ALPP CLC EXAM 2025 CERTIFIED LACTATION COUNSELOR REAL/AUTHENTIC PROCTORED EXAM QUESTIONS AND ANSWERS GRADED A+

ALPP CLC EXAM 2025 CERTIFIED LACTATION COUNSELOR REAL/AUTHENTIC PROCTORED EXAM QUESTIONS AND ANSWERS GRADED A+ “breast feeding: a public health priority - CORRECT ANSWER has been recognized as a public health priority in tropical climates since the 1930's, but not until the 1990's in the US" "costs to prevent needless deaths - CORRECT ANSWER less than $6 billion/year worldwide" "suboptimal breastfeeding - CORRECT ANSWER accounts for more than 3,340 maternal and child deaths a year, 80% are maternal" "the strategy - CORRECT ANSWER is intended as a guide for action - it identifies interventions with a proven positive impact - it emphasizes providing mothers and families the support they need to carry out their crucial roles - it explicitly defines the obligations and responsibilities in this regard of governments, international organizations, and other concerned parties" "the world breastfeeding trends initiative - CORRECT ANSWER intended to track, assess, and monitor the implementation of the "global strategy" at the country and sub-country level" "what contributes to low rates of ebf globally? - CORRECT ANSWER - caregiver and societal beliefs favoring mixed feeding -hospital and healthcare practices and policies that are not supportive of BF - lack of adequate skills and support - aggressive promotion of infant formula and other breastmilk substitutes - inadequate maternity/paternity leave legislation - workplace policies - lack of knowledge about dangers of not exclusively BF and proper BF techniques" "how to support ebf - CORRECT ANSWER increase hospital and health system capacity regarding baby friendly hospital initiative -provide community based strategies including campaigns tailored to local context -strengthen monitoring and enforcement of the code -enact at least 6 months paid maternity leave -invest in training and capacity building in protection, promotion, support" "nest or cache - CORRECT ANSWER mammal species with high fat/protein and low water content = infrequent feeds nest = bunnies cache = deer" "carry, follow, or hibernate - CORRECT ANSWER mammal species with hither water content milk have more frequent feeds carry = koala follow = elephants hibernate = bears" "our culture - CORRECT ANSWER wants us to be nesters when it comes to feeding, but our milk composition indicates that we should be carriers" "the brain - CORRECT ANSWER most rapidly developing organ in human newborns; human milk is the ideal fuel for brain growth" "nursing pattern - CORRECT ANSWER should be frequent to accommodate human milk composition" "stages of making human milk - CORRECT ANSWER lactogenesis I, lactogenesis II, lactogenesis III" "lactogenesis I - CORRECT ANSWER secretory differentiation, placental hormones, colostrum" "lactogenesis II - CORRECT ANSWER secretory activation, after complete delivery of placenta, rapid drop in progesterone, transitional milk" "lactogenesis III - CORRECT ANSWER lactation, galactopoesis, prolactin from frequent nipple stimulation, frequent removal of milk, mature milk" "breastmilk composition - CORRECT ANSWER human milk changes continually, makes it impossible to obtain a single representative sample of milk" "preterm milk - CORRECT ANSWER appears to have a different composition for the first 5-7 weeks after delivery independent of gestational age at delivery - appears to be higher in protein, fat, and electrolytes than term milk - if baby is SGA, LGA, or AGA, does not make a difference in milk composition" "after 1 year of lactation - CORRECT ANSWER has significantly increased fat and energy contents" "diarrhea mechanisms 6 - white blood cells - CORRECT ANSWER kill microbes directly or mobilize other defenses" "diarrhea mechanisms 7 - cell wall disrupters - CORRECT ANSWER kill microbes by destroying the cell walls, these include fatty acids and lysozymes" "diarrhea mechanisms 8 - B12 binding factor - CORRECT ANSWER reduces the amount of B12 in the intestines available to microbes" "diarrhea mechanisms 9 - lactoferrin - CORRECT ANSWER deprives bacteria of iron, disrupts the integrity of the outer membrane of bacteria, assists in intestinal maturation and in the recovery of the intestine from injury and other mechanisms" "diarrhea mechanisms 10 - antimicrobial activity boosters - CORRECT ANSWER such as fibronectin and gamma interferon" "diarrhea mechanisms 11 - mucosal wall protectors - CORRECT ANSWER such as mucins and oligosaccharides, which also function as food for beneficial bacteria, adhere to microbes binding them so that they can't attach to the gut wall" "diarrhea mechanisms 12 - microbes - CORRECT ANSWER from the mothers skin and bacteria in the mother's breastmilk seed, the infant gut underscoring" "diarrhea mechanisms 13 - contaminants - CORRECT ANSWER absence of contaminants (bottles, teats, water) and formula ingredients" "diarrhea mechanisms 14 - antibodies - CORRECT ANSWER a. when a mother is exposed to organisms she makes antibodies and secretes them into her milk b. another way baby is protected - cells go from the baby's mouth into the breast and antibodies are made in the breast the process of breastfeeding has effects beyond the components of the milk. breastfeeding changes both I'mmune system" "gastrointestinal hormones - gastrin, chloecystokinin - CORRECT ANSWER promote induced insulin release and growth promoting effects in the gut" "gastrointestinal hormones - somatastin - CORRECT ANSWER inhibits GI secretion, inhibits motility in the GI tract and the release of most GI hormones. inhibits the secretion of HGH from the pituitary and inhibits cellular growth and proliferation In the gut" "how do you know about breastfeeding adequacy? - CORRECT ANSWER fewer than 4 soiled diapers on day 4 when used in conjunction with delayed onset of lactation may indicate breastfeeding inadequacy - four on four... and each day after" "cooper findings re: weight loss findings - CORRECT ANSWER - babies were not identified before 10% weight loss - a "contented" (sleepy) baby is NOT a well-fed baby (calorically deprived babies are sleepy)" "breastfeeding associated hypernatremia - CORRECT ANSWER hypernatremia is a common complication of inadequate milk transfer during breastfeeding - completely preventable complication that seems to be relatively common" "hypernatremia weight loss difference - CORRECT ANSWER 1.6% in healthy infants vs. 16.2% in hypernatremic addmited infants" "hypernatremia frequency of feeds difference - CORRECT ANSWER 10.2 for healthy infants vs. 7.6 in the NHD admitted infants" "MYTH - its about the types or amounts of foods eaten during laction - CORRECT ANSWER humans have breastfed and are breastfeeding under conditions we can't even imagine. this is possible because: - lactation has a lower energy cost for humans compared to other mammals - number of kcal/day for lactation is much less than previously believed - the body adapts with physiological mechanisms in favor of lactation in humans" "when the infant suckles from the breast... - CORRECT ANSWER there is an outpouring of 19 different GI hormones in both the mother and the infant, including cholecystokinin, which cycles to the kidneys, and gastrin, which stimulates growth of the baby and mother's villi, increasing surface area and absorption of calories with each feeding" "how is it possible for humans to make milk with such a small amount of energy expenditure? - CORRECT ANSWER - maternal plasma prolactin concentration generally increases under conditions of negative energy balance, which may serve to protect lactation - changes in maternal processes can spare energy.. this may account for a third to half of the total costs of milk synthesis - together with the low cost of human lactation and large fat reserves from pregnancy, may account for human ability to breastfeed our infants under nutritional conditions which are often far from ideal" "how do we assure an adequate milk supply? - CORRECT ANSWER - universal understanding of how breastfeeding works - early initiation and adequate breastfeeding (10-12x/daily) - appropriate breastfeeding assessment - improved and early breastfeeding support to decrease "lactastrophes" - appropriate HCP and LCP follow-up in the postpartum (see reasons to refer) - admitting theres no magic bullet" What duration of breastfeeding is associated with significantly reduced incidence of acute otits media (AOM)? A) Any breastfeeding B) Up to 3 mos C) More than 4-6 months - CORRECT ANSWER C) More than 4-6 months" "Breastfeeding lowers the risk for the incidence of dental caries compared to children fed nonhuman milk from a bottle. True of False? - CORRECT ANSWER True" "Does breastfeeding lower the risk of NEC in preterm infants? - CORRECT ANSWER Yes" "Is there a difference in the protective effect against SIDS between babies that are exclusively breastfed vs. non-exclusively? - CORRECT ANSWER Yes, babies that are exclusively breastfed have a stronger protective effect against SIDS" "Does breastfeeding lower the risk for the incidence of malocclusion (misalignment of teeth)? - CORRECT ANSWER Yes" "True of False. Lactational amenorrhea, or the delay in return of menses after birth, is not associated with exclusive breastfeeding. - CORRECT ANSWER False" "When observing a feeding, what signs can indicate an issue with the infant's lips? - CORRECT ANSWER Breaks in the seal with the breast, lip retraction and lip tremors, leaking milk" "What are 2 ways to help improve tone and strengthen the lip seal for infants with abnormal lip tone? - CORRECT ANSWER 1. Provide firm pressure stimulus (i.e. tapping) on the lips prior to feeding. 2. Insert clean finger or round, somewhat firm pacifier, then partially pull it out of infant's mouth to induce the infant to pull it back." "How can parents help infant with cleft lip breastfeed? - CORRECT ANSWER By using finger or shape of the breast tissue to seal the cleft." "What are buccal pads? - CORRECT ANSWER Subcutaneous fat deposits in cheeks" "What can cause low facial tone or poorly developed buccal pads in an infant? - CORRECT ANSWER Prematurity or low birth weight" "What are possible issues due to facial hypotonia? - CORRECT ANSWER Decreased cheek stability hindering seal on the breast, infant needs to create a greater vacuum to generate and sustain suction, this increases the work of feeding and can cause fatigue before feeding is complete." "How do you do an oral assessment of an infant's jaw? - CORRECT ANSWER Insert gloved pinkie finger in corner of infant's mouth between posterior gum pads: 1. Count number of reflexive bites (chews) 2. Infant should respond with 10 chews per side 3. Observe difficulty producing reflexive bites or stress cues during assessment" "What are 2 things that can be done to assist an infant while feeding to assist with jaw issues? - CORRECT ANSWER 1. Provide external jaw support with a finger placed under bony part of lower jaw to control/stabilize distance of jaw excursions 2. Identify feeding positions that emphasize postural stability (hip flexion, stabilize trunk) and maintain head extension to bring lower jaw closer to breast" "What methods can be done to improve results of infant feeding issues due to jaw abnormalities, weakness, or injury? - CORRECT ANSWER 1. Exercise jaws several times a day 2. Refer infant for physical therapy or body work 3. Refer infant for speech or occupational therapy for assessment for feeding difficulties" "nursing a baby for a year or more - CORRECT ANSWER decreases by 10-15% the risk of developing hypertension, diabetes, hyperlipidemia, and cardiovascular disease" "women who do not breastfeed - CORRECT ANSWER are at greater risk for myocardial infarction and aspects of metabolic syndrome; are at a greater risk of breast, endometrial, and ovarian cancer" "WHO and UNICEF three strategies - CORRECT ANSWER for increased breastfeeding initiation and duration in every country: promotion, protection, and support" "breastfeeding promotion - CORRECT ANSWER focuses on advantages of breastfeeding on a personal, community, country, or global level" "breastfeeding protection - CORRECT ANSWER focuses on government, manufacturer, and social responsibility to assure breastfeeding's ability to compete with commercial interests; includes addressing improper marketing practices; the AAP advices not to provide formula, company gift bags, and industry-authored handouts; in the US, state and local breastfeeding legislation addresses breastfeeding in public, employment issues, jury duty, family law, mothers in prison, etc." "breastfeeding support - CORRECT ANSWER focuses on the interaction of "helpers" with family as well as program development and implementation" "community expertise - CORRECT ANSWER variety of community expertise is needed to promote, protect, and support breastfeeding" "International models - CORRECT ANSWER for integrating breastfeeding promotion, protection, and support as well as balancing technical information, programs, and protocols" "CLC - CORRECT ANSWER nationally recognized designation awarded by the ALPP to those who are exam eligible and pass the exam; have competenct verified" "CLCs and IBCLCs - CORRECT ANSWER health professionals who provide lactation support" "why is breastfeeding so difficult? - CORRECT ANSWER 1. unrealistic expectations 2. lack of timely interventions" "unrealistic expectations - CORRECT ANSWER lack of preparation for what the newborn period would look like" "lack of timely interventions - CORRECT ANSWER mother's problems at 3 to 7 days posed as the greatest risk to stopping" "breastfeeding trends - CORRECT ANSWER last 150 years or som rates have declined" "international code of matketing of breastmilk substitutes (the code) - CORRECT ANSWER an international health policy framework to regulate the marketing of breastmilk substitutes in order to protect breastfeeding - published by the WHO in 1981 - internationally agreed voluntary code of practice - written in response to the marketing activities of the infant feeding indurstry which were promoting formula feeding over breastfeeding, which in turn was leading to dramatic increases in maternal and infant morbidity and mortality - subsequent clarifying and extending resolutions have been passed by the world health assembly" "the code - CORRECT ANSWER regulates the marketing of breastmilk substitutes which includes infant formulas, follow-on formulas, and any other food or drink, together with feeding bottles and teats, intended for babies and young children; sets standards for the labeling and quality of products and for how the law should be implemented and monitored within countries" "restricting marketing - CORRECT ANSWER does not mean that the products cannot be made available, neither does it restrict parents choice; it simply aims to make sure that their choices are made based on full, impartial information, rather than misleading, inaccurate, or biased marketing claims" "disparity of US breastfeeding trends - CORRECT ANSWER according to the CDC, "black mothers are less likely than white to breast-feed their babies, and here's one possible reason why: hospitals in neighborhoods with many black residents do less to promote nursing than those in areas with more white residents"" "anatomy of milk cells - CORRECT ANSWER myoepithelial cells, connective tissue, capillaries, anteriole, venule, alveolar cells" "anatomy of human breast - CORRECT ANSWER glandular tissue made up of clusters of alveoli and small ducts, fat amongst the glandular tissue, milk ducts, areola, nipple with several duct openings" "making milk - CORRECT ANSWER messages from the breast travel through the nervous system to the brain, then hormones travel to the breast through the blood system" "hormone pathways - CORRECT ANSWER two separate hormone pathways, pituitary gland is important to both" "prolactin levels - CORRECT ANSWER go down in between nursing and rise during nursing" "infrequent nursing - CORRECT ANSWER leads to lower levels and less rise even with the same amount of nipple contact" "ongoing milk production - CORRECT ANSWER positively associated with suckling within the first 2 hours after birth" "initiation for mothers of preemies - CORRECT ANSWER initiation of milk expression before one hour resulted in significantly more milk when measured on days 7 and 42" "triggering oxytocin mechanism #1 - CORRECT ANSWER conditioned response - conditioned milk ejection (let down) reflex - was probably given too much importance in the years we didn't understand the other mechanisms - conditioned over time and lasts a lifetime - is faster for women who already have one from previous breastfeeding - to condition response.. smell, touch, hear the stimulus" "triggering oxytocin mechanism #2 - CORRECT ANSWER nipple stretching, happens with a proper latch" "triggering oxytocin mechanism #3 - CORRECT ANSWER baby hand massage, each hand movement releases oxytocin" "hormones of lactation - CORRECT ANSWER have an emotional/behavioral function as well as making and moving milk; aggression, protection, bonding & trust" "milk composition - CORRECT ANSWER is complex - each species of mammal milk is different - milk is "species specific"" "fore vs hind milk - CORRECT ANSWER foremilk is milk at the beginning of a feed, hindmilk is at the end of a feed - used to think that hindmilk contained more fat content but it is more complex than originally described - foremilk does not mean "low fat" and hindmilk is not always highest in fat - sometimes foremilk and hindmilk have equal amounts of fat and we should not give mothers tules based on the ideas of fore and hindmilk" "breastmilk composition changes - CORRECT ANSWER - over the course of lactation - within the day - within a feeding - between feedings is also changes by the way it is taken" "babyled feeding - CORRECT ANSWER "the breast-fed baby can regulate his fat intake quickly and thus mothers should be encouraged to practice baby-led feeding"" "maximum fat levels - CORRECT ANSWER obtained 30 mins post-feed - mothers of male infants seem to produce milk that has 25% greater energy content than mothers of female infants" "milk composition, milk action - CORRECT ANSWER milk composition is complex, milk action is redundant - milk is more than nutrition, bioavailability of nutrients is higher in human milk than in other foods or supplements" "less diarrhea - CORRECT ANSWER most readily acknowledged advantage od breastfeeding, ebf makes the biggest difference in rates and severity - 86% of diarrhea-associated infant deaths occurred among LBW infants - if breastfed baby does get diarrhea, keeping breastfeeding makes a difference in maintaining the microbiota" "mechanisms by which ebf protects from diarrhea - CORRECT ANSWER 1. ph of gut 2. low iron in gut 3. presence of bifidus factor 4. presence of hormones 5. antibodies such as SIgA 6. white blood cells 7. cell wall disrupters 8. B12 binding factor 9. lactoferrin 10. antimicrobial activity boosters 11. mucosal wall protectors 12. microbes 13. absence of exposure to contaminants 14. antibodies 15. synergistic effect" "diarrhea mechanisms 1 - ph of the gut - CORRECT ANSWER breastfed babies' gut is more acidic while formula-fed babies' guts are more neutral/basic gut bacterial colonies (the microbiome) of mixed fed babies are similar to exclusively formula fed babies" "diarrhea mechanisms 2 - low iron in the gut - CORRECT ANSWER relatively low iron content in human milk" "diarrhea mechanisms 3 - presence of bifidus factor - CORRECT ANSWER promotes intestinal presence of lactobacillus bifidus that maintain the low pH and crowd out pathogenic organisms" "diarrhea mechanisms 4 - presence of hormones - CORRECT ANSWER hormone like factors and growth factors that stimulate growth and development of the GI tract and GI motility, such as: - GI hormones - prolactin - EGF (epidermal growth factor) - prostaglandins" "diarrhea mechanisms 5 - antibodies - CORRECT ANSWER such as SIgA bind to microbes in the baby's intestinal tract and prevent them from being absorbed into the rest of the body. mother's IgA has been found to protect against the development of NEC in preterm infants. maternal IgA shapes the host-microbiota relationship of pretern neonates that IgA in maternal milk is critical and necessary factor for the prevention of NEC" "what increases gastrin and decreases somatostatin in babies? - CORRECT ANSWER - sucking babies have cutaneous (touch) receptors in their mouths that respond to sucking starting at 27 weeks gestation - species own milk - decreased stress - touch - wellness" "adult GI hormones - CORRECT ANSWER also impacted by suckling when mother suckles her gastrin and cholecystokinin go up. this increases the efficacy of insulin and increases the storage of ingested nutrients" "pregnancy & breastfeeding in re: to T2DM - CORRECT ANSWER pregnancy itself may bring an increased risk for Type 2 diabetes in the mother, which breastfeeding can negate. compared with women who have not had children, childbearing women who do not breastfeed have a 50% increased risk of T2DM in later life" "weight loss in the BF neonate - CORRECT ANSWER in first date after birth, most babies lose weight, some from normal diureses" "AAP weight loss stance in 2005 - CORRECT ANSWER "weight loss in the infant of greater than 7% from birth weight indicates possible breastfeeding problems and requires more intensive evaluation of breastfeeding and possible intervention to correct problems and improve milk production and transfer"" "AAP weight loss stance in 2012 - CORRECT ANSWER added "evaluate body weight gain - body weight loss no more than 7% from birth and no further weight loss by day five: assess feeding and consider more frequent follow-up"" "by two weeks at the latest: - CORRECT ANSWER the baby should regained to its birth weight" "infants lose more weight in the first postpartum days... - CORRECT ANSWER - when labor meds are used... but perhaps not at a baby-friendly hospital - when more intrapartum fluids have been given - when there was no labor prior to cesarean however, supplementation rates for weight loss decreased with routine use of 24 hr weight and did not increase untoward effects during the hospital stay" "what do we know about breastfed babies who become dangerously undernourished? - CORRECT ANSWER report by cooper & colleagues identified a significant increase in the incidence of malnutrition and hypernatremia in breastfed infants - 5 sentinel cases in ohio began a chart review of the prior 4 years - chart review babes were 23% below birth weight on average on readmission and showed clinical signs of dehydration and hypernatremia - babies were: not d/c early, nursing q 3-4 or 4-6 hrs, scheduled, both breasts, 5-10. min a side, SLEEPY - researchers found: the class was inadequate, inadequate follow up in the community post-partum" "how has the AAP responded to hypernatremia? - CORRECT ANSWER - ensure formal evaluation and documentation of breastfeeding by trained caregivers (including position, latch, milk transfer, examination) at least for each nursing shift - all breastfeeding newborn infants should be seen by a pediatrician at 3-5 days of age, which is within 48-72 hours after discharge from hospital - evaluate: hydration (elimination patterns), body weight gain (body weight loss no more than 7% from birth and no further weight loss by day 5), discuss maternal/infant issues - observe feeding" "MYTH - size of the breast relates to the amount of milk - CORRECT ANSWER the proportion of glandular and fat tissue and the number and size of the ducts are not related to milk production. for health providers, perceptions of who will have difficulty with breastfeeding may be related to breast size." "MYTH - not getting enough fluids impacts volume of milk - CORRECT ANSWER there is not enough evidence to support increasing fluid intake beyond with breastfeeding mothers are likely to require to meet their physiologic needs" "MYTH - exercising or working too hard impacts supply - CORRECT ANSWER maternal exercise when breastfeeding was not related to changes in macronutrients or volume or infant weight gain or growth. rest is not associated with increased milk production." "MYTH - not getting enough rest - CORRECT ANSWER "fatigue" may be tiredness, but also may be a symptom of an underlying medical problem that could affect milk supply." "MYTH? worry/stress?? - CORRECT ANSWER increased worry/stress does not seem to directly diminish milk supply in humans, however... - worry/stress may alter behavior, which may alter supply" "maternal stress - CORRECT ANSWER breastfeeding mothers may perceive less stress compared to formula fed mothers, breastfeeding mothers: - had more positive moods - reported more positive events - perceived less stress" "stress & hormones - CORRECT ANSWER stress + male hormones = fight or flight stress + oxytocin + female hormones = tend and befriend" "postpartum post traumatic stress disorder (PP-PTSD) - CORRECT ANSWER up to 9% of PP women met the DSM-5 criteria for PTSD after childbirth" "two conditions that increase odds of PP-PTSD - CORRECT ANSWER - depressive symptom scores - total number of physical symptoms experienced since birth" "What are the physical benefits of breastfeeding to the lactating parent? - CORRECT ANSWER Lower risk of breast cancer, lower risk of ovarian cancer, reduced risk of Type 2 diabetes, reduced risk of cardiovascular disease" "What are the 3 main steps of Evidence-Based Practice (EBP)? - CORRECT ANSWER Best available clinical evidence, Clinical expertise, Patient concerns and needs" "What are the benefits of breastfeeding for infants? - CORRECT ANSWER Protective against respiratory infections, asthma, gastrointestinal infections and diarrhea, ear infections, dental caries, teeth misalignment, NEC and SIDS, obesity, diabetes, higher performance on intelligence tests" "What are hypotonic lips in an infant? - CORRECT ANSWER Abnormally LOW muscle tone or weakness in lips- may impact amount of suction, increase work of feeding, can contribute to milk loss and fatigue during feedings" "What are hypertonic lips in an infant? - CORRECT ANSWER Abnormally HIGH muscle tone or overuse of lips- increased lip activity to hold breast in mouth" "What can hypertonic lips be an indication of? - CORRECT ANSWER 1. Neurological abnormality or injury of the tongue, jaws, or facial nerves. 2. Can also be compensating for muscular weakness in the cheeks, jaw, or tongue or reduced lingual or labial mobility secondary to a tight labial frenulum or ankyloglossia (tongue-tie) 3. May be sensory in nature (hypo- or hypersensitive)" "What is a tethered maxillary frenulum? - CORRECT ANSWER Referred to as upper or superior labial frenulum- a tightness or thickness in the band of tissue that attaches the upper lip to the upper gum" "What is a cleft lip? - CORRECT ANSWER A fissure or opening in the upper lip, may extend into the nose, may be unilateral or bilateral" "What is the second most common birth defect? - CORRECT ANSWER Cleft lip" "What is a sign of a possible tight maxillary frenulum? - CORRECT ANSWER Blanching of the frenulum when gently lifting the upper lip, reduced lip movement" "What may cause sucking blisters? - CORRECT ANSWER Friction from retracted lips, a tight maxillary frenulum restricting upper lip mobility, can be secondary cause of tight lingual frenulum (tongue-tie) or hypertonia" "How do you assess cheeks on an infant? - CORRECT ANSWER Place a gloved finger inside infant's mouth and place a thumb on the outside of the cheek to sense the thickness of the fat pads. With thin cheeks, finger and thumb almost touch." "How can you identify weak, thin, or unstable cheeks during a feed? - CORRECT ANSWER Cheeks will collapse while baby sucks. Also look for dimples." "What method can be used to assist an infant with low facial muscle tone during feeds? - CORRECT ANSWER Dancer hold- provide external support during feeding by using fingers and hand to support infant's jaw and cheeks" "What is micrognathia? - CORRECT ANSWER Abnormally small lower jaw" "What is retrognathia? - CORRECT ANSWER Abnormally receding lower jaw" "What can severe micrognathia (abnormal small lower jaw) and retrognathia (abnormally receding lower jaw) be signs of? - CORRECT ANSWER Pierre Robin sequence" "What can infant jaw clenching during feeding be a sign of? - CORRECT ANSWER Hypertonia or a weakness in a different area (e.g. poor tongue or lip function)" "What do you look for when assessing an infant's jaws? - CORRECT ANSWER Observe for asymmetry, Identify micrognathia or retrognathia, Identify jaw grading, clenching, or tremors during feeding"