As the date of the 2010 IBLCE examination rapidly approaches, here is a short practice test for all you exam candidates.
1. This photo illustrates:
A. Uric acid crystals in urine, a potential marker for newborn dehydration.
B. Blood-stained urine, a potential marker for infant infection
C. Infant vaginal bleeding owing to cross-over hormones from the mother.
D. Urine colored by something in the mother’s diet.
The answer is A.
The presence of uric acid crystals in the infant diaper helps reveal information about an infant’s hydration status. Urine should ideally be clear, dilute, and odorless. The presence of so-called “brick dust” urine after Day 3 (especially in cases of delayed onset of copious milk production and infant weight loss >8%) should prompt careful evaluation of the need for temporary supplementation to stabilize the infant’s hydration status. To read more about the subject of assessment of infants’ diapers, review Chapter 4 in The Breastfeeding Atlas, 4th ed.
2. Clumped milk (observed during pumping):
A. Is commonly caused by malfunctioning pumping equipment
B. Is a marker for mastitis
C. Is more common in hot weather
D. Can be caused by certain medications
The answer is B.
Clumped milk has been observed in cases of mastitis in both dairy herds and human mothers. It may occur with or without symptoms of fever. To read more about signs, symptoms, and clinical management of mastitis, review Chapter 11 in The Breastfeeding Atlas, 4th ed.
3. The LC in this photo is:
A. Trying to wake up the baby with oral stimulation
B. Assessing the infant’s suck
C. Showing the mom how to play with her baby
D. Assessing the thickness of the buccal pads
The answer is D.
A lactation consultant may wish to use a gloved finger inside and her thumb on the infant cheek to gently sense the thickness of an infant’s subcutaneous cheek fat pads (the buccal pads). In general, well-developed cheeks (as opposed to very thin cheeks) add to the stability of facial tone and serve as a marker for normal facial development. Normal facial tone and development suggest physiological stability for sucking. To read more about infant assessment, review Chapters 2-3 in The Breastfeeding Atlas, 4th ed.