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Section 4 CLC Questions and Answers

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Section 4 CLC Questions and Answers Which of the following is true ideally? -Breastfeeding hurts for 10 days and then gets better. -Breastfeeding should not be painful. -Breastfeeding hurts for the first couple days and gets better. -Breastfeeding hurts for the first few seconds and then gets better during the feeding. Breastfeeding should not be painful. According to research discussed in this section about sore nipples: -The best healing took place with glycerine gel therapy -The three groups had ratings of less pain after the intervention, including the group that only received corrective intervention assessing latch -The group with lanolin healed best -None of the above The three groups had ratings of less pain after the intervention, including the group that only received corrective intervention assessing latch T or F: In the same research study, pain was found to be associated with all aspects of poor latch. True T or F: Observation of more pre-feeding behaviors (feeding babies according to cue) was associated with less sore nipples. True T or F: A misshapen nipple at the end of the feeding is an optimal finding, and is not related to feeding issues. False Thompson's research showed that the following was associated with nipple trauma: -Shaping the breast -A hand on the back of the baby's head -Baby's hand covered with mittens -1 and 2 1 and 2; Shaping the breast & A hand on the back of the baby's head T or F: There should be no cupping the breast (c-hold) and the baby should be brought to the breast, not directing the breast to the baby. It is important not to have hands on the back of the baby's head. No more sandwiching the breast. Breastfeeding help should be conducted in a hands-off way. True T or F: All-purpose nipple ointment (APNO) was not found to be superior to lanolin when put on damaged nipples. True Green, shiny stools: -Are a normal finding -Are not related to feeding -Are a sign of not enough milk -May be a sign of oversupply May be a sign of oversupply Which of the following may NOT be helpful with oversupply? -Decreasing additional nipple stimulation if possible -Considering block feeding -Trying the Australian posture -Suggesting herbs such as sage Suggesting herbs such as sage T or F: There are concerns about vitamin E being ingested by the baby when it is put on nipples. True T or F: Raynaud's phenomenon is sometimes inappropriately treated for organisms such as yeast. True T or F: In this section, we discussed that there is no high-level evidence for tongue tie release and lip tie release to ease breastfeeding difficulties. True T or F: Anyone with a lactation credential can diagnose tongue tie. False Parents may be surprised to see milk come out that looks like string when there is: -Oversupply -Too much prolactin -Plugs or caked breasts -Mastitis Plugs or caked breasts T or F: Blebs sometimes need to be lanced by a surgeon or other appropriate health care provider. True T or F: Common mastitis typically occurs in both breasts simultaneously. False One concern about Methicillin-resistant Staphylococcus aureus (MRSA) is: -It can sometimes look like mastitis on the breast. -It often looks like yeast. -It frequently looks like Raynaud's. -It may be mistaken for oversupply. It can sometimes look like mastitis on the breast. T or F: Any unusual or suspicious area on or appearance of the breast, nipple or areola should be referred to a qualified health care provider. TRUE T or F: Persistent refusal of the baby to nurse on one or both breasts can be concerning. True T or F: Cancer diagnosis may be seen as late as 5 years after Goldsmith's sign. True Babies who have difficulty sustaining a feed in the first few days may have one of many conditions, including: -High blood sugar -Lactose intolerance -Autism Spectrum Disorder -Jaundice Jaundice As discussed in this section on neonatal hypoglycemia, according to the AAP Committee on the Fetus and Newborns, a reasonable (although arbitrary) cutoff for treating symptomatic infants is: 40 mg/dL T or F: Babies who present with jaundice should not breastfeed. FALSE T or F: Underfeeding is one reason for early onset jaundice. True T or F: The best position for a mother to be in when doing KMC with her premie is laid back False; upright position is optimal in KMC. T or F: When a mother is skin to skin with premie twins, each breast warms up to heat the closest baby True; each breast will match the baby on it (i.e., breasts may be different temperature than the other to meet the babies needs). T or F: Babies need extra calories when skin to skin because they burn more calories. False; babies burn less calories when S2S as compared to in the incubator. T or F: According to the research discussed in this section, guidelines for initiation of breastfeeding for preterm infants should be based on age and weight. False; all babies benefit Research discussed in this section showed that preterm infants do better on human milk and they have: Better brainstem maturation Greater nuclear gray matter volume More rapid intestinal barrier function All of the above All of the above Use of ___________ during gavage feedings enabled earlier transition to the breast. -odor of breastmilk -human milk fortifier -synthetic oxytocin -prolactin inhibitory factor inhibitor Odor of breastmilk Infants who have Down Syndrome, may: -Struggle with the skill of breastfeeding but breastfeeding may be possible -Have depressed reflexes -Nurse using the Dancer technique -All of the above All of the above For infants with cleft lip or cleft palate, ______ may be the challenge. -Making a seal -Creating a vacuum -Sustaining a feeding -All of the above All of the above T or F: Milk removal is needed in order to make milk. True Milk expression should start within _________ of birth for the highest milk volume. 1 hour T or F: Research in this section showed that early hand expression was more effective then pumping on days 1 to 3. True T or F: Milk from hand expression, as presented in this section, was found to have higher calories and fat than pumped milk. True T or F: Research on guided imagery while expressing milk showed an increase in milk volume. True T or F: Recommending herbs is prescribing. True In this section regarding fenugreek: -There are concerns that fenugreek can reduce the absorption of other medications (including blood pressure medicine, birth control pills and other medication). -The research show it doubles milk production. -The research showed that it is effective in improving milk supply. -Indicates it is appropriate for non-prescribing helpers to suggest There are concerns that fenugreek can reduce the absorption of other medications (including blood pressure medicine, birth control pills and other medication). Domperidone is: -Useful for increasing milk supply -FDA approved in the United States -Known to be harmless -Has rare but serious health risks -Has rare but serious health risks When looking at the research in this section on galactogogues, there is _____ correlation between increasing serum prolactin levels and long term breastfeeding success. -A direct -No direct -Somewhat of a -None of the above No direct T or F: Relacatation and induced lactation are both about increasing milk supply. True, the statement is correct. Induced lactation is when an individual lactates who was never pregnant. Relacation is when an individual who was previously pregnant in the past begins BF again. In this section, ______________ was discussed as a strategy for emergencies. -Galactagogues -Induced lactation -Relactation -Powdered infant formula Relactation When counseling to help a parent increase milk supply: -It's not necessary to assess a feeding -Suggest fenugreek -Suggest massage between feedings to increase blood flow to the breast -Consider how often the baby is being fed, how effective feeding is, and what the baby is being fed Consider how often the baby is being fed, how effective feeding is, and what the baby is being fed T or F: All supplemental feeding devices are easy for all parents to use. False T or F: A baby who is unable to sustain a seal and a feed can still easily feed with an at breast supplementer. False T or F: There are safety and efficacy studies for all of the supplemental feeding devices. False T or F: According to research presented in this section, feeding infants bottles of breast milk is no different than nursing at the breast, in terms of long-term breastfeeding rates. False T or F: When considering supplemental feeding methods, above all, the baby cannot be compromised. True Research discussed in this section showed which of the following, regarding terminating breastfeeding: -At 12 weeks, return to work or school was the major reason. -At 4 weeks, return to work or school was the major reason. -At 12 weeks, breast pain was the major reason. -At 12 weeks, not enough milk was the major reason. At 12 weeks, return to work or school was the major reason. T or F: The Lactational Amenorrhea Method (LAM) is always effective for family planning as long as nursing is still happening. False; LAM is effective as long as the 3 criteria are met. T or F: Avoiding common allergenic foods during pregnancy and breastfeeding is an excellent way to decrease food allergies in children, according to the policy statements discussed in this section. False; do not alter/restrict diet during lactation Modifiable factors for food allergies, as discussed in this section, include: -Elective Cesarean birth -Type of infant feeding method -Maternal smoking -All of the above All of the above Cow's milk whey is the one substance that consistently causes colic symptoms in some babies. True The recommendation discussed in this section suggests that anyone breastfeeding, even those partially breastfeeding, should always avoid all cow milk products in order to have a baby who cries less. False; not ALWAYS, only sometimes; 1/4 babies with colic reduced with cow's milk removal Hidden bottle practice: -Refers to when someone else is giving formula without the breastfeeding parent's knowledge -Refers to when breastfeeding parents tell friends that they are exclusively breastfeeding when they are also feeding formula -Refers to giving bottle of pumped milk at night, at home -Refers to the use of opaque bottles so that the person feeding the baby can't see how much milk is left Refers to when someone else is giving formula without the breastfeeding parent's knowledge T or F: Calcium demand is met in the same way during pregnancy as during lactation. False Research on garlic showed that babies: -Nurse less on garlic flavored milk -That garlic should be avoided during breastfeeding -That babies nurse longer on garlic flavored milk -1 and 2 That babies nurse longer on garlic flavored milk As discussed in this section, research reported in this section: -Involved how babies get the flavors of their culture through the taste and flavors in human milk -That longer duration of breastfeeding is associated with better food variety at 3 years -That foods that are unfamiliar may be rejected -All of the above All of the above T or F: Caffeine is contraindicated with breastfeeding. False; caffeine habit does not directly relate to amount of caffeine in her milk T or F: Beer, especially imported beer, increases milk supply. False; increases breast fullness however, less oxytocin (milk release) or baby consumption in studies T or F: Alcohol may block oxytocin, according to a study discussed in this section. True T or F: Pumping and dumping the milk is a research-based strategy to use for breastfeeding individuals who have consumed alcohol. False T or F: The testing of breastmilk is a way to see the impact of pollution in an area, because it is easily accessible and full of fat. True When a supplement has been ordered, which of the following is MOST important when considering using an at-breast supplementer? -Whether the supplement is medically necessary -Whether the supplemental device is made in the United States -Whether the baby is able to be positioned and transfer adequately at the breast -Whether the mother is a smoker Whether or not the baby is able to be positioned and transfer adequately at the breast is the most important consideration when thinking about using an at-breast supplementer. One plausible suggestion that might help a mother to increase the volume of milk is to: -Use two flanges and pump both breasts at the same time -Pump in a quiet room away from the baby -Pump both breasts at the same time using the highest possible vacuum setting -Pump one breast, then wait 5 minutes and pump the other breast Use two flanges and pump both breasts at the same time Raynaud's of the nipple is characterized by: -Fever -Blanching of the nipple -Itchy, flaky skin -Deep fissures -Blanching of the nipple The best advice for a mother suffering from mastitis is to: -Keep breastfeeding frequently on both sides -Breastfeed on the unaffected side only -Stop breastfeeding entirely -Stop taking her antibiotics as soon as she feels better Keep breastfeeding frequently on both sides Which of the following has been found to be a significant risk factor for mastitis? -Poor maternal nutrition -Inadequate rest for the mother -Return to work -Hurried, infrequent feedings Hurried, infrequent feedings The 2010 Health Care Reform Act: -Provides paid time off to express milk -Provides company sponsored lactation support -Provides time for milk expression during the work day -Provides a safe place to store expressed milk Provides time for milk expression during the work day Peggy Poop is 4 months old and exclusively breastfed. She has been having visible blood in her stools. What is the most likely breastfeeding-related reason for this blood? -Too much fiber in the mother's diet -Too much spicy food in the mother's diet -Not enough vitamin supplementation for the infant -Cow's milk protein in the mother's diet Cow's milk protein in the mother's diet Alcohol consumption by the breastfeeding mother may result in: -Having to pump and dump her milk for 24 hours -Lower milk consumption by the baby after the alcohol is consumed -Slower weight gain for the baby -An inebriated baby Lower milk consumption by the baby after the alcohol is consumed Which of the following is NOT a question that is important to the success of the Lactational Amenorrhea Method (LAM)? -Exclusive breastfeeding of baby under 6 months of age -No return of menses -No pacifier use -Adequate nutrition of the mother Adequate nutrition of the mother Environmental contaminants in breastmilk are: -A concern for every mother -Minimal compared to uterine exposure -Never a problem -The #1 reason mothers stop breastfeeding Environmental contaminants in breastmilk are minimal compared to uterine exposure. T or F: The following true/false question pertains to the second practice LAT: pre-feeding behaviors cannot be assessed. True

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Section 4 CLC Questions and Answers
Which of the following is true ideally?
-Breastfeeding hurts for 10 days and then gets better.
-Breastfeeding should not be painful.
-Breastfeeding hurts for the first couple days and gets better.
-Breastfeeding hurts for the first few seconds and then gets better during the feeding. -
answerBreastfeeding should not be painful.

According to research discussed in this section about sore nipples:
-The best healing took place with glycerine gel therapy
-The three groups had ratings of less pain after the intervention, including the group that
only received corrective intervention assessing latch
-The group with lanolin healed best
-None of the above - answerThe three groups had ratings of less pain after the
intervention, including the group that only received corrective intervention assessing
latch

T or F: In the same research study, pain was found to be associated with all aspects of
poor latch. - answerTrue

T or F: Observation of more pre-feeding behaviors (feeding babies according to cue)
was associated with less sore nipples. - answerTrue

T or F: A misshapen nipple at the end of the feeding is an optimal finding, and is not
related to feeding issues. - answerFalse

Thompson's research showed that the following was associated with nipple trauma:
-Shaping the breast
-A hand on the back of the baby's head
-Baby's hand covered with mittens
-1 and 2 - answer1 and 2; Shaping the breast & A hand on the back of the baby's head

T or F: There should be no cupping the breast (c-hold) and the baby should be brought
to the breast, not directing the breast to the baby. It is important not to have hands on
the back of the baby's head. No more sandwiching the breast. Breastfeeding help
should be conducted in a hands-off way. - answerTrue

T or F: All-purpose nipple ointment (APNO) was not found to be superior to lanolin when
put on damaged nipples. - answerTrue

Green, shiny stools:
-Are a normal finding
-Are not related to feeding

, -Are a sign of not enough milk
-May be a sign of oversupply - answerMay be a sign of oversupply

Which of the following may NOT be helpful with oversupply?
-Decreasing additional nipple stimulation if possible
-Considering block feeding
-Trying the Australian posture
-Suggesting herbs such as sage - answerSuggesting herbs such as sage

T or F: There are concerns about vitamin E being ingested by the baby when it is put on
nipples. - answerTrue

T or F: Raynaud's phenomenon is sometimes inappropriately treated for organisms
such as yeast. - answerTrue

T or F: In this section, we discussed that there is no high-level evidence for tongue tie
release and lip tie release to ease breastfeeding difficulties. - answerTrue

T or F: Anyone with a lactation credential can diagnose tongue tie. - answerFalse

Parents may be surprised to see milk come out that looks like string when there is:
-Oversupply
-Too much prolactin
-Plugs or caked breasts
-Mastitis - answerPlugs or caked breasts

T or F: Blebs sometimes need to be lanced by a surgeon or other appropriate health
care provider. - answerTrue

T or F: Common mastitis typically occurs in both breasts simultaneously. - answerFalse

One concern about Methicillin-resistant Staphylococcus aureus (MRSA) is:
-It can sometimes look like mastitis on the breast.
-It often looks like yeast.
-It frequently looks like Raynaud's.
-It may be mistaken for oversupply. - answerIt can sometimes look like mastitis on the
breast.

T or F: Any unusual or suspicious area on or appearance of the breast, nipple or areola
should be referred to a qualified health care provider. - answerTRUE

T or F: Persistent refusal of the baby to nurse on one or both breasts can be
concerning. - answerTrue

T or F: Cancer diagnosis may be seen as late as 5 years after Goldsmith's sign. -
answerTrue

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