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IBCLC FINAL STUDY QUESTIONS & ANSWERS
1. % of breastmilk that is carbohydrates: Approximately 7%
2. % of breastmilk that is fat: Approximately 4%
Hale and Hartman, 2007. Textbook of Human Lactation, page 50.
3. % of breastmilk that is protein: Approximately .8 - 1 %
Mannel, Martens & Walker, 2008. Core Curriculum for Lactation Consultant Prac- tice (2nd ed.), page 272.
4. % of calories in breastmilk from carbohydrates: Approximately 40%
Hale and Hartman, 2007. Textbook of Human Lactation, page 69.
5. % of calories in breastmilk from fat: Approximately 50%
Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
6. % of calories in breastmilk from protein: Approximately 10%
Mannel, Martens & Walker, 2008. Core Curriculum for Lactation Consultant Practice (2nd ed.), page 272.
7. l‘phalactalbumin: A major protein found in human milk whey. Assists in
process- ing lactose.
Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
8. Aspirin: Salicylate analgesic, L3. Use associated with Reye's Syndrome in
infants. Hale, 2010. Medications and Mother's Milk (14th ed.), page 87.
9. ²lactaglobin: Major protein in bovine milk.
Hale & Hartman, 2007. Textbook of Human Lactation, page 40.
10. Bactrim/Septra: Sulfonamide antibiotic, L3. The mixture of trimethoprim and
sulfamethoxazole. No concerns reported via breastmilk in term healthy infants. Use with caution in preterm or jaundiced infants. Hale, 2010. Medications and Mother's Milk (14th ed.), page 249.
16. Dong quai: Herb contraindicated in lactation. Used to quell uterine cramps.
Humphrey, 2003. The Nursing Mother's Herbal, page 239.
17. Dopamine: A prolactin inhibiting factor. Decrease releases prolactin and milk
production begins. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page 88.
18. Estrogen (after delivery): This hormone dramatically drops after birth allow-
ing milk production to begin. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page 88.
19. Expected daily weight gain in the first 3 months: 15-30 grams or 1/2 to 1
ounce a day. Walker, 2009. Breastfeeding Management for the Clinician: Using the Evidence (2nd ed.), page 284.
20. Fourth intercostal nerve: Essential for inervation of the nipple. Enters the
areola at 5 o'clock position on the left breast and the 7 o'clock position on the right breast. Walker, 2009. Breastfeeding Management for the Clinician: Using the Evidence (2nd ed.), page 56.
21. Galactocele: A milk filled lacteal cyst. Most frequent lump found in a lactating
breast. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page311.
22. Galactose: A monosaccharide derived from lactose. Helps with central ner-
vous system development. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
23. Low birth weight infant: A birth weight of less than 2500 grams.
Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
26. Milk-plasma ratio: Quantity of a drug in human milk in relation to maternal
plasma. If the M/P ratio > 1.00, the drug is found in greater quantities in milk than in plasma. M/P ratio < 1.00, the drug is found in lesser quantities in milk than plasma. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
- Hale, Medicaitons in Mother's Milk 2010, p 18.
27. Heroine: Narcotic analgesic, L5. Not recommended for breastfeeding. Infant
should be observed for sedation, tremors, vomiting, restlessness, and poor feed- ing. Hale, 2010. Medications and Mother's Milk (14th ed.), page 500.
- :
29. Holder pasteurization: A pasteurization process in which the milk is heated
to 62.5o Celsius for 30 minutes, and then rapidly cooled in ice water. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
30. Mode: The value that occurs most frequently in a data set. For example, if the
data set is 1, 3, 3, 3, 5, 7, 8, 8, the mode is 3. Wikipedia. en.wikipedia.org/wiki/Mode_(statistics).
31. IgE mediated allergy: Allergic reaction to food causing immediate, systemic
reaction; can sometimes be severe.
Wikipedia. Available online: http://en.wikipedia.org/wiki/Food_allergy.
32. Key milestones 1 month: Watches faces intently, follows objects, reacts to
noise. WebMD. Is Your Baby on Track? www.webmd.com/parent- ing/guide/is-your-baby-on-track.
33. Key milestones 2 months: Smiles at sound of voices. Lifts head and chest
while on stomach. WebMD. Is Your Baby on Track? www.webmd.com/parent- ing/guide/is-your-baby-on-track.
WebMD. Is Your Baby on Track? www.webmd.com/parent- ing/guide/is-your-baby-on-track; Wikipedia. en.wikipedia.org/wiki/Child_develop- ment_stages.
39. Key milestones 12 months: Walks with or without support, beginning to say
words, imitates people. WebMD. Is Your Baby on Track? www.webmd.com/parent- ing/guide/is-your-baby-on-track.
40. Key milestones 18 months: Walks independently, drinks from a cup, says at
least 15 words. WebMD. Is Your Baby on Track? www.webmd.com/parent- ing/guide/is-your-baby-on-track?
41. Lactase: Enzyme needed by the infant to breakdown lactose in breastmilk to
simple sugars. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
42. Lactobacillus bifidus: Main bacteria in the intestine of a breastfed infant.
Called the bifidus factor, promotes the growth of beneficial bacteria. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
43. Lactoferrin: -An iron binding protein that prevents gastrointestinal diseases.
Found only in human milk, not bovine milk. -Declines over lactation Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
44. Lactose: -Primary carbohydrate found in human milk; supplies energy to the
infant's rapidly growing brain -Present in the newborn's gut at birth -Constant amount throughout lactation (although more concentrated the more frequent the feeds) -Enhances calcium absorption Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
48. Oligosaccharide: A carbohydrate consisting of monosaccharides found in
breastmilk. Antibacterial properties. Promotes the growth of Lactobacillus bifidus. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
49. Orbicularis oris: Muscle that encircles the mouth and controls most move-
ments of the lips (as compressing, closing, or pursing movements). Merriam-Webster Medical Dictionary. www.merriam-webster.com/medical/orbicu- laris+oris.
50. Palate, hard: The hard portion of the roof of the mouth. During breastfeeding
the infant compresses the breast tissue against this area with his tongue. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
51. Paget's disease: Type of breast cancer, 1-3% of all breast cancers. Occurs
unilateral with demarcated, red, scaly plaque on the nipple and/or areola. Blood tinged discharge, pain, crusting, itching, burning, skin thickening, redness, ulcera- tion, or nipple retraction. Mannel, Martens & Walker, 2008. Core Curriculum for Lactation Consultant Prac- tice (2nd ed.), page 652.
52. Palate, soft: The soft portion of the roof of the mouth, located between the
hard palate and the throat. This area rises when the infant swallows to close the
nasal passages. Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
53. Physiologic engorgement: Physiologic engorgement is normal increase in
milk production of lactogenesis II.
54. Pathologic engorgement: Pathologic engorgement is excessive fullness due to
restrictive feeding practices or ineffective milk removal.
55. Prolactin inhibiting factor: Stimulates dopamine releases and thus inhibits
prolactin. Nipple stimulation and milk removal suppresses PIF and dopamine, causing prolactin levels to rise and the breast to produce milk. From the hypothal- amus.
61. TE Fistula Tracheoesophageal fistula: A fistula (passage way) between the
trachea and esophagus. Oral feedings are withheld until the fistula is surgically repaired due to the risk of aspiration. Merck manuals Online Medical Library. www.merckmanuals.com/profession- al/sec19/ch289/ch289b.html?qt=tracheoesophageal fistula&alt=sh.
62. Very low birth weight infant: A birth weight of less than 1500 grams.
Riordan & Wambach, 2010. Breastfeeding and Human Lactation (4th ed.), page
63. Weaning milk: Breastmilk during the end of lactation (whether intentional or
unintentional). This milk is higher in sodium and immunoglobins. Mannel, Martens & Walker, 2008. Core Curriculum for Lactation Consultant Practice (2nd ed.), page 676.
64. Preterm milk: Higher levels of protein, nitrogen, fatty acid, some
vitamins/min- erals, immune factors and anti-inflammatory elements, lactoferrin
65. 11 weeks gestation: swallows amniotic fluid
66. 16 weeks gestation: swallow reflex
67. 24 weeks gestation: suck reflex
68. 26 weeks gestation: immature suck pattern
69. 34 weeks gestation: suck-swallow reflex
70. 37 weeks gestation: synchronized coordination of sucking and swallowing
with breathing is achieved consistently
71. Infant's mouth: -Vertically short
-When closed, the tongue is in lateral contact with the gums and roof of the mouth
72. Infant's jaw: Lower jaw is small and somewhat receded
73. Infant's cheeks: Fat pads assist with sucking stability (no sucking pads in
preterm infants which is one of the reasons preterm infants have difficulty breast- feeding)
79. Progesterone (after delivery): Lactogenesis II is triggered by a rapid drop in
progesterone after delivery of the placenta
80. Placental Lactogen: Promotes areolar growth during pregnancy
81. Estrogen (during pregnancy): Proliferation & Differentiation of the ductal
system
82. ACTH & Growth Hormone (during pregnancy): together they promote mam-
mary growth
83. Relative Risk (RR): -Refers to the likelihood of something happening in a
population exposed to a substance or event compared to the risk of what it would be for an unexposed population -If the RR is "1" then each group has equal risk. RR of "2 or more" means that the exposure group has a higher chance of getting whatever is being studied (i.e. sore or damaged nipples) Example: RR of a woman developing sore or damaged nipples from using a breast pump to remove milk versus the risk of only using a baby to remove milk.
84. Odds Ratio: Represents the odds that the outcome will occur given in a
particular exposure compared to the odds of the outcome occurring in the absence of that particular exposure. Example: What are the odds that a group of woman will get mastitis if they have cracks in their nipples versus the odds of a group of women developing mastitis
who have no nipple cracks.
85. Confidence interval: Should be 95%
Example: Bhutani curve is an example of confidence interval (represents all babies and has accurate results)
86. Trigeminal Nerve-5th: Facial sensation
Mastication
87. Facial Nerve-7th: Taste sensation
Facial expression
88. Glossopharyngeal nerve-9th: Taste sensation from the one third back of the
tongue
