Certified Lactation Counselor (CLC) Study Questions and Answers

Certified Lactation Counselor (CLC) Study Questions and Answers Down Syndrome A congenital condition characterized by moderate to severe mental retardation [textbook definition]. Also called trisomy 21. Dyad A group of two. In lactation terms, usually refers to a nursing mother and baby. Duarte Galactosemia A variant of galactosemia with generally milder complications. EBF Exclusively breastfed. ELBW (Acronym) Extremely low birth weight. An infant with a birth weight less than 1,000 grams (2.2 pounds). Failure to Thrive (FTT) A serious condition in which baby's growth is inadequate and requires medical evaluation. Engorgement Swelling in the breast that blocks milk flow; caused by inadequate or infrequent milk removal the breast(s). Breasts will be hot to the touch, painful and will look tight and shiny. With severe engorgement, milk production may stop. With inadequate drainage, clogs and/or mastitis can occur. Everted Nipple A nipple that turns outward when stimulated. Exclusive Breastmilk Feeding (EBMF) A term used by The Joint Commission (2011) to describe those babies who are receiving only human milk. Feeding Cues Infant behavior that indicates an interest in eating, including rapid eye movement, movement of hands near the face and mouth (sucking hands and fingers), rooting and seeking motions (turning head side to side while gaping). Flat Nipple A nipple that everts in response to stimulation but is otherwise not projected. Foremilk The milk that is expressed from the breast at the beginning of a feed. Glactocele A milk-filled cyst in the breast, most likely caused by an obstructed duct. Glactogogue Food or drinks given to the lactating parent that are believed to increase milk production. Galactose A simple sugar that is portion of lactose; the sugar present in milk. Galactosemia Congenital metabolic disorder causing inability of the body to use the simple sugar galactose, causing accumulation of galactose 1-phosphate in the body, which results in damage to the liver, central nervous system, and other body systems with permanent, even fatal, outcomes. Gestational Diabetes Mellitus (GDM) A form of diabetes that occurs in pregnancy. Goldsmith's Sign The association of a baby's persistent refusal of one breast with possible breast cancer in the mother. Glucose-6-Phosphate Dehydrogenase Deficiency A hereditary metabolic enzyme deficiency that leads to mild destruction of red blood cells and jaundice when the individual is ill or exposed to substances ranging from fava beans to sulfa drugs and beyond. Hematoma A blood filled lump/swelling resulting from a broken blood vessel. Hindmilk The milk expressed from the breast toward the end of a feed. Human Immunodeficiency Virus (HIV) A group of retroviruses, especially HIV-1, that infect and destroy helper T-cells of the immune system, causing the marked reduction in their numbers that is diagnostic of Acquired Immune Deficiency Syndrome. Also called AIDS virus. Inverted Nipple A nipple that turns inward when stimulated. Has 3 degrees of variation. Kernicterus Bilirubin encephalopathy, a form of brain damage resulting from unconjugated bilirubin entering the brain. Characterized by lethargy, poor feeding, vomiting, irregular respiration, perhaps death. Jaundice Condition that results when red blood cells break down faster than the liver can handle, causing a yellow tint of the skin. In the newborn, normal physiologic jaundice is caused by the immaturity of the liver. There are different degrees of jaundice, severity differs among gestational age groups and post-natal age of baby. IUGR Acronym for "intrauterine growth restriction." Lactogenesis The stages of development of milk. The production process of human lactation. Has 3 stages of development. The first stage starts during pregnancy. Following the detachment of the placenta after birth. And then frequent nipple stimulation in the early postpartum days. Lactose A disaccharide (sugar) that is commonly found in milk and consists of galactose and glucose. Late Pre-Term Infant (LPTI) Am infant born between 34 0/7 weeks gestation and 36 6/7 weeks gestation. LBW (Low Birth Weight) Acronym for "low birth weight." Infant weighs less than 2,500 grams (5lbs8oz). Milk Ejection Reflex Also called the letdown reflex. Indication and sudden reflex of milk flowing from the nipples when oxytocin release is triggered. Oxytocin causes the contraction of myoepithelial cells, ejecting milk from the breast. Methicillin-resistant Staphylococcus aureus (MRSA) A bacterium that causes infections in different parts of the body and is often resistant to commonly used antibiotics; can be found on the skin, in surgical wounds, in the bloodstream, lungs, and urinary tract. Mastitis Inflammation in the breast causing localized tenderness, redness, and warm to the touch. Mother may have a fever, feel tired, achy, or nauseous, they have a headache. Similar symptoms to influenza. Mastitis may or may not be infective process (requiring antibiotics). Meconium An infants first stool, varying from a greenish black to light brown with a tarry, sticky consistency. Montgomery Glands Small tubercles in the areola of the breast that contain both sebaceous and mammary lobes. These glands become more marked in pregnancy and secrete a fluid that lubricates the nipple area. Moro Reflex Infant reflex where a baby will startle in response to a loud sound or sudden movement. A response present in the normal infant from the 3rd trimester through the 4th or 5th month after birth. When pulled up from a laying position and then released, the infant will spread its arms, then fold them back to the body, usually crying. Myoepithelial Cells Smooth muscle cells that and circle the alveoli and duct of the breast. Contraction of the cells, caused by oxytocin release, causes the outward flow of milk, or milk ejection reflex. Multipara A woman who has given birth to multiple babies. Non-nutritive Sucking Suckling that causes little or no milk secretion, associated with eight or more sucks per swallow. (8:1 + ratio) May be "flutter sucking" or "comfort sucking." Nutritive Sucking Actively suckling causing milk flow and milk transfer, typically thought of as one or two sucks per swallow (1:1 or 2:1 ratio) No more than 6 sucks per swallow (6:1) NSAIDs Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, Naprosyn, ect.) Oxytocin A hormone released by the posterior pituitary that stimulates uterine contractions during childbirth and milk ejection during breastfeeding. Contracts the cells around the alveoli and sending milk down the ducts and out the nipple pores causing milk ejection reflex, AKA "letdown." Patent Refers to the structures such as to milk ducts that are connected or open, rather than closed. Perinatal Refers to the time around birth, pre- and postpartum. Phenylalanine An essential amino acid found in proteins and needed for growth of children and for protein metabolism in children and adults. Phenylketonuria (PKU) And inherited disease resulting in the inability to digest phenylalanine. People with this diagnosis month avoid phenylalanine due to the risk of brain damage. Polycystic Ovary Syndrome (PCOS) A hormonal condition among women that is a major cause of infertility. Postpartum Adjustment Disorder (PPAD) Mood changes occurring to a woman in the first year after giving birth. Postpartum Depression (PPD) Depression occurring in the first year postpartum. Predominant Breastfeeding The feeding of both mother's milk as well as water, water-based drinks, ritual foods (teas), oral rehydration solution, vitamins, minerals, and oral medication to the infant. LGA Large for gestational age (above 90th percentile) Premature Infant Infant born before completing 37 weeks of gestation (also called preterm infant). Primpara (primip) A woman who is giving birth for the first time. Progestin A synthetic form of progesterone, used in many birth-control methods. Prolactin The hormone that stimulates the production of milk. Reynaud's Syndrome A medical condition associated with vasoconstriction and reduce blood flow to an extremity of the body in response to cold stress/stimuli. Relactation The process of reestablishing adequate milk production in a parent who has greatly reduced milk production or who has stopped breastfeeding. Reverse Cycle Nursing Description of a feeding pattern of more frequent nursing during night time than during daytime. Rooting Reflex An infants instinctual tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple. SGA Small for gestational age. Sheehan's Syndrome Damage to the pituitary gland (caused by postpartum hemorrhage), resulting in the inability to produce pituitary hormone, including prolactin. SIDS Sudden infant death syndrome. Crib death. SNS Acronym for "supplemental nursing system", a type of at-breast supplementer. Submucosal Cleft An opening in the bone above the roof of the pallet that is covered with normal skin lining and is therefore more difficult to identify. Supplementary Feeding The giving of food other than breastmilk to an infant to replace breast milk calories.