Certified Lactation Counselor Exam

true

Women who do not breastfeed are at greater risk for myocardial infarction and aspects of metabolic syndrome.

Academy of Lactation Policy and Practice

ALPP

myocardial infarction, metabolic syndrome

Women who do not breastfeed are at greater risk for _______ _____ and aspects of ______ _____.

myocardial infarction

occurs when blood flow to the heart muscle stops or drops completely, causing heart tissue to die

metabolic syndrome

a cluster of five specific health conditions that together raise your risk for heart disease, stroke, and type 2 diabetes such as large waistline, high blood pressure, high blood sugar, high triglycerides, and low HDL cholesterol

Breastfeeding has been recognized as a public health priority in tropical climates since the 1930s but not until the _____ in the US.

1990s

true

Nursing a baby for a year or more decreases by 10-15% the risk of developing hypertension, diabetes, hyperlipidemia and cardiovascular disease when postmenopausal compared to those who had been pregnant but never breastfed.

breast, endometrial, ovarian cancer.

Women who do not breastfeed are at greater risk of ______, ________, and ________ _______.

Breastfeeding Promotion, Breastfeeding Protection, Breastfeeding Support

The World Health Organization (WHO) & UNICEF Have set out three strategies needed for increasing breastfeeding initiation and duration in every country. What are the three strategies?

breastfeeding promotion

focuses on advantages of breastfeeding on a personal, community, country or global level

breastfeeding protection

focuses on government, manufacturer and social responsibility to assure breastfeeding’s ability to compete with commercial interests

breastfeeding protection

includes addressing improper marketing practices as described in “The International Code”

breastfeeding support

focuses on the interaction of “helpers” with family as well as program development & implementation

unrealistic expectations and lack of timely interventions

Why is breastfeeding so difficult that mothers need help?

The International Code of Marketing of Breastmilk Substitutes

an international health policy framework to regulate the marketing of breastmilk substitutes in order to protect breastfeeding published by the World Health Organization in 1981

The International Code of Marketing of Breastmilk Substitutes

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 dramatic increases in maternal and infant morbidity and mortality

marketing, breastmilk substitutes, sets standards, labelling, quality

The International Code of Marketing of Breastmilk Substitutes regulates the ______ of ______ ___________ which includes infant formulas, follow-on formulas and any other food or drink, together with feeding bottles and teats. It also ______ ______ for the ____ and ______ of products and for how the law should be implemented and monitored within countries

The World Breastfeeding Trends Initiative

WBTI

The World Breastfeeding Trends Initiative

intended to track, assess and monitor the implementation of the “Global Strategy” at the country and sub-country level

aggression, protection, bonding, trust

The hormones of lactation have an emotional/behavioral function as well as making and moving milk such as ______, ________, _____ & ______.

true

What contributes to low rates of exclusive breastfeeding globally?

Caregiver and societal beliefs favoring mixed feeding

Hospital and health-care practices and policies that are not supportive of breastfeeding  

Lack of adequate skilled support

Aggressive promotion of infant formula and other breast milk substitutes Inadequate maternity and paternity leave legislation and other workplace policies

Lack of knowledge about the dangers of not exclusively breastfeeding and of proper breastfeeding techniques

true

How to Support Exclusive Breastfeeding

-Increase hospital and health system capacity including revitalizing, expanding and institutionalizing the Baby-Friendly Hospital Initiative in health systems

-Provide community-based strategies including communication campaigns tailored to the local context.

-Strengthen the monitoring, enforcement and legislation related to “the Code” and subsequent resolutions.

-Enact at least 6 months paid maternity leave

-Invest in training and capacity building in breastfeeding protection, promotion and support.

Baby-Friendly Hospital Initiative

BFHI

Baby-Friendly Hospital Initiative

a global program launched by the World Health Organization and UNICEF in 1991 to protect, promote, and support breastfeeding in maternity facilities

United Nations Children's Emergency Fund

UNICEF

World Health Organization and United Nations Children's Emergency Fund

Who launched the Baby-Friendly Hospital Initiative?

United Nations Children’s Emergency Fund

a specialized agency of the United Nations responsible for providing humanitarian and developmental aid to children and mothers worldwide

nervous system, brain

Messages from the breast travel through the ______ ______ to the _______.

post-partum

In ________ women, prolactin is much more responsive.

true

Each species of mammal milk is different.

species specific

Milk is _________ _______.

lactose

All mammal milk contains _________.

true

Mammal species with higher water content milk have more frequent feeds.

water content, frequent

Mammal species with higher ______ _______ milk have more ______ feeds.

true

Mammal species with high fat/protein and low water content milk have infrequent feeds.

fat, protein, low, infrequent

Mammal species with high _______, ____, and ____ water content milk have ______ feeds.

true

Human milk changes continually. This makes it impossible to obtain a single representative sample of milk.

representative sample

Human milk changes continually. This makes it impossible to obtain a single ______ ________ of milk.

prolactin

______ levels go down in between nursings and rise during nursing.

down, rise

Prolactin levels go ___ between nursings and ____ during nursing.

rise

Prolactin levels _____ during nursing.

between

Prolactin levels go down in _______ nursings.

exclusive breastfeeding

infant is reliant soley on breastfeeding for nutrition

true

Exclusive breastfeeding includes things like oral rehydration solution and medications.

true

Infants diagnosed with galactosemia may not breastfeed or receive the mother’s expressed milk. They must be fed a special formula.

galactosemia

congenital metabolic disorder causing inability of the body to use the simple sugar galactose, causing accumulation of galactose 1-phosphate in the body, which results in damage to the liver, central nervous system, and other body systems with permanent, even fatal, outcomes

zinc, iron

After the first 6 months, appropriate other family foods, especially those high in ____ and ______, should be added to the infant’s diet while breastfeeding continues through the first year and beyond.

6

Exclusive breastfeeding throughout the first __ months is a target of many public health goals.

true

Infants diagnosed with phenylketonuria (PKU) may be partially breastfed but also must receive a special formula. The amount of breastfeeding allowable will be determined by monitoring the infant’s blood levels

phenylketonuria (PKU)

an inherited disease resulting in the inability to digest the amino acid phenylalanine, therefore, they must avoid foods containing phenylalanine due to the risk of brain damage

phenylalanine

an essential amino acid that acts as a building block for proteins in the body

premature infants

_____ ______ may require additional minerals, calories, and vitamins.

true

Breastfeeding may cease temporarily if the mother has a contraindicated medical condition, is taking a contraindicated drug, or is undergoing certain radiation treatment.

exclusive breastmilk feeding

EBMF

Human Milk Banking Association of North America

HMBANA

true

Supplementation method of breastmilk does not matter when considering if a child is exclusive breastmilk feeding.

predominantly breastfed

infant is receiving the mother’s milk as well as water, water-based drinks, ritual foods (such as teas), and oral rehydration solution, vitamins, minerals, and oral medications, but is receiving any other foods or drinks, including infant formula and other animal milks

complementary feeding

the child is between 6 and 23 months of age and is receiving both human milk and solid or semisolid food

iron, zinc, protein

The introduction of appropriate foods, especially those rich in ____, ____, and ______ is crucial after 6 months of age.

1/3

As of 2019, at least ___of children under 5 years of age are not growing well due to malnutrition

Observe, Explore, and Coach

What are the 3 roles of a lactation counselor according to the Healthy Children’s Project?

true

Herpes can be fatal to newborns.

feeding cues

visible hunger signals

true

Crying is a late feeding cue— crying babies do not feed well.

bring fist to mouth, seek food, smack lips and extend tongue

Name 4 feeding cues.

true

In the first hours and days postpartum, the dyad learns to breastfeed together and move gradually from self-attached breastfeeding to collaborative breastfeeding.

postpartum period

the time that begins immediately after childbirth and typically lasts 6-8 weeks

6-8 weeks

How long does the postpartum period typically last?

self-attached breastfeeding

a natural process where the newborn uses their innate reflexes to find and latch onto the breast with minimal guidance or support from the mother

collaborative breastfeeding

refers to the interative and biological team-based process between nursing parent and infant

dyad

baby-mother

true

Nursing should not be painful.

true

The healthy baby should be dried after birth and placed on the chest for prolonged skin-to-skin holding. Babies warm better with skin-to-skin than electric warmers. The breast will increase and decrease temperature according to the needs of the baby.

true

When breastfeeding, the breast should not be held or shaped with the hand. Towels may be used under larger breasts.

true

REM is a feeding cue.

true

When breastfeeding, there should be no pressure against the back of the baby’s head. The baby must be able to tilt their head.

true

The baby’s nose and nipple should be lined up.

true

Breastfeeding sessions should be ended by the baby.

1989

When were the 10 Steps to Successful Breastfeeding published?

Baby-Friendly Hospital Initiative

encourages hospitals and birth facilities to develop policies and implement practices that support parents in learning appropriate, responsive infant feeding

what are the 10 original steps

prenatal

refers to the time before birth

antenatal care

What is another term for prenatal care?

antenatal care (prenatal care)

the medical healthcare you receive during pregnancy

factors that affect duration of breastfeeding

lactation insufficiency

Breast augmentation increases the chance of ______ _____.

lactation insufficiency

the inability to produce enough breastmilk to meet the nutritional needs of an infant

increases

Breast augmentation ______ the change of lactation insufficiency.

periareolar incision

The ______ ________ is most significantly associated with lactation insufficiency.

true

It is not likely for breastfeeding to harm implants.

true

Breast reduction increases the chance of lactation insufficiency and may result in a decrease in the duration of exclusive and overall breastfeeding.

engorgement

the painful swelling, hardness, and overfilling of breasts that commonly happens in the first few days after childbirth

page 43 what to do

true

It is most appropriate to ask about breast augmentation surgeries in private with the mother.

perialeolar incision

a surgical cut made along the outer edge of the areola, where the dark skin meets the lighter breast tissue

nervous system, blood stream

When suckling, messages from the breast travel to the ____ ____ to the brain. Hormones travel to the _____ _____.

storage capacity

the amount of milk that can accumulate before the growing fullness signals the mammary cells to make less milk

right

The _____ breast has been shown to usually have greater storage capacity, although the amount of difference varies.

true

The more opportunities the baby has to practice breastfeeding, the more skill he or she will develop.