CLC EXAM QUESTIONS WITH COMPLETE
SOLUTION
Breastfeeding contraindications
Galactosemia, PKU, Ebola, HTLV I & II, premature infants (may require
additional kcals, vits, mins), mothers medical conditions, drug use, radiation
treatment.
when are moms most likely to stop BF?
days 3-7 pose the greatest risk of stopping, fastest drop off is within 10
days following hospital discharge
milk ejection reflex (MER)
oxytocin in response to skin to skin, suckling, and interacting with infant;
causes myoepithelial muscle contractions, ducts to dilate, and milk to flow
Lactogenesis I
(second half of pregnancy) Starts in second trimester and beyond. (16
weeks)
- Lactocytes (milk secretory cells) form on basement membrane of
myoepithelial cells in the alveoli (milk factory)
- making of colostrum
Lactogenesis II
(39-96hr PP) Traditional milk. Rapid drop in progesterone allows prolactin
to work, tells body to make lactose. Lactose draws water from surrounding
cells. Closure of space between epithelial cells. Full capacity gathered over
next 5 days.
Lactogenesis III
Galactopesis. Maintenance stage of lactation.
who has highest risk for dirrhea
LBW infants
infant feeding cues
rooting, increased alertness, REM under closed eyelids, flexing of limbs,
mouthing suckling motions, hands to mouth, smacking lips, extending
tongue, sucking on fist, crying (late)
Questions to ask for a breast augmentation
did the surgery alter your nipple?
are the ducts and nipple pores patent?
did the mother report changes in breast size/appearance during
pregnancy?
breast augmentation - what to do
, - watch milk supply closely. May need weight check for first months
- avoid tight bras (recommend tank tops with shelf bras)
- Reassure BF wont affect impants
- talk to MD
- recommend milk expression to optimize production
Breast reduction what to ask
Did the surgery alter nipple sensation?
are the ducts and nipple pores patent?
did the mother report any changes in breast size/appearance during
pregnancy?
breast reduction what to do
watch supply closely. May need weekly weight check for first few months
- consider breast supplementation if needed
- report surgery to MD
- consider milk expression to optimize production
breasts are different in size. what to do
-close follow up
- consider SNS if needed
flat nipple - questions to ask
does the nipple evert with surrounding tissue?
is the nipple flat appearing bc of engorgement or was it flat before delivery?
does the nipple evert when cold or to stimulation?
is the baby able to compress the areola and breast tissue and draw the
nipple into mouth to form a teat?
did the mom get muscle relaxants or excess fluid during labor?
flat nipple - what to do
- if nipple was flat before birth, focus on asymmetric latch. if jaw and bottom
lip reach breast first than nipple is not important
- if flat d/t engorgement than hand express till soft enough for baby
- watch as mom latches off to observe if nipple is evert during BF
- temporarily use nipple shield for 1-2 feedings (avoid long term use)
- nipples become everted over time with BF
inverted nipple what to ask
is this new since birth? (edema around nipple? Area around nipple
engorged?)
does nipple evert to cold/stimulation?
is baby able to compress areola and breast tissue to draw nipple area into
mouth to form the teat?
grade 1 nipple inversion
easily pulled out by suckling or a BP
SOLUTION
Breastfeeding contraindications
Galactosemia, PKU, Ebola, HTLV I & II, premature infants (may require
additional kcals, vits, mins), mothers medical conditions, drug use, radiation
treatment.
when are moms most likely to stop BF?
days 3-7 pose the greatest risk of stopping, fastest drop off is within 10
days following hospital discharge
milk ejection reflex (MER)
oxytocin in response to skin to skin, suckling, and interacting with infant;
causes myoepithelial muscle contractions, ducts to dilate, and milk to flow
Lactogenesis I
(second half of pregnancy) Starts in second trimester and beyond. (16
weeks)
- Lactocytes (milk secretory cells) form on basement membrane of
myoepithelial cells in the alveoli (milk factory)
- making of colostrum
Lactogenesis II
(39-96hr PP) Traditional milk. Rapid drop in progesterone allows prolactin
to work, tells body to make lactose. Lactose draws water from surrounding
cells. Closure of space between epithelial cells. Full capacity gathered over
next 5 days.
Lactogenesis III
Galactopesis. Maintenance stage of lactation.
who has highest risk for dirrhea
LBW infants
infant feeding cues
rooting, increased alertness, REM under closed eyelids, flexing of limbs,
mouthing suckling motions, hands to mouth, smacking lips, extending
tongue, sucking on fist, crying (late)
Questions to ask for a breast augmentation
did the surgery alter your nipple?
are the ducts and nipple pores patent?
did the mother report changes in breast size/appearance during
pregnancy?
breast augmentation - what to do
, - watch milk supply closely. May need weight check for first months
- avoid tight bras (recommend tank tops with shelf bras)
- Reassure BF wont affect impants
- talk to MD
- recommend milk expression to optimize production
Breast reduction what to ask
Did the surgery alter nipple sensation?
are the ducts and nipple pores patent?
did the mother report any changes in breast size/appearance during
pregnancy?
breast reduction what to do
watch supply closely. May need weekly weight check for first few months
- consider breast supplementation if needed
- report surgery to MD
- consider milk expression to optimize production
breasts are different in size. what to do
-close follow up
- consider SNS if needed
flat nipple - questions to ask
does the nipple evert with surrounding tissue?
is the nipple flat appearing bc of engorgement or was it flat before delivery?
does the nipple evert when cold or to stimulation?
is the baby able to compress the areola and breast tissue and draw the
nipple into mouth to form a teat?
did the mom get muscle relaxants or excess fluid during labor?
flat nipple - what to do
- if nipple was flat before birth, focus on asymmetric latch. if jaw and bottom
lip reach breast first than nipple is not important
- if flat d/t engorgement than hand express till soft enough for baby
- watch as mom latches off to observe if nipple is evert during BF
- temporarily use nipple shield for 1-2 feedings (avoid long term use)
- nipples become everted over time with BF
inverted nipple what to ask
is this new since birth? (edema around nipple? Area around nipple
engorged?)
does nipple evert to cold/stimulation?
is baby able to compress areola and breast tissue to draw nipple area into
mouth to form the teat?
grade 1 nipple inversion
easily pulled out by suckling or a BP
