CLC EXAM TEST BANK 2023 CERTIFIED LACTATION CONSULTANT EXAM TEST BANK 400+ QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS)
CLC EXAM TEST BANK
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.
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
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
-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
Nipple pain and poor milk transfer that is persistent despite optimal latch
-can use nipple shield as a test to see if baby exerting too much pressure?
-OT involvement
-in rare cases baby have a strong sucking vacuum as measured by a pressure
transducer or nipple shield
Clogs/plugs
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 of milk
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