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IBCLC EXAM FLASHCARDS QUESTIONS & ANSWERS
1. Micrognathia: Condition where jaw is undersized; common but can
interfere with feeding and breathing
2. PKU (phenylketonuria): Body does not produce enzyme to break-down amino
acid phenylalanine and this builds-ups in blood; need low phe formula and CAN breastfeed
3. Maple Syrup Disease: Body is unable to break-down certain proteins/amino
acids (leucine); sweet smelling urine. Need low protein diet/special formula i.e. Ketonex-1. BF CONTRAINDICATED
4. Galactosemia: Rare genetic (metabolic) disorder; cannot metabolize galactose.
BM is Lactose (galactose/glucose) - need soy-based formula - BF CONTRAINDI- CATED
5. Wessel's Rule of 3 (Colic): 3 hours per day 3
x per week for 3 weeks
6. Down Syndrome: Marked hypotonia; decreased suck-swallow-
breathe cordi nation, large tongue with poor control, poor gape and mouth control - Dancer Hold for BFing
7. Hypotonia: Decreased muscle tone; "floppy"
difficulty coordinating suck-swallow-breathe poor gape and mouth control
poor search and tongue extension loss of suction long/slow feeds Dancer Hold for BFing w/ upright positioing; tube at breast prn - switch nursing & compressions
8. Hypertonia: High, rigid muscle tone; rigid
tight jaw, clamping down on breast restricted tongue movement Finger feeding in prone position over the arm of an adult before BFing - use prone (tummy down) position; increased SSC, swing in blanket, colic hold
18. SGA (Small gestational age): Weight, length or head circumference <10th
%tile at birth
19. Acrocyanosis: Very common; bluish discoloration of hands and feet for first 24
hours after birth
witho
n
head
and
ne
spot
to form
seal
20. Dehydration: Results from inadequate intake
decreased output, weak cry, lethargy, dry MM, sunken fontanelles >14% weight loss Require IV fluids and BF management
21. Erythema Toxicum Neonatorum: Very common, benign newborn rash
Comes and goes
22. Breastmilk Jaundice: Breast milk jaundice can last for 3-12 weeks after birth,
but as long as the baby is feeding well and bilirubin levels are monitored, it rarely leads to serious complications.
23. Caput succedaneum: Swelling of the infant scalp; disappears
hours/days (1 week)
24. Cephalohematoma: Blood collection between the bones of the
periosteum - likely delivery related - increased risk of jaundice weeks to recover
25. Plagiocephaly: Infant flattened head; often from prolonged lying in o
26. Torticollis: Wry neck
May see breast preference, jaw clenching, jaw asymmetry, inability Cranio-sacral therapy helpful
ed
without
white),
Family om
younger
29. Cow's Milk Protein Allergy: Proteins from mother's diet can pass into breast-
milk and cause an allergy 2-5% of infants Avoidance or restriction of causal food may be needed Full allergy - may need hydrolyzed formula IF BFing not possible
30. Hydrolysate formula: Extensively-hydrolyzed formulas are hypoallergenic; of-
fer nutrition for infants who cannot digest intact cow's milk protein these formulas break casein into smaller pieces that can be absorb allergic reaction.
31. Partially Hydrolyzed Formulas (e.g. Carnation Good Start®): Partially hy-
drolyzed formulas take a cow's milk protein whey, and break it into large pieces. Unfortunately, most babies allergic to cow's milk will react to these large pieces of milk protein. So, these formulas are not used for infants allergic to cow's milk.
32. Soy Formulas (e.g. Isomil®, Prosobee® or Nestlé Good Start Soy®): Soy
formulas are no less allergenic than cow's milk-based formulas. Eight to 14 percent of infants with cow's milk allergy will react to soy. Some infants will develop proctocolitis or enterocolitis. The term enterocolitis refers to the inflammation of the GI tract, which includes both the small and large intestine (colon). soy formulas are not recommended in the treatment of cow's milk allergy.
33. Milk-Based Formulas (e.g. Similac® Advance® or Enfamil® Lipil®): - Milk-
based formulas offer complete nutrition. But, babies sometimes develop an allergy or intolerance to the cow's milk protein in these formulas.
34. Amino Acid-Based Formulas (e.g. Neocate® or EleCare®): Amino acid-
based formulas offer complete nutrition for infants. These formulas are for infants who are unable to tolerate extensively-hydrolyzed formulas. Amino acid-based formulas are also known as "elemental" formulas
35. SIDS: Risk factors: Sex (boys), Age (2-4 months), Race (non-
history, SHS, prematurity, maternal drug/alcohol use, poor PN care, m than 20
Prevention/Harm reduction: Back to sleep, breastfeeding, pacifier, tions, avoid SHS.
36. Cleft lip/palate: Cleft lip (orbicularis oris muscle interrupted)
Cleft palate (Unilateral or bilateral) Creates one large naso-oro cavity - tongue sits upward and backward in mouth *Difficulty creating negative pressure - uncontrolled tongue movements, recurrent
- calcium & iron absorption HMO (Human milk olligosaccharides)
- Probiotic; lactobacillus bifidus factor
- energy; brain development
44. Carbohydrates in human milk: Most stable component
40% calories in milk 7% total
45. 3 - main fats in human milk: 1) Cholesterol
- remains constant; mom's diet does not affect 2) Triglycerides
- 98-99% milk fats are triglycerides
- maternal diet can affect
- increased digestability
- AHA, DHA (palmitic acid, Oleic acid)
- CYTOTOXIC to parasites E. coli, G. lambia etc
- NEEDS lipases (x4) to break down chains (bile-salt/lingual/gastric/pancreatic) 3) Phospolipids
- fat soluble vitamins
46. Fats in human milk: Most variable component
50% calories in milk 4% total R/T degree of fullness in breast Low concentraion when breast is fullest and more when breast is drained
47. 4 - main protein components in human milk: 1) Whey (60%)
- a-lactalbumin = HAMLET cells - Lactoferrin - more in colostrum binds to the iron that bacteria need to thrive; kills candida Lysosome - enzymes attack E.Coli/salmonella and increases at around 6 months Serum Albumin Immunoglobulins sIgA - targeted protection 2) Casein (40%) b-casein - forms soft curd, mainly nutritive *3) NPN * 19 amino acids, creatinine, urea, uric acid, peptides 4) Growth Factors promote GI maturation
51. Breastfeeding provides this type of immunity:: Passive immunity
52. Human milk has the highest content of of all mammals: Lactose
53. Human milk has lower and higher and -
: Lower protein Higher fat Higher carbs
54. Cholecystokinine: Hormone that signals sedation and feeling of full-
ness/well-being during sucking; CCK release in mom and baby produces sleepy feeling
55. Leptin: Hormone that helps control appetite
56. Phagocytes and lymphocytes: Attack and digest bacteria
57. Water soluble vitamins: Maternal diet DOES affect
B12 main one that can affect supply Vitamin B and C
58. Fat soluble vitamins: Transported in fat
Vitamin A (vision), D (Rickets), E (anti-oxidant and protects cells memebranes), K (clotting)
59. Colostrum is....: more nutrient dense
immune function - high sIgA HIGH protein (lactoferrin, growth factors, immune protection) Whey:Casein = 90:10 HIGH sodium and chloride low fat, lactose and vit B 5-10 mL day 1- 15-24mL day 3-
60. Preterm milk is....: similar to colostrum
more nutirent dense and increased immune factors
61. Mature milk is....: *nutritive
function* 20 cals per oz end of second week (7-10 days) Whey:Casein = 60:40 Higher lactose 780 mL/day average milk volume
62. Tanner's Staging - breast development: 1) no development
2) breast dveelopment/sparse pubic hair
Estrogen and progesterone Estrogen - increased growth and branching of ductal system Progesterone - lobular-alveolar development
68. Stages of Lactogenesis: 1) Lactogenesis I - mid-pregnancy-2 days pp
* Secratory differentiation - functional changes to breast tissue; HPL has greatest
effect on breast growth in pregnancy ENDOCRINE
2) Lactogenesis II - day 3-day 8
* Secretory Activation - COPIUS milk
ENDOCRINE
y
glands*
y
east
: presence
of xilla
3) Lactogenesis III - Day 9 -maintenance
AUTOCRINE
4) Involution - 40 days after weaning
69. Why is there not copius milk during pregnancy......Progesterone holds milk
in check until delivery of placental and progesterone levels drop
70. Which breast surgery is more destructive to milk supply?: Reduction
surgeries tend to be more destructive as they affect nerve sensation needed for let- down and hormonal pathways (4th intercostal nerve). The 4th intercostal nerve runs at 4:00 o'clock on left breast and 8:00 o'clock on right.
* horizontal incisions are more damaging (anchor)
* assess location of scars, nipple sensitivity
71. Macromastia (hyperplasia): Over development of breast
* abnormally large breasts
* starts in puberty
* mastia: condition of having (such or so many) breasts or mammar
May be a reason to seek reduction mammoplasty
72. Gigantomastia: Severe over development of breasts
*mastia: condition of having (such or so many) breasts or mammar May be a reason to seek reduction mammoplasty
73. Hypoplasia: Under development of breasts
* Affect milk supply and milk production d/t decreased functional br
* Plasia=formation, growth, development *
May be a reason to seek augmentation
74. Hyperadenia (polymastia/hypermastia) extra breast tissue
additional breast tissue (with or without nipples); most common in a
* can become engorged during initiation
77. Intraductal Papilloma: BENIGN spontaneous discharge fromone only
78. Breast quadrants: 2 upper quadrants
2 lower quadrants
79. Duct ectasia: Multi-coloured sticky discharge
