Man the Force - AG BOLC| 270 QUESTIONS| WITH COMPLETE SOLUTIONS
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Course
Certified Lactation Consultant
Institution
Certified Lactation Consultant
What is the key factor to strength reporting? - correct answerPersonnel Accountability
Which competency does personnel accountability fall under? - correct answerMan the force
Personnel Accountability - correct answerBY NAME
Accurate and Timely Manner
Soldiers, civilians, CAAF, joint, interag...
which competency does personnel accountability fal
what isare some of the characteristics of effecti
army service component comman
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Certified Lactation Counselor QUESTIONS AND
ANSWERS| GRADED A 100%
Predominant Breastfeeding - correct answerBabies who receive breastmilk and other liquids (e.g. water,
minerals, vitamins, oral meds).
Breastfeeding - correct answerBaby receives human milk, as well as other foods or fluids, including formula.
Complementary Feeding - correct answerProcess starts when BM alone or infant formula alone is no longer
sufficient to meet nutritional requirements of infants, therefore other foods or liquids are introduced. Typically
child is between 6-23 months
3 strategies for increasing BF initiation and duration - correct answerPromotion, Protection, Support
Promotion - correct answerFocuses on advantages of BF on a personal, community, country, or global level.
BF to the community.
Protection - correct answerFocuses on government, manufacturer, and social responsibility to assure BF ability
to compete with commercial interests.
Includes state, local, an national laws regarding BF.
International Code of Marketing of Breast-milk Subsitutes - correct answerAddresses improper marketing
practices by formula companies. It is not currently a law in the US.
What does the International Code Prohibit? - correct answerDistributing free formula
Giving coupons for formula
What did the AAP resolution state in regards to the International Code? - correct answerNo distributing formula,
discharge bags, industry written handouts.
Support - correct answerFocuses on interaction of helpers with family, as well as program development and
implementation.
10 steps to successful BF - correct answer1. 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
Healthcare staff responsibility for working with lactating mothers include what? - correct answer1. Training
2. Minimum of 20 hours of training
3. 3 hours of competency verification
What are the indications for providing supplementation other than breast milk? - correct answer1. Medical
condition
2. Parents request after being informed of consequences
Protocol for calculating Baby's daily needs - correct answerBaby's weight x 2.5 (2.7 or 3.0 if Baby needs to
catch up weight) = daily ounces. PCP decides what the multiplier is!!!
What should be assessed 3-5 days after birth by PCP? - correct answerHydration (elimination patterns)
Body weight (no more than 7% loss)
Observe Feeding
Maternal or infant issues
What is a CLC? - correct answerNationally recognized designation awarded by the ALPP. Practice parameters
are designated by professional scope of practice.
How many stools per day should a breast fed newborn have? - correct answer4, some yellow by day 4.
When should a baby be back to birth weight? - correct answer12-14 days post birth
How much weight should a baby gain daily? - correct answerApproximately 1 ounce
Why do women supplement with formula when there is no medical need? - correct answer1. Lack of
preparation for what the newborn period would be like.
2. Lack of timely interventions
Alveoli - correct answerSmall glands in the breast that produce milk
At-Breast Supplementer - correct answera device that allows a supplement to be given while a baby is actively
nursing at the breast,
,ex: Supplement Nursing System
Atopy - correct answerhypersensitive or allergic state involving an inherited predisposition
What is the BFHI Baby Friendly Hospital Initiative - correct answerInitiative by UNICEF and WHO (1991) to
support breastfeeding in hospitals and maternity centers. "The 10 Steps".
Unicef. Baby-Friendly Hospital Initiative. Available online:
http://www.unicef.org/programme/breastfeeding/baby.htm.
Bilirubin - correct answeran orange-yellow pigment formed in the liver by the breakdown of hemoglobin and
excreted in bile.
CCK (cholecystokinin) - correct answerHormone that regulates the emptying of the gallbladder and secretion of
enzymes by the pancreas.
Colostrum - correct answerThick, milky fluid secreted by the breast during pregnancy and during the first days
after birth before lactation begins. Causes a laxative effect which helps the baby pass meconium.
Coryllos type - correct answerClassification system for anklyloglossia (tongue-tie)
Dancer Hand Position - correct answerTechnique used to support Baby's chin and mother's breast. Use Thumb
and index finger under chin, remaining 3 fingers to support breast.
Alveolar Cells - correct answerfound in the walls of the alveoli, simple squamous epithelial cells, main sites of
gas exchange
myoepithelial cells - correct answercontract in response to stimulation by sympathetic nervous system and
squeeze milk up the duct
Montgomery glands - correct answerBumps on breasts (Look like goosebumps)
Produce a unique blend of milk and sebum (skin oil)
Modern study of the structure of the breast reveals what? - correct answer-Fat is mixed throughout the breast
-Uneven spacing of the ducts
-3-5 functioning nipple pores (May have 5-9, but not all work)
-No lactiferous sinus
What are the 2 hormones pathways that control lactation? - correct answerProlactin and Oxytocin
Prolactin (4 details related to milk production) - correct answer1. is triggered by touch (pregnant and non
pregnant women). Higher levels when stimulating breast/nipples vs breast alone.
2. Lengthening time between feeding leads to lower baseline levels. (Weaning)
3. levels go down between nursings and rise during nursing.
4. Infrequent nursing leads to lowering of this hormone
Average number of feeds in a day? - correct answer8-12
What produces colostrum? - correct answerProgesterone in the receptor sites
What produces more mature milk? - correct answerProlactin in the receptor sites
What happened when infants suckled in the first 2 hours of birth? - correct answerIngested significantly more
milk on day 4
What happened to mother of preemies who initiated milk expression within 1 hour of birth? - correct answerHad
significantly more milk when measured on days 7 and 42. Better to stimulate breasts throughout the day right
after birth to continue to stimulate production.
Oxytocin - correct answerA hormone released by the posterior pituitary that stimulates uterine contractions
during childbirth and milk ejection during breastfeeding.
What 3 things can trigger Oxytocin? - correct answer1. Conditioned response
2. Nipple stretching
3. Hand massage
Conditioned Response from Milk Ejection (Let down) - correct answer-Example- Mother lets down when not
near baby, but hears a baby cry.
-Conditioned over time
-Faster for women who have BF in the past
-To condition the response can use any sense-smell, touch, sound
Nipple stretching - correct answerOnly happens with a proper latch
Hand massage: Baby - correct answerWhen we allow babies to be more hands on they can help control flow
rate by how they massage the breast.
How many triggers does Oxytocin have? Can it be triggered by stress. - correct answer3 triggers. Yes.
What is hormone is triggered by stimulation? - correct answerProlactin
What 3 emotional/behavioral function do the hormones of lactation have besides making milk? - correct
answer1. Aggression
2. Protection
3. Bonding/trust
, What is special about the composition of milk? - correct answer1. Mammal species with higher water content
milk feed more frequently.
2. Prolactin triggers production of lactose in the mammary cells.
What are the different care patterns of mammalian mother's and their babies? - correct answer1. Nest (eg.
puppies, cats) OR cache (deer, rabbit)
2. Carry (monkey), follow (giraffe, bison), or hibernate (bear)
What kind of milk has the highest lactose of all mammalian milk? - correct answerHuman milk: high in water,
low in protein and fat.
When does paracellular transport occur? - correct answer1. In the first few days after birth
2. Mother with low prolactin levels
When are cells not plump? - correct answerDuring paracellular transport
Transcelluar pathway - correct answerSubstances must go through the milk cell to enter the milk.
Cells are plump and can no longer go around.
Why is colostrum easier to suck/swallow - correct answerBecause it is thicker and takes longer to express from
the breast.
What are the 3 stages of milk making? - correct answer1. Secretory Differentiation: Lactogenesis I
2. Secretory Activation: Lactogensis II
3. Lactation: Lactogenesis III
What happens during Secretory Activation? Lactogensis II - correct answerRapid drop in progesterone, mature
milk making is activated
What happens during Secretory Differentiation? Lactogenesis I - correct answerCells grow and expand
When does breast milk composition change? - correct answerCan occur:
1. Within a feeding
2. Within a day
3. Over course of lactation
What happens during Lactation? Lactogensis III - correct answerMature milk is being made. frequent
expression of milk
Preterm milk composition is... - correct answerHigher in protein, fat, and electrolytes than mature milk
What is foremilk? - correct answerfirst milk excreted at the beginning of feeding. Does not always mean low fat.
What is hindmilk? - correct answerMilk at the end of the feed. Not always higher in fat.
When is fat transfer high? - correct answerWhen oxytocin levels are high.
Does a mother need to nurse both breasts in one feed? - correct answerNo. Some babies do better on one
breast per feeding.
Who regulates the fat intake when feeding? - correct answerThe baby can regulate his fat intake quickly.
When is fat content higher? - correct answerWhen the flow is faster.
Can milk fat be different if the baby is male or female? - correct answerYes.. Mother's seem to produce milk
that is 25% higher in fat content for males.
galactorrhea - correct answerabnormal discharge of milk.
Ex: Men make milk, due to brain tumors or drug side effects (haldol, Thorazine).
Reasons why BF protects babies from diarrhea? - correct answer1. pH of the gut is lower. Bifidus factor
promotes growth of friendly bacteria which maintains lower pH in the gut.
2. Low iron in the gut. Organisms need iron to survive! Lactoferrin deprives bacteria of iron.
3. Hormones and growth factors stimulate growth, development, and motility of the gut.
4. Antibodies (e.g. Secretory IgA [SIgA] which bind to microbes in the digestive tract and prevent them from
being absorbed.
5. WBC kill microbes (e.g. B and T lymphocytes)
6. Cell wall disrupters that kill microbes by destroying the cell walls
7. B12 binding factor. Same result as iron.
8. Mucous also wall protectors which keep bacteria from attaching to the cell wall.
9. Microbes (bacteria from the mother's intestine) from the mother's skin transferred to baby.
10. Absense of exposure to contaminants (e.g. bottle, water, teat)
11. Exposure to mother's immunize system.
12. Cells from the babies mouth go into the mother's breast. Antibodies are made in the breast.
Does feeding a baby formula occasionally make a difference? - correct answerYes, even just one bottle can
impact the pH of the babies gut.
Gut of exclusive BF baby is lower (more acidic), while gut of formula fed baby is more neutral
What bacteria do formula fed babies have an over abundance of? - correct answerC Diff
Vagal nerves (parasympathetic) - correct answerStimulates peristalsis and secretion not the GI tract
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