Certified Lactation Counselor
QUESTIONS AND ANSWERS
GRADED A+
Predominant Breastfeeding - Answer - : Babies who receive breastmilk and other liquids (e.g. water, minerals, vitamins, oral meds).
Breastfeeding - Answer - : Baby receives human milk, as well as other foods or fluids, including formula.
Complementary Feeding - 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 - Answer - : Promotion, Protection, Support
Promotion - Answer - : Focuses on advantages of BF on a personal, community, country, or global level. BF to the community.
Protection - 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 - Answer - : Addresses improper marketing practices by formula companies. It is not currently a law in the
US.
What does the International Code Prohibit? - Answer - : Distributing free formula
Giving coupons for formula
What did the AAP resolution state in regards to the International Code? - Answer - : No distributing formula, discharge bags, industry written handouts. Support - Answer - : Focuses on interaction of helpers with family, as well as program development and implementation.
10 steps to successful BF - 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? - 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? - Answer - : 1. Medical condition
2. Parents request after being informed of consequences
Protocol for calculating Baby's daily needs - 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? - Answer - : Hydration (elimination patterns)
Body weight (no more than 7% loss)
Observe Feeding
Maternal or infant issues
What is a CLC? - 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? - Answer - : 4, some yellow by day 4. When should a baby be back to birth weight? - Answer - : 12-14 days post birth
How much weight should a baby gain daily? - Answer - : Approximately 1 ounce
Why do women supplement with formula when there is no medical need? - Answer - : 1. Lack of preparation for what the newborn period would be like.
2. Lack of timely interventions
Alveoli - Answer - : Small glands in the breast that produce milk
At-Breast Supplementer - Answer - : a device that allows a supplement to be given
while a baby is actively nursing at the breast,
ex: Supplement Nursing System
Atopy - Answer - : hypersensitive or allergic state involving an inherited predisposition
What is the BFHI Baby Friendly Hospital Initiative - 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 - Answer - : an orange-yellow pigment formed in the liver by the breakdown of hemoglobin and excreted in bile.
CCK (cholecystokinin) - Answer - : Hormone that regulates the emptying of the gallbladder and secretion of enzymes by the pancreas.
Colostrum - 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 - Answer - : Classification system for anklyloglossia (tongue-tie)
Dancer Hand Position - 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 - Answer - : found in the walls of the alveoli, simple squamous epithelial cells, main sites of gas exchange
myoepithelial cells - Answer - : contract in response to stimulation by sympathetic
nervous system and squeeze milk up the duct
Montgomery glands - 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? - 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? - Answer - : Prolactin and Oxytocin
Prolactin (4 details related to milk production) - 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? - Answer - : 8-12
What produces colostrum? - Answer - : Progesterone in the receptor sites
What produces more mature milk? - Answer - : Prolactin in the receptor sites
What happened when infants suckled in the first 2 hours of birth? - Answer - : Ingested significantly more milk on day 4
What happened to mother of preemies who initiated milk expression within 1 hour of birth? - 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.
QUESTIONS AND ANSWERS
GRADED A+
Predominant Breastfeeding - Answer - : Babies who receive breastmilk and other liquids (e.g. water, minerals, vitamins, oral meds).
Breastfeeding - Answer - : Baby receives human milk, as well as other foods or fluids, including formula.
Complementary Feeding - 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 - Answer - : Promotion, Protection, Support
Promotion - Answer - : Focuses on advantages of BF on a personal, community, country, or global level. BF to the community.
Protection - 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 - Answer - : Addresses improper marketing practices by formula companies. It is not currently a law in the
US.
What does the International Code Prohibit? - Answer - : Distributing free formula
Giving coupons for formula
What did the AAP resolution state in regards to the International Code? - Answer - : No distributing formula, discharge bags, industry written handouts. Support - Answer - : Focuses on interaction of helpers with family, as well as program development and implementation.
10 steps to successful BF - 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? - 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? - Answer - : 1. Medical condition
2. Parents request after being informed of consequences
Protocol for calculating Baby's daily needs - 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? - Answer - : Hydration (elimination patterns)
Body weight (no more than 7% loss)
Observe Feeding
Maternal or infant issues
What is a CLC? - 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? - Answer - : 4, some yellow by day 4. When should a baby be back to birth weight? - Answer - : 12-14 days post birth
How much weight should a baby gain daily? - Answer - : Approximately 1 ounce
Why do women supplement with formula when there is no medical need? - Answer - : 1. Lack of preparation for what the newborn period would be like.
2. Lack of timely interventions
Alveoli - Answer - : Small glands in the breast that produce milk
At-Breast Supplementer - Answer - : a device that allows a supplement to be given
while a baby is actively nursing at the breast,
ex: Supplement Nursing System
Atopy - Answer - : hypersensitive or allergic state involving an inherited predisposition
What is the BFHI Baby Friendly Hospital Initiative - 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 - Answer - : an orange-yellow pigment formed in the liver by the breakdown of hemoglobin and excreted in bile.
CCK (cholecystokinin) - Answer - : Hormone that regulates the emptying of the gallbladder and secretion of enzymes by the pancreas.
Colostrum - 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 - Answer - : Classification system for anklyloglossia (tongue-tie)
Dancer Hand Position - 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 - Answer - : found in the walls of the alveoli, simple squamous epithelial cells, main sites of gas exchange
myoepithelial cells - Answer - : contract in response to stimulation by sympathetic
nervous system and squeeze milk up the duct
Montgomery glands - 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? - 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? - Answer - : Prolactin and Oxytocin
Prolactin (4 details related to milk production) - 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? - Answer - : 8-12
What produces colostrum? - Answer - : Progesterone in the receptor sites
What produces more mature milk? - Answer - : Prolactin in the receptor sites
What happened when infants suckled in the first 2 hours of birth? - Answer - : Ingested significantly more milk on day 4
What happened to mother of preemies who initiated milk expression within 1 hour of birth? - 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.
