Certified lactation consultant exam (2023) questions and answers all correct

The World Health Organization and UNICEF have set out three strategies needed for increasing breastfeeding initiation and duration in every country. What are the 3 strategies? Correct answerBreastfeeding Promotion Breastfeeding Protection Breastfeeding Support 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 Correct answerBreastfeeding 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.. Correct answerBreastfeeding Protection Focuses on the interaction of "helpers" with family as well as program development and implementation Correct answerBreastfeeding Support Women how do not breastfeed are at a greater risk for what diseases? Correct answerMyocardial infarction Metabolic syndrome Coronary artery disease Stroke DMII HTN Hyperlipidemia Cardiovascular disease Breast, endometrial, and ovarian cancer Reason #1 why women do not exclusively breastfeed Correct answerUnrealistic expectations from society about motherhood. Along with lack of preparation for what the newborn period would be like. Reason #2 why women do not exclusively breastfeed Correct answerLack of timely interventions. Mother's problems at 3-7 days posed the greatest risk for stopping which is when they are home from the hospital and alone with no support. The fastest drop-off is in the first 10 days following discharge from the hospital The International Code of Marketing of Breast milk Substitutions Correct answerAn international health policy framework to regulate the marketing of breast milk substitutes in order to protect breastfeeding. It was written in response to the marketing activities of the infant feeding industry which were promoting formula feeding over breastfeeding, which in turn was leading to a dramatic increase in maternal and infant morbidity and mortality. What does "The Code" do? Correct answerRegulates the marketing of breast milk substitutes which includes infant formulas and any other food or drink, together with feeding bottles, and teats, intended for babies and young children. Sets standards for the labeling and quality of products and for how the law should be implemented and monitored within countries. Aims to make sure that parental choices on feeding are based on full, impartial information, rather than misleading, inaccurate or biased marketing claims. The Global Strategy for Infant & Young Child Feeding Correct answerIs intended as a guide for action; it identifies interventions with a proven positive impact, it emphasizes providing mothers and families the support they need to carry out their crucial roles, and it explicitly defines the obligations and responsibilities in this regard of governments, international organizations, and other concerned parties. What contributes to low rates of exclusive breastfeeding globally? Correct answerCaregiver and societal beliefs favoring mixed feedings (believing that breast milk is not enough or that babies actions/issues are related to the breast milk/breastfeeding) Hospital and healthcare practices and policies that are not supportive of breastfeeding Lack of adequate skilled support Aggressive promotion of infant formula and other breast milk substitutes rather than promoting support for breastfeeding Inadequate maternity and paternity leave legislation and other workplace policies Lack of knowledge about the dangers of not exclusively breastfeeding and of proper breastfeeding techniques How to support exclusive breastfeeding Correct answerIncrease hospital and health system capacity including revitalizing, expanding, and institutionalizing the babyfriendly hospital initiative in health systems Provide community based strategies including communication campaigns tailored to the local context Strengthen the monitoring, enforcement, and legislation related to "The Code" and subsequent resolutions. Enact at least 6 months paid maternity leave Invest in training and capacity building in breastfeeding protection, promotion, and support What is the role of the pituitary glade in milk making? Correct answerMessages from certain stimulation travels through the breast to the pituitary gland which triggers it to produce prolactin and oxytocin which are two hormones needed to make milk. How in prolactin produced? Correct answerBreast stimulation Nipple stimulation (makes the most) What is the first way oxytocin can be triggered? Correct answerConditioned response/Conditioned Milk Ejection Reflex (Let down). Automatic response that comes with the association of smell, touch, sounds of baby at the breast. Also occurs on babies end with knowing what to do when placed at the breast. What is the second way oxytocin can be triggered? Correct answerNipple stretching that occurs with a proper latch What is a third way oxytocin can be triggered? Correct answerBaby hand massage What does prolactin do? Correct answerEnters receptor sites in the milk making cells and helps produce breastmilk What does oxytocin do? Correct answerAllows for the milk to move from the milk making cells and through the nipple with "contractions" that squeeze the cells and the ducts. CONTACT VIA or Preterm milk Correct answerAppears to have different composition for the first 5-7 weeks after delivery independent of gestational age Preterm milk appears to be higher in protein, fat, and electrolytes than mature milk This is determined by being preterm not just having a small baby therefor it does not matter if the baby is SGA or LGA only dependent of gestational age 1+ year of lactation Correct answerAfter 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 Breast milk composition changes... Correct answerOver 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 Fat content in breast milk Correct answerLonger 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 1 breast or 2? Correct answerThere 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 Lactogenesis 1/Secretory Differentiation Correct answerProduction of colostrum from the placental hormones (progesterone) When placenta delivers the progesterone levels drop to allow for prolactin to take its place in the milk making cells Lactogenesis 2/Secretory Activation Correct answerBegins when progesterone leaves the cells and prolactin enters the receptor sites Milk will be a mix of colostrum and mature milk Lactogenesis 3/Galactopoesis Correct answerLong term production of mature milk Need frequent removal of milk and frequent nipple stimulation to continuously produce milk How does pH of the gut effect babies Correct answerGut 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 iron effect baby's gut Correct answerLow 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 the presence of lactobacillus bifidus affect baby's gut Correct answerPresence 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 Correct answerAntibodies 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 Weight loss in breastfed infant Correct answerNo more than 7% weight loss from with birth weight and no more weight loss by day 5 and should be back to birth weight by 2 weeks Weight loss greater than 7% from birth weight indicates a possible breastfeeding problem and requires more intensive evaluation of breastfeeding and possibly intervention (not supplementation!) to correct problems and improve milk production and transfer What causes infants to lose weight in the first postpartum days Correct answerLabor medications More intrapartum fluids are given, they have more fluid to loss which is a normal process No labor prior to a c-section, maybe they weren't ready to be born How do I know my baby is getting enough milk? Correct answerOne 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 much weight should my baby be gaining Correct answerApproximently 1 ounce per day is expected in the early months by more may be needed for babies with metabolic or respiratory distress because they tend to burn more calories breathing, keeping warm, etc.. Size of the breast relates to the amount of milk produced Correct answerNo!! the proportion of glandular and fat tissue and the number and size of the ducts are not related to milk production Need to drink a lot of fluids to produce a lot of milk Correct answerNo!! There is not enough evidence to support increasing fluid intake beyond what breastfeeding mothers are likely to require to meet their needs Maternal exercise is related to infant weight gain growth Correct answerNo!!