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PCE Certified Breastfeeding Counselor Exam Q&A
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PCE Certified Breastfeeding Counselor Exam Q&A
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PCE Certified Breastfeeding Counselor Exam Q&ADifferent stages of breast development - Embryogenesis - Mammogensis - Lactogenesis 1 - Lactogenesis 2 - Lactogenesis 3 Correct Ans - Embryogenesis: mammary gland devo while 5 wk embryo
Mammogenesis: @ puberty, estrogen influences growth of ducts and buds
Lactogenesis 1: completion of mammary development from placenta stimulation; ducts stimulated + colostrum secretion at 16 wks
Lactogenesis 2: Secretory activation when placenta out --> decr progesterone --> inc prolactin --> inc milk supply Lactogenesis 3: Milk removal --> mature milk prod; Infant sucking= ^ oxytocin= let down.
Estrogen Progesterone
Prolactin Oxytocin TSH Correct Ans - Estrogen - ^ during pregnancy; stim growth in ductile system Progesterone - ^ during pregnancy; stim alveoli and lobes Prolactin - frm ant pituitary gland; lands on prolactin receptor sites to start milk prod Oxytocin - from post pituitary gland; cause LETDOWN TSH - ^ responsiveness of mammary cells
Tail of spence: What is it, symptoms Correct Ans - Mammary gland tissue that extends to axillary area, connected to milk ducts --> can cause swollen armpits & mastitis
Accessory tissue: Where are they found? Can they lactate? Correct Ans - Diagonal line from axilla to groin area - can lactate & undergo malignant change
Flat nipples
Pseudo inverted nipple Retracted nipple Inverted nipple - possible issues, short shank, solutions Correct Ans - Flat - remains flat after stimulation or retract with compression (short shank) --> diff w/ latch Pseudo - seems inverted but erect upon stimulation Retracted - retracts upon stimulation Inverted - retracted at rest &s stimulation Nipple shield may help. Hypoplasia, what is it? Correct Ans - Underdevelopment, insufficient glandular tissue --> can lead to insufficient milk
Active let down - How is milk ejected into ducts from alveoli? aka let down - signs of let down - postions that are helpful for let down Correct Ans - Myoepitheal cells encase the aveoli, contract in response to oxytocin. In response to sucking oxytocin increases
Tingling, warmth, fullness, dripping, contractions
helpful in australian/saddle
What is breast milk composed of? Correct Ans - - Fats: most variable, help brain devo, hi in evenings
-Protein: Casein- allows for iron to be absorbed, mature milk. Whey- hi in colostrum, contains IGA; has lysozyme that kills bacteria
Carbs: creates acidic environment in gut & has lactose that reg milk vol Vitamins: A,D,E,K,C, thiamin, riboflavin, b's that influenced by mom. Minerals: calcium, phosphorus, magnesium, not affected by diet. + 88% water
Impact of breast surgery on lactation - Implants - hyaluronic acid injections - breast reduction Correct Ans - Implants - compress milk ducts --> impede milk flow --> compromise reaching max milk vol Hyaluronic acid injections - no risk of being absorbed in baby's GI tract Reduction - BF might not be possible after - BF early + stim bm early
Signs of milk transfer Correct Ans - Swallowing, air from nose, ca sound, movement seen
Feeding patterns 24-48 hrs & 48 and further Correct Ans - 24-48hr --- > Cluster feeding (feed freq over short amt of time) , must stimulate breast
48 and further --> on demand (cue based feeding) ; offer q 3 hrs
How does poop transform?
Normal urine output Correct Ans - Black to green to yellow (by end of first week). Watery and seedy at first
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