CLC SECTION 3A & 3B QUESTIONS WITH
UPDATED ANSWERS 2025 - 2026
Lactation,Counseling,ANS,--observe,,explore,,and,coach
-parents,,baby,,&,other,family,members,know,more,about,their,situation,&,resources,than,we,do
-
our,job,to,observe,,collect,info,,&,explore,mature,of,presenting,issues,,&,to,coach,families,regarding,feedi
ng,&,nurturing,their,babies
-
as,we,seek,to,understand,the,nature,of,the,presenting,issues,,other,problems,&,concerns,may,be,uncover
ed
-
in,our,conceptual,framework,,problems,&,symptoms,are,not,the,same,thing,(for,example,,pain,w/,BF,is,a,s
ymptom,of,a,different,problem,perhaps,a,poor,latch)
-
thru,BF,counseling,we,seek,to,ID,the,true,nature,of,the,underlying,problems,rather,than,only,removing,th
e,presenting,symptoms
-
once,we,have,gathered,enough,info,about,the,nature,of,the,problems,at,hand,,we,can,formulate,potentia
l,solutions,&,propose,them,to,the,family
-it,is,up,to,the,family,to,choose,the,solutions,they,are,willing,to,implement,&,to,carry,them,out
-it's,our,responsibility,to,provide,info,&,suggestions,in,an,open,,transparent,,non-
judgmental,manner,,IDing,strategies,that,may,be,useful,for,the,family,,sharing,pros,&,cons,of,IDed,strategi
es,,all,in,full,acknowledgement,that,the,family,will,make,the,final,determination,regarding,what,actions,to
,take,,if,any,,to,address,IDed,challenges
-
it's,our,responsibility,to,refer,families,for,additional,clinical,support,or,other,eval,as,needed,,if,it,is,not,avai
lable,at,our,workplace,or,within,our,scope,of,practice
-it's,our,responsibility,to,ensure,adequate,follow,up,for,IDed,BF,problems
Normal,BF,ANS,--should,be,enjoyable,experience
-shouldnt,have,pain,or,discomfort,,but,they,are,common
-
follow,feeding,cues,signaled,by,REM,,bringing,fist,to,mouth,,seeking,food,w/,lips,tongue,&,head,,smack,lip
s,,extend,tongue
,-crying,is,late,feeding,cue
Getting,Started,w/,BF,ANS,--
in,first,hours,and,days,the,dyad,learn,to,BF,together,and,move,gradually,from,self-
attached,BF,to,collaborative,BF
-each,dyad,moves,in,a,unique,pattern:,one,feed,may,be,self-attachment,and,the,next,collaborative
-BF,moves,into,more,collaborative,after,baby,is,able,to,locate,the,breast
-both,will,become,more,&,more,comfortable,w/,collaborative,feeding,as,they,learn,together
-baby's,arms,should,not,cross,over,his/her,body,,but,should,embrace,the,breast
-baby's,hands,knead,breast,while,suckling,,do,not,swaddle,hands,away
-
shouldn't,be,pain,while,nursing;,after,feed.,nipple,shouldn't,be,misshapen,,abraded,,fissured,,bruised,,or,
blanched
-if,there,is,pain,,baby,should,be,gently,removed,and,allowed,to,relatch
Self-Attached,BF,ANS,--healthy,baby,should,be,dried,after,birth,&,placed,on,chest,for,prolonged,S2S
-dyad,covers,w/,warm,blanket
-mom,&,newborn,assessment,,eye,care,,&,other,procedures,are,done,w/,baby,in,S2S
-
babies,warm,better,in,S2S,compared,to,electric,warmers,(breasts,will,increase,and,decrease,in,temp,accor
ding,to,baby's,needs),
-
allow,newborn,baby,to,find,breast,&,self,attach.,This,may,take,more,than,2,hours,when,labor,analgesia,ha
s,been,used;,do,not,force,baby,to,breast,,doing,so,may,stress,baby,,decrease,willingness,,&,cause,baby,to,
place,tongue,on,roof,of,mouth
S2S,9,Distinct,Behaviors,in,Prep,for,Feeding,ANS,--birth,cry
-relaxation
-awakening
-activity
-rest
-crawling/sliding
,-familiarization
-suckling
-sleeping
Collaborative,BF,ANS,--as,the,baby,seeks,the,breast,the,parent,gently,assists
Sequence,of,Successful,Feeding,ANS,--
newborn,held,S2S,or,close,to,breast,so,feeding,cues,may,be,observed
-when,baby,has,cues,,baby,is,brought,to,breast
-
breast,should,be,at,normal,angle,(not,held,or,shaped,w/,hand;,if,large,breast,put,rolled,up,towel,under,br
east,,do,not,fold,breast,upward,to,see,the,nipple)
-
collaborative,BF,may,bb,initiated,when,baby,exhibits,appropriate,cues:,rooting,,increasing,alertness/REM,
,flexing,of,legs,&,arms,,mouthing,w/,little,sucking,motions,,attempting,to,bring,hand,to,mouth,,sucking,on,
fist,or,finger,,mouthing,motions,of,lips,and,tongue
-
crying,is,late,feeding,cue,because,it,does,not,usually,begin,in,full,term,babies,until,more,subtle,cues,have,f
ailed,to,elicit,the,parents,attention
-less,mature,&,more,disorganized,babies,may,pass,quickly,from,deep,sleep,(no,REM),to,crying
-
when,using,collaborative,BF,strategy,,baby,is,supported,by,the,frame,of,the,parent's,body,which,provides,
support,needed,to,keep,the,baby,at,the,breast,
-parent,finds,a,comfortable,posture,&,makes,breast,accessible,to,baby
-baby,is,allowed,the,freedom,to,achieve,pain-free,suckling,w/,maximal,milk,transfer
-
BF,sessions,are,best,ended,by,the,baby,,when,feeding,ends,baby,is,relaxed,,hands,are,open,,arms,are,flop
py,,brow,is,smooth,,toes,are,curled
Baby,Position,At,Breast,For,Maximal,Milk,Transfer,ANS,--baby,is,near,breast
-baby's,shoulders,are,supported,at,base,of,the,neck
-no,pressure,on,back,of,baby's,head,,baby,must,be,able,to,tilt,head
-baby's,body,rotated,toward,parent's,chest,(tummy,to,mummy)
, -baby,moved,towards,breast,,lining,up,nose,at,nipple
-breast,is,not,moved,to,baby;,breast,should,lie,in,natural,position,&,baby,be,brought,to,breast
-start,feed,w/,nose,opposite,nipple,assists,baby,to,orient,to,breast,via,well-
developed,sense,of,smell,&,aligns,mouth,at,breast,when,baby's,head,tilts,back
-
as,baby,chin,comes,closer,to,breast,,he,will,gape,,opening,mouth,very,wide,as,head,tilts,back,(if,baby,fails,
to,gape,,repeat,this,maneuver)
-consider,additional,S2S,to,improve,baby's,motor,state,organization,for,baby,who,fails,to,gape,or,nurse
-
do,not,push,nipple,into,baby's,mouth,,doing,this,can,result,in,optimal,positioning,of,nipple,or,appropriate,
compression,&,release,of,breast,&,nipple,tissue,(can,cause,pain,,damage,,&,slow,flow,of,milk)
-head,tilt,allows,lower,lip,to,seal,to,breast,first,followed,by,upper,lip
-baby's,mouth,will,appear,off-
center,when,compared,w/,areola,,baby's,lower,lip,will,be,against,breast,much,father,from,nipple,than,upp
er,lip,(asymmetric,latch)
-
baby,seals,to,breast,&,begins,to,suck,rapidly,(could,be,8,or,more,sucks,to,1,swallow),,then,shifts,into,patte
rn,of,2,sucks,to,1,swallow,or,1,suck,to,1,swallow
-
2:1,or,1:1,suck,to,swallow,is,a,time,of,greater,milk,transfer;,these,are,interspersed,w/,more,rapid,sucking,s
equences,&,occasional,rest,periods
-
after,colostral,stage,,baby,can,transfer,several,oz,of,milk,in,very,few,minutes,when,appropriately,latched,
&,hungry
-
there,is,no,right,length,of,feed,to,ensure,adequate,milk,transfer,,however,babies,with,consistently,short,(
<5,min),or,long,(>20,min),feeds,should,be,assessed,to,ensure,adequate,milk,transfer
Proof,of,Success,of,BF,Baby,ANS,--baby,who,is,responsive,&,interactive
-growing,well,(about,an,oz,a,day,after,5th,day)
-producing,at,least,6,wet,and,4,dirty,diapers,starting,on,day,4,and,continuing,into,the,early,weeks
Concern:,Baby,Won't,Latch:,Feeding,Refusal,That,is,Continuous,ANS,--
baby,refuses,to,feed,from,breast;,baby,won't,latch,,or,will,&,immediately,pull,off,&,cry
UPDATED ANSWERS 2025 - 2026
Lactation,Counseling,ANS,--observe,,explore,,and,coach
-parents,,baby,,&,other,family,members,know,more,about,their,situation,&,resources,than,we,do
-
our,job,to,observe,,collect,info,,&,explore,mature,of,presenting,issues,,&,to,coach,families,regarding,feedi
ng,&,nurturing,their,babies
-
as,we,seek,to,understand,the,nature,of,the,presenting,issues,,other,problems,&,concerns,may,be,uncover
ed
-
in,our,conceptual,framework,,problems,&,symptoms,are,not,the,same,thing,(for,example,,pain,w/,BF,is,a,s
ymptom,of,a,different,problem,perhaps,a,poor,latch)
-
thru,BF,counseling,we,seek,to,ID,the,true,nature,of,the,underlying,problems,rather,than,only,removing,th
e,presenting,symptoms
-
once,we,have,gathered,enough,info,about,the,nature,of,the,problems,at,hand,,we,can,formulate,potentia
l,solutions,&,propose,them,to,the,family
-it,is,up,to,the,family,to,choose,the,solutions,they,are,willing,to,implement,&,to,carry,them,out
-it's,our,responsibility,to,provide,info,&,suggestions,in,an,open,,transparent,,non-
judgmental,manner,,IDing,strategies,that,may,be,useful,for,the,family,,sharing,pros,&,cons,of,IDed,strategi
es,,all,in,full,acknowledgement,that,the,family,will,make,the,final,determination,regarding,what,actions,to
,take,,if,any,,to,address,IDed,challenges
-
it's,our,responsibility,to,refer,families,for,additional,clinical,support,or,other,eval,as,needed,,if,it,is,not,avai
lable,at,our,workplace,or,within,our,scope,of,practice
-it's,our,responsibility,to,ensure,adequate,follow,up,for,IDed,BF,problems
Normal,BF,ANS,--should,be,enjoyable,experience
-shouldnt,have,pain,or,discomfort,,but,they,are,common
-
follow,feeding,cues,signaled,by,REM,,bringing,fist,to,mouth,,seeking,food,w/,lips,tongue,&,head,,smack,lip
s,,extend,tongue
,-crying,is,late,feeding,cue
Getting,Started,w/,BF,ANS,--
in,first,hours,and,days,the,dyad,learn,to,BF,together,and,move,gradually,from,self-
attached,BF,to,collaborative,BF
-each,dyad,moves,in,a,unique,pattern:,one,feed,may,be,self-attachment,and,the,next,collaborative
-BF,moves,into,more,collaborative,after,baby,is,able,to,locate,the,breast
-both,will,become,more,&,more,comfortable,w/,collaborative,feeding,as,they,learn,together
-baby's,arms,should,not,cross,over,his/her,body,,but,should,embrace,the,breast
-baby's,hands,knead,breast,while,suckling,,do,not,swaddle,hands,away
-
shouldn't,be,pain,while,nursing;,after,feed.,nipple,shouldn't,be,misshapen,,abraded,,fissured,,bruised,,or,
blanched
-if,there,is,pain,,baby,should,be,gently,removed,and,allowed,to,relatch
Self-Attached,BF,ANS,--healthy,baby,should,be,dried,after,birth,&,placed,on,chest,for,prolonged,S2S
-dyad,covers,w/,warm,blanket
-mom,&,newborn,assessment,,eye,care,,&,other,procedures,are,done,w/,baby,in,S2S
-
babies,warm,better,in,S2S,compared,to,electric,warmers,(breasts,will,increase,and,decrease,in,temp,accor
ding,to,baby's,needs),
-
allow,newborn,baby,to,find,breast,&,self,attach.,This,may,take,more,than,2,hours,when,labor,analgesia,ha
s,been,used;,do,not,force,baby,to,breast,,doing,so,may,stress,baby,,decrease,willingness,,&,cause,baby,to,
place,tongue,on,roof,of,mouth
S2S,9,Distinct,Behaviors,in,Prep,for,Feeding,ANS,--birth,cry
-relaxation
-awakening
-activity
-rest
-crawling/sliding
,-familiarization
-suckling
-sleeping
Collaborative,BF,ANS,--as,the,baby,seeks,the,breast,the,parent,gently,assists
Sequence,of,Successful,Feeding,ANS,--
newborn,held,S2S,or,close,to,breast,so,feeding,cues,may,be,observed
-when,baby,has,cues,,baby,is,brought,to,breast
-
breast,should,be,at,normal,angle,(not,held,or,shaped,w/,hand;,if,large,breast,put,rolled,up,towel,under,br
east,,do,not,fold,breast,upward,to,see,the,nipple)
-
collaborative,BF,may,bb,initiated,when,baby,exhibits,appropriate,cues:,rooting,,increasing,alertness/REM,
,flexing,of,legs,&,arms,,mouthing,w/,little,sucking,motions,,attempting,to,bring,hand,to,mouth,,sucking,on,
fist,or,finger,,mouthing,motions,of,lips,and,tongue
-
crying,is,late,feeding,cue,because,it,does,not,usually,begin,in,full,term,babies,until,more,subtle,cues,have,f
ailed,to,elicit,the,parents,attention
-less,mature,&,more,disorganized,babies,may,pass,quickly,from,deep,sleep,(no,REM),to,crying
-
when,using,collaborative,BF,strategy,,baby,is,supported,by,the,frame,of,the,parent's,body,which,provides,
support,needed,to,keep,the,baby,at,the,breast,
-parent,finds,a,comfortable,posture,&,makes,breast,accessible,to,baby
-baby,is,allowed,the,freedom,to,achieve,pain-free,suckling,w/,maximal,milk,transfer
-
BF,sessions,are,best,ended,by,the,baby,,when,feeding,ends,baby,is,relaxed,,hands,are,open,,arms,are,flop
py,,brow,is,smooth,,toes,are,curled
Baby,Position,At,Breast,For,Maximal,Milk,Transfer,ANS,--baby,is,near,breast
-baby's,shoulders,are,supported,at,base,of,the,neck
-no,pressure,on,back,of,baby's,head,,baby,must,be,able,to,tilt,head
-baby's,body,rotated,toward,parent's,chest,(tummy,to,mummy)
, -baby,moved,towards,breast,,lining,up,nose,at,nipple
-breast,is,not,moved,to,baby;,breast,should,lie,in,natural,position,&,baby,be,brought,to,breast
-start,feed,w/,nose,opposite,nipple,assists,baby,to,orient,to,breast,via,well-
developed,sense,of,smell,&,aligns,mouth,at,breast,when,baby's,head,tilts,back
-
as,baby,chin,comes,closer,to,breast,,he,will,gape,,opening,mouth,very,wide,as,head,tilts,back,(if,baby,fails,
to,gape,,repeat,this,maneuver)
-consider,additional,S2S,to,improve,baby's,motor,state,organization,for,baby,who,fails,to,gape,or,nurse
-
do,not,push,nipple,into,baby's,mouth,,doing,this,can,result,in,optimal,positioning,of,nipple,or,appropriate,
compression,&,release,of,breast,&,nipple,tissue,(can,cause,pain,,damage,,&,slow,flow,of,milk)
-head,tilt,allows,lower,lip,to,seal,to,breast,first,followed,by,upper,lip
-baby's,mouth,will,appear,off-
center,when,compared,w/,areola,,baby's,lower,lip,will,be,against,breast,much,father,from,nipple,than,upp
er,lip,(asymmetric,latch)
-
baby,seals,to,breast,&,begins,to,suck,rapidly,(could,be,8,or,more,sucks,to,1,swallow),,then,shifts,into,patte
rn,of,2,sucks,to,1,swallow,or,1,suck,to,1,swallow
-
2:1,or,1:1,suck,to,swallow,is,a,time,of,greater,milk,transfer;,these,are,interspersed,w/,more,rapid,sucking,s
equences,&,occasional,rest,periods
-
after,colostral,stage,,baby,can,transfer,several,oz,of,milk,in,very,few,minutes,when,appropriately,latched,
&,hungry
-
there,is,no,right,length,of,feed,to,ensure,adequate,milk,transfer,,however,babies,with,consistently,short,(
<5,min),or,long,(>20,min),feeds,should,be,assessed,to,ensure,adequate,milk,transfer
Proof,of,Success,of,BF,Baby,ANS,--baby,who,is,responsive,&,interactive
-growing,well,(about,an,oz,a,day,after,5th,day)
-producing,at,least,6,wet,and,4,dirty,diapers,starting,on,day,4,and,continuing,into,the,early,weeks
Concern:,Baby,Won't,Latch:,Feeding,Refusal,That,is,Continuous,ANS,--
baby,refuses,to,feed,from,breast;,baby,won't,latch,,or,will,&,immediately,pull,off,&,cry
