ALPP CLC EXAM 2025/2026 UPDATED TEST QUESTIONS WITH ACCURATE SOLUTIONS
(GRADED A+)
breast feeding: a public health priority
has been recognized as a public health priority in tropical climates since the 1930's, but not
until the 1990's in the US
preterm milk
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
has significantly increased fat and energy contents
fore vs hind milk
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
- over the course of lactation
- within the day
- within a feeding
- between feedings
is also changes by the way it is taken
babyled feeding
"the breast-fed baby can regulate his fat intake quickly and thus mothers should be
encouraged to practice baby-led feeding"
maximum fat levels
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
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
,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
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
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
relatively low iron content in human milk
diarrhea mechanisms 3 - presence of bifidus factor
promotes intestinal presence of lactobacillus bifidus that maintain the low pH and crowd
out pathogenic organisms
diarrhea mechanisms 4 - presence of hormones
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
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
(GRADED A+)
breast feeding: a public health priority
has been recognized as a public health priority in tropical climates since the 1930's, but not
until the 1990's in the US
preterm milk
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
has significantly increased fat and energy contents
fore vs hind milk
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
- over the course of lactation
- within the day
- within a feeding
- between feedings
is also changes by the way it is taken
babyled feeding
"the breast-fed baby can regulate his fat intake quickly and thus mothers should be
encouraged to practice baby-led feeding"
maximum fat levels
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
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
,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
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
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
relatively low iron content in human milk
diarrhea mechanisms 3 - presence of bifidus factor
promotes intestinal presence of lactobacillus bifidus that maintain the low pH and crowd
out pathogenic organisms
diarrhea mechanisms 4 - presence of hormones
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
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
