PCE Certified Breastfeeding Counselor Exam QUESTIONS AND ANSWERS 2024

Standards of of practice for CBC - Help families define and achieve goals -Problem solving: Assessment, plan, implementation, evaluation -Education and counseling -Professionalism -Legal considerations What can affect a hc professionals presentation about breastfeeding? -Experience, philosophy, credentials What are responsibilities of staff? -Provide education and foster environment -Baby friendly practices -Evidence based knowledge - Help preterms w/ moms milk or donor -Culturally and developmentally sensitive -WHO growth charts -Legislation International code of marketing substitutes -No advertising -No free sample - Scientific info Not law but should be use Baby friendly 10 steps -Written policy -Proper training -Proper education -Initiation w/in 1 hr -Maintain lactation even if separated -Breastmilk only unless medically required -Rooming in -Cue feeding, 8-12x -No artificial teats -Support groups Where is milk produced? Alveoli How is milk ejected into ducts from alveoli? aka let down Myoepitheal cells encase the aveoli, contract in response to oxytocin. In response to sucking oxytocin increases Different stages of breast development - embryogenesis: Mammary gland while embryo - Mammogenesis: @ puberty, estrogen influences growth of ducts and buds -Lactogensesis 1: Fullness and tenderness while pregnant. Ducts stimulated. Lactogenesis 2: Secretory activation when placenta out. D/t increase of prolactin when progestrone decreases. Lactogenesis 3: Milk removal= production. Infant sucking= oxytocin= let down. How long after cessation of breast feeding does milk production stop? 40 days What happens to estrogen and progesterone during pregnancy and birth? Increase during pregnancy, decreases after birth. Helps development of lobes. Signs of letdown? Tingling, warmth, fullness, dripping, contractions Tail of spence: What is it, symptoms, how to treat Mammary gland tissue that extends to axillary area, connected to milk ducts. = Swollen armpits and mastitis. Treatment: Cold compress, tylenon or motrin Accessory tissue: Where are they found? Can they lactate? Diagonal line from axilla to groin area. Can lactate and undergo malignant change. Flat/ inverted nipples: possible issues and solutions? What is short shank? Difficulty w/ latch. Nipple shield may help. Short shank= retraction w/ stimulation Hypoplasia, what is it? Underdevelopment, insufficient glandular tissue. No changes during pregnancy, insufficient milk. What is breast milk composed of? - Fats: higher in mature milk and evenings -Protein: Casein- allows for iron to be absorbed, mature milk. Whey- early milk, IGA, kills bacteria Carbs: Lactose, makes up alories/ energy. Vitamins: A,D,E,K,C, thiamin, riboflavin, b's. Influenced by mom. Minerals: Calcium, phosphorus, magnesium, not affected by diet. -Mostly water How is preterm milk different? Higher in protein and immune factors Which component of breast milk is most variable? Lipids What component of human milk is destroyed by freezing? Macrophages B R E A S T assessment Body position, responses, emotional bonding, anatomy, suckling, time swallowed When is side lying helpful? Sleepy, lacerations Which position for infant attachment? Laid back aka biological When is australian/ saddle helpful? Active let down Dancer hand Hand below breast in U shape. Good for infants w/ poor jaw support. Signs of milk transfer Swallowing, air from nose, ca sound, movement seen Stages of the magic hour? 9: Birth cry, relaxation, awakening, activity, rest crawling, familiarization, suckling, sleep. Feeding patterns 24-48 hrs Cluster feeding, must stimulate breast How does poop transform? Black to green to yellow (by end of first week). Watery and seedy at first Stomach size at birth? 1-7 ml, 1-2 tsp When should infant stop losing wt? When should infant be back at birth wt Lose weight first 4 days. Back to birthweight by 2-3 wks. What is considered failure to thrive? -<1 month: Loses wt after 10 days doesn't regain birth wt by 3 wks. below 10% at 1 month ->1 month: Below 30%, drop in growth of length and head. Evidence of malnutrition and dehydration. Bad feeds, no milestones. What is the normal wt loss in the first 3-4 days 5-7% How many calories should a lactating mom intake? . 500 for milk production. What type of supplementation should vegans and bariatric patients use? b12 What kinda diet should moms be on? Normal foods. Eat when hungry, drink when thirsty. 50% carb, 15% protein, 20-30 fats How much vitamin D does a baby need? When to supplement 400/day. Supplement if mom is deficient. Cause for sore nipples, how to fix Improper latch, correct position. Open wide mouth, body in straight line, nipple in between two palates. Feed on less tender side, warm compresses.