ibclc exam.xlsx

Approximately 7%

Approximately 4%

Approximately .8 - 1 %

Approximately 40%

Approximately 50%

Approximately 10%

Any of the small sacs or alveoli that terminate the ducts and are lined with secretory cells.

Bluish discoloration of the hands and feet in the newborn; peripheral cyanosis. Should not persist beyond 24 hours after birth.

Immunity conferred by the production of antibodies by one's own immune system.

Passage of drug into breastmilk assisted by components in breastmilk.

Antiviral used to treat herpes infections, L2.

Bacteria requiring air for metabolic processes. The breast is colonized with this type of bacteria.

Appropriate for Gestational Age. Having a birth weight between the 10th and 90th percentile on intrauterine growth charts.

Alcohol can decrease milk supply. Breastfeeding must be interrupted for 1 hour per drink, or until mother is sober.

Antihypertensive, L2. Frequently used to treat hypertension during pregnancy. No concerns reported via breastmilk.

A substance that causes an allergic response, such as foods, drugs, inhalants. Cow's milk is common source for infants.

A major protein found in human milk whey. Assists in processing lactose.

The ridges on the upper and lower jaw where infant's teeth will grow.

Secrete and store milk for let down. Surrounded by myoepithelial cells, contractile cells and connective tissue.

A natural phase of infertility that takes place when a mother is exclusively breastfeeding. Menstruation has not returned.

Antibiotic, L1. Observe for change in intestinal flora, compatible.

Antibiotic, L1. Observe for change in intestinal flora, compatible.

Hypersensitivity (as to foreign proteins or drugs) resulting from sensitization following prior contact with the causative agent.

Surgical technique for breast reduction, slang.

A tongue tie. Characterized by a thick, short, or tight frenulum under the tongue. Can cause breastfeeding issues, such as a painful latch or inefficient milk transfer.

This gland releases prolactin into the blood effecting milk production and ejection. It is susceptible to stress.

Infectious disease caused by a spore-forming bacterium (Bacillus anthrax), characterized by external ulcerating nodules or by lesions in the lungs.

Immunoglobulin formed in response to an antigen, including bacteria and viruses. Antibodies attack those bacteria or viruses helping the body resist infection.

Substance that stimulates antibody production. May be dust, food, or bacteria.

Index to evaluate the condition of a newborn infant based on a rating of 0, 1, or 2 for color, heart rate, reflex response, muscle tone, and respiration with 10 being a perfect score.

Sweat glands located on the areola that secrete a scent.

Programmed normal cell death.

Research that focuses on solving or finding an answer to a clinical or practical problem.

The darker pigmented skin that surrounds the nipple. Contains sebaceous glands (Montgomery Glands)

Salicylate analgesic, L3. Use associated with Reye's Syndrome in infants.

Inherited allergic tendency to skin rashes or inflammation. Exclusively breastfed infants are less likely to develop as cow's milk protein is a common allergen.

The point in lactation when milk supply is controlled by milk removal. Local control in the breast.

The capacity of a rational individual to make an informed, un-coerced decision.

The middle value of a data set. Add all the numbers and divided by the amount of numbers in the set.

Underarm. Breast tissue (the axillary tail) can sometimes extend into axilla.

Lymphocyte produced in bone marrow and peripheral lymphoid tissue; found in breastmilk. Attacks antigens.

Major protein in bovine milk.

A campaign that significantly reduced SIDS. Babies are less prone to SIDS when sleeping on their back.

Destroys bacteria.

Prevents the growth of bacteria.

Sulfonamide antibiotic, L3. The mixture of trimethoprim and sulfamethoxazole. No concerns reported via breastmilk.

Bronchus/gut/mammary-associated immunocompetent lymphoid tissue. Intermammary pathway. IgA antibodies are transferred through breastmilk to the infant.

Research that generates knowledge for the sake of knowledge.

Sharing adult bed with baby. Questioned safety in reduction of SIDS. Safe bed sharing has been shown to extend the duration of breastfeeding.

Meeting to develop protocol for the Lactational Amenorrhea Method of birth control. 1988.

The duty to do good.

Initiative by UNICEF and WHO (1991) to support breastfeeding in hospitals and maternity centers. "The 10 Steps".

The amount of a nutrient that is actually absorbed by the body. Nutrients found in breastmilk are easily absorbed by the infant's body.

(BPA) organic compound found in plastics. Linked to disease in infants. Now banned.

Statistics derived from the analysis of the relationship between two variables.

An herbal galactagogue. L3.

A quantity of medication given by IV, or a quantity of fluid (milk) given orally.

Relatively slow heart rate. Opposite of tachycardia.

A breastfeeding mother and baby.

Fat pads on the masseter muscles in an infant's cheeks giving them a plump cheeked appearance. Provide stability for the tongue during suckling.

Mature milk has approximately 20 cal/oz.

Fungal infection caused by Candida albicans; also called "thrush."

Diffuse swelling or collection of serum under the scalp of the newborn from birth trauma. Differentiated from cephalhematoma by unrestriction by the sutures of the skull.

The main protein in breastmilk. Creates the curd when digested in the infant stomach.

Breast reduction surgical technique. Intended to keep ducts intact.

Antibiotic, L1. Observe for change in intestinal flora; compatible.

Collection of blood beneath the periosteum due to birth trauma; contrasted with caput succedaneum, where the effusion overlies the periosteum and consists of serum.

A herb, L3. Used for anti-inflammatory, calminative, antispasmodic, milk sedative, and antiseptic properties. No concerns reported via breastmilk.

A virus infection, mothers can continue to breastfeed. Antibodies from her breastmilk provides immunity for the baby.

Statistical procedure that uses nominal level data and determines significant differences between observed frequencies in relation to data and expected frequencies.

A rare congenital anomaly, blocked posterior nostrils on one or both sides. Feedings by mouth are either difficult or impossible. Surgery opens the airways.

Congenital anomaly, obstruction of the lymphatic system. Chyle (lymphatic fluid) collects in the chest cavity and is drained via chest tubes. Managed by diet and medication. Fat free breastmilk has been used successfully.

Antibiotic, L3. Recently approved by AAP.

Long-acting antihistamine, L1. Observe for sedation, dry mouth, and tachycardia.

Type of herpes virus found in human milk, genital tract, urine, and pharynx. Transmitted by close contact. Avoid pumping or breastfeeding in premature infants if mom has acute infection.

Syndrome in early infancy characterized by episodic loud crying, apparent abdominal pain (legs drawn up and rigid abdomen) and irritability.

First milk created during late pregnancy and early postpartum period. Has higher concentrations of immunoglobins, fat soluble vitamins and some minerals.

An herbal poultice, L5. Is not considered safe due to alkaloids found in breastmilk after use.

Structure of interrelated concepts that may be generated inductively by qualitative research to provide a base for quantitative study.

Infection existing at birth that was acquired via placenta. Includes HIV and TORCH organisms.

Inflammation of the mucous membrane that lines the eyelid. Sometimes treated with fresh breastmilk.

Higher order theoretical or empirical idea or phenomenon that has abstract meaning and requires multiple concepts to represent it more concretely.

Preventing conception. Hormonal pill, barrier methods, intrauterine device. Breastfeeding can provide contraceptive protection.

Also know as the "suspensory ligaments." Attaches the skin of the breast to the chest wall.

Blood remaining in the umbilical cord after birth. May be saved for later stem cell transplantation.

Statistic that indicates the degree of relationship between two variables. The range in value is +1.00 to -1.00; 0.0 indicates no relationship, +1.00 is a perfect positive relationship, and -1.00 is a perfect inverse relationship.

The amount of cream in a milk sample. The amount of cream (fat) varies from mother to mother, feeding to feeding, and throughout the course of lactation.

Informal, short term wet nursing. Typically seen in the context of child care.

Ability to understand, communicate, and interact effectively with people from different cultures. Four components: Awareness of one's own cultural worldview; attitude towards cultural differences; knowledge of different cultural practices and worldviews; cross-cultural skills.

Acknowledging the variation in beliefs and actions given to the behaviors of different cultures.

The values, beliefs, norms, and practices shared by a group of people that guide the thoughts and behaviors of that group.

Bluish coloring due to low oxygen levels.

Protection from inflammation and death for cells.

Latin word meaning "of" or "from."

Process of reasoning from a general premise to the concrete and specific.

Approach to ethics that judges the morality of an action based on the action's adherence to rules. Described as duty or obligation, because rules 'binds you to your duty'.

Variable the investigator measures in response to the independent or treatment variable; the outcome variable that is affected by the independent variable.

Docosahexanoic acid and Arachidonic acid. Essential fatty acids known for improving visual acuity and cognitive ability.

Process by which the molecules of one substance (e.g., a drug) are spread uniformly throughout blood or plasma.

Chemical contaminant in the environment. As dioxin levels increase, the EPA has still determined it safe for mothers to breastfeed in the United States.

Complex sugar consisting of two monosaccharides. Forms the principle sugar in breastmilk, known as lactose.

Remote from the point of attachment or origin. Opposite of proximal.

Herb contraindicated in lactation. Used to quell uterine cramps.

Human milk voluntarily given to a milk bank. Donor is screened, milk is pasteurized.

A prolactin inhibiting factor. Decrease releases prolactin and milk production begins.

Duplication of the 21st chromosome. Characterized by epicanthal folds, a flat nasal bridge, broad hands and short fingers, a single crease in the upper palm (simian crease), a flattened forehead, small mouth, large tongue (macroglossia), and hypotonia. Some have congenital heart disease.

Diagnostic Related Groups, used by insurance companies for reimbursement.

Milk that leaks from the opposite breast during a feeding. This milk is low in fat.

The small ducts in the mammary gland that transfer the milk from the alveoli to the lactiferous ducts.

Herbal immunostimulant, L3. Known for stimulating immune system and wound healing. No concerns reported via breastmilk.

A skin inflammation or rash.

"Tiny swellings on the inner surfaces of the infant's lips that help the infant to retain a grasp on the breast during suckling."

Expressed Mother's Milk/Expressed Breastmilk.

The point in lactation when milk supply is hormone driven. Milk will come in whether or not a mother is breastfeeding.

Antigens enter maternal gut, pass to the lymph system where IgA specific antibodies are produced, then enter breastmilk.

Virus that cannot infect other cells without a coat (envelope). If the envelope is destroyed (e.g., by heat or soap and water) it is unable to produce infection. Ex. Cytomegalovirus and the human immunodeficiency virus.

Study of the frequency and distribution of disease and the factors causing that frequency and distribution.

Analgesia for childbirth. Anesthesia is placed in the epidural space just outside of the dura mater.

Cartilaginous structure of the larynx, just below the soft palate. When the infant swallows it closes the larynx maintaining passage of milk to the esophagus.

This hormone dramatically drops after birth allowing milk production to begin.

Ethical doctrine that holds that individuals have a moral obligation to help, serve, or benefit others, if necessary at the sacrifice of self interest.

Ethical position that moral agents ought to do what is in their own self-interest.

Assessing other cultures based on how one's own culture defines appropriate behavior.

A research method that attempts to understand the beliefs, practices, and behaviors of the culture of study from the perspective of those living within the culture.

Feeding with only breastmilk, no supplements of water, glucose water, artificial breastmilk, or foods.

Moderate exercies is fine. Exercise to exhaustion can increase lactic acid levels in milk and baby may refuse to breastfeed.

A cell releases secretory vesicles as in production of protein and lactose in the alveoli.

Derived from outside the body - such as iron supplements.

15-30 grams or 1/2 to 1 ounce a day.

1 pound per month.

Unbending movement around a joint in a limb that increases the angle between the bones. Opposite of Flexion.

Extent to which study findings can be generalized to samples and settings different from those studied.

Variables that can affect the relationship of the independent and dependent variables (i.e., interfere with the effect of treatment.

Vitamins including A, D, E, K. These vitamins are not affected by recent maternal diet, as they can be stored in the body.

Opiate analgesic, L2. A narcotic analgesic used during labor and delivery. Controversy about effect on breastfeeding.

Most commonly used herb to stimulate milk production.

Glandular structure (such as breast) with a large amount of fibrous tissue (benign tissue).

An alternative feeding method that involves a feeding tube running along side the finger during a feed. It is believed to help coordinate suck, swallow, and breath and allows baby to pace themselves.

Hard plastic shields used to collect milk while pumping. Sometimes a soft plastic or silicone. The nipple opening is often available in a variety of diameter sizes to accommodate differing nipple sizes.

Quick, high temperature pasteurization.

A nipple that does not protrude out or retract in (it is neither everted or inverted). It may or may not have slight movement inward or outward when stimulated or compressed.

Bending movement around a joint in a limb that decreases the angle between the bones of the limb at the joint. Opposite of extension.

Refers to the milk flow during milk ejection. Can also refer to the flow of a bottle nipple. When the milk flow is high the baby sucks slower and when the milk flow is low the baby sucks faster.

Antibiotic, L2. Safe; no untoward effects have been reported.

Psychotropic drug, L2 in older infants and L3 in neonates.

Meat, fish, poultry, beans, and many fruits and vegetables, such as bananas and spinach.

Milk, milk products, broccoli, kale, and most grains.

Leafy green vegetables, citrus fruits, dried beans and peas.

Meat, fish, poultry, lentils, and beans.

Animal products, such as fish, meat, poultry, eggs, milk and milk products. For vegitarians, fortified cereals or nutritional yeast.

Citrus fruits, peppers, broccoli, and strawberries.

Nuts, seeds, vegetable oils, and green leafy vegetables.

The milk at the beginning of a breastfeeding. This milk has low fat content.

The process of adding extra nutrients to breastmilk for premature infants. These nutrients can be derived from human milk or cow's milk base.

Essential for inervation of the nipple. Enters the areola at 5 o'clock position on the left breast and the 7 o'clock position on the right breast.

Release of tongue tie by clipping the lingual frenulum. Often preformed without anesthesia with few complications.

Surgical procedure to release a tongue tie. Used for more extensive tongue tie.

Membrane on the underside of the tongue that anchors it to the floor of the mouth. If short or tight it may restrict tongue extension and cause breastfeeding problems.

Reflex that protects the airway by causing a contraction in the back of the throat.

A milk filled lacteal cyst. Most frequent lump found in a lactating breast.

A food, herb or drug that is thought to increase milk supply in lactating women.

Mainting lactation once lactogenesis has been established.

Secretion of breastmilk in non-lactation women. Common among women who have previously been pregnant or breastfed.

A monosaccharide derived from lactose. Helps with central nervous system development.

Disorder of the metabolism of galactose, a milk sugar. Baby must be on galactose-free formula.

Inflammation of the stomach and intestines resulting from bacterial or viral invasion.

Congenital malformation characterized by herniation of abdominal contents through a fusion defect.

Purple dye with antifungal properties used to treat candida.

Infant's age since conception, usually specified in weeks and partial weeks. Counted from the first day of the last normal menstrual period.

Massive enlargement of breasts during pregnancy can result in tissue necrosis, ulceration, and infection.

An herbal galactagogue. Chemically similar to metformin.

Cytoplasmic organelle that is active in production and transport of breastmilk proteins—called also Golgi complex.

Common streptococcus bacteria in lower intestines. Harmless in adults, serious infection in neonates.

Commonly called the Swine Flu. Mother baby separation needed during communicable stage. May feed pumped breastmilk.

Length of time for half of a drug dosage to be eliminated. Five half-lives from time of original dosage usually clears the drug.

The manual removal of milk. Mothers push hands back towards chest wall and then roll fingers towards the nipple.

Harmless color change in a newborn in which the dependent side of the body is a deep color while the other side is pale.

Hepatitis B specific immunoglobulin. Infants who are born to mothers with hepatitis B should receive this immunization at birth.

Hepatitis B Virus.

H (intravascular hemolysis), EL (elevated liver enzymes; LP (low platelets). Develops as a result of preeclampsia in about 0.1% of women.

Vomiting of blood. The bleeding may be from the infant's upper gastrointestinal (GI) tract or a crack in the mother'snipple.

Acute viral infection of the liver usually transmitted through food and water-borne routes. The newborn can be infected by vertical transmission from the mother. Baby and mother should be given gamma globulin. Breastfeeding can proceed as normal.

Acute viral infection of the liver. It is safe for baby to breastfeed from infected mother, if baby receives a hepatitis vaccine with 12 hours after birth.

Chronic viral infection of the liver. Breastfeeding is allowed if mother's titers are not high.

Viral infection of the liver, usually a co-infection with Hepatitis B. Once immunization has begun breastfeeding can begin.

Viral infeciton of the liver that is self-limited and is not chronic. It is typically association with water contamination. Breastfeeding is considered safe.

Viral infection of the liver is associated with blood transfusions and has not been proven to transmit through breastmilk.

Narcotic analgesic, L5. Not recommended for breastfeeding. Infant should be observed for sedation, tremors, vomiting, restlessness, and poor feeding.

Sexually transmitted disease. Type 1 is infection of the mouth. Type 2 occurs in genitalia. However, lesions can occur on any place of the body including the breasts. Infants should not come in contact with active lesions. Good hand washing should be encouraged.

Method of pasteurization of breastmilk to preserve nutrients.

The milk at the end of a breastfeeding. This milk has a higher fat content.

Sexually transmitted disease . Antiretroviral drugs are helpful in prevention of it's spread to infant during pregnancy. In the U.S. it is recommended that women do not breastfeed. In developing countries exclusive breastfeeding is recommended.

A pasteurization process in which the milk is heated to 62.5o Celsius for 30 minutes, and then rapidly cooled in ice water.

The "X" axis in a graph

Transmission of pathogens through direct contact.

Bilateral electric breast pump. Used in hospitals, available for rent in community. Achieves more effective suction levels and frequency.

Human Lymphotropic Virus. Causes T-cell leukemia and lymphoma. Breastfeeding is not recommended.

Found in human milk, it provides growth promoting and protective effects on cells.

Organization that collects, screens, processes and distributes donor milk. The milk is dispensed on prescription for infants and adults in need.

Nutrients derived from human milk or cow's milk and added to human milk to enhance the growth of very low birth weight infants.

Meaning "excessive."

Mammary tissue without a nipple present (sometimes seen in axilla).

Intravenous feeding of an infant, commonly a very premature infant, with a solution of amino acids, glucose, electrolytes, and vitamins.

A condition characterized by elevated levels of bilirubin and decreased elimination of bilirubin.

Higher-than-normal prolactin levels, which may result in spontaneous breastmilk production and amenorrhea. Causes include pituitary tumors and some pharmaceuticals.

Having supernumerary nipples (extra nipples).

Meaning "deficient."

Low blood glucose levels. Breastfed infants tend to have lower glucose levels than formula fed infants.

Links the nervous system to the endocrine system via the pituitary gland. Secrets the prolactin-inhibiting factor (dopamine).

Low blood oxygen causing tachycardia, hypertension, peripheral, vasoconstriction, dizziness, and mental confusion.

Infant of Diabetic Mother

Allergic reaction to food causing immediate, systemic reaction; can sometimes be severe.

Immunoglobulins that cause phagocytic (engulf and absorb) destruction of microorganisms, bind to and activate complement, and are the only immunoglobulins to cross over the placenta from mother to fetus.

Allergic reaction to food causing delayed, diffuse symptoms.

Proteins produced by plasma cells to respond to a immunogen. The 5 different types include: IgG, IgA, IgM, IgE, and IgD.

How much a particular behavior is practiced at a given time.

Period between exposure to infectious pathogens and the first signs of illness.

Experimental (treatment) variable that is manipulated by the investigator to influence the dependent (outcome) variable.

The process of stimulating milk production in a woman who has not been pregnant for the current child.

Process of reasoning from specific observations or abstractions to a general premise.

Breast reduction surgical technique.

A patient has been given full information and offered appropriate options.

Technique used in breast augmentation where the incision is made in the fold under the breast and the implant is placed under the breast tissue.

Hormone that regulates carbohydrate and fats. L1, no concerns reported breastmilk. Insulin is too large a molecule to be secreted into breastmilk.

Extent to which manipulation of the independent variable makes a significant difference on the dependent variable, or the extent to which the independent variable, rather than extraneous variables, has caused the change in the dependent variables.

Occurring within cells. For example, viruses live within cells as part of their reproductive period.

Within the uterus; in utero.

Normal rate of weight gain of a fetus. It is considered by many to be the ideal growth rate for premature infants.

Nipple below the skin live. Umbilicated nipple can be pulled out or everted, while an invaginated nipple cannot be everted. Occurs in 3 percent of women.

When breasts return to a non-lactating state.

Antituberculosis agent, L3. No concerns reported via milk but infant should be monitored for toxicity.

A birth control device inserted into the uterus. Nonhormonal types have been shown to have no effect on lactation.

Intrauterine Growth Restriction. An infant with slower than expected intrauterine growth.

The yellow discoloration of skin, caused by high bilirubin levels. Physiologic jaundice usually resolves within the first weeks of life. Breastmilk jaundice is prolonged physiologic jaundice.

Bilirubin encephalopathy, a form of brain damage resulting from unconjugated bilirubin entering the brain. Characterized by lethargy, poor feeding, vomiting, irregular respiration, perhaps death.

Watches faces intently, follows objects, reacts to noise.

Smiles at sound of voices. Lifts head and chest while on stomach.

Raises head and chest while on stomach, holds head up for periods of time, grasps objects, smiles at people, makes vowel noises.

Babbles, laughs, imitates sounds. Rolls over, sits with support, holds rattle.

Holds head steady, reaches for objects and gets them, places objects in mouth.

Rolls over, moves objects from hand to hand, pulls self up to sit, makes double syllable sounds like "dada".

Responds to name, finds partially hidden objects, sits without support, crawls, picks up objects with pincer grasp.

Walks with or without support, beginning to say words, imitates people.

Walks independently, drinks from a cup, says at least 15 words.

Drugs that have been taken by a large number of breastfeeding mothers with no observed adverse effects in infants. Controlled studies have not shown any risk or harm to infant or the drug is not orally bioavailable in the infant. These drugs are considered "safest" to use when breastfeeding.

Drugs that have not been widely studied in breastfeeding women, but have not been shown to have an adverse effect on the infant or the risk of adverse effect is unlikely. These drugs are considered "safe" for breastfeeding moms to use.

Drugs that have no controlled studies on breastfeeding women or the adverse effect shown by controlled studies is only minimal. These drugs should only be given if the benefit justifies the potential risk to the infant. These drugs are considered "moderately safe" for breastfeeding moms to use.

Drugs with positive evidence of risk to breastfeed infant or to breastmilk production. However, the benefits for the breastfeeding mother may justify the risk to the infant. These types of drugs are considered "possibly hazardous" for breastfeeding women to use.

These drugs are considered "contraindicated" for breastfeeding mothers to use. Studies or human experience have shown that there is a significant risk to infant. The risk of using these drugs in breastfeeding women clearly outweighs the benefit of breastfeeding.

Enzyme needed by the infant to breakdown lactose in breastmilk to simple sugars.

The 15-24 milk ducts that collect milk from ducteles and carry it to the nipple. If the alveoli are the "grapes" these structures would be the "stems".

Main bacteria in the intestine of a breastfed infant. Called the bifidus factor, promotes the growth of beneficial bacteria.

An epithelial cell that lines the alveoli. Secretory cell.

The process of adding nutrients to human milk that are derived from human milk.

An iron binding protein that prevents gastrointestinal diseases. Found in both human and bovine milk.

The onset of milk production.

Beginning milk production; mid-pregnancy to day 2 postpartum.

Rapid increase in volume increases due to rapid drop in progesterone. Milk production switches from endocrine to autocrine control. Day 3 and 8 postpartum.

Maintenance stage of milk production. Controlled by the autocrine system (supply and demand).

A disaccharide that is the primary carbohydrate found in human milk.

Inability of the intestines to digest lactose; the principal carbohydrate in human milk.

Unusual flaccidity of laryngeal structures, a benign congenital condition that accounts for 70 percent of persistent stridor in infants.

Upper end of the trachea (windpipe) through which the voice is produced. In the infant, the larynx lies close to the base of the tongue; during swallowing, it rises and is closed off by the epiglottis.

An infant born between 34 0/7 and 37 6/7 weeks gestation.

The muscle that controls certain movements of the jaw (medial) and acts as an antagonist of other facial muscles (lateral). It works in conjunction with the masseter and temporalis muscles.

A crystalline fatty acid found in fats and oils, also called dodecanoic acid. Active against viruses, bacteria and protozoa.

The side of the brain characterized by vision and hearing, art, pleasure, feeling, subjectivity.

A hormone found in breastmilk that regulates appetite, metabolism, and food intake. Not present in formula.

Area of injured or diseased skin.

Oxytocin causes the myoepithelial cells surrounding the alveoli to contract and remove milk from the breast. Stimulated by the suckling infant and causes the suckling pattern to change from non-nutritive sucking to nutritive sucking as the milk flow increases.

Living cells found in breastmilk that fight infection. Includes macrophages and lymphocytes.

Large for Gestational Age. Having a birth weight greater than the 90th percentile on intrauterine growth charts. There is a concern for hypoglycemia.

Professional responsibility for an occurrence or omission. Being the cause.

Small molecule that binds specifically to a larger molecule (e.g., the binding of an antigen to an antibody, or of a hormone to a receptor).

Scale that primarily measures attitudes by asking respondents their degree of agreement or disagreement to a number of statements.

Enzyme that digests the fat in breastmilk.

Clusters of several alveoli with their ducts. Each breast contains 15-20 of these structures. Included in each one is 10-100 alveoli.

A structure composed of branching ductules that end in alveolar clusters.

A birth weight of less than 2500 grams.

A type of hormonal birth control that includes both estrogen and progestin in lower doses. May reduce milk supply but less likley than estrogen based pills.

A developed leukocyte that is bactericidal.

A process preformed to obtain human milk nutrients used to fortify human milk. The milk is rapidly frozen and dried in a high vacuum.

Found in the whey component of breastmilk, this enzyme creates a bactericidal and anti-inflammatory response.

Type of white blood cells, dominant type of phagocytes. They engulf and absorb pathogens, and also produce lactoferrin and lysozyme.

Type of white blood cell that ingests foreign material. Destroys bacteria, protozoa, and tumor cells; in addition to stimulating cells in the immune system.

Professional negligence by act or omission. Deviation from accepted standards of practice that causes injury or death to the patient, with most cases involving medical error.

A cluster of embryonic epithelial cells that mark the beginning of milk ducts. Forms approximately 49 days after conception.

The development of mammary glands and related breast structures.

The lower jaw, which causes the compressions during breastfeeding helping to milk the breast.

Hand operated pump, generally used for short term or occasional pumping.

An herbal galactagogue. Safety rating A.

Becoming a mother.

The breastmilk after colostrum and transitional milk, typically beginning 2 weeks postpartum.

Middle number in a series of numbers; the number on either side of which exist an equal amount of numbers.

Oral hypoglycemic agent for diabetes, L1. Can also be used to treat Polycystic Ovary Syndrome. No side effects reported.

Antibiotic, L2. Milk levels moderately high, but significantly less than pediatric therapeutic dose (15 mg/kg/d).

Underdevelopment of the jaw, especially the mandible.

Breast infection usually caused by S aureus. Localized breast tenderness and flu-like symptoms, hot, reddened spot on the breast. Stress, cracked nipples, plugged ducts, large milk supply, and engorgement/milk statis are risk factors. Treated with dicloxacillin, amoxycillin-clavulinic acid, cephalexin, erythromycin, clindamycin, ciprofloxacin or nafcillin.

Breastmilk retention causing uncomfortable breast fullness. Results in slower milk production.

Quantity of a drug in human milk in relation to maternal plasma. If the M/P ratio > 1.00, the drug is found in greater quantities in milk than in plasma. M/P ratio < 1.00, the drug is found in lesser quantities in milk than plasma.

Cell division in which each daughter cell contains the same DNA as the parent cell.

The value that occurs most frequently in a data set. For example, if the data set is 1, 3, 3, 3, 5, 7, 8, 8, the mode is 3.

The chemical size of a molecule of a drug. The smaller the molecular weight of the medication (9300 Daltons or lower) the greater the diffusion across cell membranes.

A bluish-black pigmented area on the newborn's buttocks or back. Seen in newborns with dark skin and typically fade over time. Can easily be confused for bruising.

Number of ill persons or instances of disease in a specific population.

Number of deaths in a specific population.

Membranes that line body passages or cavities that communicate directly or indirectly with the exterior (such as respiratory tract).

Having carried two or more pregnancies to viability.

Protective fatty sheath around nerve fibers. Long-chain polyunsaturated fats that are important to myelination are abundant in human milk.

Contractile cells that surround the milk secreting alveoli creating the milk letdown.

Inflammation of the intestinal tract that may cause tissue to die. Premature infants not receiving human milk are at markedly greater risk for this serious complication.

Birth through the first 26 days of life.

100 - 160 beats per minute

30-60 breaths per minute.

Nongovernmental organization. Organizations that operate independently of any government.

Chemical in cigarette smoke, L2.

Neonatal Intensive Care Unit

A protein found in the whey component of milk. Includes alphalactalbumin, serum albumin, lactoferrin, immunoglobulins, and lysozyme.

The duty to do no harm.

Sucking not on the breast, such as a pacifier, or sucking at the breast with brief sucks and long rest periods with minimal milk flow.

Statistical procedures used when required assumptions for using parametric procedures are not met, especially assumptions regarding a normal probability distribution.

Approximately 1/4 of nitrogen found in breastmilk. Contains essential amino acids for infant.

Infections resulting from hospital treatment. Can be prevented by hand washing, hand sanitizer gels, disposable gloves, and disinfection of baby equipment.

A compound that has a nitrogen base. Essential for energy metabolism, enzyme reactions, gastrointestinal tract development, and immune function.

Rhythmic sucking at the breast with milk flow.

Maternal obesity is linked to hypertension, type 2 diabetes, and a greater risk of birth interventions. Delays lactogenesis, lower milk supply and earlier weaning.

A carbohydrate consisting of monosaccharides found in breastmilk. Antibacterial properties. Promotes the growth of Lactobacillus bifidus.

Explicit description of a concept or variable of interest in measurable terms.

Muscle made up of several layers of fibers passing in different directions that encircles the mouth and controls most movements of the lips (as compressing, closing, or pursing movements).

A condition of bone loss. Breastfeeding for 6 months or longer is the best protection against bone loss. Although calcium is lost during breastfeeding, more calcium is deposited after weaning.

Hormone responsible for the milk-ejection-reflex. Causes contraction of uterus after delivery and creates a sense of calmness and relaxation.

Style of bottle feeding that helps avoid overly fast flow, especially in less mature infants. This technique includes: positioning infant upright in the caregiver's arms, positioning bottle horizontally with just enough angel to keep milk in the tip of the nipple, and pacing the feeding to approximately the same time as a breastfeeding would take.

Type of breast cancer, 1-3% of all breast cancers. Occurs unilateral with demarcated, red, scaly plaque on the nipple and/or areola. Blood tinged discharge, pain, crusting, itching, burning, skin thickening, redness, ulceration, or nipple retraction.

The hard portion of the roof of the mouth. During breastfeeding the infant compresses the breast tissue against this area with his tongue.

The soft portion of the roof of the mouth, located between the hard palate and the throat. This area rises when the infant swallows to close the nasal passages.

A large gland that secretes digestive enzymes which pass through the intestine and break-down proteins, fats, and carbohydrates. It also secretes insulin.

Statistical procedures used when a sample is randomly selected, represents a normal distribution of the target population, and is considered sufficiently large in size, and interval level data are collected.

Essential and distinctive tissue of an organ as distinguished from its supportive framework.

Introduction of fluids, nutrients, or drugs into the body by an avenue other than the digestive tract (intravenous, intramuscular).

Immunity passed to infant by antibodies manufactured passed to the infant transplacentally or in breastmilk. Passive immunity is temporary.

Passage of drug into breastmilk by diffusion, molecular weight and relative amount of drug circulating in maternal serum.

Heating milk to destroy pathogens.

Substance or organism capable of producing illness.

Patent ductus arteriosis. Abnormal blood flow between the aorta and pulmonary artery.

Reduces gastric acid secretion, L1. No concerns reported via breastmilk.

A technique used in breast augmentation where the incision is made around the areola. It is associated with loss of nipple sensation.

Involuntary, rhythmic, wavelike action. To strip milk from the breast, and infant's tongue uses a peristaltic motion that begins at the tip of the tongue and progresses toward the back of the mouth.

Bilateral electric breast pump. Used primarily by working mothers. Achieves good suction and frequency.

Muscular tube at the rear of the mouth, through which air travels to the larynx and food from the mouth travels to the esophagus.

A reflex that is characterized by a rhythmic opening and closing of the jaw when the gums are stimulated. Appears around 28 weeks gestation.

The region between the nose and lips. The midline area should be grooved and defined. In fetal alcohol syndrome the area is flat.

A treatment for jaundice involving blue spectrum light. The light is absorbed by bilirubin and changes the structure, allowing it to be excreted from the body more easily.

Physiologic engorgement is normal increase in milk production of lactogenesis II. Pathologic engorgement is excessive fullness due to restrictive feeding practices or ineffective milk removal.

Syndrome of oral facial abnormalities, micrognathia (a small jaw) and glossoptosis (tongue often blocks airway). Cleft palates are common. Difficulty maintaining the airway frequently causes feeding problems.

Preeclampsia or toxemia. Characterized by increased blood pressure during pregnancy, after 20 weeks gestation. Treatment often includes preterm delivery. Can progress to HELLP syndrome.

Compressing the areola to see wither the nipple protrudes or retracts.

Ph of a drug when equally ionic and nonionic. Drugs with pKa higher than 7.2 may be sequestered in breastmilk.

Inherited disorder where phenylalanine metabolism is impaired. Abnormal metabolites accumulate in blood and tissue, including the brain causing damage. Partial breastfeeding and special low PKU formula may be used.

Intrauterine organ that transfers nutrients from the mother to the fetus. After the delivery the drop in estrogen and progesterone levels allows milk secretion to begin.

A endocrine-metabolic disorder where multiple cysts interfere with ovarian function. Common symptoms are unusual breast development, amenorrhea, male pattern hair growth, obesity. Can effect milk supply.

Having more than 2 breasts. Additional breasts occur along the milk line and typically have little glandular tissue.

Total set of individuals that meet the study criteria from which the sample is drawn and about whom findings can be generalized.

Nevus flammeus. Reddish or flat pink lesion that does not blanch with pressure, caused by dilated capillaries below the epidermal skin. This lesion usually remains constant in size and does not fade with time.

After, later than.

This gland releases oxytocin into the blood effecting milk ejection. It is susceptible to stress.

Probability that a statistical test will reject a null hypothesis when it should be rejected, or, in other words, detect a significant difference that does exist.

3 types of disorders: Postpartum blues is a temporary depression lasting a few days. Postpartum depression is a mild to moderate depression lasting at least 2 weeks. Postpartum psychosis is the most severe form, beginning at 2-4 weeks postpartum. Mothers may have insomnia, irrational ideas, feelings of failure, depression, hallucinations, and self-accusatory thoughts.

Prior to, before, earlier than.

Steroid, L2. No concerns reported via breastmilk. Safe for short term use.

Characterized by increased blood pressure during pregnancy, after 20 weeks gestation. Treatment often includes preterm delivery.

Born at less 37 weeks gestation.

Under 37 weeks gestation.

First incidence of the illness after exposure to a pathogen.

First pregnancy. Having carried one pregnancy to viability.

Latin word meaning "for."

A hormone high during pregnancy delaying lactogenesis II. Dramatically decreases after birth.

Hormonal birth control that does not contain estrogen. Called the "mini-pill." Not likley to decrease milk production.

Hormone essential for initiating and maintaining milk production.

Stimulates dopamine releases and thus inhibits prolactin. Nipple stimulation and milk removal suppresses PIF and dopamine, causing prolactin levels to rise and the breast to produce milk. From they hypothalamus.

Binding sites on the walls of the lactocytes that receive prolactin. Frequent breastfeeding early in lactation creates more receptor sites resulting in increased milk production.

Lying facing down.

Percentage of a drug bound to maternal plasma. High PB means less in breastmilk.

Closer to the point of attachment. Opposite of distal.

Decongestant, L3. Usually compatible with breastfeeding, but can effect maternal milk supply.

Temporary vascular condition; intense pain and pallor of the skin (usually of the fingers or toes, but in breastfeeding woman the nipples), cause by vasospasm. Can include white, red and blue phases.

Degree to which collected data are accurate, consistent, precise, and stable over time.

Technique to allow feeding on an engorged breast: apply steady pressure with fingers around the areola, pressing back towards chest wall. Moves edema towards lymphatic drainage system, triggers milk ejection reflex by stimulating nerves near the areola.

Abnormal calcification of the bones and changes in growth plates that lead to soft or weak bones due to lack of Vitamin D. AAP advises that full-term breastfed infants receive vitamin D supplement beginning at 2 months of age."

The side of the brain characterized by logic, order, analysis, sequential.

Infant turns his head towards touch and opens mouth. Appears at 28 weeks gestation and disappears around 4 months.

Viral illness causing severe diarrhea.

Respiratory syncytial virus. Viral respiratory illness; can be severe in infants.

The ridges behind the gum line on the hard palate. This structure helps the infant to maintain grasp of the breast during suckling.

Subset of the population selected for study.

Procedure of selecting the sample from the population of interest.

Immunoglobulin that forms antibodies in body and is critical in mucosal immunity. The most common immunoglobulin in breastmilk.

Three stages: Protest stage a child attempts to recover the mother/caregiver by crying, kicking, screaming for a few hours to days. Despair stage a child grievs or mourns as they accept their new environment. May show regressive behavior, such as sucking the thumb. Denial or detachment a child begins to interact and approach others.

Presence of bacteria in fluid or tissue.

Serum shows the presence of a factor that previously was absent. Ex., when cytomegalovirus antibodies become present in blood due to CMV disease the person is said to have seroconverted.

Serum that demonstrates (positive) or does not demonstrate (negative) the presence of a factor.

Clear fluid portion of blood that remains after coagulation.

Protein in serum (blood).

Having a birth weight that is below the 10th percentile on intrauterine growth charts. There is a concern for malnutrition and hypoglycemia.

A herbal galactagogue. Safety rating B.

Diagnosis when all other possible causes of death were ruled out. Major risk factors are maternal smoking, prone position, and formula feeding.

Involuntary muscle fiber that responds to hormones. Ex., muscle around alvoli contracts in response to oxytocin.

Unusual milk production in a non-breastfeeding woman. Also known as galactorrhea.

Alternative feeding method. Feed infant via small spoon.

Class of antidepressants (as fluoxetine or sertraline) that inhibit the inactivation of serotonin by blocking its reuptake by nerve cell endings.

Antidepressant, L2. No concerns reported via breastmilk, probably safe for breastfeeding.

Stem cells can differentiate into all of the specialized cells types. Have been found in breastmilk.

The supporting tissues of an organ, ie, the breast.

Skin to skin or Kangaroo Care.

The action of baby milking the breast. Related more to tongue movement than suction.

Lying on one's back.

System for supplementing the baby while feeding at the breast. Reservoir holding milk with a tube attached that is secured to the breast.

Baby is switched back and forth between the two breasts during a feeding to help stimulate multiple letdowns and increase milk intake.

Intimate association of two different kinds of organisms. An example is the breastfeeding dyad.

Any of several kinds of thymic lymphoid cells or lymphocytes that help to regulate cellular immune response.

Relatively rapid heart rate whether physiological (as after exercise) or pathological. Opposite of bradycardia.

Abnormally rapid rate of breathing.

Five stages of sexual development in adolescence evaluating pubic hair, genitals and breast development

Population that is of interest to the investigator and about which generalizations of study results are intended.

Contagious bacterial infection usually involves lungs. Mothers may breastfeed after treatment is begun.

A fistula (passage way) between the trachea and esophagus. Oral feedings are withheld until the fistula is surgically repaired due to the risk of aspiration.

The belief that all events are directed toward some ultimate purpose.

Baby Friendly Hospital Initiative uses the Ten Steps as outlined by UNICEF/WHO.

Promotes mammary growth and lactation through a permissive rather than a regulatory role.

Acronym for organisms that can damage the fetus: toxoplasmosis, rubella, cytomegalovirus, herpes simplex.

Condition of the neck in which the cervical muscles are contracted, producing twisting of the neck and an unnatural position of the head.

Malformation of the trachea cartilage causing collapse and wheezing sound during respiration.

Device that estimates bilirubin concentrations in the blood by measuring the intensity of yellowish skin coloration.

Breastmilk produced between colostrum and mature milk, during the first 4-10 days postpartum.

Transferred from mother to fetus through the placenta.

Cranial nerve V.

High blood sugar levels due to lack of insulin prodution in he pancreas. An insulin dependent disease. Can delay lactogenesis II.

High blood sugar levels due to lack of insulin prodution in the pancreas. A noninsulin dependent disease known as adult onset diabetes.

Branch of the United Nations that advocates for children's rights. Developed the International Code of Marketing of Breastmilk Substitutes in conjunction with the WHO.

Statistics derived from the analysis of a single variable (e.g., frequencies).

Guidelines for infection control, based on the assumption that every person receiving health care carries an infection that can be transmitted by blood, body fluids, or genital secretions.

The idea that the moral worth of an action is determined solely by its usefulness in maximizing utility and minimizing negative utility.

Degree to which collected data are true and represent reality; the extent to which a measuring instrument reflects what it is intended to measure.

Attributes, properties, and/or characteristics of persons, events, or objects that are examined in a study.

The nipple blanches sometimes turning blue or red temporarily due to vasoconstriction. Also occurs in other extremities, such as fingers and toes.

The soft palate.

The "Y" axis in a graph

Transmission of infection from mother to child transplacentally or through breastmilk.

A birth weight of less than 1500 grams.

Approach to ethics that emphasizes the character of the moral agent, rather than rules or consequences, as the key element of ethical thinking.

A fat soluble vitamin that prevent rickets. Produced in the skin from exposure to sunlight. Found in fatty fish, eggs and meat.

Fat soluble vitamin necessary for blood clotting. Insufficient amounts of this vitamin can cause hemorrhagic disease. Injections of this vitamin are routinely given postpartum to infants.

Formed in 1991, this global organization's goal is to protect, promote, and support breastfeeding.

Dissolve in water and not stored in the body. Vitamin C, nicotinic acid, B12, riboflavin, and B6. B12 can be deficient in women who eat a vegan diet.

Breastmilk during the end of lactation (whether intentional or unintentional). This milk is higher in sodium and immunoglobins.

Viral disease spread by mosquitos. Breastfeeding is permitted.

A woman who breastfeeds a infant that is not her own.

The liquid portion of milk that is left after curds separate. Primarily consists of proteins alphalactalbumin and lactoferrin.

Ratio changes throughout lactation. Early milk the ratio is 90:10, mature milk is 60:40, weaning milk is 50:50. The ratio in formula is 20:80.

The code protects and promotes breastfeeding by ensuring the proper use of breastmilk substitutes. The code applies to the marketing of formula, milk products, beverages, complimentary foods used for the replacement of breastmilk. The code covers the marketing of feeding bottles and nipples (teats).

Colostrum, formed under the influence of maternal hormones, which may be temporarily present in newborn's breasts.

Antidepressant, L2. A serotonin reuptake inhibitor with a short half-life. No concerns reported via breastmilk, probably safe for breastfeeding.