The Gold Standard Line

May

Q & A: What Is It?

by Marie

Question: WITHOUT LOOKING IT UP: A drug that blocks an action is called which of the following?
A. agonist
B. antagonist
C. protagonist

Answer: The correct answer is B: antagonist! An antagonist is a drug that blocks an action or works against it. (Here’s a memory tip: If someone is antagonizing you, they are against you, not for you. The same is true with drugs!)

By comparison, an agonist is drug that binds to a cell’s receptors and triggers a response. It often mimics the action of a naturally-occuring substance.

And while you’ll find “protagonists” in dramas, you won’t find the term in drug therapy.

While it’s unlikely you’ll see this question on the IBLCE exam, but knowing these terms may help you figure out the answer to a more complicated question you encounter.

Remember to “like” Breastfeeding Outlook on Facebook for updates of the latest breastfeeding-related research and news, weekly Q & As to improve clinical care and aid exam prep, and info about our upcoming programs, products and special discounts.

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May

Q & A: Injection

by Marie

And now for this week’s question:
Question: The injection of a medicine under the skin is said to be which of the following?

A. intramuscular
B. subcutaneous
C. sublingual
D. transdermal

Answer: The answer is B, subcutaneous.
Let’s break it down. “Sub” means “under,” and “cutaneous” means “skin.” A common example of a drug that is given subcutaneously is insulin.

A, intramuscular, means “into” the “muscle.”

C, sublingual, means “under” the “tongue.”

D, transdermal, means the drug is applied to the skin.

It is highly unlikely that you would get this question, as it is written here, on the IBLCE exam. However, it is fairly common to see a question on absorption, and knowing what this word means may be key to answering the question correctly.

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May

Q & A: Burp!

by Marie

And now for this week’s question:
Question: Which of the following is the BEST indicator that the baby needs to burp?

A. he has finished suckling the first breast
B. he is starting to fall asleep
C. he arches his back and throws his legs outward
D. he begins to have much slower breathing

Answer: C is the right answer. Very typically, babies will arch their backs and throw their legs out when they need to burp.

It’s not A because, while some babies will need to burp after finishing the first side, doing so is not an indicator that a burp is forthcoming.

It’s not B because, while air in the stomach could possibly make the baby feel “full” and sleepy, the act of falling asleep isn’t necessarily an indicator that a burp is on its way; in this case, it is definitely not the “best” answer.

As for D, babies’ breathing tends to become more rapid when they need to burp, not slower.

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Apr

Q & A: Counseling the Mother of an Ill/Preterm Baby

by Marie

And now for this week’s question:
Question: THINK ABOUT IT: When a mother who intends to breastfeed changes her mind because her baby is ill or preterm, which of the following strategies would BEST encourage breastfeeding?
A. Provide her with a list of all of the benefits of breastfeeding a preterm or critically ill infant.
B. Generate a list of the hazards that are associated with artificial feedings for preterm infants.
C. Convince her that pumping and feeding her milk from a bottle is a good compromise in this case.
D. pInvite her to revisit her original reasons for breastfeeding and explore these within this context.

Answer: The best answer is (D). This is not the only possible strategy, but of the options listed it is likely to be the most effective. The mother is already “on board” with the idea of breastfeeding, but helping her to revisit the decision—and tailoring the discussion to the premature/ill baby situation—is most likely to encourage her to breastfeed.
(A) is wrong because the mother already expressed an intention to breastfeed; it is unlikely that listing the benefits will change her mind now that her circumstances are different than she expected.
(B) is a tempting option, isn’t it? But it is unlikely to be the BEST option in this case. Her original intention was to breastfeed, so giving her more info on the risk/benefit is unlikely to help her at this point. While not a bad strategy, this is not the BEST strategy.
(C), too, is a tempting option but it is unlikely to be the BEST strategy. “Convincing” the mother contradicts the principles of good counseling techniques—namely, helping the person to come to her own conclusions.

Stay tuned for another Q & A next week.
In the meantime, if you’re preparing to take the IBLCE Exam, you might want to register for the Lactation Exam Review course. Early-bird rates are still available for a few locations, but time is running out!

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Apr

Q & A

by Marie

We hope you’ll “like” Breastfeeding Outlook on Facebook and join in the Q & A discussion there. Every Tuesday, I post a question to help you think about facts or issues related to breastfeeding support or IBLCE exam-taking. The answer is posted on Wednesday.

Also on the Breastfeeding Outlook Facebook page, you’ll find links to new breastfeeding-related research and news, as well as information about our new programs. It’s good stuff. Who knows — this just might be the reason you’ve been looking for to test the Facebook waters!

And now for this week’s question:
Question: WITHOUT LOOKING IT UP: Which of these conditions is incompatible with breastfeeding?
A. Down syndrome
B. Turner syndrome
C. galactosemia
D. phenylketonuria

Answer: The correct answer is (C). Infants who are born with galactosemia, an inborn error of metabolism, are unable to break down lactose into glucose and galactose.
Although infants with Down syndrome (A) may need more time and patience to …learn how to breastfeed, they generally can. Although (B) is a chromosomal defect, it does not affect breastfeeding ability. Also (D), though an error of metabolism, does not prohibit breastfeeding.

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Mar

New Q & A Feature

by Marie

If you have “liked” Breastfeeding Outlook on Facebook, you may have noticed a new “Q & A” feature that launched this week. Every Tuesday, I’ll be posting a question there that will help you think about facts or issues related to breastfeeding support or IBLCE exam-taking. On Wednesday, I’ll post the answer.

If you’re not on Facebook, don’t worry! You won’t miss out. Just stop by this blog every Wednesday, when the question and answer will both be shared. And now … without further ado … the first question:

Question: WITHOUT LOOKING IT UP: Which of the following is true about LACTOSE?
A. it is a disaccharide that breaks down into glucose and galactose,
B. it is a disaccharide that breaks down into sucrose and galactase,
C. human milk contains a smaller proportion of lactose than cow’s milk,
D. it is primarily used by the body to build and repair cells.

Answer: The correct answer is (A).
It may help to remember that “disaccharide” means “two” (di-) and “sugars” (saccharide). (B) is wrong because lactose does not yield these two substances. As for (C), human milk actually contains a larger proportion of lactose than cow’s milk. Turning to (D), we know what’s primarily used to build and repair tissue. Not lactose (which is primarily fuel) but protein.

While this particular question won’t be on the test, several biochemistry questions—especially questions about the biochemistry of human milk—will be, and they are likely to be among the most difficult ones. Candidates need to be able to field questions on all 13 categories of the exam blueprint.

Stay tuned for another Q & A next week.
In the meantime, if you’re preparing to take the IBLCE Exam, you might want to consider some helpful study tools.

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Mar

“The Lesser Child”

by Marie

Thank you, Atlanta Lactation Exam Review and Picture Perfect participants!

You have pushed me to improve the clarity of my explanation about the Pakistani woman with twins who formula-fed one and breastfed the other. Through the efforts of UNICEF, the photo and an accompanying article appeared on the cover of SCN News in 1991, and they have been widely reproduced. This gripping image is quite famous in the breastfeeding support community.

I strongly advise you to know its meaning, because this would be a prime example of how the IBLCE exam often asks “social” questions that are illustrated with a photo.

To recap, the two messages conveyed in the photo are: (1) formula can have fatal consequences (the girl twin died), and (2) in some cultures, the girl is the lesser child.

Be sure to check out Baby Milk Action’s “Every Picture” overview of decoding marketing messages, which examines this photo.

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Mar

Don’t Give Up

by Marie

Have you taken the IBLCE exam in the past, and failed it? Don’t give up–you can still pass it! And we can help.

Today, I had a sad phone call from a woman we’ll call Pam. Pam felt distressed because she had taken the IBLCE exam last summer and failed it. Pam didn’t know how this had happened—she had taken not one, but two comprehensive lactation courses before sitting the exam (not Breastfeeding Outlook’s, though!)

She plans to take the exam again this summer, and she desperately wants to pass it this time around. But what could she do for that to happen? She asked: “Would coming to Breastfeeding Outlook’s Lactation Exam Review course help?” My response: “Umm, I don’t know. But let’s talk.”

As we spoke, I began to feel as though I was eliciting a “health history” from Pam. I asked her many questions: when she took her last course, how many credits it was (90), and whether it was LEAARC approves (yes). I asked about her basic nursing education, as well as her work history. Pam works in a hospital, sees mostly well babies, and has been an RN for more than a decade.

I probed more, trying to gauge her learning gap. I’m still not sure I pinpointed it. But by talking to Pam, I could tell several things about her that give me faith in her future exam success: She’s smart. She’s a hard worker. And she’s determined.

But back to Pam’s question. It’s one I’ve heard from several people who have sat for the IBLCE exam, only to be stunned by a failing mark. Although less than 1% of our review course participants in the past 8 years have told us they’ve failed, other exam candidates are less fortunate; in 2011, roughly 12% of IBLCE exam takers failed the exam.

Can I help her pass the exam?

I certainly hope so. I suggested to Pam that she attend my Lactation Exam Review course this spring. I look forward to seeing her there. After all, she’s now on my personal “passing zone” radar.

She’s not the only one who is. I want to do all I can to help dedicated professionals prepare for–and pass!–the IBLCE exam.

If you or someone you know has had a bad IBLCE exam outcome in the past—regardless of what other prep course may’ve been taken—I hope you’ll contact me. I want to hear your story. I can help.

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Feb

Great Start for my Comprehensive Course

by Marie

Here I am with Sandy Spencer from Catholic Health Services. Sandy and a handful of others were responsible for inviting me to come to Buffalo. And what a great group of women are sitting in the seats! At a time when I was feeling a little worn out from teaching this course several times in the fall, they have re-energized me! Today ranked as one of the best days I’ve had in ages.

And if you’re wondering, yes, it’s cold! I don’t think it got above 20 degrees. Still, it was warm inside with so many smiles and much, much loud laughter!

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Feb

Shuffle off to Buffalo …

by Marie

Off I’m gonna shuffle, shuffle off to Buffalo!

My earliest recollection of being in Buffalo was when I was in high school. The National League for Nursing Exam was being given in Buffalo, and I needed to take it. At least, I *think* it was the NLN Exam. Seems like it was some kind of an aptitude test. I distinctly remember it was the coldest day of the year. And, of course, there was snow. (Isn’t there always snow in Buffalo?)

My father had driven me as close to the testing site as possible. I was wearing a warm wool coat with a beaver collar (quite THE thing to wear in those days) and knee-high boots. The small part of my legs that wasn’t covered by the coat or the boots was red from the bitter, sub-zero cold. Buffalo is cold.

Tonight, it’s a fairly decent night in Buffalo. Cold, but not bitterly cold. Windy–quite windy–but tolerable.

And that’s not the only difference. Now I’m a real nurse, offering a real course. And I’m a nurse with white hair! So much time has passed.

Some days, though, I wake up and wonder if I’m really a nurse. How did I ever get to be a nurse? How did I ever get into nursing school? How did I ever pass the boards….on the first try, at that! To me, becoming a nurse was always just a little far out of my reach. But somehow, I was able to reach that goal.

So here I am. I’ve shuffled off to Buffalo to present my Comprehensive Lactation Course, starting tomorrow. I was finished for the 2011 season; this is an encore performance. I feel truly lucky to be asked to present in Buffalo at Catholic Health System.

“Off we’re gonna shuffle, shuffle uffle uffle uffle, shuffle off to Buffalo.” (Song lyrics by Don Bestor.)

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