IBCLC review Exam questions and answers 2024 already graded A+

What week gestation does the breast begin to develop in utero? 4th week of gestation Where does the primitive milk streak develop Bilaterally from the axilla to the groin By the 5th week gestation the milk streak becomes what? Mammary Milk Ridge (or milk line) Thickening and inward growth into the chest wall continues during what weeks gestation? 7-8 weeks gestation Between weeks 12 and 16 gestation specialized cells differentiate into what? Smooth muscles of the nipple and areola What forms the mammary pit? Lactiferous ducts and their branches open into a shallow epithelial depression What failure creates an inverted nipple? When the Mammary pit fails to elevate What is witches milk? After birth, a neonate's mammary tissue (under the influence of maternal hormones) might recreate colostral like fluid At what age do the primary and secondary ducts grow and divide and form the terminal end buds that become the alveoli? 10-12 years old (puberty) When does complete development of mammary function occur? During pregnancy What is superficial fiscia? Fibrous tissue beneath the skin Where is the breast located? In the superficial fascia between the 2nd rib and 6th ICS What are the two major divisions of the breast? Parenchyma and Stroma What makes up the Parenchyma? Ducts, lobes, and aveoli What are alveoli? Small sacs where milk is secreted What makes up the Stroma? Connective and fat tissue, blood vessels, nerves, and lymphatics. What is Cooper's Ligament? Suspensory ligament that are the fibrous connections between the inner side of the breast skin and pectoral muscles. Help to shape the breasts What does the nipple contain? 15-25 milk ducts, smooth muscle fibers, sebaceous and apocrine sweat glands, and dense innervations of sensory nerve endings How many milk ducts does the nipple contain? 15-25 What are Montgomery Tubercles? Sebaceous glands in the areola surrounding the nipple What do the Montgomery Tubercles secrete? Oily secretions (lipoid fluid) to keep the areola and the nipple lubricated and protected What 2 arteries supply blood to the breast (60% / 30%)? Internal mammary artery (60%) and lateral thoracic artery (30%) Where does the lymphatic system of the breast drain excess fluids from tissue space, bacteria and cast off cells? Auxiliary lymph node Where do the nerves of the breast branch from? 4th, 5th, and 6th intercostal nerve What nerve supplies the greatest amount of sensation to the areola? 4th intercostal nerve What part of the breast is most sensitive? The areola followed by the general skin of the breast, and then the nipple which is least sensitive. What percent of breast milk is carbohydrates? Approximately 7% What are the six infant behavioral "states" Crying Active alert=fussy Quiet alert=ready to play Drowsy= irreg. breathing, heavy eyes Active sleep= eye movement under lids, twitching Quiet sleep= reg resp. relaxed, diff. to wake Milk components that protect the infant/lactating breast actively bind ______, preventing their passage through the permeable infant _____ _____ pathogens gut mucosa How does the infant get the antibodies produced by mom? antibodies are produced in moms blood, targeted SIgA which is transported across the mammary secretory cells and released in the milk. What is sIgA? Immunoglobulin A is an antibody that coats mucosal surfaces to prevent adherence and penetration by pathogens What are the most common food allergies? 1. Cow's milk protein 2. Eggs 3. Peanuts 4. Tree nuts 5. Fish 6. Shellfish 7. Soy 8. Wheat What are the common symptoms of food allergies? 1. Eczema 2. Hives 3. Digestive or respiratory problems (e.g. mucus or blood in the stool) The infant uses their _____ to draw in the nipple and ____ it in the mouth Lips Stabilize Weak lip tone is also called? Hypotonic lips result in the inability to seal lips around the breast impacting the amount of suction created What is a sucking blister? What are 2 things it can be caused by? friction abrasions resulting from retracted lips or a labial frenulum that restricts the lips from flanging What does weak lip tone look like? Milk spilling, smacking sound (breaking suction), infant tires faster due to increased work of the feedings even though they aren't efficient feedings Things to look for when assessing the lips: Seal Tone Stretchy labial frenulum No breaks in suction No milk spilling What do fat deposits in the cheeks help provide? structural support to stabilize nipple in the mouth Does low/weak tone cause the infant to have higher or lower levels of suction? lower levels of suction What does Hypotonia mean? Low tone What does it mean if an infant has thin cheeks due to reduced fat pads? That the infants intraoral space is larger than normal, forcing them to create a larger vacuum to generate and sustain suction. So the work for a feeding increases What does the dancer's hand help with? Cheek stability What does the jaw provide stability for? Tongue, lips, and cheeks Almost all babies have ___ jaws receding Preterm infants usually have jaw instability because of what 2 things? Low muscle tone Immature muscles What is micrognathia? abnormally receding chin (can happen in certain breach positions) What is Pierre Robin Syndrome? Severe micrognathia ( receding chin) that can obstruct the airway How do you help with nipple pain if a baby has a receding jaw? Tip the infants head in a slightly extended position to bring the chin closer to the breast Abnormally wide jaw excursions can cause a ____ in ____ break in suction What are some methods to help during a feeding with an abnormality in the jaw? 1. provide external support with a finger placed under the jaw to help with distance of jaw excursions 2. Position infant so head is extended up to help lower jaw extend to breast 3. find a position that is comfortable for mom and baby to help with jaw stability