Certified Lactation Consultant Exam QUESTIONS AND ANSWERS

Certified Lactation Consultant Exam 1 breast or 2? ans: There is no difference in baby's net fat intake according to the number of breasts suckled per feeding or the breastfeeding frequency Offer the 1st breast 1st and the 2nd breast 2nd it really doesn't matter 1 breast or 2 whatever they want 1+ year of lactation ans: After one year of lactation the milk expressed has significantly increased fat and energy contents, compared with milk expressed by women who have been lactation for a shorter time. The volume of milk does not have to change as the baby gets older/bigger because the composition of the milk changes Anemia and breastfeeding ans: Postpartum hemorrhage can cause sheehans syndrome which in turn causes hormonal issues including milk making hormones Retained placenta fragments prevents the shift from lactogenesis stage 1 to stage 2 which can affect your mature milk coming in Breast milk composition changes... ans: Over the course of lactation Within the day there are variations on the composition of milk Within a feeding By the way it is taken during a feeding and also between feedings Canabis use and breastfeeding ans: Exposure of infant to any kind of passive smoke is a concern. There is no safe threshold limit for cannabis use in pregnancy. Among pregnant women cannabis use was significantly associated with an increased risk of preterm birth and low birth weight The high fat solubility of cannabinoids make them difficult to analyze in breast milk. THC (delta-9-tetrahydrocannabinol) is measurable in milk 6 days after maternal use Colic ans: An easily identifiable childhood problem that has no clearly identified treatment Does not seem to be associated with GERD Colicky babies had more than double the abundance of microbia in the gut Constructed Knowing ans: The position at which truth is understood to be contextual, knowledge is tentative, and it is understood that the knower is part of the known Have abandoned either/or thinking Have learned to live with conflict and have high tolerance for internal contradiction and ambiguity Believe all knowledge is constructed and the knower is an intimate part of the known Want to avoid compartmentalizing thought and feeling, home and work, self and other Want to embrace all the pieces of the self in some ultimate sense of the whole: mother-daughter-wife-artist Aspire to work that contributes to the empowerment and improvement in the quality of life of others Believe that ideas and values must be nurtured Have a unique and authentic voice Engorgement ans: Breasts hard, hot, and shiny Temp above normal Feels discomfort in the breast Nipple difficult to grasp, makes difficult for baby to latch Occurs most commonly day 3-5 As the pressure builds up inside the breast milk production decreases, this is natures early dry up mechanism Failure to effectively resolve prolonged symptomatic engorgement may have a negative impact on continued adequate milk supply Placing breasts in a bowl of warm water will stimulate the milk to flow out to relieve some pressure so you can then feed Fat content in breast milk ans: Longer times in between feedings made for a lower fat content but faster feedings made for a higher fat content where as feedings lasting longer than 30 mins made for a lower fat content Breastfed babies can regulate fat intake quickly and thus mothers should be encouraged to practice baby led feeding Maximum fat levels were obtained 30 mins post-feed Focuses on advantages of breastfeeding on a personal (personal connection), community, country (amount spent on healthcare), or global level (waste from formula & formula products) Focuses on the good "advantages" of breastfeeding ans: Breastfeeding Promotion Focuses on government, manufacturer, and social responsibility to assure breast feeding's ability to compete with commercial interests. Includes addressing improper marketing practices Addressing breastfeeding in public, at work, jury duty, family law, mothers in prison, etc.. ans: Breastfeeding Protection Focuses on the interaction of "helpers" with family as well as program development and implementation ans: Breastfeeding Support Formula preparation and storing ans: Formula needs to be mix with water that is at least 70ºC or 158ºF in order to kill Enerobacter Sakazakii Formula made with hot water need to be cooled quickly to body temperature if it is being fed to the baby immediately If the formula is not being fed immediately, refrigerate it right away and keep refrigerated until feeling Hierarchy of infant feeding choices ans: 1. Baby at mothers breast 2. Mother's own expressed milk 3. Milk from a milk bank 4. Cows milk forumla 5. Soy formula How do I know my baby is getting enough milk? ans: One wet diaper for how old the baby is (however this can be skewed by the diuresing process and is not a good indicator of adequate hydration) 4 wets on day 4 and each day after Multiple poops each day that change in consistency and color How do we assure an adequate milk supply? ans: Universal understanding of how breastfeeding works Early initiation and adequate breastfeeding (10-12x per day) Appropriate breastfeeding assessment Improved and early breastfeeding support Appropriate HCP and LCP follow-up in the postpartum period Admitting there is no magic bullet More nursing= more milk How does iron effect baby's gut ans: Low iron in the gut is good, breastmilk has relativly low iron content Tons of different bacteria thrives on excess iron so having to much can cause issues How does pH of the gut effect babies ans: Gut pH of breastfed babies is higher than those who are formula fed or even mixed fed. Higher pH means less harmful bacteria is able to grow which helps have less issues with diarrhea How does the presence of lactobacillus bifidus affect baby's gut ans: Presence of bifidus factor in breast milk promotes the growth of lactobacillus bifidus which helps maintain the low pH and crowd out the harmful bacteria How does the presence of SIgA antibodies effect baby's gut ans: Antibodies such as SIgA bind to microbes in the baby's intestinal tract and prevent them from being absorbed into the rest of the body. Mothers IgA has been found to protect against the development of necrotizing enterocolitis in preterm infants How in prolactin produced? ans: Breast stimulation Nipple stimulation (makes the most)