CLC Exam 2022. All Questions With Accurate Answers. Graded A+

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What are green/shiny stools a sign of? - ✔✔--sign of overproduction leading to less fat in milk, faster digestion causing not enough time for lactase to digest the lactose in milk. An improved lat... ch could allow for more fat flow Signs of oversupply - ✔✔-Rapid weight gain in infant, unsettled baby after feeding, recurrent plugged ducts and mastitis, painful feedings, voluminous (huge volumes of) stools- often green & shiny What causes nipple pain? - ✔✔-Improper latch--> need lactation support to help with proper latch on, good seal True/false: baby should be pulled into breast. - ✔✔-False! Do not pull baby into breast, let baby tilt head back for optimal latch. Hand on back of baby's head can interfere baby's interoral function by restricting the movement of the cranio-cervical spine--> causes nipple trauma. Make sure crook of arm in cradle position does not block baby from being able to fully tilt back. Should a latch be symmetric or asymmetric? - ✔✔-Asymmetric! A baby should form a teat with breast tissue underneath the nipple as part of a latch What is a symmetric latch - ✔✔-Not a good latch, causes nipple damage Asymmetric latch - ✔✔-Optimal attachment to the breast, where the baby's lips are not centered in relationship to the areolar, but rather vertically off-centered with the baby's chin and lower lip closer to the edge of the areola than the baby's upper lip. A baby should form a teat with breast tissue underneath the nipple as part of a latch Do nipple creams work? - ✔✔-Continued questions of effectiveness, fear of ingestion by baby Should a frenotomy be suggested for tongue tie? - ✔✔-No study was able to report that frenotomy led to better long term breastfeeding Tongue tied breastfeeder - ✔✔--complete feeding assessment and suggest ways to optimize latch. -refer onward for diagnosis (have PCP diagnose TT) -provide support What is a fissure straight down the nipple evidence of? - ✔✔-A symmetric latch. Top lip needs to have good seal, moist part of lip should be touching nipple, can roll out top lip, to reduce injury during BF Is there a deep latch with nipple stretching? - ✔✔-If nipple not stretched deeply into mouth, less oxytocin flows, less fat is in mix. With less fat, milk digested quicker = not enough time for baby to make enough lactase to digest lactose in milk. What to do for oversupply? - ✔✔-Decrease additional stimulation/milk removal if possible Consider block feeding (only nursing on one side only per feeding) Watch for mastitis Try australian posture (mother down under, baby on top) Consider donating to milk bank Consult with HCP for medical dx How many mL considered oversupply? - ✔✔-normal milk production = 750-1000 mL/day Thrush during BF - ✔✔-painful for mother & baby. may be visible or may not (whiteness that can't be wiped off) -mother will have itchy, flaky, shiny skin -candida not found inside the ducts or milk Treatment of candida on breast - ✔✔--nystatin first line -flucanizole second line -throw out all yeast vectors (pacifiers sterilize breast pumps) -flucanazole oral capsules may be used to clean yeast vectors due to the biofilm created on pacifiers by candida What to do if antifungal treatment for yeast doesn't work? - ✔✔-Not candida infection! Reynaud's Phenomenon - ✔✔--vasospasm of nipple, recognized by triple color sign: from white--> blue--> raspberry or bicolor sign white --> raspberry. pain is extreme and spasmodic (not continuous) -this happens after feeding once baby's mouth comes off nipple has vasospasm, feels like frostbite treatment of reynauds - ✔✔--prevent/decrease cold exposure -avoid vasoconstrictive drugs such as caffeine and hypertensive drugs, nicotine -can use nifedipine or calcium channel blocker Nipple pain and poor milk transfer that is persistent despite optimal latch - ✔✔--can use nipple shield as a test to see if baby exerting too much pressure? -OT involvement -in rare cases baby have a strong sucking vacuum as measured by a pressure transducer or nipple shield Clogs/plugs - ✔✔-Palpable lumps of milk within the lumen or duct system, usually not visible. Solids dont get absorbed...could be too tight of a bra slowing flow of milk what to do for clogs/plugs - ✔✔-Encourage massage using side of hand and warm compresses. Do double nursing by doubling up on side of clog to push it out. point baby's chin toward clog See PCP if clog hasnt moved in 24-48 hours or systemic symptoms of inflammation (flu like s/s) When to call PCP for clog/plug - ✔✔-If plug hasn't moved in 24-48 hrs or systemic signs of inflammation (flu like s/s) Causes of clogs/plug - ✔✔-too tight nursing bra what is a bleb - ✔✔-small white spots on the face of the nipple that look like milk-filled blisters. one duct opening is usually covered what does a bleb feel like - ✔✔-painful stabbing pinpoint pain how to get rid of blebs - ✔✔-Same as clog treatment. Sometimes need t be lanced by HCP Common mastitis - ✔✔--can be non-infective or infective -blocked ducts from engorgment, hurried feedings, nipple shield (pressure will build until milk sneaks out of space, body reacts to this like invader) causes of common mastitis - ✔✔--tight bra (look for indentation of breast straps) -use of breast shell or nipple shell -attachment difficulties -anemia in the mother -tongue tie in baby (ineffective milk emptying) s/s common mastitis - ✔✔-systemic- fever, ill, malaise, redness, pain, one inflamed breast What bacteria causes infective mastitis - ✔✔-Staphylococcus tx common mastitis - ✔✔-NSAIDS first line but make sure diagnosed by PCP -must keep pumping/breastfeeding to keep milk flowing. keeps breasts soft/comfortable to avoid abscess development Abscess on breast - ✔✔-Localized areas of pus and necrotic tissue that can develop with a breast infection •Can develop in the subcutaneous, intramammary, retromammarylayers •Symptoms include pain, swelling, redness, fever, increased WBC count, palpable mass -pocket of pus forms in the breast -from untreated mastitis Antibiotics for mastitis? - ✔✔-Usually for double mastitis, not generally proscribed for one breast common mastitis. If treatment uneffective consider anemia, ductal or inflammatory breast cancer Double mastitis - ✔✔-EMERGENT AND UNCOMMON- tissue of both breasts inflamed. organism cause of double mastitis - ✔✔-strep -potentially fatal, whole body inflammation, sepsis -not a problem with milk signs of inflammatory breast cancer - ✔✔-- breast tissue is red, warm, has orange peel (peau d'orange), pitting appearance on skin surface [Show More]

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