Day One

Question 0

UNICEF

Answer 0

United Nations Children’s Fund

Question 1

What three strategies have WHO and UNICEF set out to increase breastfeeding and initiation and duration

Answer 1

Promotion
Protection
Support

Question 2

WHO

Answer 2

World Health Organization

Question 3

Promotion

Answer 3

Focuses on advantages of BF

Question 4

Protection

Answer 4

governmental, manufacturer, and social responsibility to assure BF ability. Includes addressing moms about BF rather than formula

International code of marketing of breast milk substitutes

Question 5

Support

Answer 5

Interaction of helpers with family as well as program development

Question 6

10 steps to successful BF UNICEF/WHO

Answer 6

1. Written BF policy that’s routinely communicated to all health staff
2. Train all health care staff in skills necessary to implement policy
3. Inform all pregnant woman about benefits and management of BF
4. Help mothers initiate BF with in one hour of birth
5. Show moms how to BF and how to maintain lactation even If separated from infant
6. No food/drink, other than breast milk, unless medically indicated
7. Practice Rooming in: allow mom and baby to remain together 24 hours a day
8. Encourage BF on demand
9. No artificial teats or pacifiers
10. Establish BF support groups and refer to them on discharge

Question 7

How long is the CLC credential valid?

Answer 7

3 years. May be renewed via submission of 18 hours of continuing education in BF and lactation

Retrieve by attending more classes vas attending conferences

Question 8

ALPP

Answer 8

Academy of Lactation Policy and Practice

Question 9

Why mothers stop BF

Answer 9

Not enough milk
Latch-on difficulties
Breast pain/soreness
Work/school

Question 10

Fastest drop off occurs when?

Answer 10

10 days after discharge

Question 11

Why is BF so difficult that mothers need help

Answer 11

Unrealistic expectations
Lack of timely interventions
Misunderstanding about why mom stop BF

Question 12

BF rates went up in the 1990’s because…

Answer 12

WIC program

Question 13

Goals for 2000

Answer 13

75% initiation and 50% continuation to 6 mo.

Question 14

Goals for 1990

Answer 14

75% initiation and 35% continuation to 6 mo.

Question 15

What tissues in the breast contribute to milk making

Answer 15

• Milk making cells (glandular, lactocyte, or alveolar cells) with receptor sites
• Distal tissue
• Extensive vascular tissues: arteries, veins, capillar
• Lymphatic nodes
• 3rd, 4th, & 5th intercostal (thoracic) nerves
• Montgomery glands (tubercles)

Question 16

Myoepithelial cells

Answer 16

Smooth muscle cell that forces milk through the duct and to the pores

Alveolar cells are Surrounded by myoepithelial cells. 3rd layer is capillary network

Question 17

Outdated ideas of the internal structure of the Breast included…

Answer 17

Fat only behind mammary tissue
Ducts evenly spaced
9-27 nipple pores (opening at tip of nipple)

Question 18

Making milk

Answer 18

Messages from the Breast travel through the nervous system to the brain. Hormones then travel to the breast through the blood stream

Question 19

Modern ultrasound study of structure of breast

Answer 19

Fat mixed in throughout the Breast
Uneven spacing in ducts
5-9 nipple pores
No lactiferous sinus (milk would gather in duct-not true)

Question 20

Montgomery glands (tubercles)

Answer 20

Unique blend of mammary and sebaceous glands. A waxy layer can start forming out of gland during pregnancy

Question 21

Prolactin

Answer 21

• Makes milk
• Anterior pituitary
• Much more responsive in postpartum
• lengthening time between feeding=Lower baseline prolactin levels (weaning)
• levels go down in between nursing and rise shrine nursing
• infrequent nursing leads to lower levels and less rise
• non pregnant, non lactating women’s breasts and nipples respond to touch by triggering increases In prolactin secretion

Question 22

Oxytocin

Answer 22

Posterior pituitary

Question 23

De Carvalho’s Research

Answer 23

Frequent nursers: 
10X per 24hours 
138 min per day 
14 min/nursing 
Wt. gain @ 15 days: 561 grams 

Infrequent nursers: 
7X per 24 hours 
137 min per day 
20 min/nursing 
Wt. gain @ 15 days: 347 grams