IBCLC Exam Questions With 100% Correct Answers 2024, Exams of Advanced Education

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IBCLC Exam Questions With 100% Correct Answers 2024 When does the breast begin to develop in utero? - Correct Answer-4th week of gestation Where does the primitive milk streak develop - Correct Answer-Bilaterally from the axilla to the groin By the 5th week gestation the milk streak becomes what? - Correct Answer-Mammary Milk Ridge (or milk line) Thickening and inward growth into the chest wall continues during what weeks gestation? - Correct Answer-7-8 weeks gestation Between weeks 12 and 16 gestation specialized cells differentiate into what? - Correct Answer-Smooth muscles of the nipple and areola What forms the mammary pit? - Correct Answer-Lactiferous ducts and their branches open into a shallow epithelial depression What creates an inverted nipple? - Correct Answer-When the Mammary pit fails to elevate What is witches milk? - Correct Answer-After birth, a neonate's mammary tissue (under the influence of maternal hormones) might recreate colostral like fluid At what age do the primary and secondary ducts grow and divide and form the terminal end buds that become the alveoli? - Correct Answer-10-12 years old When does complete development of mammary function occur? - Correct Answer-During pregnancy What is superficial fiscia? - Correct Answer-Fibrous tissue beneath the skin Where is the breast located? - Correct Answer-In the superficial fascia between the second rib and sixth intercostal space What percent of breast milk is carbohydrates? - Correct Answer-Approximately 7% What are the six infant behavioral "states" - Correct Answer- Crying, active alert, quiet alert, drowsy, active sleep, and quiet sleep Milk components that protect the infant/lactating breast actively bind ______, preventing their passage through the permeable infant _____ _____ - Correct Answer-pathogens gut mucosa How does the infant get the antibodies produced by mom? - Correct Answer-antibodies are produced in moms blood, targeted SIgA which is transported across the mammary secretory cells and released in the milk. What is sIgA? - Correct Answer-Immunoglobulin A is an antibody that coats mucosal surfaces to prevent adherence and penetration by pathogens What are the most common food allergies? - Correct Answer- 1. Cow's milk protein 2. Eggs 3. Peanuts 4. Tree nuts 5. Fish 6. Shellfish 7. Soy 8. Wheat What are the common symptoms of food allergies? - Correct Answer-1. Eczema 2. Hives 3. Digestive or respiratory problems (e.g. mucus or blood in the stool) The infant uses their _____ to draw in the nipple and ____ it in the mouth - Correct Answer-Lips Stabilize What is weak lip tone? - Correct Answer-Hypotonic lips result in the inability to seal lips around the breast impacting the amount of suction created What is a sucking blister? - Correct Answer-friction abrasions resulting from retracted lips or a labial frenulum that restricts the lips from flanging What does weak lip tone look like? - Correct Answer-Milk spilling, smacking sound (breaking suction), infant tires faster due to increased work of the feedings even though they aren't efficient feedings Things to look for when assessing the lips: - Correct Answer- Seal/maintain seal around the breasts, normal lip tone, stretchy labial frenulum, no breaks in suction, no milk spilling What do fat deposits in the cheeks help provide? - Correct Answer-structural support to stabilize nipple in the mouth Does low/weak tone cause the infant to have higher or lower levels of suction - Correct Answer-lower levels of suction with each drop of the tongue, the oral cavity gets larger and creates negative pressure When assessing the tongue you should look for all of the following: - Correct Answer-1. shape 2. restrictions 3. position 4. abnormalities True or false: an infant who is struggling with a fast flow will break suction on their own - Correct Answer-True! How does the palate get shaped in utero? - Correct Answer- The tongue pressed against it Bubble palates result from what? - Correct Answer-Tongue Tie. The tongue is not able to extend all the way to the middle of the palate due to the restriction. So where the tongue is anchored, you will feel a bubble on the palate What is the job of the hard palate during a feeding? - Correct Answer-It opposes the tongue helping to compress the nipple and maintain its position in the mouth What are Epstein's pearls? - Correct Answer-They are small, round, white cysts that are found on the ridge of the hard palate or gums and they usually go away within 2 months (do not affect BF) Epstein's Pearls can sometime be mistaken for what? - Correct Answer-teeth or thrush What is a partial or incomplete cleft lip? - Correct Answer- Small gap or indentation of the lip What is the difference between a unilateral and bilateral complete cleft lip? - Correct Answer-Unilateral refers to 1 side, bilateral refers to both sides and complete means that it continues into the nose. What is an incomplete cleft palate? - Correct Answer-A "hole" in the roof of the mouth, usually as a cleft soft palate What is a complete cleft palate? - Correct Answer-Soft and hard palate, possibly including a gap in the jaw Why does a cleft palate make BF more difficult? - Correct Answer-Because the infant is unable to seal the oral cavity to create suction What is a submucosal cleft? - Correct Answer-A defect in the closure of the shelves behind the hard palate. These are hard to identify because a thin layer of skin grows over the hole How do you identify a submucosal cleft? - Correct Answer-By shining a light on the palate-it reveals a translucent area What is a bifurcated uvula and what does it usually indicated? - Correct Answer-A forked uvula that usually reveals a cleft defect What does nasal regurgitation usually indicate? - Correct Answer-Cleft palate What position helps a prevent nasal regurgitation and aspiration? - Correct Answer-sitting up right What is the labial frenulum and if it is short or extends what does it cause? - Correct Answer-Membrane that attaches the lips to the gum ridge. if it is short or attaches to the papilla it can cause a lip tie What is the oropharnyx? - Correct Answer-Area between the elevated soft palate and epiglottis Where do the estuation tubes originate? - Correct Answer- Nasopharynx What does the oral anatomy consist of? - Correct Answer- Nose, mouth, pharynx, airways, and esophagus From birth-6 months the ____ ____ and _____ are close in proximity - Correct Answer-Soft palate and epiglottis From birth-6 months that oral cavity is _____ - Correct Answer-short What happens to the oral cavity between 6-12 months? - Correct Answer-The oral cavity elongates vertically. Soft palate and epiglottis are no longer close in proximity, and now the larynx must elevate farther to allow the epiglottis to fully seal during a swallow What are the two oral reflexes during a feeding? - Correct Answer-1. Adaptive (rooting and sucking) 2. Protective (gag and cough) What does non-nutritive sucking help with? - Correct Answer- 1. Increase peristalsis of GI tract 2. Enhance secretion of digestive fluids 3. Decrease infant crying and helps them find a calm state 4. Reduces risk for sids What doe MER stand for? - Correct Answer-Milk Ejection Reflex What controls the volume of milk? - Correct Answer-MER Does positive or negative pressure within the oral cavity help support milk removal? - Correct Answer-Negative What is Oxytocin? - Correct Answer-Hormone produced in the pituitary gland that signals the body to let down stimulated by the infant suckling. It also is released during loving behaviors What is Prolactin? - Correct Answer-It is a hormone released when a baby is sucking at the breast and it's primary function is to signal to the body to make more milk What three tasks does the infant need to be able to coordinate? - Correct Answer-Sucking, swallowing, and breathing What is an immature suck pattern? - Correct Answer-3-5 sucks per burst what is a transitional suck pattern? - Correct Answer-6-10 sucks per burst What is a mature suck pattern? - Correct Answer-10-30 sucks per burst What is a dysfunctional suck pattern? - Correct Answer-Lack of suckling and abnormal movements of the tongue and jaw What is Colic? - Correct Answer-Excessive crying- more than 3 hours a day 3 days a week How long is an infant sleep pattern? - Correct Answer-60 minutes How long do newborns usually sleep on average? - Correct Answer-16-17 hours How long do older infants usually sleep? - Correct Answer-13- 14 hours At what age do night wakings usually decrease? - Correct Answer-12-16 weeks How many grams in an ounce? - Correct Answer-28.3 How many ounces in a pound? - Correct Answer-16 How many ML in an ounce? - Correct Answer-29.5 True or false: a CC is a ML - Correct Answer-True Day 1, how much does baby eat? - Correct Answer-about 30 ml (1 ounce) Step 1 of baby friendly - Correct Answer-Have a written breastfeeding policy that is routinely communicated to all health care staff Step 2 of baby friendly - Correct Answer-Train all health care staff in the skills necessary to implement this policy Step 3 of baby friendly - Correct Answer-Inform all pregnant women about the benefits and management of breastfeeding Step 4 of baby friendly - Correct Answer-Help mothers initiate breastfeeding within one hour of birth Step 5 of baby friendly - Correct Answer-Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants Step 6 of baby friendly - Correct Answer-Give infants no food or drink other than breast-milk, unless medically indicated Step 7 of baby friendly - Correct Answer-Practice rooming in - allow mothers and infants to remain together 24 hours a day Step 8 of baby friendly - Correct Answer-Encourage breastfeeding on demand Step 9 of baby friendly - Correct Answer-Give no pacifiers or artificial nipples to breastfeeding infants Step 10 of baby friendly - Correct Answer-Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center Breast milk lacks vitamin ___ - Correct Answer-D Cow's milk should not be given before - Correct Answer-1 year (whole milk) What does Hypotonic mean? - Correct Answer-Floppy and loos muscles (rag doll) At what week does breast development begins with a primitive milk streak running bilaterally from the axilla to the groin - Correct Answer-3-4 When does the milk streak becomes mammary milk ridge or milk line. Which is the paired breasts develop from this line of glandular tissue - Correct Answer-4-5 When do specialized cells differentiate into smooth muscle of nipple and areola. Epithelial cells develop into mammary buds, epithelial branches form to eventually become alveoli - Correct Answer-12-16 What is galatorrhea? - Correct Answer-"Witches milk" secretion of colostral like fluid from babies mammary tissue resulting from moms hormones. DO NOT EXPRESS could cause mastitis in baby Where are the exterior of breasts located? - Correct Answer-In the superficial fiscia ( fibrous tissue beneath the skin) between the second rib and 6th intercostal space What is the tail of spence? - Correct Answer-Mammary glandular tissue that projects into the axillary region How many duct openings does the nipple have? - Correct Answer-5-10 What is a Lactocyte? - Correct Answer-Milk producing cells of the alveoli What are prolactin receptor sites? - Correct Answer-They are in lactocytes and allow prolactin to be absorbed from the blood and enter the alveoli to stimulate milk production Milk ducts ______ temporarily in response to MER and _____ when duct is drained - Correct Answer-Widen and narrow What is coopers ligament ? - Correct Answer-Suspensory ligament running vertically through the breast that are responsible for maintaining the shape and configuration of the breast. They bear a major portion of the task of preventing breast ptosis (sagging) What supplies 60% of the blood to the breast? - Correct Answer-Internal mammary artery What supplies 30% of the blood to the breast? - Correct Answer-Lateral thoracic artery Where does fluid from the breast drain? - Correct Answer- Axillary lymph nodes Where do the breast innervation's derive from? - Correct Answer-4th, 5th, and 6th intercostal nerve What nerve penetrates the posterior aspect and supplies the greatest amount of sensation to the nipple? - Correct Answer- 4th intercostal nerve What is Hypermastia? - Correct Answer-Breast enlargement When does lactogenesis II occur? - Correct Answer-Typically, once the placenta is delivered What happens to the hormones once the placenta is delivered during lactogenesis II? - Correct Answer-Withdrawal of progesterone in the presence of high circulating levels of prolactin What hormone is a prolactin inhibitor? - Correct Answer- Progesterone When does lactogenesis II usually occur? - Correct Answer-30- 40 hours postpartum (not related to stimulation) What is another word for lactogenesis III? - Correct Answer- Galactopoiesis What is lactogenesis III? - Correct Answer-On going maintenance of milk secretion What are some maternal risk factors for delayed onset of lactation? - Correct Answer-1. Over fluids during labor 2. C section 3. Type 1 diabetes 4. PCOS 5. Obesity 6. Hypoplasia 7. Sheehan's syndrome Why does type 1 diabetes pose the risk for delayed onset of lactation? - Correct Answer-May cause temporary imbalance in the amount of insulin required for glucose homeostasis Glucose homeostasis is required for what to take place? - Correct Answer-initiation of lactation (lactogenesis II) What is Feedback inhibitors of Lactation (FIL)? - Correct Answer-Small whey protein that slows milk synthesis when the breast is full Babies consume about ___% of available milk per feed - Correct Answer-67 The _____ the breast the ______ it refills - Correct Answer- Emptier faster What is the primary function of Colostrum? - Correct Answer- Protective. It coats the gut to prevent adherence of pathogens an promotes gut closure What does lactoferrin do? - Correct Answer-It is a protein that inhibits the survival, growth and spread of bacteria, viruses and fungal infections Compared to mature milk, colostrum is lower in ____, ____, and _______ - Correct Answer-Lactose, fate, and water- soluble vitamins Compared to mature milk, colostrum is higher in ____, _____, ___,____,____,____, ____, and ____ - Correct Answer-Vitamin A, E, carotenoids, protein, sodium, zinc, chloride, and potassium Breast milk is ____% water - Correct Answer-87.5 When breastfeeding multiples, it is easiest to feed both at the same time or one at a time? - Correct Answer-Both at the same time Why is it best to feed multiples at the same time? - Correct Answer-Saves time, helps establish a routine, and if 1 baby can't transfer well, the other baby can help trigger MER True or false: When feeding multiples alternate both breasts and babies each feeding (some moms have 1 breast per kid) - Correct Answer-True Older infants/toddlers who are BF will most likely need supplements of what? - Correct Answer-Vit D Common reasons for nursing strikes for older infants/ toddlers? - Correct Answer-Otitis media, nasal congestion, unusual separation of dyad, negative emotional encounter, frequent use of bottle, low milk supply, or unknown What does hypoglycemia mean? - Correct Answer-Low blood sugar When is newborn hypoglycemia most likely to occur? - Correct Answer-First 2-3 hours Why do babies born before 38 weeks need to be monitored more closely for hypoglycemia? - Correct Answer-They have limited glycogen reserves What is used for brain fuel? - Correct Answer-Glucose What is induced lactation? - Correct Answer-Purposeful stimulation of lactation where it was previously absent (normally seen when a mom isn't pregnant) What is relactation? - Correct Answer-Induced lactation in a mom who has previously breastfed What medications can help increase lactation? - Correct Answer-Domperidone, sulpiride, and metoclopramide What is the milk composition like following the induction of lactation or relactation? - Correct Answer-Usually mimics breast milk after delivery, no real colostrum phase- not a lot of studies on it If the baby has labial frenulum that is tight lips are usually __________ - Correct Answer-Retracted What type of damage is done if lips are retracted during a feeding? - Correct Answer-Friction trauma Why does the baby do a lip roll if there is a labial frenulum? - Correct Answer-To keep on the breast-prevent slipping What is a lingual frenulum? - Correct Answer-Lip tie- congenital midline anomaly in which the bottom of the tongue is attached to the floor of the mouth by the lingual frenulum Symptoms of a lingual frenulum - Correct Answer-Infants typically have a hard time emptying the breast which could result in poor weight gain and impact milk production What is galctosemia? - Correct Answer-Deficiency of enzyme galactose which makes it hard for infant to metabolize galactose What is Physiologic jaundice? - Correct Answer-Normal increase in bilirubin associated with red blood cells breakdown after birth and immaturity of bilirubin metabolism systems Is it usual for physiologic jaundice to reach "high risk zones"? - Correct Answer-Nope True or false: All newborns experience physiologic rises in bilirubin, but the level may not rise enough for visible jaundice - Correct Answer-True Physiologic jaundice has an onset of what day (s) - Correct Answer-48-72 hours (peak at 3-5 days) What is the condition of the infant with physiologic jaundice? - Correct Answer-Baby is thriving, normal weight loss, and normal output What is breastfeeding associated jaundice? - Correct Answer- Jaundice associated with an infant who is BF What type of jaundice is one of the significant cause of hyperbilirubinemia? - Correct Answer-Breastfeeding associated jaundice How does breastfeeding associated jaundice work? - Correct Answer-Lack of intake leads to delayed stooling and re circulation of bilirubin When is the onset of breastfeeding associated jaundice? - Correct Answer-3-5 days What is the condition of the infant who has breastfeeding associated jaundice? - Correct Answer-Lethargic/fussy, excessive weight loss, ineffective feeding, scant urine/stool output, signs of dehydration What is breast milk jaundice? - Correct Answer-Infants who have breastmilk jaundice are healthy breastfed infants who have no pathological cause for indirect hyperbilirubinemia. They are breast feeding effectively, have good weight gain, and no other signs and symptoms of illness How to test for breast milk jaundice? - Correct Answer- Bilirubin levels go down with formula Do we want mom to stop breastfeeding if baby has breast milk jaundice? - Correct Answer-No, jaundice usually goes away over 3-12 weeks Low thyroid levels in mom have been associated with - Correct Answer-Low milk supply Raynaud's is present in about 30% of women with what - Correct Answer-Lupas What is Raynaud's of the nipple? - Correct Answer-Narrowing of the blood vessels Raynaud's of the nipple get's worse when the temp is - Correct Answer-Cold Raunaud's of the nipple can cause __________ of the nipple - Correct Answer-Blanching What is the most common type of mastitis? - Correct Answer- Staph If mom has bilateral mastitis it is usually - Correct Answer- Strep What are the symptoms of mastitis? - Correct Answer-•Fever (100.4) •Chills/headache •Increased pulse •Flu like symptoms/body aches •Pain/swelling at site •Red, tender, hot area •Increased sodium level in milk (giving milk a saltier taste) •Red streaks extending towards the axilla Typical causes of mastitis - Correct Answer-Milk stasis and inefficient milk removal What would cause recurrent mastitis? - Correct Answer- Delayed or inadequate treatment of initial infection If the bacteria is resistant or not sensitive to prescribed antibiotics Most commonly prescribed med for Mastitis - Correct Answer- Dicloxacillin If symptoms of mastitis do not improve even slightly by what day should the mom go back to doctor? - Correct Answer-48 hours What is a plugged duct? - Correct Answer-Localized tenderness, firm red area usually result of inadequate milk removal from one duct How to resolve a plugged duct - Correct Answer-For test: Heat Per Jeanne: Ice What is a bleb? - Correct Answer-Blocked nipple pore What does a bleb block? - Correct Answer-Terminal opening for drainage of one lobes of the breast What is an Abscess? - Correct Answer-Localized collection of pus that the body walls off, once encapsulated it must be surgically drained An abscess almost always follows what? - Correct Answer- Inappropriate/ineffective management of mastitis Signs of low milk supply (baby) - Correct Answer-Unsettled, fusses after feedings, feeds for long periods at a time What can cause low milk supply? - Correct Answer-Ineffective transfer, delayed onset of lactogenesis II, low prolactin levels, retained placenta, structural breast issues, hormonal issues, nutrition related issues What is a galactocele? - Correct Answer-Benign cyst in the duct of a breast containing milk fluid What causes thrush? - Correct Answer-C. albicans How do you diagnosis a retained placenta? - Correct Answer- Mom bleeds A LOT What can a retained placenta delay? - Correct Answer- Lactogenesis II because hormones don't get released Symptoms of retined placenta: - Correct Answer-Moms breasts don't feel full by day 5, colostrum stage that persists beyond day 4, bright red vaginal bleeding that continues to be heavy after day 3, uterus might be painful to palpate What hormone can decrease your supply - Correct Answer- Estrogen Does THC from marijuana get absorbed in BM? - Correct Answer-Yes How should a baby sleep? - Correct Answer-On their backs What is the most preferred method of weaning? - Correct Answer-Gradual weaning How to safely wean: - Correct Answer-Substitute one feeding with substitute, then wait 2-3 days and substitute another etc What is the haberman feeder? - Correct Answer-Uses valve and teat mechanism to adjust milk flow to prevent overwhelming or flooding baby with milk. 3 lines on bottle correspond to flow rate Who is the haberman feeder ideal for? - Correct Answer- Severe feeding problems like downs, cleft lip/palate, disorganized suck, cardiac defects, CP, etc How do gel dressings help heal nipple? - Correct Answer- •Promote moist wound healing and are used for nipples with crack, fissures, and deep wounds •Keep wound surface moist so epidermal cells can migrate across would •Thermal insulation for blood flow •Protect wound from bacteria or trauma What is the most important information to include in BF class? - Correct Answer-How mom can be comfortable while BF When do most pregnancy breast growth completed by? - Correct Answer-22 weeks A baby who is EBF for longer than 6 months is not at risk for what? - Correct Answer-iron deficiency A congenital deficiency of zinc in an infant can cause what? - Correct Answer-Failure to thrive and skin lesions What are some symptoms of hypoglycemia? - Correct Answer- high pitched cry, exaggerated reflexes, tremors What is the most important fact bout lactoferrin? - Correct Answer-It absorbs iron in the gut of the infant If a baby is in the NICU and mom is pumping, what can have a negative effect on milk production? - Correct Answer-Annual income less than $50K, length of stay, amount of milk mom makes at day 5. In comparison to mature milk, weaning milk has a decreased amount of what? - Correct Answer-Lactose voluntarily grasps objects, vocalizes when spoken to, turns head as well as eyes in response to moving objects What is the typical breastfeeding behavior of a 3 month old? - Correct Answer-Will interrupt feeding to turn to look at father or ther familiar person coming in room and smile at mom, rolling from belly to back What is the typical psychosocial behavior of a 4-5 month old? - Correct Answer-Shows interest in strange setting and smiles at mirror images What is the typical psychosocial behavior of a 6 month old? - Correct Answer-Laughs aloud, shows increased awareness of caregivers vs strangers, may become distressed if mom or care giver leaves, sitting, acrobatic nursing What is the typical psychosocial behavior of a 7-8 month old? - Correct Answer-Imitates actions and noises, responds to name, responds to "no", enjoys peak a boo games, reaches for toys that are out of reach, crawling. What is the typical psychosocial behavior of a 9-10 month old? - Correct Answer-Distress by new situations or people, waves bye-bye, reaches for toys that are out of reach, crawling, standing. What is the typical psychosocial behavior of a 11-12 month old? - Correct Answer-Drops objects to be picked up by people, rolls a ball, speaks a few words, appears interested in picture books, shakes head for "no". What is the typical psychosocial behavior of a 12-15 month old? - Correct Answer-Fears unfamiliar situations, but will leave moms side to explore familiar settings, shows emotions, speaks several words, understands meanings of many words. What is the typical psychosocial behavior of a 16-20 month old? - Correct Answer-Has frequent temper tantrums, imitates parents, enjoys solitary play or observing others, speaks 9-10 words. What is the typical psychosocial behavior of a 20-24 month old? - Correct Answer-Helps with simple tasks, has fewer tantrums, engages in parallel play, combines 2/3 words, speaks 15-20 words