CLC Exam with 100% Correct Answers 2024
What are green/shiny stools a sign of? - Correct answer--sign of overproduction leadingto 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 - Correct answer-Rapid weight gain in infant, unsettled baby afterfeeding, recurrent plugged ducts
Page | 1
and mastitis, painful feedings, voluminous (huge volumes of) stools- often green & shiny
What causes nipple pain? - Correct answer-Improper latch--> need lactation support tohelp with proper latch on, good seal
True/false: baby should be pulled into breast. - Correct answer-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 blockbaby from being able to fully
tilt back.
Should a latch be symmetric or asymmetric? - Correct answer-Asymmetric! A babyshould form a teat with breast
tissue underneath the nipple as part of a latch
What is a symmetric latch - Correct answer-Not a good latch, causes nipple damage
Asymmetric latch - Correct answer-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. Ababy should form a teat with breast tissue underneath the nipple as part of a latch
Do nipple creams work? - Correct answer-Continued questions of effectiveness, fear ofingestion by baby
Should a frenotomy be suggested for tongue tie? - Correct answer-No study was able toreport that frenotomy led to better
long term breastfeeding
Tongue tied breastfeeder - Correct answer--complete feeding assessment and suggestways to optimize latch.
-refer onward for diagnosis (have PCP diagnose TT)
-provide support
STUDYGUIDESOLUTIONS
, CLC Exam with 100% Correct Answers 2024
What is a fissure straight down the nipple evidence of? - Correct answer-A symmetric latch. Top lip needs to have good
seal, moist part of lip should be touching nipple, canroll out top lip, to reduce injury during BF
Is there a deep latch with nipple stretching? - Correct answer-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
Page | 2
lactose in milk.
What to do for oversupply? - Correct answer-Decrease additional stimulation/milkremoval 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? - Correct answer-normal milk production = 750-1000 mL/day
Thrush during BF - Correct answer-painful for mother & baby.may be visible or may
not (whiteness that can't be wiped off)
-mother will have itchy, flaky, shiny skin
-candida not found inside the ducts or milk
Treatment of candida on breast - Correct answer--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 biofilmcreated on pacifiers by candida
What to do if antifungal treatment for yeast doesn't work? - Correct answer-Not candidainfection!
Reynaud's Phenomenon - Correct answer--vasospasm of nipple, recognized by triplecolor 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, feelslike frostbite
treatment of reynauds - Correct answer--prevent/decrease cold exposure
-avoid vasoconstrictive drugs such as caffeine and hypertensive drugs, nicotine
-can use nifedipine or calcium channel blocker
Nipple pain and poor milk transfer that is persistent despite optimal latch - Correct answer--can use nipple shield as a
test to see if baby exerting too much pressure?
-OT involvement
STUDYGUIDESOLUTIONS
, CLC Exam with 100% Correct Answers 2024
-in rare cases baby have a strong sucking vacuum as measured by a pressuretransducer or nipple shield
Clogs/plugs - Correct answer-Palpable lumps of milk within the lumen or duct system, usually not visible. Solids dont get
absorbed...could be too tight of a bra slowing flow ofmilk
Page | 3
what to do for clogs/plugs - Correct answer-Encourage massage using side of hand andwarm compresses. Do double nursing
by doubling up on side of clog to push it out. point baby's chin toward clog
See PCP if clog hasnt moved in 24-48 hours or systemic symptoms of inflammation (flu like s/s)
When to call PCP for clog/plug - Correct answer-If plug hasn't moved in 24-48 hrs orsystemic signs of inflammation
(flu like s/s)
Causes of clogs/plug - Correct answer-too tight nursing bra
what is a bleb - Correct answer-small white spots on the face of the nipple that look likemilk-filled blisters. one duct opening
is usually covered
what does a bleb feel like - Correct answer-painful stabbing pinpoint pain
how to get rid of blebs - Correct answer-Same as clog treatment. Sometimes need t belanced by HCP
Common mastitis - Correct answer--can be non-infective or infective
-blocked ducts from engorgment, hurried feedings, nipple shield (pressure will build untilmilk sneaks out of space, body reacts
to this like invader)
causes of common mastitis - Correct answer--tight bra (look for indentation of breaststraps)
-use of breast shell or nipple shell
-attachment difficulties
-anemia in the mother
-tongue tie in baby (ineffective milk emptying)
s/s common mastitis - Correct answer-systemic- fever, ill, malaise, redness, pain, oneinflamed breast
What bacteria causes infective mastitis - Correct answer-Staphylococcus
tx common mastitis - Correct answer-NSAIDS first line but make sure diagnosed byPCP
-must keep pumping/breastfeeding to keep milk flowing. keeps breasts soft/comfortableto avoid abscess development
STUDYGUIDESOLUTIONS
, CLC Exam with 100% Correct Answers 2024
Abscess on breast - Correct answer-Localized areas of pus and necrotic tissue that candevelop with a breast infection
develop in the subcutaneous, intramammary, retromammarylayers
Page | 4
include pain, swelling, redness, fever, increased WBC count, palpable mass
-pocket of pus forms in the breast
-from untreated mastitis
Antibiotics for mastitis? - Correct answer-Usually for double mastitis, not generally proscribed for one breast common
mastitis. If treatment uneffective consider anemia,ductal or inflammatory breast cancer
Double mastitis - Correct answer-EMERGENT AND UNCOMMON- tissue of bothbreasts inflamed.
organism cause of double mastitis - Correct answer-strep -potentially fatal, whole bodyinflammation, sepsis
-not a problem with milk
signs of inflammatory breast cancer - Correct answer-- breast tissue is red, warm, hasorange peel (peau d'orange), pitting
appearance on skin surface
- breast mass may or may not be present
True/false: MRSA can look like mastitis when on breast - Correct answer-TRUE canmasquerade as mastitis. might see
peeling skin, pitting. can also cause lesions and abscess.
Abscess on breast is full of ... - Correct answer-PUS not MILK. as many as 60% positivefor MRSA.
can you nurse on same side as abscess - Correct answer-No should nurse on other breast. must be aware of possible
contamination on flanges, pump parts, can not trackinfection from one side to other.
abscess surgical intervention - Correct answer-can cut through nerves and ducts. try toavoid surgical intervention
treatment of abscess - Correct answer-drainage through ultrasound-guided technique isfirst choice (needle aspiration often
has to be repeated)
Report any suspicious area of the breast to a qualified provider because it could be... -Correct answer-MRSA or herpes-
fatal for babies
Goldsmith's sign - Correct answer-The association of a baby's persistent refusal of onebreast with possible breast cancer in the
mother
STUDYGUIDESOLUTIONS
What are green/shiny stools a sign of? - Correct answer--sign of overproduction leadingto 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 - Correct answer-Rapid weight gain in infant, unsettled baby afterfeeding, recurrent plugged ducts
Page | 1
and mastitis, painful feedings, voluminous (huge volumes of) stools- often green & shiny
What causes nipple pain? - Correct answer-Improper latch--> need lactation support tohelp with proper latch on, good seal
True/false: baby should be pulled into breast. - Correct answer-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 blockbaby from being able to fully
tilt back.
Should a latch be symmetric or asymmetric? - Correct answer-Asymmetric! A babyshould form a teat with breast
tissue underneath the nipple as part of a latch
What is a symmetric latch - Correct answer-Not a good latch, causes nipple damage
Asymmetric latch - Correct answer-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. Ababy should form a teat with breast tissue underneath the nipple as part of a latch
Do nipple creams work? - Correct answer-Continued questions of effectiveness, fear ofingestion by baby
Should a frenotomy be suggested for tongue tie? - Correct answer-No study was able toreport that frenotomy led to better
long term breastfeeding
Tongue tied breastfeeder - Correct answer--complete feeding assessment and suggestways to optimize latch.
-refer onward for diagnosis (have PCP diagnose TT)
-provide support
STUDYGUIDESOLUTIONS
, CLC Exam with 100% Correct Answers 2024
What is a fissure straight down the nipple evidence of? - Correct answer-A symmetric latch. Top lip needs to have good
seal, moist part of lip should be touching nipple, canroll out top lip, to reduce injury during BF
Is there a deep latch with nipple stretching? - Correct answer-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
Page | 2
lactose in milk.
What to do for oversupply? - Correct answer-Decrease additional stimulation/milkremoval 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? - Correct answer-normal milk production = 750-1000 mL/day
Thrush during BF - Correct answer-painful for mother & baby.may be visible or may
not (whiteness that can't be wiped off)
-mother will have itchy, flaky, shiny skin
-candida not found inside the ducts or milk
Treatment of candida on breast - Correct answer--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 biofilmcreated on pacifiers by candida
What to do if antifungal treatment for yeast doesn't work? - Correct answer-Not candidainfection!
Reynaud's Phenomenon - Correct answer--vasospasm of nipple, recognized by triplecolor 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, feelslike frostbite
treatment of reynauds - Correct answer--prevent/decrease cold exposure
-avoid vasoconstrictive drugs such as caffeine and hypertensive drugs, nicotine
-can use nifedipine or calcium channel blocker
Nipple pain and poor milk transfer that is persistent despite optimal latch - Correct answer--can use nipple shield as a
test to see if baby exerting too much pressure?
-OT involvement
STUDYGUIDESOLUTIONS
, CLC Exam with 100% Correct Answers 2024
-in rare cases baby have a strong sucking vacuum as measured by a pressuretransducer or nipple shield
Clogs/plugs - Correct answer-Palpable lumps of milk within the lumen or duct system, usually not visible. Solids dont get
absorbed...could be too tight of a bra slowing flow ofmilk
Page | 3
what to do for clogs/plugs - Correct answer-Encourage massage using side of hand andwarm compresses. Do double nursing
by doubling up on side of clog to push it out. point baby's chin toward clog
See PCP if clog hasnt moved in 24-48 hours or systemic symptoms of inflammation (flu like s/s)
When to call PCP for clog/plug - Correct answer-If plug hasn't moved in 24-48 hrs orsystemic signs of inflammation
(flu like s/s)
Causes of clogs/plug - Correct answer-too tight nursing bra
what is a bleb - Correct answer-small white spots on the face of the nipple that look likemilk-filled blisters. one duct opening
is usually covered
what does a bleb feel like - Correct answer-painful stabbing pinpoint pain
how to get rid of blebs - Correct answer-Same as clog treatment. Sometimes need t belanced by HCP
Common mastitis - Correct answer--can be non-infective or infective
-blocked ducts from engorgment, hurried feedings, nipple shield (pressure will build untilmilk sneaks out of space, body reacts
to this like invader)
causes of common mastitis - Correct answer--tight bra (look for indentation of breaststraps)
-use of breast shell or nipple shell
-attachment difficulties
-anemia in the mother
-tongue tie in baby (ineffective milk emptying)
s/s common mastitis - Correct answer-systemic- fever, ill, malaise, redness, pain, oneinflamed breast
What bacteria causes infective mastitis - Correct answer-Staphylococcus
tx common mastitis - Correct answer-NSAIDS first line but make sure diagnosed byPCP
-must keep pumping/breastfeeding to keep milk flowing. keeps breasts soft/comfortableto avoid abscess development
STUDYGUIDESOLUTIONS
, CLC Exam with 100% Correct Answers 2024
Abscess on breast - Correct answer-Localized areas of pus and necrotic tissue that candevelop with a breast infection
develop in the subcutaneous, intramammary, retromammarylayers
Page | 4
include pain, swelling, redness, fever, increased WBC count, palpable mass
-pocket of pus forms in the breast
-from untreated mastitis
Antibiotics for mastitis? - Correct answer-Usually for double mastitis, not generally proscribed for one breast common
mastitis. If treatment uneffective consider anemia,ductal or inflammatory breast cancer
Double mastitis - Correct answer-EMERGENT AND UNCOMMON- tissue of bothbreasts inflamed.
organism cause of double mastitis - Correct answer-strep -potentially fatal, whole bodyinflammation, sepsis
-not a problem with milk
signs of inflammatory breast cancer - Correct answer-- breast tissue is red, warm, hasorange peel (peau d'orange), pitting
appearance on skin surface
- breast mass may or may not be present
True/false: MRSA can look like mastitis when on breast - Correct answer-TRUE canmasquerade as mastitis. might see
peeling skin, pitting. can also cause lesions and abscess.
Abscess on breast is full of ... - Correct answer-PUS not MILK. as many as 60% positivefor MRSA.
can you nurse on same side as abscess - Correct answer-No should nurse on other breast. must be aware of possible
contamination on flanges, pump parts, can not trackinfection from one side to other.
abscess surgical intervention - Correct answer-can cut through nerves and ducts. try toavoid surgical intervention
treatment of abscess - Correct answer-drainage through ultrasound-guided technique isfirst choice (needle aspiration often
has to be repeated)
Report any suspicious area of the breast to a qualified provider because it could be... -Correct answer-MRSA or herpes-
fatal for babies
Goldsmith's sign - Correct answer-The association of a baby's persistent refusal of onebreast with possible breast cancer in the
mother
STUDYGUIDESOLUTIONS
