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CERTIFIED LACTATION COURSE EXAM
Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -85 Questions and Answers
-Format: Multiple-choice / Flashcard
Question 1: Lactogenesis II
Answer:
occurs between PP day 3-8 where there is a rapid increase in milk volume for 2-5 days, then abruptly levels off; this is the onset of copious milk supply triggered by rapid drop in progesterone levels after placenta is delivered will feel fullness and warmth in breasts now switches from endocrine to autocrine control
Question 2: what is the WHO code?
Answer:
an attempt to prevent excessive marketing of ABM (artificial baby milk) and to bring awareness of benefits of breastfeeding (although this code is not law in many countries as it interferes with marketing & freedom) breastfeeding education to pubic is critical!
Question 3: mature milk
Answer:
occurs between days 10-14 and onward the longer the breastfeed, the higher the fat (caloric) content of milk (in both one feed and longevity of feedings); fat content higher at end of feedings and the longer one breastfeeds for in total not all breastmilk is 20 cal/ounce milk in second year of lactation has significantly increased fat & calories
Question 4: What are some birthing practices that HCPs and CLS's can delay to promote bonding and breastfeeding between mothers & infants?
Answer:
-infant physical exam in L&D -infant weight -suctioning -eyes (after first feed) & thighs (within 4 hrs) -painful procedures -swaddling -maternal-infant separation
Question 5: what are signs that the let-down reflex is occuring?
Answer:
- leaking from opposite breast than feeding on -nausea -intestinal colic -headaches -infant may feed faster with each let down during a feed
Question 6: what is the role of prolactin?
Answer:
prolactin receptors develop early in lactation and remain constant after that, so increasing prolactin levels are not needed it is permissive rather than regulatory
Question 7: galactopoiesis
Answer:
maintenance of the established milk production under autocrine control works on a supply & demand basis breasts will decrease slightly by 6-9 months pp
Question 8: can a mother breastfeed an infant with galactosemia?
Answer:
NO
Question 9: which hormone helps keep milk production under control until after delivery?
Answer:
Progesterone--levels drop after delivery of placenta & milk production begins in earnest
Question 10: List the 11 steps to SUCCESSFUL breastfeeding?
Answer:
1A. Comply full with International Code of Marketing & WHA resolutions 1B. Have a written evidence-based breastfeeding policy that is routinely communicated to ALL health care staff (keep short & simple so they are implementable) 1C. Establish ongoing monitoring and data-management systems in your facility (TJC req.)
- Educate staff- Ensure they have sufficient knowledge, competence, and skills to support
breastfeeding (this includes ALL interdisciplinary team members in a facility) & evaluate staff attitudes towards BF
- Prenatal education- discuss importance & management of BF with pregnant women and and their
families at prenatal visits and classes/tours
- Skin to skin- immediately & uninterrupted for at least 60 minutes
- Maintain lactation & essential education- positioning & latching, prevention of sore nipples &
- Breastfeed Exlusively- nothing other than breast milk unless medically indicated
- Rooming in- remain together 24 hours a day, decrease interruptions on PP unit (cluster cares)
- Breastfeed on cue- recognize hunger cues & respond, do not feed "according to a clock"
- No bottles/pacis- prevent nipple and/or flow confusion
- Support groups & follow ups- discharge planning for follow-up, breastfeeding support groups &
- Interventions- decrease the use of interventions during the labor process; honor & support mother's
engorgement, how to tell infant is "getting something", nutritional concerns
resources within 3 weeks or less
wishes & birth plan & offer nonpharm pain relief methods when possible
Question 11: proteins (i.e. whey, casein, lactoferrin, lysozyme, SIgA)
Answer:
concentration in breast milk decreases over first few months of life more whey found in breast milk than casein, but vice versa in formula -whey can help kill of different cancerous cells; -casein can cause behavioral issues
Question 12: what is the "foundation" of milk production?
Answer:
lactocytes (milk producing cells) Question 13: What is the most important goal in helping breastfeeding mothers achieve for success?
Answer:
CONFIDENCE
Question 14: Lactogenesis I
Answer:
occurs between 16-20 weeks of pregnancy until milk surges, or comes in, after birth breast size increases differentiation between alveolar cells into secretory cells occur hormone prolactin stimulates mammary secretory epithelial cells to produce milk endocrine (hormonal) control
Question 15: what is breast tissue composed of?
Answer:
2/3 glandular tissue 1/3 adipose tissue
Question 16: what is the purpose of Feedback Inhibitor of Lactation? (FIL)
Answer:
the concept that you must remove milk to make milk; supply & demand, which helps to protect supply ensures amounts of milk in excess of infant's needs are not produced under autocrine control the more FIL, the less milk production; vice versa
Question 17: when is it important to establish good feeding techniques?
Answer:
In the first two weeks; early and often