Dear Andrea, this is the time of year when we begin to hear from panicked
test applicants. Try to relax and calm down. It is an entry level exam,
you don't have to know it ALL before the test date :-) Try and build some
relax time into your days. Pace your review. And yes, it is normal to have
your reading generate more questions. After going through your questions
tho I think you need a basic text and need to use the index more. I hope
you have one of the
basic texts (Riordan & Auerbach, Lawrence, Lauwers & Shinskie etc.).
1. What is primary engorgement? when does this occur and how long does it
last?
Riordan and Auerbach have an excellent description of breast fullness VS
breast engorgement (p.294-quoted from Lawrence). Get ahold of a copy and
read these 2 pages. Lawrence, any ed., has excellent info on engorgement.
Every one of the ref I looked in explains that engorgement is not normal. (I
pulled out 6). Fullness is normal, day 2-4, engorgement is really
pathological, day 2-10 and relates to mismanagement (ie: mother/baby
separation, not enough time at breast etc.)
2. what is the difference between a galactocele, mastitis, and a clogged
duct?
A clogged duct occurs in an area of the breast, that for whatever reason,
doesn't get adequate drainage when baby nurses (tight bra, infrequent
nursing or long periods between nursing, awkward positioning, etc). The
duct "clogs" and lets milk build up behind it. It is a term familarily used
by LLLLs and LCs. It responds to frequent nursing, warm compresses,
sometimes gentle pressure behind the clog while baby is nursing. Usually no
fever present.
Mastitis is a general term and refers to any inflammation in the breast (LLL
BF Answer Book). Most HCPs refer to mastitis as a breast lump with other
signs of bacterial infection, fever, aches, flu-like sx). She needs to see
her dr and may need abx.
BF answer book also quotes R. Lawrence with a good list to differentiate
between plugged duct (PD) and breast infection (BI)
"A galactocele is a cyst that fills with milk, causing a lump that does not
respond to tx for a plugged duct." BF Answer Book. Again Lawrence has a
good description, quoted in BF Answer Book.She also calls it "milk retention
cyst." She also states that it probably derives from a plugged duct.
3. Is there a known etiology to a galactocele? see above
4. what is the difference between a short tongue and a short lingual
frenulum? I am guessing the they both have about the same impact on the BF
dyad, am I wrong to think this? The lingual frenulum is a small piece of
tissue that holds the bottom side of the tongue, if short it restricts
baby's movement of tongue. Frequently causes sore nipples in mom and poor
milk transfer, leading to FTT. A short tongue is simply that, shorted than
"normal." I would suppose they have the same general effect - sore nipples
and poor milk transfer.
5. what is an alveolar gum ridge? the ridge where teeth will eventually be.
6. What is a philtrim? philtrum is that little groove between the upper lip
and the nose. Missing philtrum is one of the signs of fetal alcohol
syndrome.
7.what is micrognathia? abnormal smallness of the jaw, especially the lower
jaw.
Andrea Bass, RN
Lactation Specialist
future IBCLC
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