Certified Breastfeeding Counselor Exam
Questions and Answers ()
(Verified Answers)
Different stages of breast development
- Embryogenesis
- Mammogensis
- Lactogenesis 1
- Lactogenesis 2
- Lactogenesis 3
Embryogenesis: mammary gland devo while 5 wk embryo
Mammogenesis: @ puberty, estrogen influences growth of ducts and buds
Lactogenesis 1: completion of mammary development from placenta stimulation; ducts stimulated +
colostrum secretion at 16 wks
Lactogenesis 2: Secretory activation when placenta out --> decr progesterone --> inc prolactin --> inc
milk supply
Lactogenesis 3: Milk removal --> mature milk prod; Infant sucking= ^ oxytocin= let down.
Estrogen
Progesterone
Prolactin
Oxytocin
TSH
Estrogen - ^ during pregnancy; stim growth in ductile system
Progesterone - ^ during pregnancy; stim alveoli and lobes
Prolactin - frm ant pituitary gland; lands on prolactin receptor sites to start milk prod
Oxytocin - from post pituitary gland; cause LETDOWN
TSH - ^ responsiveness of mammary cells
Tail of spence: What is it, symptoms
Mammary gland tissue that extends to axillary area, connected to milk ducts --> can cause swollen
armpits & mastitis
Accessory tissue: Where are they found? Can they lactate?
Diagonal line from axilla to groin area
- can lactate & undergo malignant change
Flat nipples
Pseudo inverted nipple
Retracted nipple
Inverted nipple
- possible issues, short shank, solutions
Flat - remains flat after stimulation or retract with compression (short shank) --> diff w/ latch
Pseudo - seems inverted but erect upon stimulation
Retracted - retracts upon stimulation
Inverted - retracted at rest &s stimulation
Nipple shield may help.
Hypoplasia, what is it?
Underdevelopment, insufficient glandular tissue --> can lead to insufficient milk
, Active let down
- How is milk ejected into ducts from alveoli? aka let down
- signs of let down
- postions that are helpful for let down
Myoepitheal cells encase the aveoli, contract in response to oxytocin. In response to sucking oxytocin
increases
Tingling, warmth, fullness, dripping, contractions
helpful in australian/saddle
What is breast milk composed of?
- Fats: most variable, help brain devo, hi in evenings
-Protein: Casein- allows for iron to be absorbed, mature milk. Whey- hi in colostrum, contains IGA; has
lysozyme that kills bacteria
Carbs: creates acidic environment in gut & has lactose that reg milk vol
Vitamins: A,D,E,K,C, thiamin, riboflavin, b's that influenced by mom.
Minerals: calcium, phosphorus, magnesium, not affected by diet. + 88% water
Impact of breast surgery on lactation
- Implants
- hyaluronic acid injections
- breast reduction
Implants
- compress milk ducts --> impede milk flow --> compromise reaching max milk vol
Hyaluronic acid injections
- no risk of being absorbed in baby's GI tract
Reduction
- BF might not be possible after
- BF early + stim bm early
Signs of milk transfer
Swallowing, air from nose, ca sound, movement seen
Feeding patterns 24-48 hrs & 48 and further
24-48hr --- > Cluster feeding (feed freq over short amt of time) , must stimulate breast
48 and further --> on demand (cue based feeding) ; offer q 3 hrs
How does poop transform?
Normal urine output
Black to green to yellow (by end of first week). Watery and seedy at first
Urine output --> 1 diaper per day of life (e.g: 2 day old infant min of 2 wet diapers)
LATCH tool
Questions and Answers ()
(Verified Answers)
Different stages of breast development
- Embryogenesis
- Mammogensis
- Lactogenesis 1
- Lactogenesis 2
- Lactogenesis 3
Embryogenesis: mammary gland devo while 5 wk embryo
Mammogenesis: @ puberty, estrogen influences growth of ducts and buds
Lactogenesis 1: completion of mammary development from placenta stimulation; ducts stimulated +
colostrum secretion at 16 wks
Lactogenesis 2: Secretory activation when placenta out --> decr progesterone --> inc prolactin --> inc
milk supply
Lactogenesis 3: Milk removal --> mature milk prod; Infant sucking= ^ oxytocin= let down.
Estrogen
Progesterone
Prolactin
Oxytocin
TSH
Estrogen - ^ during pregnancy; stim growth in ductile system
Progesterone - ^ during pregnancy; stim alveoli and lobes
Prolactin - frm ant pituitary gland; lands on prolactin receptor sites to start milk prod
Oxytocin - from post pituitary gland; cause LETDOWN
TSH - ^ responsiveness of mammary cells
Tail of spence: What is it, symptoms
Mammary gland tissue that extends to axillary area, connected to milk ducts --> can cause swollen
armpits & mastitis
Accessory tissue: Where are they found? Can they lactate?
Diagonal line from axilla to groin area
- can lactate & undergo malignant change
Flat nipples
Pseudo inverted nipple
Retracted nipple
Inverted nipple
- possible issues, short shank, solutions
Flat - remains flat after stimulation or retract with compression (short shank) --> diff w/ latch
Pseudo - seems inverted but erect upon stimulation
Retracted - retracts upon stimulation
Inverted - retracted at rest &s stimulation
Nipple shield may help.
Hypoplasia, what is it?
Underdevelopment, insufficient glandular tissue --> can lead to insufficient milk
, Active let down
- How is milk ejected into ducts from alveoli? aka let down
- signs of let down
- postions that are helpful for let down
Myoepitheal cells encase the aveoli, contract in response to oxytocin. In response to sucking oxytocin
increases
Tingling, warmth, fullness, dripping, contractions
helpful in australian/saddle
What is breast milk composed of?
- Fats: most variable, help brain devo, hi in evenings
-Protein: Casein- allows for iron to be absorbed, mature milk. Whey- hi in colostrum, contains IGA; has
lysozyme that kills bacteria
Carbs: creates acidic environment in gut & has lactose that reg milk vol
Vitamins: A,D,E,K,C, thiamin, riboflavin, b's that influenced by mom.
Minerals: calcium, phosphorus, magnesium, not affected by diet. + 88% water
Impact of breast surgery on lactation
- Implants
- hyaluronic acid injections
- breast reduction
Implants
- compress milk ducts --> impede milk flow --> compromise reaching max milk vol
Hyaluronic acid injections
- no risk of being absorbed in baby's GI tract
Reduction
- BF might not be possible after
- BF early + stim bm early
Signs of milk transfer
Swallowing, air from nose, ca sound, movement seen
Feeding patterns 24-48 hrs & 48 and further
24-48hr --- > Cluster feeding (feed freq over short amt of time) , must stimulate breast
48 and further --> on demand (cue based feeding) ; offer q 3 hrs
How does poop transform?
Normal urine output
Black to green to yellow (by end of first week). Watery and seedy at first
Urine output --> 1 diaper per day of life (e.g: 2 day old infant min of 2 wet diapers)
LATCH tool
