CERTIFIED LACTATION CONSULTANT (CLC) Q&A EXAM 300 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)

CERTIFIED LACTATION CONSULTANT (CLC) Q&A EXAM 300 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) What are green/shiny stools a sign of? - ANSWER -sign of overproduction leading to less fat in milk, faster digestion causing not enough time for lactase to digest the lactose in milk. An improved latch could allow for more fat flow Signs of oversupply - ANSWER Rapid weight gain in infant, unsettled baby after feeding, recurrent plugged ducts and mastitis, painful feedings, voluminous (huge volumes of) stools- often green & shiny What causes nipple pain? - ANSWER Improper latch-- need lactation support to help with proper latch on, good seal True/false: baby should be pulled into breast. - ANSWER False! Do not pull baby into breast, let baby tilt head back for optimal latch. Hand on back of baby's head can interfere baby's interoral function by restricting the movement of the cranio-cervical spine-- causes nipple trauma. Make sure crook of arm in cradle position does not block baby from being able to fully tilt back. Should a latch be symmetric or asymmetric? - ANSWER Asymmetric! A baby should form a teat with breast tissue underneath the nipple as part of a latch What is a symmetric latch - ANSWER Not a good latch, causes nipple damage Asymmetric latch - ANSWER Optimal attachment to the breast, where the baby's lips are not centered in relationship to the areolar, but rather vertically off-centered with the baby's chin and lower lip closer to the edge of the areola than the baby's upper lip. A baby should form a teat with breast tissue underneath the nipple as part of a latch Do nipple creams work? - ANSWER Continued questions of effectiveness, fear of ingestion by baby Should a frenotomy be suggested for tongue tie? - ANSWER No study was able to report that frenotomy led to better long term breastfeeding Tongue tied breastfeeder - ANSWER -complete feeding assessment and suggest ways to optimize latch. -refer onward for diagnosis (have PCP diagnose TT) -provide support What is a fissure straight down the nipple evidence of? - ANSWER A symmetric latch. Top lip needs to have good seal, moist part of lip should be touching nipple, can roll out top lip, to reduce injury during BF Is there a deep latch with nipple stretching? - ANSWER If nipple not stretched deeply into mouth, less oxytocin flows, less fat is in mix. With less fat, milk digested quicker = not enough time for baby to make enough lactase to digest lactose in milk. What to do for oversupply? - ANSWER Decrease additional stimulation/milk removal if possible Consider block feeding (only nursing on one side only per feeding) Watch for mastitis Try australian posture (mother down under, baby on top) Consider donating to milk bank Consult with HCP for medical dx