CLC - Certified Lactation Counselor Special Infant Considerations Questions and Answers

Question 1

A CLC is counseling the parents of a late preterm infant (35 weeks gestation).
The mother reports the baby is very sleepy, often falls asleep after only a few minutes at the breast, and has had infrequent stools.
Which of the following is the MOST important concept for the CLC to explain to the parents?

Accepted Answer

Sleepiness and a weak suck are common and can lead to inadequate milk transfer, requiring careful monitoring and management.

Answer

The infant is likely getting all the needed nutrition in those few minutes.

Answer

Late preterm infants often need formula to have enough energy to breastfeed.

Answer

The mother's milk supply is likely low and is the primary cause of the infant's sleepiness.

Question 2

A mother is concerned because her 5-day-old breastfed infant's skin appears yellow. What is the CLC's best advice regarding the management of common, physiologic jaundice?

Accepted Answer

Ensure the infant is feeding effectively and frequently, at least 8-12 times in 24 hours, to promote stooling.

Answer

Temporarily stop breastfeeding for 48 hours and give formula to see if the yellow color improves.

Answer

Give the baby sips of sterile water between feedings to help flush out the bilirubin.

Answer

Advise the mother to get as much rest as possible, as maternal fatigue is the main cause of infant jaundice.

Question 3

An infant is born with a cleft palate but an intact lip. The mother is highly motivated to provide breast milk. Which of the following presents the MOST significant challenge for direct breastfeeding with this condition?

Accepted Answer

The infant's inability to create adequate negative pressure for suction.

Answer

The mother's breast tissue being too large to fit in the infant's mouth.

Answer

The infant's tendency to swallow excessive amounts of air.

Answer

The risk of milk irritating the exposed nasal passages.

Question 4

A CLC is working with a mother and her newborn diagnosed with Down syndrome. The CLC observes that the infant has difficulty sustaining a latch and seems to tire quickly. This is most likely related to which common characteristic of infants with Down syndrome?

Accepted Answer

Hypotonia, or low muscle tone.

Answer

An unusually strong suck reflex.

Answer

Aversion to close physical contact.

Answer

A smaller-than-average oral cavity.

Question 5

A hospital-based CLC is reviewing a list of newborns on the postpartum unit. Which of the following infants should be most closely monitored for hypoglycemia and require a proactive feeding plan?

Accepted Answer

A 40-week gestation infant who is large for gestational age (LGA) and whose mother has gestational diabetes.

Answer

A 39-week gestation infant who is average for gestational age (AGA) and whose mother had an uncomplicated pregnancy.

Answer

A 41-week gestation infant whose mother plans to formula feed from birth.

Answer

A 38-week gestation infant who had a brief period of tachypnea after a vaginal birth that has since resolved.

Question 6

A mother of newborn twins is concerned about her ability to produce enough milk for two babies. Which of the following is the most important principle for the CLC to emphasize for establishing an ample milk supply?

Accepted Answer

Ensuring frequent and effective milk removal from both breasts, aiming for 8-12 sessions per 24 hours.

Answer

Limiting feeding duration to 15 minutes per baby to avoid exhaustion.

Answer

Assigning one baby permanently to each breast to create a specialized supply.

Answer

Supplementing with formula after every feeding for the first two weeks.