FREE IBCLC Certification Exam Question and Answers
A home visit from the lactation consultant is requested due to feeding issues. Because the mom was unaware that she was pregnant until after the birth, the birth history does not mention any prenatal care. She claims that she went to the emergency room and gave birth to her child, who weighed 5 lb 7 oz at birth, after feeling unwell and in pain for two days. She claims that after spending 48 hours in the maternity ward, she was released from the hospital. Her baby is 4 days old today, has subcostal and intercostal retractions, and his complexion is mottled and pale. He did wake up during the consultation to nurse. What suggestion would be most suitable?
Explanation:
The baby's history and physical appearance raise suspicions of neonatal sepsis. We do not know the group B step status of this woman because she did not receive prenatal care, and because of her hurried labor when she arrived at the hospital, it is possible that she did not have time to take antibiotics. The length of time the mother's membranes were ruptured before giving birth was unknown, however this is another risk factor for infection. Additionally, it is likely that this baby is preterm or SGA, which adds another risk factor for infection. Since neonatal sepsis can advance rapidly and pose a life-threatening hazard, this baby's care cannot wait until a scheduled checkup the next day.
A mother claims that she only breastfeeds three to four times per day. She speaks of experiencing severe grief, disgust, and nausea at the beginning of breastfeeding sessions when asked what the obstacles are to nursing on demand. She claims that her partner saw her crying while she was breastfeeding and advised she quit, which made her feel even more depressed, and she does not want to stop. What kind of lactation intervention would be most effective in helping this mother enhance her breastfeeding?
Explanation:
Performing a dopamine-producing activity soon before or at the start of a nursing or pumping session may help with the symptoms of dysphoric MER, according to some anecdotal data. Diaphragmatic breathing, diversions in cold water, amusing television shows, eating, getting more sunlight, getting more sleep, and a connection with someone or through a support group are all dopamine-producing activities for nursing women. Unfortunately, a number of dopamine-producing behaviors, such as constantly indulging in decadent eats or abusing nicotine, caffeine, or alcohol, are unhealthy. Some people who find it difficult to deal with these emotions may decide to wean; in this case, they should be encouraged, but they should also be watched out for postweaning depression.
The hospital maternity practices are asked to consult with the lactation consultant on a new policy and procedure document for staffing the newborn nursery. The following day is the first policy formulation meeting. Which of the following tasks should the lactation consultant conduct first in order to get ready for the meeting?
Explanation:
The newborn nursery is not necessary for hospitals, because it hinders breastfeeding by normalizing and increasing dyad separation, according to several research studies conducted over many years. This is a great chance for the lactation consultant to change the hospital's culture and guide it toward the success of breastfeeding by implementing the next 10 steps. Policymakers will understand the significance of the shift if an extensive list of studies supporting the abolition of the well-newborn nursery and the use of 24-hour rooming for dyads in the hospital is compiled.
In a lactation clinic, a lactation mentee is measuring test weights to establish milk transfer at the breast. The baby is first given a diaper change, stripped of her clothing (but a bow stays in her hair), and weighed at 3,746 g. Following another diaper change, the mother nurses the baby on the first side before seeing that the baby's bow has fallen out of her hair and into the floor. The mentee then weighs the infant again while she is only wearing her diaper, and she sets the bow that was previously in the baby's hair next to the infant on the scale. Despite objective indicators of milk transfer during the meal, the post-feeding weight of 3,742 g shows that the newborn did not transfer any milk. What erred on the mentee's part?
Explanation:
Before the initial weight measurement, the diaper should be changed, and it shouldn't be changed again until the post-feeding weight measurement. The baby might urinate or pass stool while being weighed, in which case the weight of whatever was previously in the baby's bowel or bladder is lost. By taking off the dirty diaper if the baby is nursing, the weight from the pee or stool is taken out of the equation. The baby will appear to have lost weight or to have gained none at all. Before the pre-feeding weight, all of the newborn's clothing and accessories should be removed; however, if something is forgotten, the infant should simply be weighed again while wearing the same clothing and accessories. Another illustration is socks. Parents frequently keep the baby's socks on at the pre-feeding weigh-in, but during the feeding, the socks will likely fall off and get misplaced, and they may not be found again during the post-feeding weigh-in.
The lactation consultant receives a confidential report from a NICU nurse about one of her patients who was born preterm and had fetal exposure to drugs. The infant appears to experience more apneic episodes after being fed her mother's breast milk and fewer apneic episodes following a few days of artificial baby formula feedings, according to the author, who also reports that the mother occasionally brings in pumped breast milk. What is the lactation consultant supposed to do?
Explanation:
If this mother is currently misusing drugs, a lab test can establish it. Breast milk feedings are not advised if laboratory testing reveals substance usage. A decrease in the respiration rate, apneic episodes, drowsiness, and even death could ensue from exposure to drugs of abuse through milk since tolerance is built up by the abuser, requiring increasingly higher doses of the substance to have the desired effect. The NICU social worker should be involved if laboratory testing reveals maltreatment.
In three weeks, the woman the lactation consultant is seeing will resume her full-time employment. Which of the following pertains to a going-to-work consultation is most crucial?
Explanation:
A high-quality pump that can remove milk quickly and regularly will be necessary for the working mother who wants to keep feeding her infant her own breast milk to keep up her milk supply. The most crucial component of the back-to-work consultation is pumping because it is a requirement for a breastfeeding woman who works full-time. It is necessary to tailor a pumping schedule to the mother's available downtime and breast storage capacity. In order to develop a sleeping schedule that works for her family, a mother should be informed that night breastfeeding may rise if she returns to work. The dialogue may include informational sessions regarding employees' rights to express breast milk and the opportunity to make a formal accommodation request, but this is not the most crucial part.
According to study, how long must breastfeeding last to reduce the incidence of SIDS by 50%?
Explanation:
Any amount of breastfeeding for more than two months lowers the incidence of SIDS by about 50%, according to a study. An infant may be more susceptible to SIDS if breastfed for less than two months. This information suggests that, for the best risk reduction, bed-sharing by a family for breastfeeding and sleep sustainability might be postponed until after 2 months of age.
