Lactation Consultant Exam Study Guide: Breastfeeding Strategies and Health Risks, Exams of Nursing

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Certified Lactation Consultant Exam Guide 2025 - 2026 Tests

The World Health Organization and UNICEF have set broaslfecding inilialion and duration in every country. Whal are the 3 ¢ ANSWER-Breastfeeding Promotion out three strat Breastfeeding Protection I Breastfeeding Support Focuses on advantages of breastfeeding on a personal (personal connection), community, country (amount spent on healthcare), or global level (waste from formula & formula products) Focuses on the good “advantages” of breastfeeding - CORRECT ANSWER-Breastfeeding I Promotion | Focuses on government, manufacturer, and social responsibility to assure breast ft I to compete with commercial interests. I Includes addressing improper markeling prac I Addressing breastfeeding in public, at work, jury duty, family law, mothers in prison, etc..- CORRECT ANSWER-Breastleeding Protection Foe on the interaction of “helpers” with family as well as program development and implementation - CORRECT. ANSWER-Breastfeeding Support. Women how do not breastfeed are at a greater risk for what diseases? - CORRECT ANSWER- Myocardial infarction Metabolic syndrome Coronary artery disease Stroke DMII HTN Hyperlipidemia Cardiovascular disease Broasl, cndomctrial, and ovarian cancer Reason #1 why women do nol. exclusively breastlood - CORRECT ANSWER-Unrealistic expectations from soci y about motherhood. Along with lack of preparation for what the newborn period would be like. interventions. Mother's problems at 3-7 days posed the greatest. risk for stopping which is when they are home from the hospital and alone with ne support. The fastest drop-off is in the first 10 days following discharge from the hospital The Intemational Code of Markeling of Br milk Substitutions - R-An intemational health policy framework to regulate the marketing of breast milk substitutes in order to protect breastfeeding. It was written in response to the marketing activities of the infant feeding industry which were promoting formula feeding over breastfeeding, which in turn was leading to a drama. ase in maternal and infant morbidily and mortalily. What does "The Code" do? - substitutes which includes infant formulas and any other food or drink, together with feeding -Rogulales the markeLing of breast milk bottles, and teats, intended for babies and young children. Sets standards for the labeling and quality of products and for how the law should be implemented and monitored within countrics. Aims to make sure that parental choices on feeding are based on full, impartial information, rather than misleading, inaccurate or biased marketing claims. A SS SS SS ac ORRECT ANSWERMessages from certain stimulation travels through the breast to the pituitary What is the role of the pituitary glade in milk making? - gland which triggers it to produce prolactin and oxytocin which are two hormones needed to make milk. How in prolactin produced? - CORRECT ANSWER-Breast stimulation Nipple stimulation (makes the most) response/Conditioned Milk Ejection Reflex (Let down). Automatic response that comes with the association of smell, touch, sounds of baby at the breast. Also occurs on babies end with knowing what to do when placed at the breast. What is the second way oxytocin can be trigg that occurs with a proper latch What is a third way oxytocin can be Lriggored? - CORRECT ANSWER-Baby hand massage What docs prolactin do? - CORRECT. ANSWER-Entors receptor siles in the milk making cells and helps produce breastmilk What does oxytocin do? - CORRECT ANSWER-Allows for the milk to move from the milk making cells and through tl ; nipple with “contractions” that squeeze the cells and the ducts. Preterm milk - <-Appears to have different composition for the first 5-7 weeks after del t of gestational age Preterm milk appears to be higher in protein, fat, and electrolytes than mature milk This is determined by being preterm not just having a small baby therefor it does not matter if the baby is SGA or LGA only dependent of gestational age A SS SS SS ac L+ year of lactation - CORRECT ANS significantly increased fat and energy contents, compared with milk expressed by women who have been lactation for a shorter time. The volume of milk does not have to change as the baby gets older/bigger because the composition of the milk changes Breast milk composition changes... - -Over the course of lactation Within the day there are variations on the composition of milk Within a feeding By the way it is taken during a feeding and also between feedings Fat content in breast milk - CO. ik-Longer times in between feedings made for a lower fal content but fastor focdings made for a higher fat content whore as Iecdings lasting longer than 30 mins made for a lower fat content Breastfed babies can regulate fat intake quickly and thus mothers should be encouraged to practice baby led [ecding Maximum fat levels were obtained 39 mins post-feed 1 breast or 2?- CORRECT ANSWER-There is no difference in baby’s net fat intake according to the number of bre suckled per feeding or the breas ding frequency Offer the Ist breast Ist and the 2nd breast 2nd it really doesn’t matter 1 breast or 2 whatever they want Lactogenesis 1/Secretory Differentiation Production of colostrum from the placental hormones (progesterone) A SS oo ll ac ac birth weight and no more weight loss by day 5 and should be back to birth weight by 2 weeks We. requires more intens ht loss greater than 7% from birth weight indicates a possible breastfeeding problem and ve evaluation of breastfeeding and possibly intervention (not supplementation!) to correct problems and improve milk production and transfer medications More intrapartum fluids are given, they have more fluid to loss which is a normal process No labor prior to a c-seclion, maybe they weren't ready Lo be born old the baby is (however this can be skewed by the diuresing process and is not a good indicator of adequate hydration) 4 wets on day 4 and each day after Multiple poops each day that change in consistency and color How much weight should my baby be gaining - CORRECT ANS per day is expected in the early months by more may be needed for babies with metabolic or respiratory distress because they tend to burn more calories breathing, keeping warm, etc.. Size of the breast relates to the amount of mill produced RE FNo!! the proportion of glandular and fat tissue and the number and size of the ducts are not related to milk production Need to drink a lot of [nids Lo produce a lot of milk - No!! There is not enough evidence to support increasing fluid intake beyond what breastfeeding mothers are likely to require to meet their needs A SS SS SS Maternal exercise is related to infant weight gain growth - CORRECT ANSWERNa!! worry/stress may alter behavior which could alter supply but not nursing enough or removing milk often enough How do we assure an adequate milk supply? - CO how breastfeeding works Early initiation and adequate breastfeeding (10-12x per day) Appropriate breastfeeding assessment Improved and early breastfeeding support Appropriale HCP and LCP follow-up in the postpartum period Admitting there is no magic bullet More nursing= more milk -Long spaced belween feedings Negalive influences on milk production - Long. slow feedings-can effect. prolactin production Negative influences on milk production: Excessive pressure in the breast - CORRECT ANSWER Prose ure on the milk making cells s milk Lo be made Pressure can result from: vascular, lymphatic, and third spacing forces Too much milk in the breast (engorgement) Missed focdings Restrictive bras and clothing A SS SS SS ac No postpartum breast fullness or signs of abundant milk production Hypoplastic breast(s) (underdeveloped, tubular, or inadequate glandular tissue) Discrepant breast size (Unilateral underdeveloped breasts) Inverted Nipples - CORR’ ER-Grade infant nursing (look inverted with rest but evert with use) :are easily pulled out with a breast pump or Grade 2: can be pulled out but don't maintain their projection (may invert as soon as baby comes off breast) Grade 3: difficult or impossible to pull out Classification is about function during feeding not about how inverted or flat the nipple looks at rest Does the nipple ever evert? Look over the mothers shoulder to sec what the nipple looks like immediately follawing [ecding Negalive influences on milk producuon: Sub-optimal or allered physiology - CORRECT exhaustion or depression altering mothers coping behavior Hemorrhage: Shechan’s syndrome (the piluitary gland is deprived of blood and ils functions are impaired) Hormone imbalance: Thyroid, abesily, GDM PCOS Certain drugs: Pseudoephdrines & corticosteroids (betamethasone) Smoking mothers may have lower prolactin levels because prolactin docsn’t rise like il should Babies tended to nap less when fed milk from mothers who smoked vs those who did not smoke A SS SS SS ac Quiting smoking during pregnancy resulted in a lower chance of preterm birth ! 22% of SIDS cases can be directly attributed to maternal smoking during pregnancy ! Canabis use and breastfeeding - CORRECT ANSWER-Exposure of infant to any kind of passive I = is no safe threshold limit for cannabis use in pregnancy. smoke is a concern. The Among pregnant women cannabis use was significantly associated with an increased risk of preterm birth and low birth weight The high fat solubility of cannabinoids make them difficult to analyze in breast milk. THC I (delta-9-tetrahydrocannabinol) is measurable in milk 6 days after maternal use I I Anemia and breastfeeding - CORRECT ANSWER-Postpartum hemorrhage can cause sheehans I syndrome which in Lum causes hormonal issucs including milk making hormon ! . . . . I I Retained placenta fragments prevents the shift from lactogenesis stage 1 to stage 2 which can I I affect your mature milk coming in H I I -I is safe as long as you are nol at risk Is nursing during pregnancy sale? - C for preterm delivery, however the composition of your milk might change due to placental hormones being on board and your toddler may not want to feed anymore Tandem Nursing - CORRECT ANSWER-The practice of breastfeeding 2 babies not from the same pregnancy at the same time | Milk volumes increase faster bul less engorgement is expericnecd wilh two nurslings I May require specific teaching to manage faster flow Help parents respond to different needs of cach child I I I Nurse newborns frequently I | Find time for non-nursing interactions with older babies H Can not tolerate ambiguity I I ! Submit to the command of authority-not inner voice ! ! o: . es I I Sense of self is embedded in external definitions and roles I H Live at the behest of those around them H To develop a relationship with Receivers of knowledge: Teacher or counselor must project authority Never be atnbiguous Advantages must be concrete and appropriate for her Teaching should be centered on the right way and include return demo Subjective knowing - CORRECT ANSWER-Believes knowing is personal, private, and based on H intuition and/or feeling states, rather than on thought and articulated ideas that are defended H with evidence H Sense of self is embedded in external definitions and roles I Sense of authority arises primarily from the power of a group I Trust their own intuition Inner voice helps guide them Distrust male authority figures “Experts don't know what they are talking about” ! pe . ! I Trust other women with similar experiences I H Find female support groups helpful H Attracted to natural things, like breastfeeding Want to be helped by someone who has breastfed Interested in breastfeeding from her own point of view To develop a relationship with Subjective knowers: Create time for them to talk about themselves and what they think about breastfeeding I I ! Offer help with possible misconceptions about breastfeeding ! I on I I Offer to make contacts and referrals I I Procedural Knowing - CORRECT ANSWER-The position at which techniques and procedures I for acquiring, validating, and evaluating knowledge claims are developed and honored I . . . . I I Invested learning, constantly taking in new information I H Interested in obtaining and applying knowledge H I Want to understand other people's points of view I Assume that every one including themselves can be wrong Will read a varicty of books with different points of view May attend several classes and change health care providers easily May be viewed as inconsistent by others May want very technical information about breastfeeding I To develop a relationship with Procedural knowers: I I Be prepared to back up statements with evidence | Be knowledgeable about multiple sources of reference Limit personal stories Understand that options and change are part of the process Constructed Knowing - CORRECT ANSWER-The position at which truth is understood to be contextual, knowledge is tentative, and it is understood that the knower is part of the known Have abandoned either/or thinking Have learned to live with conflict and have high tolerance for internal contradiction and ambiguity If the formula is not being fed immediately, refrigerate it right away and keep refrigerated until Hierarchy of infant feeding choices - -1. Baby at mothers breast 2. Mother’s own expressed milk 3. Milk from a milk bank 4. Cows milk forumla 3. Soy formula Does not seem to be associated with GERD recessive genetic disorder; If baby is diagnosed with Galactosemia - characterized by body's inability to tolerate galac Can be rapidly fatal is lactose is not completely removed from the infants diet Breastfeeding is contraindicated Ifmother is infected with HIV not advisable If mother is infected with T-cell lymphotopie virus - CORRECT. feeding at the breast is not advisable I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I H Colicky babies had more than double the abundance of microbia in the gut I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I A SS SS SS ac ac If mother is using illicit street drugs such as PCP or cocaine - CORRECT ANSWER- Breastfeeding or feeding at the breast is not advisable Exceptions being narcotic dependent mothers who are enrolled in a supervised methadone program and have a negative screening for HIV infection If mother is suspected or confirmed of having Ebola - CORRECT ANSWER-Breastfeeding or feeding at the breast is not advisable If mother is infected with untreated brucellosis - CO. ANSWER-Mothers should temporarily not breastfeed or feed expressed breast milk If mother is taking certain medications (medications and decrease cells proliferation: cancer drugs) - © R-Mothers should temporarily not breasticed or food cxprossod breast mill Tf mother is undergoing diagnostic imaging with radiopharmaceuticals - CORRECT ANSWER- Mothers should temporarily not breastfeed of feed expressed breast milk R unaffected side if affected side is completely covered If both sides are affected mother should temporarily not breastfeed or feed expressed breastmilk If mother has active TB - Mother should temporarily not breastfeed but can feed expressed breast milk A SS SS SS