CLC Exam with 100% Correct Answers 2023

The International Code - Correct answer-addresses improper marketing practices ex hospital giving out discharge packages with formula Milking Stool- 3 legs - Correct answer-Protect, promote & Support-want all to be equal Levels of evidence based pyramid - Correct answer-top - bottom: 1.Metanalysis &systemic reviews 2. Single randomized controlled studies 3. Cohort studies 4. Case Controlled Studies 5. Case Studies When is greatest risk of stopping breastfeeding? - Correct answer-3-7 days (after going home from hospital) Top reasons people stop breastfeeding - Correct answer-baby won't latch, breast pain/soreness, work/school Russ Labs Marketing Survey - Correct answer-survey formula company tracking breastfeeding goals Races in Order most likely to BF - Correct answer-spanish speaking-hispanic, white, hispanic, black Global Strategy for Infant and young feeding - Correct answer-WHO and UNICEF developed this global strategy to focus world attention on impact of feeding practices on the nutritional status, growth, development and health and thus the survival of infants and young children. World Breastfeeding trends innitive - Correct answer-help track how they are doing on global outcomes innocenti ospitale -florence - Correct answer-BF orphan babies increased rate of survival-today UNICEF child resource nutrition center path of messages to make milk - Correct answer-message to breast-to nervous system -to brain- to hormones to travel to breast- then to blood stream what cells make milk - Correct answer-alveolar cells alveolar cells are what? what are they surrounded by - Correct answer-layer of cells with milk inside, surrounded by myoepitheal cells Myoepitheal cells will contract when what hits them - Correct answer-oxytocin Are the ducts in breast evenly spaced? - Correct answer-No varies woman to woman How many nipple pores each breast? - Correct answer-3-5 Milk is ____ &_____ from sebaceous gland - Correct answer-antimicrobial and sticky what are the two major hormone of lactation? Where are they secreted from? - Correct answer-oxytocin and prolactin, pituitary gland Prolactin is the hormone responsible for? - Correct answer-Milk production What is the passage of prolactin being produced - Correct answer-baby sucklesmessage to nervous system tells brain to secrete prolacin in blood- then tranverse into mother body into milk cells where milk is produced When doe humans have prolactin in them - Correct answer-all the time (non pregnant, non lactating breast and nipples increase level of prolactin when touched) Prolactin levels go _____ in between nursing and _____ during nursing. - Correct answer-down, rise _______ nursing leads to lower levels of prolactin and less rise with same amount of contact. - Correct answer-infrequent If infants do no have frequent times at breast first few days prolactin will be _____ and sites will ____ be primed and receptor sites will start to ______ _______. - Correct answer-low, not, start shutting down What is in receptor site during pregnancy? - Correct answer-Progesterone When placenta leaves the body, the body responds by pushing ______ out of the receptor sites? - Correct answer-progesterone When placenta is pushed out of body, progesterone leaves the receptor sites and they are open briefly, what goes inside to set site for lactation? - Correct answer-Prolactin If prolactin is not set during first few hours after birth- - Correct answer-there will be fewer sites and cause issues with milk supply Ongoing milk supply is associated with suckling within first ______ hours after birth - Correct answer-2 For mothers with preemies initation of milk expression before _______ hours resulted in significantly more milk by day 7 - Correct answer-one What hormone T3, T4, T5 - Correct answer-Oxytocin When oxytocin hits myoepitheal cells what happens? - Correct answer-They start retracting Oxytocin helps ducts to ______ in size and lumen to get ______ - Correct answerincrease, smaller What triggers oxytocin? - Correct answer-1. conditioned response (repeated stimuli over time) 2. Nipple Stretching (happens with proper latch- oxytocin levels goes up and down with suck and swallow) 3. baby hand massage (has to do with T3 and T5) each hand movement releases oxytocin Where is oxytocin and prolactin excreted? - Correct answer-pituitary gland ______ is excreted from posterior pituitary? - Correct answer-Oxytocin ______ is excreted from anterior pituitary? - Correct answer-Prolactin Prolactin is produced mainly by nipple ______, by presence of baby stimulation T ____ & T____ - Correct answer-stimulation, 4 and 5 ________ hormone is affected by stress and ______ hormone is not affected by stress - Correct answer-oxytocin (extreme situation, will stop flowing), prolactin Milk is species ______. - Correct answer-Specific Mammal species with high fat/protein and low water content have ______ feeds. - Correct answer-infrequent Lactose is essential for milk production because it provides the driving ______ force behind the formation of milk. - Correct answer-osmotic Human milk has the highest _______ of all mammal milk. - Correct answer-lactose human milk is ideal for ______ growth - Correct answer-brain Lactogensis stage 1 is secretory differentiation and production of _______ under influence of _______ hormones. When placenta is delivered _________ hormones is gone and _____ goes into receptor sites. Then we go to ________. - Correct answer-colustrum, placental, progesterone, prolactin lactogensis stage 2 Lactogensis stage 2- rapid decrease in _______ and now ______ is in cells. The colustrum will change over to ______ milk and colustrum will go ______. - Correct answer-progesterone, prolactin, mature, down Lactogensis stage 3 is also called ( has two other names) - Correct answer-lactation or galactopoesis Lactogensis stage 3 has _____ from frequent nipple stimulation, there is ______removal of milk and long term production of ______ - Correct answer-prolactin, frequent, milk As prolactin goes into receptor sites and makes milk the ______ disappear - Correct answer-spaces Preterm milk appears to have higher ______, _______ and _____ than term milk (sga, lga does not matter) - Correct answer-protein, fat and electrolytes Breastmilk changes after 6 months it is more _____, fat _____ and after a year fat _________ and energy content ______ - Correct answer-dense, increases, increases, increases does it matter if it is foremilk, hindmilk - Correct answer-no think of kalahari desert nurse for 2.5 min at a time Breastmilk composition ______ during a feed. - Correct answer-changes when doing before and after breastfeeding weight even if volume is low, fat content can be _______. - Correct answer-high the degree of breast ______ influences the amount of milk available and breast storage _____ influences the amount of fat transfered. - Correct answer-emptying, capacity longer times in between feed leds to ______ fat concentration - Correct answer-lower faster milk removal is associated with _____fat content and longer feeding time is associated with ______ levels of milk transfer and _____ fat - Correct answer-higher, lower, lower Does one breast or two breast feed matter? - Correct answer-doesnt matter just do whatever seems better for baby Do male babies haver higher energy content in milk? - Correct answer-yes Can men produce milk? What situation? Men can never produce? - Correct answer-yes, tumor/drugs, colustrum Formula fed babies have ______ extra in the gut - Correct answer-iron Presence of bifidus factor in milk promotes presence of _________ ________ maintaing. a ____ PH and crowd out pathogenic _______. - Correct answer-lactobicillus bifidus, low, organisms Formula fed babies have increased number of species and over representation of - Correct answer-C-diff BF babies have antibiodies that bind to _______ in GI tract that keep them from getting absorbed. This helps to protect from NEC IN preemies. - Correct answer-microbes What do human milk oligosaccharides (HMOs) do? - Correct answer-Protect against pathogenic infection, promote development of intestine, help establish gut microbia, stimulate maturity of immune system Breastfeeding changes immune system in mother or baby - Correct answer-both forever when baby is suckling it activates her _______nervous system. Decreasing levels of _________ and increasing levels of ____ causing a feeling of sedation and satiety. - Correct answer-parasympathetic , somatostatin and gastrin Pregnancy can increase risk for type 2 diabetes, breastfeeding can negate this, suckling changes insulin back to ________. - Correct answer-pre pregnancy state After first few days of birth most babies loose weight (diuresis-loosing fluid after birth) how much weight loss is acceptable? When should weight loss stop? When should baby be back to birth weight? - Correct answer-less that 7% according to AAP, by day 5, by 2 weeks Breastfeeding stool color change - Correct answer-meconium-dark to start then greenish tinge then seedy orange or yellow Need at least _____ breastfeeds per day? - Correct answerAAP says should be at least _____ formal evaluation and documentation of trained caregiver per shift - Correct answer-one Does it make a difference if mother is undernourished for breastfeeding? In refugee camp what is safer breastfeeding or formula? - Correct answer-No, breastfeeding - no access to clean water, heating sterilization Breast size affects milk production? T/F - Correct answer-False Does increasing fluid increase milk production T/F? - Correct answer-False Too much exercise can impact milk production? T/F - Correct answer-False Does stress impact milk production? T/F - Correct answer-False although stress can change behavior When infant suckles at breast there is outpoor of ___ different GI hormones? - Correct answer-19 How many extra calories per day are required when breastfeeding? - Correct answer500 secretory activation is also called - Correct answer-lactogensis stage 2 the absence of the placenta leads to lactogensis stage, then drop in progesterone leads to lactogensis stage ___ - Correct answer-2, 3 In nipple engorgement breast is _____, body temp ____, brest can be hot and ____ - Correct answer-hard, increased , shiny Engorgement typically happens days ___-___, women with c-sections may experience engorgement ______ - Correct answer-3-5, laet With engorgement the more time spent breastfeeding in the first 48 hours will result in less _____, it pressure is not resolved it will have a ____ impact on breast milk supply. - Correct answer-engorgement, negative Engorgement can be natures _____ - Correct answer-dry up method Inbetween milk making cell systems there is a capillary network delivering nutrients for making milk, if those are crushed nutrient and hormones cannot go where they need to go. What can crush these and cause problems? - Correct answer-Engorgement Will pumping help engorgement - Correct answer-No can bust capillaries and cause bleeding How to help with engorgement? - Correct answer-Bucket warm water-immerse breast and within seconds milk will come out, dont want to let all milk into bucket just get some out until plyable and softer, then feed rest to baby What can cause engorgement? - Correct answer-too much milk left in breast (baby is too weak), breast implants, tight bra What is a marker that they had a breast augmentation - Correct answer-really round aeorola, or incision Can woman with implants/ breast reduction breast feed? - Correct answer-Yes do not know impact until trying, just because colostrum not sure if will get normal milk - colustrum is pregnancy hormone induced, need nerves for rest of milk Can a baby latch with inverted nipple? - Correct answer-Yes baby can form teat, although thing about the need for nipple stroking (prolactin) and nipple stretching (oxytocin) 3 classification of inverted nipples - Correct answer-grade 1- easily pulled out by breast pump or nursing, at reast look inverted grade 2 can be pulled out but dont maintain their projection grade 3 difficult or impossible to pull out iron deficiency anemia has been associated with milk supply problems due to? - Correct answer-Poor oxygen to milk making cells, or causing mom to feel exhausted or depressed causing lack of bf Sheehan's syndrome (postpartum pituitary necrosis) - Correct answer-A patient fails to lactate after an emergency C-section with marked blood loss. Pituitary has been deprived of blood and functions are impaired other symptoms included low blood pressure, anemia, fatigue, profound hair loss, dull hair. Can have symptoms partially or fully resolved. Maternal obesity/overweight can delay lactogenis ___ - Correct answer-2 PCOS excess insulin increases production of _____, higher androgens cause acne, excessive hair growth, wt gain and problems with ovulation and _______, possible treatment with - Correct answer-androgens, lactation, metformin Drug that cause milk delay? - Correct answer-peeudoephedrine (think pseudofed), corticosteriods, betamethason (giving to women who will deliver before 24 weeks) if given 3-9 days before delivery can delay lactogensis 2 Mothers who smoke have lower _____ levels if smoked within 12 hrs. - Correct answerprolactin Are nicotine patches safe during BF - Correct answer-refer to healthcare provider Cadmimum is a heavy metal found in _____ and _____ - Correct answer-cigarettes and formula What types of formulas have more cadmimum? - Correct answer-Soy based 22% of all SIDs contributed deaths can be contributed to - Correct answer-maternal smoking during pregnancy Are electronic cigarettes safe in pregnancy? - Correct answer-tested by FDA some contain nicotine and carcinogens, nicotrine transfer appears minimal Cannabis and Breastfeeding? - Correct answer-passive exposure is a concern, no safe threshold, lack of studies and high fat solubility makes cannabis difficult to analyaze in breast milk, opinions vary THC is still measurable in EBM ____ days after maternal marijuana use - Correct answer-6 Pacifiers increase risk for ______ and _____ - Correct answer-diarrhea and ear infections Pacifiers for preemies? - Correct answer-May have earlier hospital discharge, tube fed may gain weight faster, improve physiologic and behavioral responses and reduce the time to oral feeds, will not affect breastfeeding for preemies Babies that recieve additional water are at risk for? And this can cause - Correct answer-Water intoxication- can cause seizures, stroke, death Early cessation/negative experience of breastfeeding has a increased risk of postpartum _______ - Correct answer-depression What is postpartum depression scale? - Correct answer-Edinburgh Postnatal Depression Scale -EPDS Mothers with EPDS scores greater than ____ are likely to d/c breastfeeding by week 4- 12. - Correct answer-12 Womans ways of knowing is by - Correct answer-Mary Belenky What are the 5 characteristics of womans ways of knowing? - Correct answer-1. Silence 2. Recievers of knowledge 3. subjective knowing 4. Procedural knowing 5. Constructive Knowing Silence way os knowling - Correct answer-afraid of words, feels powerless, depends on others, little awareness of intellectual capabilities, having powerful person in charge ex paulette legally blonde How do we develop relationship with person in Silence? - Correct answer-Few words, short easy, comfortable, nothing to remember advocate Recievers of Knowledge? - Correct answer-Believe all authorities tell truth, like to learn right answer and tell it to the teacher, cannot tolerate ambiguity ex: vivian pretty woman