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CLC EXAM 20 26 VERSION 2 /CERTIFIED
LACTATION COUNSELOR EXAM VERSION 2
NEWEST 20 26 ACTUAL EXAM COMPLETE 250
QUESTIONS AND CORRECT ANSWERS
How does breastfeeding affect T2DM risk? - CORRECT ANSWER✔✔ It negates the risk that incurs during pregnancy. Not breastfeeding increases risk by 50% What is the expected weight loss in a newborn? - CORRECT ANSWER✔✔ < 7% before day 5, regain birth weight by 2 weeks of age what birth factors cause infants to lose more weight? - CORRECT ANSWER✔✔ - Use of labor meds in non-baby friendly hospital
- more interpartum fluids given
- no labor prior to c-section What is the First 1000 Days Campaign? - CORRECT ANSWER✔✔ A worldwide initiative to prevent stunting and increase prevalence of breastfeeding and education
How can breastfeeding prevent maternal death? - CORRECT ANSWER✔✔ Decreased risk for MI, stroke, and metabolic syndrome. BF decreases risk of breast and ovarian cancer, as well as cancer mortality What are the three pillars of breastfeeding? - CORRECT ANSWER✔✔ Protection, Promotion, Support Which pillar of BF includes assuring breastfeeding ability to compete with commercial interests and create BF-friendly legislation? - CORRECT ANSWER✔✔ Protection Which pillar of BF describes advantages of BF on many levels? - CORRECT ANSWER✔✔ Promotion Which pillar of BF is associated with interventions to increase rates of BF? - CORRECT ANSWER✔✔ Support What are some unrealistic expectations that moms have with breastfeeding? - CORRECT ANSWER✔✔ - Being a stay at home mom
How do messages from the breast cause milk to be made? - CORRECT ANSWER✔✔ messages travel through CNS to brain via hormone signaling triggered by breastfeeding what cells make milk? what are they surrounded by? - CORRECT ANSWER✔✔ Alveolar cells make milk and are surrounded by myoepithelial cells What cells squeeze milk out of alveolar cells and into duct? - CORRECT ANSWER✔✔ Myoepithelial cells are ducts even or unevenly spaced in the breast? - CORRECT ANSWER✔✔ uneven, but can congregate what is the impact of unevenly spaced ducts on breastfeeding? - CORRECT ANSWER✔✔ Babies get more milk in different positions When do Montgomery glands appear? - CORRECT ANSWER✔✔ soon in pregnancy on areolar surface
What hormone is responsible for milk production? Where is it released? - CORRECT ANSWER✔✔ Prolactin, released from anterior pituitary What causes release/increase in prolactin? - CORRECT ANSWER✔✔ Nipple stimulation What is the ideal timing of feeding to increase prolactin production? - CORRECT ANSWER✔✔ Frequent nursing with short inter-bout interval How does immediate feeding after birth lead to better milk supply? - CORRECT ANSWER✔✔ It increases prolactin sites available for binding with a decrease in progesterone. This maximizes sites for prolactin binding which allows for greater milk production. Which hormone stimulates release of milk? - CORRECT ANSWER✔✔ Oxytocin What triggers oxytocin release? Give three - CORRECT ANSWER✔✔ 1. Conditioned response from previous BF experience
In what stage of lactogenesis does the placenta have influence? - CORRECT ANSWER✔✔ Stage 1, Secretory differentiation. Decreases after placental delivery. What stage of lactogenesis results in colostrum? - CORRECT ANSWER✔✔ Stage 1, Secretory differentiation What hormonal changes occur with lactogenesis stage 2 (secretory activation)? what kind of milk is produced? - CORRECT ANSWER✔✔ Progesterone quickly decreases and transitional milk produced Galactopoiesis - CORRECT ANSWER✔✔ production of milk lactogenesis stage 3 is characterized by an increase in what hormone? - CORRECT ANSWER✔✔ Prolactin from frequent nipple stimulation What is the expected amount of breastmilk to be produced with mature milk? - CORRECT ANSWER✔✔ 750 - 1000 mL/day
What is the paracellular pathway? - CORRECT ANSWER✔✔ the space between cells is minimized due to prolactin drawing water into the cells, preventing blood substances from entering the milk how does milk change calorically vs volume after 6 months? - CORRECT ANSWER✔✔ no change in volume, increase in caloric density What three factors can influence fat transfer from breastmilk? - CORRECT ANSWER✔✔ 1, degree of breast emptying
- amount of mlk
- breast storage capacity How does longer time between feedings affect fat concentration? - CORRECT ANSWER✔✔ decreases are longer or shorter feedings associated with lower fat content? - CORRECT ANSWER✔✔ longer How can breastmilk affect the pH of an infant gut to prevent diarrhea? -
How does suckling affect gastrin, CCK and somatostatin? How does this affect growth? - CORRECT ANSWER✔✔ Increases gastrin, decreases somatostatin. It increases insulin efficacy and storage of nutrients, promoting growth
in BF infants, what is hypernatremia reflective of? - CORRECT ANSWER✔✔ inadequate milk transfer during breastfeeding What should be evaluated at a PCP visit at DOL 3-5? - CORRECT ANSWER✔✔ Hydration, elimination, weight gain/loss how does undernutrition in mom affect breastfeeding? - CORRECT ANSWER✔✔ no difference in infant growth, but moms are more attentive with better nutrition status T/F: proportion of glandular tissue and breast size are related with milk production - CORRECT ANSWER✔✔ false T/F: increased fluids above maintenance does not increase milk supply - CORRECT ANSWER✔✔ true T/F: exercise decreases milk production - CORRECT ANSWER✔✔ False
T/F: women with flat or inverted nipples cannot breastfeed - CORRECT ANSWER✔✔ False; they form a teat and usually are able to breastfeed How are inverted nipples classified? - CORRECT ANSWER✔✔ By function during feeding Grade 1: pulled out easily during nursing Grade 2: can be pulled out but do not maintain projection Grade 3: difficult or impossible to pull out Why does anemia affect breastfeeding? - CORRECT ANSWER✔✔ Poor oxygen delivery to milk-making tissue and alteration of coping behavior What syndrome is characterized by pituitary deprivation of blood, hair loss, fatigue, anemia, and can be diagnosed up to 30 years after pregnancy/ - CORRECT ANSWER✔✔ Sheehan's syndrome How do thyroid imbalances affect breastfeeding? - CORRECT ANSWER✔✔ Affect release of hormones and can cause increased/decreased supply
What is the effect of pseudoephedrine and corticosteroids on milk production? - CORRECT ANSWER✔✔ Pseudoephedrine decreases milk supply by decreasing prolactin. Corticosteroids suppress lactation and milk volume what changes to milk can occur if pregnant while lactating/ - CORRECT ANSWER✔✔ - switches back to colostrum
- sore nipples
- hormonal shifts How does smoking affect milk supply? - CORRECT ANSWER✔✔ Decreases prolactin which decreases milk production What can pacifier use indicate in terms of breastfeeding? Which group of infants may benefit from pacifier use? - CORRECT ANSWER✔✔ More education needed on feeding cues, hunger, crying, etc. Premature infants can benefit from pacifier use
What way of learning believes that authority figures tell the truth, do not like ambiguity, and like to repeat the right answer? - CORRECT ANSWER✔✔ Category 2: Receivers of Knowledge Which way of learning believes knowledge is personal and private, trusts their own intuition over experts, and embeds themselves in definitions and roles? - CORRECT ANSWER✔✔ Category 3: Subjective Knowing Which way of learning prefers procedures for acquiring knowledge, understands other POV, will change providers easily, but may want technical information? - CORRECT ANSWER✔✔ Category 4: Procedural Knowing Which way of learning understands truth to be contextual, can live with conflict, embraces all titles given to them, and has significant empathetic potential? - CORRECT ANSWER✔✔ Category 5: Constructed knowing Starting at the top of the WHO feeding pyramid, what is the order of type of feeding for a term baby? - CORRECT ANSWER✔✔ 1. Baby at mother's breast
- Mother's own expressed milk
- Donor expressed milk
- Cow's milk formula
- Soy formula What does pasteurization process for donor milk do to the milk? - CORRECT ANSWER✔✔ Destroys some of the beneficial components found in human milk What are some reasons that formula use is so high in the US? - CORRECT ANSWER✔✔ inadequate maternity leave, unequal pay, maternal morbidity, lack of counseling, healthcare access why is the UN/WHO concerned about formula usage? - CORRECT ANSWER✔✔ - Presence of microorganisms infecting the formula
- Not sanitized water
- Improper bottle cleaning
- Lack of training on how to prepare Are there any marketed formulas/products that have evidence to support their claims of improving outcomes and brain development? - CORRECT
CORRECT ANSWER✔✔ Fathers who are taught about breastfeeding are more likely to be supportive, increase EBF rates, and help out more with the baby During childbirth, what are 3 ways of increasing the rate of EBF? - CORRECT ANSWER✔✔ 1. Encouraging bonding time and discouraging long visits
- Providing labor support via doula
- decrease Pitocin use Immediately after birth, what has the biggest effect on likelihood of BF success? - CORRECT ANSWER✔✔ Skin to skin What are the 9 stages of skin to skin? - CORRECT ANSWER✔✔ 1. Birth cry
- Relaxation
- Awakening
- Activity
- rest
- crawling
- familiarization
- suckling
- sleeping Why should newborn baths be delayed in the hospital? - CORRECT ANSWER✔✔ newborn baby smell elicits activation of cerebral areas in mom's brain - reward centers How do babies use their senses to reach the breast? - CORRECT ANSWER✔✔ Smell milk/colostrum Temperature of areola is hotter During which of the following stages should BF be initiated:
- Deep sleep
- light sleep
- quiet alert
- active alert
- crying - CORRECT ANSWER✔✔ Light sleep, quiet alert, sometimes active alert what are the two most common feeding behaviors exhibited in newborns? -
