ALPP CLC Exam
Clinical management procedures - Answer-First half of 2018 revised WHO/UNICEF 10 steps/baby
friendly hospital initiative
Key Clinical Practices - Answer-Second half of 2018 reviewed WHO/UNICEF 10 steps/baby friendly
hospital initiative
Step 1.a. of BFHI - Answer-Comply fully with international code of marketing of breastmilk substitutes
and relevant world health assembly resolutions
global standards of step 1.a. of BFHI - Answer-1. Standard procurement of feeding bottles and nipples,
not through gifts or subsidies
2. No display of products under code or items with logos of companies that produce breastmilk
substitutes, bottles, etc
3. Facility policy about abiding by code
4. At least 80% of health professionals can explain at least 2 elements of the code
Step 1.b. of BFHI - Answer-Have a written infant feeding policy that is routinely communicated to staff
and parents
Step 1.c. of BFHI - Answer-establish ongoing monitoring and data-management systems
Step 2 of BFHI - Answer-Ensure all staff have sufficient knowledge, competence, and skills to support
breastfeeding
Step 3 of BFHI - Answer-Discuss the importance and management of breastfeeding with pregnant
women and their families
, Minimum components of step 3 of BFHI - Answer-Discussion of: importance of breastfeeding,
recommendation of at least 6 months EBF, importance of immediate and sustained skin-to-skin, early
initiation of breastfeeding, rooming in, good positioning and attachment, and feeding cues
Step 4 of BFHI - Answer-Facilitate immediate and uninterrupted skin-to-skin contact
Step 5 of BFHI - Answer-Support mothers to initiate and maintain breastfeeding and manage common
difficulties
Step 6 of BFHI - Answer-Do not provide breastfed newborns food or fluids other than breast milk unless
medically indicated
Step 7 of BFHI - Answer-Enable mothers and their infants to remain together and practice rooming in 24
hours a day
Step 8 of BFHI - Answer-Support mothers to recognize and respond to their infants' cues for feeding
Step 9 of BFHI - Answer-Counsel mothers on use and risks of feeding bottles, teats, and pacifiers
Step 10 of BFHI - Answer-Coordinate discharge so that parents and their infants have timely access to
ongoing support and care
periareolar incision - Answer-In history of breast surgery/injury, this factor is most significantly
associated with lactation insufficiency
Further history after breast augmentation - Answer-Is there nipple senstation? Are ducts patent? Are
nipple pores patent? Is there a history of change in breast size/appearance during pregnancy?
Clinical management procedures - Answer-First half of 2018 revised WHO/UNICEF 10 steps/baby
friendly hospital initiative
Key Clinical Practices - Answer-Second half of 2018 reviewed WHO/UNICEF 10 steps/baby friendly
hospital initiative
Step 1.a. of BFHI - Answer-Comply fully with international code of marketing of breastmilk substitutes
and relevant world health assembly resolutions
global standards of step 1.a. of BFHI - Answer-1. Standard procurement of feeding bottles and nipples,
not through gifts or subsidies
2. No display of products under code or items with logos of companies that produce breastmilk
substitutes, bottles, etc
3. Facility policy about abiding by code
4. At least 80% of health professionals can explain at least 2 elements of the code
Step 1.b. of BFHI - Answer-Have a written infant feeding policy that is routinely communicated to staff
and parents
Step 1.c. of BFHI - Answer-establish ongoing monitoring and data-management systems
Step 2 of BFHI - Answer-Ensure all staff have sufficient knowledge, competence, and skills to support
breastfeeding
Step 3 of BFHI - Answer-Discuss the importance and management of breastfeeding with pregnant
women and their families
, Minimum components of step 3 of BFHI - Answer-Discussion of: importance of breastfeeding,
recommendation of at least 6 months EBF, importance of immediate and sustained skin-to-skin, early
initiation of breastfeeding, rooming in, good positioning and attachment, and feeding cues
Step 4 of BFHI - Answer-Facilitate immediate and uninterrupted skin-to-skin contact
Step 5 of BFHI - Answer-Support mothers to initiate and maintain breastfeeding and manage common
difficulties
Step 6 of BFHI - Answer-Do not provide breastfed newborns food or fluids other than breast milk unless
medically indicated
Step 7 of BFHI - Answer-Enable mothers and their infants to remain together and practice rooming in 24
hours a day
Step 8 of BFHI - Answer-Support mothers to recognize and respond to their infants' cues for feeding
Step 9 of BFHI - Answer-Counsel mothers on use and risks of feeding bottles, teats, and pacifiers
Step 10 of BFHI - Answer-Coordinate discharge so that parents and their infants have timely access to
ongoing support and care
periareolar incision - Answer-In history of breast surgery/injury, this factor is most significantly
associated with lactation insufficiency
Further history after breast augmentation - Answer-Is there nipple senstation? Are ducts patent? Are
nipple pores patent? Is there a history of change in breast size/appearance during pregnancy?
