Certified Lactation Counselor
QUESTIONS AND ANSWERS|
GRADED A
Predominant Breastfeeding Correct Answer: Babies who receive breastmilk and
other liquids (e.g. water, minerals, vitamins, oral meds).
Breastfeeding Correct Answer: Baby receives human milk, as well as other foods
or fluids, including formula.
Complementary Feeding Correct Answer: Process starts when BM alone or
infant formula alone is no longer sufficient to meet nutritional requirements of
infants, therefore other foods or liquids are introduced. Typically child is between
6-23 months
3 strategies for increasing BF initiation and duration Correct Answer: Promotion,
Protection, Support
Promotion Correct Answer: Focuses on advantages of BF on a personal,
community, country, or global level. BF to the community.
Protection Correct Answer: Focuses on government, manufacturer, and social
responsibility to assure BF ability to compete with commercial interests.
Includes state, local, an national laws regarding BF.
International Code of Marketing of Breast-milk Subsitutes Correct Answer:
Addresses improper marketing practices by formula companies. It is not currently
a law in the US.
What does the International Code Prohibit? Correct Answer: Distributing free
formula
Giving coupons for formula
,What did the AAP resolution state in regards to the International Code? Correct
Answer: No distributing formula, discharge bags, industry written handouts.
Support Correct Answer: Focuses on interaction of helpers with family, as well
as program development and implementation.
10 steps to successful BF Correct Answer: 1. Written BF policy. Skin to Skin
immediately after birth.
2. Train healthcare staff
3. Inform pregnant women about benefits and management of BF
4. Help all mothers initiate BF within 1 hour after birth
5. Show mother's how to BF and maintain lactation
6. Exclusive breast milk only
7. Practice rooming in 24 hours a day
8. Encourage BF on demand
9. No artificial teats or pacifiers
10. Establishment of BF support groups
Healthcare staff responsibility for working with lactating mothers include what?
Correct Answer: 1. Training
2. Minimum of 20 hours of training
3. 3 hours of competency verification
What are the indications for providing supplementation other than breast milk?
Correct Answer: 1. Medical condition
2. Parents request after being informed of consequences
Protocol for calculating Baby's daily needs Correct Answer: Baby's weight x 2.5
(2.7 or 3.0 if Baby needs to catch up weight) = daily ounces. PCP decides what
the multiplier is!!!
What should be assessed 3-5 days after birth by PCP? Correct Answer: Hydration
(elimination patterns)
Body weight (no more than 7% loss)
Observe Feeding
Maternal or infant issues
,What is a CLC? Correct Answer: Nationally recognized designation awarded by
the ALPP. Practice parameters are designated by professional scope of practice.
How many stools per day should a breast fed newborn have? Correct Answer: 4,
some yellow by day 4.
When should a baby be back to birth weight? Correct Answer: 12-14 days post
birth
How much weight should a baby gain daily? Correct Answer: Approximately 1
ounce
Why do women supplement with formula when there is no medical need? Correct
Answer: 1. Lack of preparation for what the newborn period would be like.
2. Lack of timely interventions
Alveoli Correct Answer: Small glands in the breast that produce milk
At-Breast Supplementer Correct Answer: a device that allows a supplement to be
given while a baby is actively nursing at the breast,
ex: Supplement Nursing System
Atopy Correct Answer: hypersensitive or allergic state involving an inherited
predisposition
What is the BFHI Baby Friendly Hospital Initiative Correct Answer: Initiative by
UNICEF and WHO (1991) to support breastfeeding in hospitals and maternity
centers. "The 10 Steps".
Unicef. Baby-Friendly Hospital Initiative. Available online:
http://www.unicef.org/programme/breastfeeding/baby.htm.
Bilirubin Correct Answer: an orange-yellow pigment formed in the liver by the
breakdown of hemoglobin and excreted in bile.
CCK (cholecystokinin) Correct Answer: Hormone that regulates the emptying of
the gallbladder and secretion of enzymes by the pancreas.
, Colostrum Correct Answer: Thick, milky fluid secreted by the breast during
pregnancy and during the first days after birth before lactation begins. Causes a
laxative effect which helps the baby pass meconium.
Coryllos type Correct Answer: Classification system for anklyloglossia (tongue-
tie)
Dancer Hand Position Correct Answer: Technique used to support Baby's chin
and mother's breast. Use Thumb and index finger under chin, remaining 3 fingers
to support breast.
Alveolar Cells Correct Answer: found in the walls of the alveoli, simple
squamous epithelial cells, main sites of gas exchange
myoepithelial cells Correct Answer: contract in response to stimulation by
sympathetic nervous system and squeeze milk up the duct
Montgomery glands Correct Answer: Bumps on breasts (Look like goosebumps)
Produce a unique blend of milk and sebum (skin oil)
Modern study of the structure of the breast reveals what? Correct Answer: -Fat is
mixed throughout the breast
-Uneven spacing of the ducts
-3-5 functioning nipple pores (May have 5-9, but not all work)
-No lactiferous sinus
What are the 2 hormones pathways that control lactation? Correct Answer:
Prolactin and Oxytocin
Prolactin (4 details related to milk production) Correct Answer: 1. is triggered by
touch (pregnant and non pregnant women). Higher levels when stimulating
breast/nipples vs breast alone.
2. Lengthening time between feeding leads to lower baseline levels. (Weaning)
3. levels go down between nursings and rise during nursing.
4. Infrequent nursing leads to lowering of this hormone
Average number of feeds in a day? Correct Answer: 8-12
QUESTIONS AND ANSWERS|
GRADED A
Predominant Breastfeeding Correct Answer: Babies who receive breastmilk and
other liquids (e.g. water, minerals, vitamins, oral meds).
Breastfeeding Correct Answer: Baby receives human milk, as well as other foods
or fluids, including formula.
Complementary Feeding Correct Answer: Process starts when BM alone or
infant formula alone is no longer sufficient to meet nutritional requirements of
infants, therefore other foods or liquids are introduced. Typically child is between
6-23 months
3 strategies for increasing BF initiation and duration Correct Answer: Promotion,
Protection, Support
Promotion Correct Answer: Focuses on advantages of BF on a personal,
community, country, or global level. BF to the community.
Protection Correct Answer: Focuses on government, manufacturer, and social
responsibility to assure BF ability to compete with commercial interests.
Includes state, local, an national laws regarding BF.
International Code of Marketing of Breast-milk Subsitutes Correct Answer:
Addresses improper marketing practices by formula companies. It is not currently
a law in the US.
What does the International Code Prohibit? Correct Answer: Distributing free
formula
Giving coupons for formula
,What did the AAP resolution state in regards to the International Code? Correct
Answer: No distributing formula, discharge bags, industry written handouts.
Support Correct Answer: Focuses on interaction of helpers with family, as well
as program development and implementation.
10 steps to successful BF Correct Answer: 1. Written BF policy. Skin to Skin
immediately after birth.
2. Train healthcare staff
3. Inform pregnant women about benefits and management of BF
4. Help all mothers initiate BF within 1 hour after birth
5. Show mother's how to BF and maintain lactation
6. Exclusive breast milk only
7. Practice rooming in 24 hours a day
8. Encourage BF on demand
9. No artificial teats or pacifiers
10. Establishment of BF support groups
Healthcare staff responsibility for working with lactating mothers include what?
Correct Answer: 1. Training
2. Minimum of 20 hours of training
3. 3 hours of competency verification
What are the indications for providing supplementation other than breast milk?
Correct Answer: 1. Medical condition
2. Parents request after being informed of consequences
Protocol for calculating Baby's daily needs Correct Answer: Baby's weight x 2.5
(2.7 or 3.0 if Baby needs to catch up weight) = daily ounces. PCP decides what
the multiplier is!!!
What should be assessed 3-5 days after birth by PCP? Correct Answer: Hydration
(elimination patterns)
Body weight (no more than 7% loss)
Observe Feeding
Maternal or infant issues
,What is a CLC? Correct Answer: Nationally recognized designation awarded by
the ALPP. Practice parameters are designated by professional scope of practice.
How many stools per day should a breast fed newborn have? Correct Answer: 4,
some yellow by day 4.
When should a baby be back to birth weight? Correct Answer: 12-14 days post
birth
How much weight should a baby gain daily? Correct Answer: Approximately 1
ounce
Why do women supplement with formula when there is no medical need? Correct
Answer: 1. Lack of preparation for what the newborn period would be like.
2. Lack of timely interventions
Alveoli Correct Answer: Small glands in the breast that produce milk
At-Breast Supplementer Correct Answer: a device that allows a supplement to be
given while a baby is actively nursing at the breast,
ex: Supplement Nursing System
Atopy Correct Answer: hypersensitive or allergic state involving an inherited
predisposition
What is the BFHI Baby Friendly Hospital Initiative Correct Answer: Initiative by
UNICEF and WHO (1991) to support breastfeeding in hospitals and maternity
centers. "The 10 Steps".
Unicef. Baby-Friendly Hospital Initiative. Available online:
http://www.unicef.org/programme/breastfeeding/baby.htm.
Bilirubin Correct Answer: an orange-yellow pigment formed in the liver by the
breakdown of hemoglobin and excreted in bile.
CCK (cholecystokinin) Correct Answer: Hormone that regulates the emptying of
the gallbladder and secretion of enzymes by the pancreas.
, Colostrum Correct Answer: Thick, milky fluid secreted by the breast during
pregnancy and during the first days after birth before lactation begins. Causes a
laxative effect which helps the baby pass meconium.
Coryllos type Correct Answer: Classification system for anklyloglossia (tongue-
tie)
Dancer Hand Position Correct Answer: Technique used to support Baby's chin
and mother's breast. Use Thumb and index finger under chin, remaining 3 fingers
to support breast.
Alveolar Cells Correct Answer: found in the walls of the alveoli, simple
squamous epithelial cells, main sites of gas exchange
myoepithelial cells Correct Answer: contract in response to stimulation by
sympathetic nervous system and squeeze milk up the duct
Montgomery glands Correct Answer: Bumps on breasts (Look like goosebumps)
Produce a unique blend of milk and sebum (skin oil)
Modern study of the structure of the breast reveals what? Correct Answer: -Fat is
mixed throughout the breast
-Uneven spacing of the ducts
-3-5 functioning nipple pores (May have 5-9, but not all work)
-No lactiferous sinus
What are the 2 hormones pathways that control lactation? Correct Answer:
Prolactin and Oxytocin
Prolactin (4 details related to milk production) Correct Answer: 1. is triggered by
touch (pregnant and non pregnant women). Higher levels when stimulating
breast/nipples vs breast alone.
2. Lengthening time between feeding leads to lower baseline levels. (Weaning)
3. levels go down between nursings and rise during nursing.
4. Infrequent nursing leads to lowering of this hormone
Average number of feeds in a day? Correct Answer: 8-12
