Certified Breastfeeding Counselor CBC Exam Questions and Answers

Where does breast tissue normally develop? - ANSWER-Along the breast line - located from under the arms down to the groin What are the 3 stages of early breast development? - ANSWER-1. In utero 2. First 2 months of life 3. Puberty Breast development during menstruation - ANSWER-- Estrogen: Induces Ductal System development - Progesterone: Induces Lobular-Alveolar development What is Lactogenesis? - ANSWER-The initiation of milk production How many stages of Lactogensis are there? - ANSWER-4 What stages of Lactogenesis occur during pregnancy? - ANSWER-1 and 2 Lactogenesis 1 - ANSWER-Ductal and Lobular-Alveolar systems grow at an accelerated rate (influenced by hormones) - breasts enlarge - high progesterone levels cause an increase in alveoli - colostrum begins to produce in the alveoli When does Lactogenesis 1 occur? - ANSWER-around 16 weeks Lactogenesis 2 - ANSWER-The placenta is released from the uterus and progesterone levels drop - this causes the alveolar cells to begin to release milk and allows them to continue to produce more milk How long does Lactogenesis 2 last? - ANSWER-2-4 days What are the 5 main areas of the breast? - ANSWER-- Upper Inner - Lower Inner - Upper Outer - Lower Outer - Tail of Spence What are the 2 types of breast tissue and what are they composed of? - ANSWER-- Parenchyma: ductal and lobular-alveolar structures - Strom: connective tissue (fat, vascular, nerve, lymphatic) What is an Alveolus - ANSWER-Small cavity where milk is produced and stored - made of epithelial cells What are Alveoli? - ANSWER-multiple alveolus What is the Intra-lobular duct? - ANSWER-Connects a lobule to the lactiferous ducts What is a Mammary Lobule? - ANSWER-10-100 alveoli combined together What are Lactiferous Ducts? - ANSWER-connects mammary lobules/intra-lobular ducts to the nipple Breast Anatomy - ANSWER- What surrounds the breast tissue? - ANSWER-Fat Nerves Lymph Tissue Vascular Network Myoepithelial Cells What is the purpose of the Myoepithelial cells? - ANSWER-They surround the alveolus and contract (like a muscle) - pushes milk out into the ducts What is the purpose of the Vascular Network surrounding breast tissue? - ANSWER-- supplies nutrients, materials, hormones to each alveolus for milk production - supplies hormones to the myoepithelial cells for ejection of milk What is the purpose of fat surrounding breast tissue? - ANSWER-protection support provides space for growth What purpose do nerves serve in the breasts? - ANSWER-Intercostal nerves 3, 4 and 5 deal with breast tissue - innervation to the nipple tells the brain to produce oxytocin when breast feeding - emptying of the alveolus tells the breast to make more milk What are Montgomery's Tubercles? - ANSWER-Glands that secrete an antibacterial-like substance that protects the nipples and areola. - found on the nipple and areola - enlarge during pregnancy Lactogenesis 3 - ANSWER-also known as galactopoiesis - the resupply of mature milk that occurs when milk is removed from the breast When does Lactogenesis occur? - ANSWER-day 10-14 postpartum - when mature milk is established - lasts until mom is ready to wean from breastfeeding Lactogenesis 4 - ANSWER-involution - milk production is decreased by apoptosis of the milk making epithelial cells What are the 2 main hormonal influences of breastfeeding? - ANSWER-Prolactin and Oxytocin What is the job of Prolactin? - ANSWER-Milk production Where is prolactin released? - ANSWER-the anterior pituitary gland into the blood stream to the alveoli What is the main inhibitor of prolactin? - ANSWER-progesterone When is prolactin released? - ANSWER-When the placenta detaches, progesterone levels decrease and prolactin levels increase What are some other purposes of prolactin? - ANSWER-- keeps alveoli glued together - inhibits ovulation Remaining fragments of placenta can cause what problem in breastfeeding? - ANSWER-delay/decrease the release of prolactin What is the job of oxytocin? - ANSWER-milk release (the let-down reflex) - tells the myoepithelial cells (and the uterus) to contract and move milk to the ducts and out the breast Where is oxytocin released? - ANSWER-the posterior pituitary gland via many stimuli Name some of the stimuli used to release both Oxytocin and Prolactin - ANSWER-- nipple stretching - massaging the breasts - Seeing/Touching/Smelling/Hearing the infant How often does the let-down reflex occur? - ANSWER-several times during a feeding What are some signs of Prolactin/Oxytocin release? - ANSWER-cramping thirst leaking pins and needles increased bleeding sleepy sometimes, nothing Does stress play a role in hormone release? - ANSWER-stress can inhibit hormonal release - high levels of cortisol/catacholamines reduce oxytocin and prolactin levels List some ways to reduce stress for breastfeeding - ANSWER-remove visitors turn lights out skin to skin sleep massage aroma therapy side lying Supportive statement example to encourage someone to breastfeed - ANSWER-What have you heard about breast feeding? - open ended International Code of Marketing of Breast Milk Substitutes - ANSWER-Must present detailed info on product composition to health care workers Cultural attitude that emphasizes sexual nature of breast due to - ANSWER-harassment of breast feeding in public - cultures that sexualize breast are more often to be resistant Breast reduction - ANSWER-try and see what happens - no assumtions, follow closely b/c ducts could be disrupted accessory nipple or breast tissue is likely to be found - ANSWER-axilla, near umbillicus or inguinal region primary or main immunoglobulin in human milk - ANSWER-IgA - also protects GI tract most variable component of human milk - ANSWER-lipids - proportion of fat in milk increases as breast empties component of human milk destroyed by freezing - ANSWER-macrophages (living cells) effective way to increase milk supply - ANSWER-hand express after feeds - milk synthesis works by supply/demand, most important regulatory mechanism is frequent thorough removal baby is properly latched on when - ANSWER-juncture of hard/soft palates