Lactation Education Questions and Answers

Lactation Education Questions and Answers A 28-year-old woman who is six months pregnant with her first child comes in for her regular prenatal clinic visit with complaints that both breasts are oozing a thick, yellowish-white fluid. She has been receiving regular prenatal care, and the pregnancy has been uncomplicated. She is concerned about the new discharge. What would be the midwife's best response to her concerns? Sounds like you are worried about this fluid leaking from your breasts. It is called colostrum and it is a normal sign that your breasts are preparing to produce milk. Many pregnant parents leak some colostrum at this time in the pregnancy. Now that you know what the fluid is, what other questions do you have? The CDC invites all hospitals & maternity services across the US to complete a survey that focuses on specific parts of hospital maternity care that affect how babies are fed. This survey is called _______________. the Maternity Practices in Infant Nutrition and Care survey. The two hormones that are elevated during lactation and important for milk production and release are: Oxytocin and prolactin The pituitary gland is: a small rounded body at the base of the brain that secretes prolactin and stores and releases oxytocin. The American Academy of Pediatrics(AAP) recommends that babies are breast/chest fed: Correct answer: exclusively for about 6 mths, with the introduction of solids after that, and continuation of breastfeeding for 1 yr or longer as mutually desired by mother and infant. Supernumerary nipples are most likely to be found in which of the following areas? Near the umbilicus Which of the following is one of the provisions in the WHO Code, also known as the International Code? No free samples of breast milk substitutes to be given to pregnant women, mothers or their families. At a prenatal breastfeeding class Anna tells you that she has very small breasts, and is worried that she won't make enough milk for her baby. What would be your best response to her concern? Correct answer: Many mothers worry about making enough milk. Most mothers are able to produce enough milk. Tell me more about your concerns. Ghrelin is found in high levels in human and is: Correct answer: a peptide hormone known as the "hunger hormone" because it signals feelings of hunger and is higher in foremilk than hindmilk. Oligosaccharides are: Correct answer: antimicrobials found in human milk that are resistant to being digested and thus serve as prebiotics to populate the infant colon. The World Health Organization(WHO) recommends that babies are breast/chest fed: for 2 yrs, with the introduction of appropriate solid foods after 6 months. As a mother breastfeeds for more weeks/months, milk production becomes dependent on which of the following factors? the frequency and degree of breast drainage The stage of breast development known as Secretory Activation refers to: Stage II lactogenesis which occurs at 2-5 days postpartum when the colostral phase ends and transitional milk is produced. To obtain Baby Friendly designation, a birth facility must: complete an internal self-assessment, have an assessment by outside evaluators, and review a presentation of the findings by UNICEF. A reassessment should be done regularly. Prolactin is: a hormone produced in the placenta and the anterior pituitary gland in the brain. After birth levels increase in response to suckling stimulation. The amount on fat a healthy, breastfed infant receives at a feeding is notinfluenced by: the number of minutes that the baby breastfeeds on each side What is the USA's current position on the WHO Code/International Code? While the US has signed onto the Code, no legislation or enforceable regulations have been enacted nationally. When compared to mature milk, colostrum has about three times more: Protein After a good breastfeeding session an infant is often drowsy. That drowsiness is due in part to the release of: Cholecystokinin (CCK) because it may be responsible for the feeling of sleepiness. Research suggests that the factors that have the most influence on how a health care provider supports breastfeeding families are their personal culture and attitudes. A couple has brought their 4-day old baby in for an initial out-patient lactation consultation. At the end of the visit the mother makes this statement, "Sammy was so fussy last night we really wanted to give him the pacifier but we didn't because we don't want to do anything wrong." Which of the following responses from the lactation consultant would be an example of using the counseling skill called Interpreting? "So last night you were looking for ways to calm Sammy. Sounds like you did not use the pacifier because you have heard that it might cause some kind of problem for Sammy. Is that right?" 1 / 1 point A lactation consultant is talking to a mother on the phone whose baby is 4 wks old and gaining weight well. The mother is asking questions about her baby's nursing pattern. She says "Bailey usually just nurses on one side so I have been pumping the other side to maintain my milk supply. That is what I should be doing isn't it?" Which of these responses would be accurate and an example of Active or Reflective Listening? Correct answer: "You have been pumping the side the Bailey does not nurse on because you are worried that your milk supply will decrease if you don't do that." Ebony is an IBCLC working in a busy hospital family birth center. She gets a referral to see Denise because she is having latch problems. When she comes into the room, Denise is struggling to latch her baby girl, Brittany, and Brittany is crying. Jim, Denise's partner, is hovering by Denise. Denise says to Ebony "Breastfeeding is so hard. I am not sure how much longer I can keep on doing it." Which of the following would be the best way for Ebony to help Denise and Brittany and Jim? Ask Denise if it would be alright for Jim to hold Brittany for few minutes while you talk. Respond with "It is natural to want to stop breastfeeding when it feels like it is not working for you and your baby. Looks like you are having trouble getting Brittany to latch on. What would be helpful to you right now? Would you like me to share some tips on calming Brittany and positioning her that might help you with latch? Or would you prefer that I use my hands to help you with positioning and latch, then you can do it on your own?" and wait for guidance from Denise. You are an IBCLC doing an outpatient consultation with Luz, Enrique and their baby girl, Isabella. The chart says that Luz is coming in due to concerns about her milk supply. Which of the following would be an example of using open-ended questions to gather more information from Luz? Sounds like you are concerned about your milk supply. What are your concerns? One of the components in communication is body language. It accounts for over _____ of how a message is received. 50% In order to become in International Board Certified Lactation Consultant an applicant needs to: be a Recognized Health Professional or complete the required Health Sciences Education, complete 95 hrs of lactation education, complete between 300-1,000 hrs of clinical experience and successfully complete the IBLCE certification exam. Which of the following documents are professional practice guidelines for IBCLCs? Correct answer: the Code of Professional Conduct, the Standards of Practice, the Clinical Competencies, the Scope of Practice The four basic elements needed for adult learning to occur are _______, __________, _________, and _________. motivation, cues, response, and reinforcement. The organization that is responsible for establishing the certification requirements, developing and administering the exam required to become an IBCLC is the: International Board of Lactation Consultant Examiners You are an experienced IBCLC and you recently became a preceptor for lactation students. You are training your first student and reviewing some of the important steps in the out-patient lactation consultation process. Which answer lists some of the important steps in the correct order? 1) a new client signs a consent form before the first consultation 2) a thorough assessment of parent and baby are completed and documented 3) a written report of the findings of the IBCLC are sent to the parent's and baby's health care providers What does HIPAA stand for? Health Insurance Portability and Accountability Act Healthcare providers are usually considered the primary member of a parent's healthcare team and can exert tremendous influence over the family's feeding practices. Implementation of the _________________________ protocol for a breastfeeding-friendly pediatric or primary care practice can yield increased chest/breast feeding initiation rates and increase the duration of exclusive breastfeeding. Academy of Breastfeeding Medicine's In the article about licensure of IBCLCs in the US by Marsha Walker, she lists a number of reasons why she feels licensure is important. Some of those reasons include: Correct answer: Licensure protects the public and allows families and the healthcare system to recognize a specific quality indicator for the delivery of lactation care and services. You are an IBCLC getting ready to do a lactation consultation at a home visit with a family you have not met before. You will need to gather a lot of information during this visit. To first build rapport with the family it would be good to ________________ . To then gather information from the family it would be good to _____________________. use listening skills, use open-ended questions Providing emotional support is an essential part of the lactation care IBCLCs offer. Which of the following would be a good example of using affirmation skills to provide emotional support? Correct answer: Celia, IBCLC, is helping Nadir, a parent whose baby boy, Amir, is very sleepy. Nadir says, "I have been trying all the things you said to do to wake him up to feed him but he still won't wake up to eat sometimes. I feel like I can't feed my baby." Celia responds saying, "Sounds like it has been hard to wake Amir up for feedings and you have been doing your best to help him wake up and get enough to eat." The worldwide professional association for lactation consultants is called the ________________________________. International Lactation Consultant Association (ILCA) The ______________________ identifies specific experiences needed to prepare for the IBLCE certification exam and to work as an IBCLC. Clinical Competencies for IBCLC Practice In some brief interactions with families it is not possible to determine their preferred learning style. In those situations it is best to ________________ teaching method/s that would appeal to most adult learners such as ___________________________. Correct answer: use a combination of, printed and verbal instructions, visual aids, videos, and demonstrations with verbal feedback You are an IBCLC who works in an obstetric practice and you provide one prenatal education visit and lactation support all patients and their families. Eden is a patient at your clinic and is 8 mths pregnant. Today you are seeing her for her prenatal education visit. When you ask her what she has heard about breastfeeding she says, "I have heard about all the benefits but I am not planning to breastfeed." Your most appropriate response would be ____________________________. I respect your feeding choice and want to know how to best support you. What led you to make that feeding choice? IBCLCs are required to recertify every ______ years by __________________. Correct answer: 5, completing a specified number of hours of continuing education or taking the exam again. Which of the following types of stimulation would notcause a breastfeeding mother to leak milk from her breasts? Painful stimulation. Parents often ask IBCLCs how many minutes they should allow their baby to nurse. An IBCLC's best response would be: A healthy baby will nurse as long as they need to naturally. Your baby will let you know when they are finished by becoming very relaxed, pausing longer, and sucking very little. Cow's milk protein allergy is ________ __________ in ____________________ infants. significantly higher, formula-fed/mixed-fed You are an IBCLC facilitating a breastfeeding support group. Jennifer is a first-time parent and she is exclusively breastfeeding her 5 week old baby girl, Vida. During the question and answer time in the group Jennifer reports that Vida has been fussier lately and she is worried that she is not making enough milk. She wants to know how much water she needs to drink to increase her milk supply. Your best response would be: Correct answer: Sounds like you are not sure why Vida is fussy lately and you think it is because you are not making enough milk. Lots of breastfeeding parents worry about milk supply when baby's behavior changes. Breastfeeding is thirsty work and most breastfeeding parents will feel thirsty every time they breastfeed or pump. If you drink water in response to that to that thirst you will be drinking enough to support your health and milk supply. Forcing yourself to drink more water than you desire does not increase milk supply and may reduce your milk production. Now let's talk about Vida's fussiness and review some ways for you to tell if you are making enough milk for her. If an infant is exclusively breast/chest fed, the ideal way to assure that a breast/chest feeding parent and breast/chest fed infant does not develop a Vitamin D deficiency is to: Correct answer: Monitor Vitamin D levels in the breast/chest feeding parent and provide appropriate supplemental doses of Vitamin D if the parent has a Vitamin D deficiency. A mother calls you for breastfeeding advice. Her baby is five days old and when asked about her baby's elimination pattern, she emails you these pictures of her baby's last wet diaper and stool. In a five day old baby, this type of urine and stool would indicate: (meconium + red dust crystals) inadequate milk intake. Which of the following lists include factors that allincrease the risk of developing allergic disease? Early exposure to artificial formula in the first few days of life, exposure to cow's milk-based formula and introduction of solid foods prior to 6 mths of age. During the first year of life, it is recommended that babies are not given ___________. cow's milk Folic acid helps prevent ________ in pregnancy and ____________. Anemia, neural tube defects A newborn's __________ levels are low and are typically supplemented via oral dosing or injection at birth to decrease the risk of _________________. Correct answer: Vitamin K, hemorrhagic disease in the newborn First-time birth parents who are overweight or obese females have a lower ______ response to suckling and experience delays in ________________. Prolactin, secretory activation(lactogenesis II) Pregnancy and lactation are times of high demand for _________ which plays an important role in building bones, blood clotting and controlling the action of the heart, muscles and nerves. Calcium What are the three primary risk factors that can affect maternal nutritional status? Age, weight, medical conditions and maternal history Exclusively breastfed infants are at risk for ________ deficiency if their breastfeeding parent consumes small amounts or no animal products and does not take a supplement. Vitamin B12 GER is ________________________________ and is distinct from _______ which is a medical diagnosis. gastroesophageal reflux which is a backflow of the contents of the stomach into the esophagus, GERD A mother comes in for a consultation with you when her baby is four days old. She is unsure if her milk has come in. When she changes him during the visit this is what the baby's stool looks like. The appearance of the baby's stool would indicate that: (yellow/orange runny stool) her milk has come in. Some parents may use risky practices in the preparation of infant formula that can result in infant illness or malnutrition. What are some of those practices and why to they occur? diluting infant formula due to the high cost of infant formula, and not following the correct mixing directions due an inability to understand the directions for proper mixing of infant formula. In the first few days after birth the daily intake for a healthy newborn would be about per day - ____________. Day 1 - 2-10 mL, Day 2 - 5-15 mL, Day 3 - 15-30 mL, Day 4 - 30-60 mL If breastfeeding does not relieve this condition, some techniques that the mother in this picture could use to relieve this condition include: (breasts look firm, without infection) express milk, feeding on cue, lymphatic massage and use cabbage leaves To increase a sleepy baby's likelihood of waking up to feed more often, it is recommended that he/she ______________ . Correct answer: be placed skin to skin, and roused to attempt feeding when in a light sleep state or every 2-3 hours. Dr Haroldson, a pediatrician who speaks Spanish, is visiting families on the Family Birth Center who have new babies. He visits a family from Mexico and he hears the grandmother of the baby encourage the baby's mother to drink some atole that she made for her. Dr Haroldson is familiar with atole which is a traditional beverage made with corn flour, milk, water and simple spices. He asks the grandmother for her recipe. She provides it saying that this is what mothers need to drink to make plenty of milk. He praises the grandmother for supporting the new mother's desire to breastfeed. The approach Dr Haroldson used would be considered ________________ _______________. Correct answer: evidence-informed practice Which of the following describes the typical suck/swallow pattern of a full-term baby in the first 2 to 3 days of life? Correct answer: Baby will have several short, rapid bursts of sucking per each swallow. You are visiting a mother in her hospital room 2 days after her baby was born. You observe the baby rooting for the breast, and the mother asks you what she should do because the baby nursed less than an hour ago. Your best response to this mother would be: Correct answer: Yes, nurse the baby again. Frequent feedings are a normal part of breastfeeding in the weeks soon after birth. Nonnutritive sucking is ___________ nutritive sucking, and usually occurs ______________ feeding. faster than, at the beginning and end of the Newborns are at an increased risk of early termination of breastfeeding if Correct answer: they are given supplemental formula or donor milk for nonmedical reasons. 0.5 / 0.5 points In order to initiate the first breastfeeding as soon as possible after a normal delivery, the most successful strategy would be: Correct answer: Baby is placed skin to skin with the birthing parent immediately after birth and remains there until the first feeding occurs or for at least 1 hr. You are a breastfeeding peer counselor working at a local WIC program. You are working with Esme who is a teen mother. She has a 3 mth old baby girl, Madison, that she is breastfeeding exclusively. Breastfeeding is going well but today she asks you when she should wean her baby. She says her mother keeps asking her how much longer she is going to breastfeed. She says her mother says that it would be easier for other people to take care of Madison if Esme weaned her. Your best response to her would be . . . What are your thoughts about weaning Madison? It seems like breastfeeding is going well for you. What do you think your mother's concerns are? Studies show that the presence of a doula during labor is associated with: Use of fewer medications, less anesthesia, and fewer complications. You are an IBCLC working in a community organization that provides parenting support to low income families. Today you are doing a prenatal home visit with Mai. She is pregnant with her 2nd baby and due in 1 mth. She tells you that she breastfed her 3 yr old daugther, Kim-ly, until she was 2 yrs old. When you ask about her breastfeeding plans for her new baby she says she only has two weeks off from her job working in a busy restaurant so she thinks she will have to formula feed this baby. She says she would like to breastfeed but she doesn't see how she can do it. Your best response to her would be . . . Correct answer: Sounds like you feel that returning to work so soon after your new baby is born would make it hard to breastfeed. I can tell you would like to breastfeed your new baby so that must be disappointing. Would you like to hear about some ways you may be able to breastfeed this baby for a little while or would you rather talk about what to do when your breasts start to feel full a few days after birth?