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Some brands of artificial baby milk produced in the 1980s lacked which essential nutrient causing brain damage and learning disabilities in infants that were fed this milk exclusively? a. sodium b. chloride c. potassium d. calcium - ANSWER: B A baby's tongue is pressing a mother's nipple against the baby's hard palate. Which cranial nerve is MOST responsible for this tongue movement? a. Spinal accessory b. Vagus c. Hypoglossal d. Trigeminal - ANSWER: C (CN XII) - the other nerves listed are more involved in suck/swallow/breathe actions Which of the following BEST describes fetal nutrition? a. The umbilical cord delivers nutrients directly to the fetal gut b. The fetus swallows and digests amniotic fluid c. The fetus absorbs nutrients from the amniotic fluid through his skin
d. The fetus has no digestive enzymes of his own until after 40 weeks - ANSWER: B (amniotic fluid has protein and other nutrients) Which of the following milk component is MOST LIKELY to explain higher scores in cognitive development and vision for breastfed babies? a. Long-chain fatty acids b. Short-chain fatty acids c. Phospholipids d. Sterols - ANSWER: A (Omega-3 fatty acids DHA and AA especially) 1 - 3 Month-old babies may: a. Breastfeed 6-8 times per 24 hours b. Sleep for 2-3 hours once a day c. Grasp their toes during nursing d. Recognize other adults and smile - ANSWER: B What is the average normal heart rate of a full-term infant? a. 80-100 BPM b. 100-120 BPM c. 120-160 BPM d. 160-200 BPM - ANSWER: C Which term refers to the most frequent number in a set of numbers?
A qualitative study: A) Cannot be used if research subjects only speak English B) Allows for exploration of ideas and experiences in depth C) Deals with numbers and statistics D) Must have a statistically significant result - ANSWER: B (qualitative has the letter "l" which is "lovely"--words and experiences are "Lovely") A Likert scale is an example of: A) Gender data B) Economic disparity data C) Nominal data D) Ordinal data - ANSWER: D (ordinal=order) A meta-analysis: A) Is another word for protocol B) Is another word for policy C) Summarizes the literature on a topic D) Statistically combines the results from several studies as if they were all part of one big study - ANSWER: D A Type 2 error is sometimes referred to as a false negative error. This is when a study concludes there is no difference even though there actually is a difference. What can lead to a Type 2 error?
A) The sample size being too big B) The control group being too big C) The sample size being too small D) The control group being too small - ANSWER: C Researchers in a hospital were trying to figure out how to improve their breastfeeding rates. They conducted a study in the Labor and Delivery suite where one group of birthing women held their babies skin-to-skin for 20 minutes immediately after birth and another group held their babies skin-to-skin for 60 minutes after birth. All mothers had vaginal births, all were taught skin-to-skin holding the same way, and all mothers and babies were stable. Length of time breastfeeding for the first two hours of birth prior to the mother leaving the L/D suite was studied. In this study the independent variable is: A) Length of time breastfeeding in the labor and delivery suite B) The number of vaginal versus cesarean births in the study C) Length of time of skin-to-skin holding D) Rates of hand expression - ANSWER: C (independent is what is manipulated) What is the dependent variable in a study? - ANSWER: It is what is being measured Which P-value is considered not statistically significant? A) P =. B) P = <. C) P =. D) P = .001 - ANSWER: A
B) Cohort study C) Randomized controlled trial D) Systematic review and meta-analysis - ANSWER: D Bias is defined as any tendency which prevents unprejudiced consideration of a question. A) True B) False - ANSWER: A Which type of study design tries the best to eliminate bias in research? A) Case report B) Cohort study C) Case - control study D) Randomized controlled trial (especially if double blinded) - ANSWER: D Which milk component of human milk is active against at least 40 tumors? A)Alpha-lactalbumin B)Beta-lactoglobulin C)Lactoferrin D)Gangliocides - ANSWER: A (also known as HAMLET) About how many calories are utilized in making milk per day? - ANSWER: 500
Which component of human milk affects stool composition and frequency in the baby? A. Whey:casein ratio B. Soluble proteins C. Lactose D. Lipids - ANSWER: A (ratio changes from around 90:10 to around 60:40 from early postpartum to around 6 months of lactation-higher casein usually means more firm/less frequent stools) When are the growth factors most concentrated in human milk? A. 38 weeks gestation B. 2 days postpartum C. 2 months postpartum D. 7 months postpartum - ANSWER: B (most concentrated in colostrum and early milk) When does object permanence emerge? - ANSWER: 4 - 8 month old period In the first 3-14 days, babies typically consume how much of the available milk from mother? A. all of it B. 3/ C. 2/ D. 1/2 - ANSWER: C
B. Development of the duct system C. Growth of secretory epithelial cells D. Growing uterus triggers ribcage expansion - ANSWER: C (Lactocytes) What is a mutually interdependent occurrence? - ANSWER: two phenomena that arise together and are connected by cause and effect (example infant's gut closure happens around the time they are ready for solid foods) What is the most important function of lactose in human milk? A. Supplies 40% of the infant's energy needs B. Aids absorption of phosphorous and manganese C. Protects the GI tract from pathogens D. Supports CNS and cognitive development - ANSWER: D Which of the following components of human milk protects the baby by binding nutrients needed by pathogens in the baby's gut? A. Lactoferrin B. Lysozyme C. Mucins D. Oligosaccharides - ANSWER: A (binds to iron and starves pathogens of iron needed to proliferate) Which description of oral function of the baby during breastfeeding has emotional implications?
A. Sense of taste and smell of milk B. Pressure of the breast against the oral tissues C. Tactile sensation of breast filling the infant's mouth D. Ability of infant to control shape of breast - ANSWER: C (critical part of imprinting and emotional and psychological development) Which is the MOST IMPORTANT factor in how breastfeeding protects the infant against allergy? A. Preventing the baby from exposure to nonhuman proteins B. Slowing or preventing the absorption of allergens through the baby's gut C. Protecting the baby's gut from inflammation, which weakens the mucosal barrier D. Providing white cells in milk, which attack the allergens directly - ANSWER: A (they are key trigger in allergic disease) Which nodes collect most of the lymph drainage from the lactating breast? - ANSWER: Axillary nodes At what developmental age is self-feeding MOST LIKELY to begin? - ANSWER: 6 - 7 months At what gestational age does the swallowing reflex first appear? - ANSWER: 16 weeks At what gestational age does an infant develop an immature suck pattern? - ANSWER: 26 weeks
The standard temperature and time for Holder pasteurization used in donor human milk banks is: a. 87 degrees C for 10 minutes b. 70 degrees C for 25 minutes c. 62.5 degrees C for 30 minutes d. 60 degrees C for 60 minutes - ANSWER: c. 62.5 degrees C for 30 minutes A baby born at 34 weeks gestation is being sent home after several weeks in the NICU. Which feeding behavior would you MOST emphasize to the mother? a. express milk after each nursing as he probably can't get all your milk b. expect his sucking bursts to be short and irregular c. if he doesn't nurse well, give expressed milk with slow-flow nipple d. restrict nursing sessions to 10 minutes so he does not tire - ANSWER: b. short and irregular sucking bursts A disgruntled family files a malpractice suit after you provided lactation consultant services to them. The FIRST thing you should do is: a. call an attorney b. contact your professional insurance agent c. talk to the couple to find out why they are upset d. speak to the couple's physician - ANSWER: b. contact insurance agent (they have access to qualified attorneys) Which organization fostered and financially supported the development of the lactation consultant profession?
a. International Lactation Consultant Association b. La Leche League International c. American Academy of Pediatrics d. IBLCE - ANSWER: b. La Leche League Which of the following conditions occurs MORE often in children who were never breastfed? a. obesity b. lower respiratory tract diseases requiring hospitalization c. diarrhea and vomiting d. asthma - ANSWER: b. lower respiratory problems (257% higher), then D/V, then asthma, then obesity last Guidelines from the U.S. CDC state that health care workers should wear gloves when assisting breastfeeding mothers in which of the following situations? a. touching a mother's breast b. positioning a baby at the breast c. helping a mother pump her milk d. processing donor human milk - ANSWER: d. processing donor milk (human breast milk does not require special handling precautions otherwise) In the global context, the MOST IMPORTANT reason to use an open cup for feeding a preterm baby who cannot yet breastfeed is: a. it is inexpensive and readily available
c. implementation of the International Code of Marketing Breast-Milk Substitutes d. passage of legislation protecting a mother's right to breastfeed in public - ANSWER: c (code also protects breastfeeding rights of working women not right to breastfeed in public) Which of the following features is MOST IMPORTANT in a pamphlet promoting breastfeeding? a. listing advantages of breastfeeding b. comparison of breastfeeding with artificial feeding c. information about making enough milk d. local sources of breastfeeding help - ANSWER: c (not enough milk is a chief cause of breastfeeding failure) What is the most effective strategy in virtually all populations to support breastfeeding goals? - ANSWER: peer support Which is the MOST IMPORTANT feature of an effective breast pump? - ANSWER: effective milk transfer (operate at about 40-60 cycles per minute) A mother is collecting milk for her ill, premature baby. Which is the BEST container for her milk? a. open plastic cups or bottles b. nurser bags c. large containers holding several feeds d. glass containers with airtight lids - ANSWER: d. glass
What is the MOST LIKELY reason you would recommend finger feeding with a syringe? a. baby has a cleft palate b. baby has a weak suck c. baby is clamping down on mother's nipple d. baby is failing to thrive - ANSWER: c (may help the baby get back to direct breastfeeding after early difficulties) A 38-week neonate with a birth weight of 7 lb 12 oz is referred to you with a discharge weight of 6 lb 12 oz at 72 hours post delivery. The FIRST thing you should do is: a. weigh the infant to see if the hospital's scale was correct b. tell the mother that this weight loss is WNL c. take a thorough history of the dyad's breastfeeding practices d. suggest the mother discuss any interventions with her baby's doctor - ANSWER: c. assess current feeding patterns What is the reason that professions develop theoretical frameworks? a. to keep graduate students busy b. to establish a systematic point of view c. to systematize their policies d. to establish standards of practice - ANSWER: b. helps to establish a systematic point of view and starting/reference point for professional activities
Which product falls within the scope of the International Code of Marketing Breast- Milk substitutes? a. breast pumps b. milk storage bags c. pacifiers/dummies d. feeding bottles - ANSWER: d feeding bottles and teats A mother is concerned that her baby has suddenly lost interest in breastfeeding. Your BEST response is to: a. do nothing. Breastfeeding mothers are usually overprotective b. reassure her that her baby's appetite may change abruptly c. carefully investigate the situation d. instruct her how to give milk via a bottle - ANSWER: c (mothers are reliable reporters of their baby's condition) What is often the first level of research of a new phenomenon? a. an observational study c. a qualitative study c. a case report d. a clinical trial - ANSWER: c. case report What is the most important difference between pasteurized donor milk and mother's own milk?
a. species specificity b. allergy prevention c. bioavailability d. potential HIV exposure - ANSWER: d (pasteurization kills the HIV virus) What is a clinically appropriate use of a nipple shield? a. feels like the breast in the baby's mouth b. therapeutic changes in the baby's oral-motor response c. enhance milk transfer in some babies with weak suck d. extends the duration of breastfeeding - ANSWER: c (a thin shield found to be helpful in transfer of milk in premature babies) Why can't an LC refer a patient to the LC's own private breast pump rental business?
- ANSWER: Conflict of Interest Which component of human milk is destroyed by freezing? a. lactoferrin b. macrophages c. lysozyme d. SIgA - ANSWER: Macrophages (living cells are killed by freezing) After you have corrected the latch-on technique for a mother with nipple pain and who has an 8-day-old infant that has been at the breast constantly since birth, has a
