Certified Lactation Counselor Latest
Exam 2024
__________________ increases and _____________________ decreases in babies while suckling. -
ANSWER Gastrin, somatostatin
10 steps to successful BF - ANSWER 1. Written BF policy. Skin to Skin immediately after
birth.
2. Train healthcare staff
3. Inform pregnant women about benefits and management of BF
4. Help all mothers initiate BF within 1 hour after birth
5. Show mother's how to BF and maintain lactation
6. Exclusive breast milk only
7. Practice rooming in 24 hours a day
8. Encourage BF on demand
9. No artificial teats or pacifiers
10. Establishment of BF support groups
3 strategies for increasing BF initiation and duration - ANSWER Promotion, Protection,
Support
AAP recommendations for BF observation in hospital - ANSWER Formal
eval/documentation by trained staff at least once per shift
Assess latch, position, transfer, exams
Abscess - ANSWER Full of pus, not milk
May be MRSA +
Nursing other breast can still be possible
May not be visible; deep in breast
Ultrasound-guided technique to drain is safe and efficient; should be first choice (though may need
to be repeated)
Alcohol and lactation - ANSWER -Oxytocin decreases while prolactin increases
-Oxytocin release can easily be blocked
-Is water soluble, so it passes in and out of milk as it does blood. Pump and dump won't speed up
process.
All mammals have ____________________________ in their milk - ANSWER lactose
Allergy vs. intolerance - ANSWER -Allergy is a full-body response: eczema, asthma, skin
eruptions, etc
,Certified Lactation Counselor Latest
Exam 2024
-Intolerance is discomfort is a specific location: gas, colic
Alveolar Cells - ANSWER found in the walls of the alveoli, simple squamous epithelial cells,
main sites of gas exchange
Alveoli - ANSWER Small glands in the breast that produce milk
Are mother's GI hormones impacted by sucking and skin contact? - ANSWER Yes, it
activates the parasympathetic nervous system. Increases in gastrin, CCK, and insulin have been
observed.
At-Breast Supplementer - ANSWER a device that allows a supplement to be given while a
baby is actively nursing at the breast,
ex: Supplement Nursing System
Atopy - ANSWER hypersensitive or allergic state involving an inherited predisposition
Average number of feeds in a day? - ANSWER 8-12
Baby poop on days 1-2, 2-3, and 4+ - ANSWER Meconium, greenish transitional,
yellow/seedy
Baby suckle causes a signal to go through the - ANSWER Thoracic/intercostal nerves (T3-T5)
Benefits of BF-SIDS - ANSWER EBF at 1 month, decreased SIDS rate 50% & after
2months +, BF has protective effect against
Benefits of BM for premies - ANSWER faster brain maturation
rapid maturation in intestinal barrier function
significantly lower odds of incidence of NEC & death
Benefits of donor milk - ANSWER -Preventative
-Cost Effective
-Safe
Benefits of rooming-in - ANSWER -Feeding cues more easily observed
-Babies are held STS more
-Fed at their "best" times
-Learning happens together
BF and Environmental Contaminants - ANSWER Toxic exposure occurs in utero, minimally
through milk.
Some populations are at risk use to agriculture or occupational exposure.
BF and Food flavors - ANSWER -Food flavors pass through milk
,Certified Lactation Counselor Latest
Exam 2024
-Longer duration of BF, higher food variety at 3 years
BF initiation rates in the early 1970s - ANSWER 25% (all time low)
BF initiation trends by decade - ANSWER Lowest rates- early 1970s
Increased from early 70s to early 80s
Dropped between early 80s to early 90s
Increased again in 1990s
Biggest intervention time during the first 1000 days - ANSWER Labor and birth- about a 30-
hour window
Bilirubin - ANSWER an orange-yellow pigment formed in the liver by the breakdown of
hemoglobin and excreted in bile.
Blebs - ANSWER -Small white spots on the face of the nipple (looks like a milk filled blister)
-One duct opening is covered
-Stabbing pin point pen
-May exit when treated as clogs
-May require lancing
Breast Anatomy - ANSWER
Breast augmentation incision most related to milk insufficiency - ANSWER Peri-areolar
(signs: perfectly round areola, jagged line from bottom of areola)
Breast development during menstruation - ANSWER - Estrogen: Induces Ductal System
development
- Progesterone: Induces Lobular-Alveolar development
Breast reduction techniques related to BF struggles - ANSWER Free-nipple graft (nipple
entirely removed), pedicle technique, anchor incision- straight line down from areola
Breastfed baby growth patterns - ANSWER Consistent across the world
EBF babies gain faster than FF babies until 3mo, then they gain more slowly than FF babies
This is now standard and not FTT- until it became standard, healthy EBF babies seemed to drop
percentiles
Breastfeeding - ANSWER Baby receives human milk, as well as other foods or fluids,
including formula.
Breastfeeding issues with late preterm and early-term babies - ANSWER -May need more
opportunities to develop latch and transfer skills; weak suck and latch
-Often less alert with less stamina
, Certified Lactation Counselor Latest
Exam 2024
-States change quickly, from deep sleep right to cry
-Very subtle feed cues
-May have a high suck to swallow ratio
Cadmium - ANSWER Soy formula has 6x more than cow's milk. Formula fed babies can be
exposed to up to 12x the amount.
Caffeine - ANSWER -Habits doesn't relate directly to caffeine in milk
-Can accumulate in preemies and very newborns
Calcium needs in mother's - ANSWER -May need dietetic counseling
-Have a lot of calcium during pregnancy, not enough during lactation.
-Women experience 3-9% decrease in bone density during lactation.
Can a woman BF if she has a flat or inverted nipple? - ANSWER Yes!
-Baby's don't need a nipple to latch, they form the teat.
-Many nipples evert from sucking, some don't.
-If the nipple does not evert, the baby's weight gain will need to be followed closely.
Can milk fat be different if the baby is male or female? - ANSWER Yes.. Mother's seem to
produce milk that is 25% higher in fat content for males.
Candida/Thrush (Yeast overgrowth) - ANSWER -May cause pain for mother and baby
-May be visible or not
-Itchy, flaky, and dashing nipple/breast skin
Carb content of human milk - ANSWER 7%
Causes of low EBF rate globally - ANSWER Beliefs about mixed feedings
Lack of hospital/healthcare support
Formula promotion
Lack of family leave policies
Lack of knowledge of dangers of not EBF
Lack of knowledge of BF techniques
Causes of lowered milk production - ANSWER Long time between feeds
Long, slow feeds
Excess pressure in breast (vascular pressure, lymphatic pressure, excess fluid in labor, implants,
oversupply early on)
Exam 2024
__________________ increases and _____________________ decreases in babies while suckling. -
ANSWER Gastrin, somatostatin
10 steps to successful BF - ANSWER 1. Written BF policy. Skin to Skin immediately after
birth.
2. Train healthcare staff
3. Inform pregnant women about benefits and management of BF
4. Help all mothers initiate BF within 1 hour after birth
5. Show mother's how to BF and maintain lactation
6. Exclusive breast milk only
7. Practice rooming in 24 hours a day
8. Encourage BF on demand
9. No artificial teats or pacifiers
10. Establishment of BF support groups
3 strategies for increasing BF initiation and duration - ANSWER Promotion, Protection,
Support
AAP recommendations for BF observation in hospital - ANSWER Formal
eval/documentation by trained staff at least once per shift
Assess latch, position, transfer, exams
Abscess - ANSWER Full of pus, not milk
May be MRSA +
Nursing other breast can still be possible
May not be visible; deep in breast
Ultrasound-guided technique to drain is safe and efficient; should be first choice (though may need
to be repeated)
Alcohol and lactation - ANSWER -Oxytocin decreases while prolactin increases
-Oxytocin release can easily be blocked
-Is water soluble, so it passes in and out of milk as it does blood. Pump and dump won't speed up
process.
All mammals have ____________________________ in their milk - ANSWER lactose
Allergy vs. intolerance - ANSWER -Allergy is a full-body response: eczema, asthma, skin
eruptions, etc
,Certified Lactation Counselor Latest
Exam 2024
-Intolerance is discomfort is a specific location: gas, colic
Alveolar Cells - ANSWER found in the walls of the alveoli, simple squamous epithelial cells,
main sites of gas exchange
Alveoli - ANSWER Small glands in the breast that produce milk
Are mother's GI hormones impacted by sucking and skin contact? - ANSWER Yes, it
activates the parasympathetic nervous system. Increases in gastrin, CCK, and insulin have been
observed.
At-Breast Supplementer - ANSWER a device that allows a supplement to be given while a
baby is actively nursing at the breast,
ex: Supplement Nursing System
Atopy - ANSWER hypersensitive or allergic state involving an inherited predisposition
Average number of feeds in a day? - ANSWER 8-12
Baby poop on days 1-2, 2-3, and 4+ - ANSWER Meconium, greenish transitional,
yellow/seedy
Baby suckle causes a signal to go through the - ANSWER Thoracic/intercostal nerves (T3-T5)
Benefits of BF-SIDS - ANSWER EBF at 1 month, decreased SIDS rate 50% & after
2months +, BF has protective effect against
Benefits of BM for premies - ANSWER faster brain maturation
rapid maturation in intestinal barrier function
significantly lower odds of incidence of NEC & death
Benefits of donor milk - ANSWER -Preventative
-Cost Effective
-Safe
Benefits of rooming-in - ANSWER -Feeding cues more easily observed
-Babies are held STS more
-Fed at their "best" times
-Learning happens together
BF and Environmental Contaminants - ANSWER Toxic exposure occurs in utero, minimally
through milk.
Some populations are at risk use to agriculture or occupational exposure.
BF and Food flavors - ANSWER -Food flavors pass through milk
,Certified Lactation Counselor Latest
Exam 2024
-Longer duration of BF, higher food variety at 3 years
BF initiation rates in the early 1970s - ANSWER 25% (all time low)
BF initiation trends by decade - ANSWER Lowest rates- early 1970s
Increased from early 70s to early 80s
Dropped between early 80s to early 90s
Increased again in 1990s
Biggest intervention time during the first 1000 days - ANSWER Labor and birth- about a 30-
hour window
Bilirubin - ANSWER an orange-yellow pigment formed in the liver by the breakdown of
hemoglobin and excreted in bile.
Blebs - ANSWER -Small white spots on the face of the nipple (looks like a milk filled blister)
-One duct opening is covered
-Stabbing pin point pen
-May exit when treated as clogs
-May require lancing
Breast Anatomy - ANSWER
Breast augmentation incision most related to milk insufficiency - ANSWER Peri-areolar
(signs: perfectly round areola, jagged line from bottom of areola)
Breast development during menstruation - ANSWER - Estrogen: Induces Ductal System
development
- Progesterone: Induces Lobular-Alveolar development
Breast reduction techniques related to BF struggles - ANSWER Free-nipple graft (nipple
entirely removed), pedicle technique, anchor incision- straight line down from areola
Breastfed baby growth patterns - ANSWER Consistent across the world
EBF babies gain faster than FF babies until 3mo, then they gain more slowly than FF babies
This is now standard and not FTT- until it became standard, healthy EBF babies seemed to drop
percentiles
Breastfeeding - ANSWER Baby receives human milk, as well as other foods or fluids,
including formula.
Breastfeeding issues with late preterm and early-term babies - ANSWER -May need more
opportunities to develop latch and transfer skills; weak suck and latch
-Often less alert with less stamina
, Certified Lactation Counselor Latest
Exam 2024
-States change quickly, from deep sleep right to cry
-Very subtle feed cues
-May have a high suck to swallow ratio
Cadmium - ANSWER Soy formula has 6x more than cow's milk. Formula fed babies can be
exposed to up to 12x the amount.
Caffeine - ANSWER -Habits doesn't relate directly to caffeine in milk
-Can accumulate in preemies and very newborns
Calcium needs in mother's - ANSWER -May need dietetic counseling
-Have a lot of calcium during pregnancy, not enough during lactation.
-Women experience 3-9% decrease in bone density during lactation.
Can a woman BF if she has a flat or inverted nipple? - ANSWER Yes!
-Baby's don't need a nipple to latch, they form the teat.
-Many nipples evert from sucking, some don't.
-If the nipple does not evert, the baby's weight gain will need to be followed closely.
Can milk fat be different if the baby is male or female? - ANSWER Yes.. Mother's seem to
produce milk that is 25% higher in fat content for males.
Candida/Thrush (Yeast overgrowth) - ANSWER -May cause pain for mother and baby
-May be visible or not
-Itchy, flaky, and dashing nipple/breast skin
Carb content of human milk - ANSWER 7%
Causes of low EBF rate globally - ANSWER Beliefs about mixed feedings
Lack of hospital/healthcare support
Formula promotion
Lack of family leave policies
Lack of knowledge of dangers of not EBF
Lack of knowledge of BF techniques
Causes of lowered milk production - ANSWER Long time between feeds
Long, slow feeds
Excess pressure in breast (vascular pressure, lymphatic pressure, excess fluid in labor, implants,
oversupply early on)
