CLC Actual Exam 2024 Questions with
Verified & Rationalized Answers Already
Graded A+
What are green/shiny stools a sign of? - ✔✔-sign of overproduction leading
to less fat in milk, faster digestion causing not enough time for lactase to
digest the lactose in milk. An improved latch could allow for more fat flow
Signs of oversupply - ✔✔Rapid weight gain in infant, unsettled baby after
feeding, recurrent plugged ducts and mastitis, painful feedings, voluminous
(huge volumes of) stools- often green & shiny
What causes nipple pain? - ✔✔Improper latch--> need lactation support to
help with proper latch on, good seal
True/false: baby should be pulled into breast. - ✔✔False! Do not pull baby
into breast, let baby tilt head back for optimal latch. Hand on back of baby's
head can interfere baby's interoral function by restricting the movement of
the cranio-cervical spine--> causes nipple trauma. Make sure crook of arm
in cradle position does not block baby from being able to fully tilt back.
1
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,Should a latch be symmetric or asymmetric? - ✔✔Asymmetric! A baby
should form a teat with breast tissue underneath the nipple as part of a
latch
What is a symmetric latch - ✔✔Not a good latch, causes nipple damage
Asymmetric latch - ✔✔Optimal attachment to the breast, where the baby's
lips are not centered in relationship to the areolar, but rather vertically off-
centered with the baby's chin and lower lip closer to the edge of the areola
than the baby's upper lip. A baby should form a teat with breast tissue
underneath the nipple as part of a latch
Do nipple creams work? - ✔✔Continued questions of effectiveness, fear of
ingestion by baby
Should a frenotomy be suggested for tongue tie? - ✔✔No study was able to
report that frenotomy led to better long term breastfeeding
Tongue tied breastfeeder - ✔✔-complete feeding assessment and suggest
ways to optimize latch.
-refer onward for diagnosis (have PCP diagnose TT)
-provide support
2
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,What is a fissure straight down the nipple evidence of? - ✔✔A symmetric
latch. Top lip needs to have good seal, moist part of lip should be touching
nipple, can roll out top lip, to reduce injury during BF
Is there a deep latch with nipple stretching? - ✔✔If nipple not stretched
deeply into mouth, less oxytocin flows, less fat is in mix. With less fat, milk
digested quicker = not enough time for baby to make enough lactase to
digest lactose in milk.
What to do for oversupply? - ✔✔Decrease additional stimulation/milk
removal if possible
Consider block feeding (only nursing on one side only per feeding)
Watch for mastitis
Try australian posture (mother down under, baby on top)
Consider donating to milk bank
Consult with HCP for medical dx
How many mL considered oversupply? - ✔✔normal milk production = 750-
1000 mL/day
Thrush during BF - ✔✔painful for mother & baby.
may be visible or may not (whiteness that can't be wiped off)
-mother will have itchy, flaky, shiny skin
3
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
, -candida not found inside the ducts or milk
Treatment of candida on breast - ✔✔-nystatin first line
-flucanizole second line
-throw out all yeast vectors (pacifiers sterilize breast pumps)
-flucanazole oral capsules may be used to clean yeast vectors due to the
biofilm created on pacifiers by candida
What to do if antifungal treatment for yeast doesn't work? - ✔✔Not candida
infection!
Reynaud's Phenomenon - ✔✔-vasospasm of nipple, recognized by triple
color sign: from white--> blue--> raspberry or bicolor sign white -->
raspberry.
pain is extreme and spasmodic (not continuous)
-this happens after feeding once baby's mouth comes off nipple has
vasospasm, feels like frostbite
treatment of reynauds - ✔✔-prevent/decrease cold exposure
-avoid vasoconstrictive drugs such as caffeine and hypertensive drugs,
nicotine
-can use nifedipine or calcium channel blocker
4
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Verified & Rationalized Answers Already
Graded A+
What are green/shiny stools a sign of? - ✔✔-sign of overproduction leading
to less fat in milk, faster digestion causing not enough time for lactase to
digest the lactose in milk. An improved latch could allow for more fat flow
Signs of oversupply - ✔✔Rapid weight gain in infant, unsettled baby after
feeding, recurrent plugged ducts and mastitis, painful feedings, voluminous
(huge volumes of) stools- often green & shiny
What causes nipple pain? - ✔✔Improper latch--> need lactation support to
help with proper latch on, good seal
True/false: baby should be pulled into breast. - ✔✔False! Do not pull baby
into breast, let baby tilt head back for optimal latch. Hand on back of baby's
head can interfere baby's interoral function by restricting the movement of
the cranio-cervical spine--> causes nipple trauma. Make sure crook of arm
in cradle position does not block baby from being able to fully tilt back.
1
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,Should a latch be symmetric or asymmetric? - ✔✔Asymmetric! A baby
should form a teat with breast tissue underneath the nipple as part of a
latch
What is a symmetric latch - ✔✔Not a good latch, causes nipple damage
Asymmetric latch - ✔✔Optimal attachment to the breast, where the baby's
lips are not centered in relationship to the areolar, but rather vertically off-
centered with the baby's chin and lower lip closer to the edge of the areola
than the baby's upper lip. A baby should form a teat with breast tissue
underneath the nipple as part of a latch
Do nipple creams work? - ✔✔Continued questions of effectiveness, fear of
ingestion by baby
Should a frenotomy be suggested for tongue tie? - ✔✔No study was able to
report that frenotomy led to better long term breastfeeding
Tongue tied breastfeeder - ✔✔-complete feeding assessment and suggest
ways to optimize latch.
-refer onward for diagnosis (have PCP diagnose TT)
-provide support
2
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
,What is a fissure straight down the nipple evidence of? - ✔✔A symmetric
latch. Top lip needs to have good seal, moist part of lip should be touching
nipple, can roll out top lip, to reduce injury during BF
Is there a deep latch with nipple stretching? - ✔✔If nipple not stretched
deeply into mouth, less oxytocin flows, less fat is in mix. With less fat, milk
digested quicker = not enough time for baby to make enough lactase to
digest lactose in milk.
What to do for oversupply? - ✔✔Decrease additional stimulation/milk
removal if possible
Consider block feeding (only nursing on one side only per feeding)
Watch for mastitis
Try australian posture (mother down under, baby on top)
Consider donating to milk bank
Consult with HCP for medical dx
How many mL considered oversupply? - ✔✔normal milk production = 750-
1000 mL/day
Thrush during BF - ✔✔painful for mother & baby.
may be visible or may not (whiteness that can't be wiped off)
-mother will have itchy, flaky, shiny skin
3
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
, -candida not found inside the ducts or milk
Treatment of candida on breast - ✔✔-nystatin first line
-flucanizole second line
-throw out all yeast vectors (pacifiers sterilize breast pumps)
-flucanazole oral capsules may be used to clean yeast vectors due to the
biofilm created on pacifiers by candida
What to do if antifungal treatment for yeast doesn't work? - ✔✔Not candida
infection!
Reynaud's Phenomenon - ✔✔-vasospasm of nipple, recognized by triple
color sign: from white--> blue--> raspberry or bicolor sign white -->
raspberry.
pain is extreme and spasmodic (not continuous)
-this happens after feeding once baby's mouth comes off nipple has
vasospasm, feels like frostbite
treatment of reynauds - ✔✔-prevent/decrease cold exposure
-avoid vasoconstrictive drugs such as caffeine and hypertensive drugs,
nicotine
-can use nifedipine or calcium channel blocker
4
©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
