PCE Certified Breastfeeding Counselor Exam

PCE Certified Breastfeeding Counselor Exam Questions And Actual Answers 3 causes of engorgement - Congestion/ vascularity, accumulation of milk, edema 10 steps for preterm - Informed, milk supply, milk management, oral care, skin to skin, non nutritive suckling, transition to breast, measure milk transfer, prep for discharge Accessory tissue: Where are they found? Can they lactate? - Diagonal line from axilla to groin area. Can lactate and undergo malignant change. B R E A S T assessment - Body position, responses, emotional bonding, anatomy, suckling, time swallowed 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 Breast abscess: what is it, treatment? - Collection of puss d/t mastitis. Surgically drained. Abx, frequent feeds and warm compress. Candidiasis/ thrush: what is it? symptoms? - Overgrowth of fungus in mouth. Infant: No symptoms, red rash at anus, refusal to nurse Mom: Burning, itching, nipple pain, dark color 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. Dancer hand - Hand below breast in U shape. Good for infants w/ poor jaw support. 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. Feeding patterns 24-48 hrs - Cluster feeding, must stimulate breast Flat/ inverted nipples: possible issues and solutions? What is short shank? - Difficulty w/ latch. Nipple shield may help. Short shank= retraction w/ stimulation How does cleft lip/ palate affect breast feeding? - Unable to seal oral cavity/ generate suction. How does poop transform? - Black to green to yellow (by end of first week). Watery and seedy at first 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 How is preterm milk different? - Higher in protein and immune factors How long after cessation of breast feeding does milk production stop? - 40 days How many calories should a lactating mom intake? - . 500 for milk production. How much vitamin D does a baby need? When to supplement - 400/day. Supplement if mom is deficient. How to induce lactation? - Estrogen and progesterone w/ dopamine antagonist. Nipple stimulation for 2 months. How to treat cleft lip/ palate? - Cup, spoon, bottle prn. Monitor hydration/ wt gain. Cross cradle, elevated football, dancer. Semi upright. How to treat engorgement? - -Alt which breast offered first, completely empty breast, reverse pressure softening, compress areola for latch. No pumping. Supportive bra, gentle massage, green cabbage. RICE: rest, ice, ocmpression (bra), elevate