301] the PP RN calls you to the bedside of a breastfeeding mother with a 4 day old infant. The mother complains of tenderness and swelling in the axillary region. You explain to the mother that: This mammary tissue swellin can be reduced with cool compresses. This accessory mammary tissue will involute in a few days, w/o affecting milk supply [p54] In the breast, the system of ductules converge behind the nipple which, widen temporarily in response to the milk ejection reflex [p 80-81] proliferation of the duct system in the breast during pregnancy is primarily due to estrogen [pg 54] A new mother tells you that she has implants as she is beginning to breastfeed her infant. One of the most important factors in her health hx to predict successful breastfeeding is the location of the implant did not damage any nerves to the breast [p 299-300] The possible side effects of breast augmentation on breastfeeding are compromise of the ductal structure [p 299-300] A new mother tells her nurse that she has had breast reduction surgery. In her care plan, you would advise the mother : to frequently feed her newborn and monitor the babys weight loss, urine, and stool output This new mother came into your office for a consultation. Surgical scars on her breasts indicate she has had breast reduction mammoplasty [p.296] Your pt just gave birth to an infant w/ a cleft lip and an intact palate. The mother tells you she wants to breastfeed. Your 1st response is: I will assist you with latch on, evaluate a feeding, show you techniques to help the infant transfer milk and support your milk supply. your hospital d/c care plan for a mother with an infant with a cleft of the soft palate may include the following tips EXCEPT: No intervention is necessary since a cleft of the soft palate foes not effect breastfeeding. [pg 642-643] infants with severe heart defects face fatigue and the following breastfeeding challenges: greater calorie needs a new mother asks you for suggestions about breastmilk storage recommendations for her full term infant. This new mother plans to collect as much extra breastmilk as possible as she must return to work in 2 weeks. Ideally, she'd like to use some of the collected pumped/expressed milk so that her relatives, who will be helping care for the child, can feed the baby too. You tell mom: breastmilk, cleanly collected, can be left for up to 6 hrs w/o refrigeration [p 559] before a new mother begins to pump, you would recommend that she wash her hands, use a clean pump kit have available an appropriate storage container and gently massage her breasts and begin pumping [pg 379] This mother is using this technique of expressing her milk for her preterm infant. This technique may: result in greater milk production [p342 & 380] The fit of this flange for this mother can cause pain and low supply [p379] Fat is the most variable component of breast milk. You can use this fact to increase fat content in the breastmilk of a slow to gain infant. Your recommendation would be: Feed the baby more often during the day since fat content is higher during the day [p93] the composition of "weaning" milk is higher in fat The proportion of proteins in mature breastmilk is approx Whey 60%, Casein 40% [p. 96] The major immunological factor in breastmilk is IgA [pg 97] Your consultation with a breastfeeding mother should include the reason why the mother is seeking help and advice often culture defines the breastfeeding norms and expectations of the mother and her baby. In planning for care, it is most important to take into consideration preserving the mothers cultural values while recommending a plan of care [pg 741-743] When you are delivering culturally competent care, introduction can often make a good or bad impression. All of these cues may help you except introducing yourself as the breastfeeding expert [741] A new mother tells you that she is returning to work full time at 6 wks and that she wants to continue to breastfeed her baby. She has a pump for work and is already pumping and giving bottles of milk to her baby. Your 1st question to her would be: What are your goals for breastfeeding after you return to work? [552] Other helpful hints for the employed breastfeeding mother may include obtaining a breast pump and practicing Physiologic Engorgement is characterized by mild fullness and heaviness A mother who is 8 wk PP reports that she has had 2 episodes of mastitis. The following factors could contribute to this reoccurrence: the mother stopped her antibiotics when she felt better This mother is 5 days pp and complains of breast pain. You notice redness and a lumpy area. The mother does not have a fever. Your suggestion would be to: feed frequently while massaging the affected area [283-284] Mastitis this severe may have the following consequences: decreased milk supply in the affected breast [287] This mother is 6 wk PP and reports a fever of 102. The mostly likely reason is: she has signs of mastitis [284] in optimal support of breastfeeding for this newborn, you would encourage hospital practices to delay hospital interventions and initiate breastfeeding within an hour of birth [178-181] This mother has placed her infant on her chest to promote infant self attachment [180-181] Your next step with this newborn would be: place skin to skin with the mother and offer the breast for the first feeding [180-181] encouraging breastfeeding o demand would include all of the following EXCEPT pumping to establish a supply [183-185] a professional relationship is established when a LC discusses a breastfeeding issue with a mother: whether or not the LC is being paid [p.8] A breastfeeding mother is going on vacation and is considering purchasing breastmilk from an internet website. Which statement is correct: pasteurized breastmilk from a reputable milk bak is only available by physician prescription [443-444] You could recommend the use of banked donor milk to parents in all of these circumstances EXCEPT: a mother is returning to work and would like to provide additional breastmilk [443-444] In treating jaundice, the most significant way phototherapy can impact successful breastfeeding is: mother/baby separation [361] A LC is helping a mother with a 37 wk gestation baby who is 35 hours old and has a bilirubin of 10 and weight loss of 7%. The mother reports that the baby will not wake up and continues to sleep and will not latch onto the breast. Your immediate plan of care would include: teach the mother wake up techniques, spoon feed colostrum, and attempt to breastfeed In the infant described in the question above, if he does not awaken for the next feeding, the next steps would be: start the mother pumping, pre-feed the infant pumped breastmilk, then attempt breastfeeding [358] You are a LC working in a clinic that serves a primary population of new immigrant mothers. Many of your patients are being treated during their pregnancy for inactive TB with 1st line anti TB drugs. You counsel these mothers to: start breastfeeding immediately right after birth and continue taking the meds as prescribed [pg 513] many pregnant women test positive for HSV. Your care plan for breastfeeding with HSV would include all of the following EXCEPT continue breastfeeding even if active moist lesions are on the breast [163] Of the following vaccines administered to the mother, which are not safe for the breastfed baby? smallpox (it is a live vaccine) This mother complains of nipple soreness. Which of the following could be the cause of this discomfort? The mother has inverted nipples with a yeast infection, which can cause pain [290-294] A mother comes to your new nothers support group and you observe her infant after a breastfeeding. You recommend that she: make an appt with pedi for possible thrush [291] a mother with diabetes IDDM should be advised to breastfeed early and often and supplement with expressed breastmilk if neeed [516] what is the recommendation for breastfeeding mother of a 3 month old who has recently traveled to an area where zika virus is endemic and has a suspected case of the virus? breastfeed [] the mother who smokes should be counseled to quit or cut down on smoking. nicotine can reduce milk supply [514-515] Some women experience an intense fear, helplessness, loss of control or horror w/ the birthing experience. This manifests itself in a woman's feelings of helplessness, anger, and severe depression or extreme anxiety. These symptoms are associated with PTSD A parent of a 3 wk old baby born at 38 wks gestation is concerned because her baby spits up after every feeding. She reports that is seems to be "the entire feeding". The babys weight gain is approx an ounce per day. The baby is nursing in cross cradle position at most feedings. The parents has begun to give the baby a bottle once q 3-4 days. What is the 1st suggestion to this parent? suggest different positioning of the baby when nursing Many mothers of multiples worry about feeding and taking care of their babies. Which combination of factors put the mothers/babies at the greatest risks for breastfeeding failure? 38 yr old mother, IVF pregnancy, 35 wk gestation twins A new mother of twins would like to start tandem nursing before hospital discharge. A key point to discuss with the mother would be each baby has to individually learn how to breastfeed and the mother needs to recognize that each baby is feeding effectively A mother of a 2 year old and a newborn contacts you about tandem nursing. The 2 year old wants to nurse frequently. You suggest: breastfeed the infant 1st, then the toddler vegetarian mothers need a source of vitamin b12, a good source is: fortified cereals, soy milk, nutritional yeast The rooting instinct helps the infant find his mothers nipple. You can stimulate this reflex by touching the corner of the mouth the cranial nerve that controls the movements of the tongue is CN XII [p71] The WHO code requires that manufacturers of infant formula give factual and scientific info to health care workers, but the code does NOT specifically address: free supplies given to hospitals premature infants often exhibit an immature sucking reflex characterized by the poor coordination of sucking and swallowing in a rhythmic pattern [417-421] which of the following would not be a reason to use this intervention as shown (pic of a nipple shield) increase milk production to assist this premature baby with breastfeeding, this mother is using the dancer hand position to give support to her infants jaw [621-622] this premature infant (pic of a breastfeeding infant with nasogastric tube taped onto face) having nasogastric tube supplementation while breastfeeding so he can be supplemented without bottles [622] in assisting the mother of a premature infant to hold her infant, you put the infant in this position bc (pic of skin to skin) skin to skin contact stabilizes the infants body temperature, HR, and RR professional growth of the LC can best be enhanced by clinical experience, reading professional journals, public speaking, mentoring new LCs [p.7] relactation is easier for the mother to accomplish of she had a good milk supply ad there has been a short interval since the last breast stimulation (breastfeeding or pumping) [p508] domperidone and metoclopramide are galactagogues. both medications significantly: raise prolactin levels by inhibiting the action of dopamine at its receptors For optimum breastmilk production, a mother of an adopted baby should be counseled pump 8-12 x QD prior to the adoption, then feed the baby at the breast with a feeding tube device [pg 505] Lactational Amenorrhea Method (LAM) can be considered effective contraceptive when: the mother is 6 mo PP w/ no menstrual cycles, the infant is totally breastfed around the clock [485] the form of contraception that would have no impact on milk supply is barrier method This infant may have difficulty latching into the breast because he appears to have a receding chin [232] This newborn is reacting with which normal newborn reflex? (pic of one arm up one are down) asymmetric tonic neck reflex [234-235] this infant is demonstrating rooting. [184-185] during an oral assessment you notice the following anomaly: (pic of tongue tie) ankyloglossia [332-335] the consistency and color of this newborn stool is (pic of yellowish liquid stool) normal in breastfed infants You are invited to meet your neighbors new baby, but you do not remember his birth date. By his position and posture, you would estimate that he is: (pic of baby in prone position, isnt able to push self up) 2 months [582] finger feeding is a useful technique in certain circumstances and can easily be taught to parents. The main advantage of finger feeding is it: can be used to correct improper tongue movements [80-82] This mother is using a special bottle feeding technique: to slow the rate if flow of the milk and encourage the infant to suck stronger [p71] when a mothers nipple appears this way after a breastfeeding, the likely reason could be: the infant had a shallow latch [pg 254-255] one of the primary advantages of this method of alternative feeding is (pic of baby being cup fed) the infant is fed but avoids feel of a bottle nipple in the mouth [pg 254-255] this mother is having great difficulty latching on her baby. Your assessment identifies this condition and you recommend the following to assist with latch on: The infant has a heart shaped tongue which is an indication of being "tongue tied". Refer the baby to her pedi for eval [pg 332-335] Stephen is a healthy breastfed baby, you would describe his latch on as: normal the weight of this baby may be inaccurate bc: the blanket is hanging off the side [344-346] By placing this infant on his mothers chest, all of the following are true except: you will lower the infants core temp [p 178-181]