Certified Lactation Consultant(CLC) exam BUNDLE With complete solution
Certified Lactation Consultant Exam
The World Health Organization and UNICEF have set out three strategies needed for
increasing breastfeeding initiation and duration in every country. What are the 3
strategies? – Correct answer-Breastfeeding Promotion
Breastfeeding Protection
Breastfeeding Support
Focuses on advantages of breastfeeding on a personal (personal connection),
community, country (amount spent on healthcare), or global level (waste from formula &
formula products)
Focuses on the good “advantages” of breastfeeding – Correct answer-Breastfeeding
Promotion
Focuses on government, manufacturer, and social responsibility to assure breast
feeding’s ability to compete with commercial interests.
Includes addressing improper marketing practices
Addressing breastfeeding in public, at work, jury duty, family law, mothers in prison,
etc.. – Correct answer-Breastfeeding Protection
Focuses on the interaction of “helpers” with family as well as program development and
implementation – Correct answer-Breastfeeding Support
Women how do not breastfeed are at a greater risk for what diseases? – Correct
answer-Myocardial infarction
Metabolic syndrome
Coronary artery disease
Stroke
DMII
HTN
Hyperlipidemia
Cardiovascular disease
Breast, endometrial, and ovarian cancer
Reason #1 why women do not exclusively breastfeed – Correct answer-Unrealistic
expectations from society about motherhood. Along with lack of preparation for what the
newborn period would be like.
Reason #2 why women do not exclusively breastfeed – Correct answer-Lack of timely
interventions. Mother’s problems at 3-7 days posed the greatest risk for stopping which
is when they are home from the hospital and alone with no support. The fastest drop-off
is in the first 10 days following discharge from the hospital
The International Code of Marketing of Breast milk Substitutions – Correct answer-An
international health policy framework to regulate the marketing of breast milk substitutes
in order to protect breastfeeding. It was written in response to the marketing activities of
the infant feeding industry which were promoting formula feeding over breastfeeding,
which in turn was leading to a dramatic increase in maternal and infant morbidity and
mortality.
What does “The Code” do? – Correct answer-Regulates the marketing of breast milk
substitutes which includes infant formulas and any other food or drink, together with
feeding bottles, and teats, intended for babies and young children. Sets standards for
the labeling and quality of products and for how the law should be implemented and
monitored within countries. Aims to make sure that parental choices on feeding are
based on full, impartial information, rather than misleading, inaccurate or biased
marketing claims.
The Global Strategy for Infant & Young Child Feeding – Correct answer-Is intended as a
guide for action; it identifies interventions with a proven positive impact, it emphasizes
providing mothers and families the support they need to carry out their crucial roles, and
it explicitly defines the obligations and responsibilities in this regard of governments,
international organizations, and other concerned parties.
What contributes to low rates of exclusive breastfeeding globally? – Correct answerCaregiver and societal beliefs favoring mixed feedings (believing that breast milk is not
enough or that babies actions/issues are related to the breast milk/breastfeeding)
Hospital and healthcare practices and policies that are not supportive of breastfeeding
Lack of adequate skilled support
Aggressive promotion of infant formula and other breast milk substitutes rather than
promoting support for breastfeeding
Inadequate maternity and paternity leave legislation and other workplace policies
Lack of knowledge about the dangers of not exclusively breastfeeding and of proper
breastfeeding techniques
How to support exclusive breastfeeding – Correct answer-Increase hospital and health
system capacity including revitalizing, expanding, and institutionalizing the baby-friendly
hospital initiative in health systems
Provide community based strategies including communication campaigns tailored to the
local context
Strengthen the monitoring, enforcement, and legislation related to “The Code” and
subsequent resolutions.
Enact at least 6 months paid maternity leave
Invest in training and capacity building in breastfeeding protection, promotion, and
support
What is the role of the pituitary glade in milk making? – Correct answer-Messages from
certain stimulation travels through the breast to the pituitary gland which triggers it to
produce prolactin and oxytocin which are two hormones needed to make milk.
Certified Lactation Consultant Exam
1 breast or 2? ans: There is no difference in baby’s net fat intake according to the number of breasts
suckled per feeding or the breastfeeding frequency
Offer the 1st breast 1st and the 2nd breast 2nd it really doesn’t matter 1 breast or 2 whatever they want
1+ year of lactation ans: After one year of lactation the milk expressed has significantly increased fat and
energy contents, compared with milk expressed by women who have been lactation for a shorter time.
The volume of milk does not have to change as the baby gets older/bigger because the composition of
the milk changes
Anemia and breastfeeding ans: Postpartum hemorrhage can cause sheehans syndrome which in turn
causes hormonal issues including milk making hormones
Retained placenta fragments prevents the shift from lactogenesis stage 1 to stage 2 which can affect
your mature milk coming in
Breast milk composition changes… ans: Over the course of lactation
Within the day there are variations on the composition of milk
Within a feeding
By the way it is taken during a feeding
and also between feedings
Canabis use and breastfeeding ans: Exposure of infant to any kind of passive smoke is a concern. There
is no safe threshold limit for cannabis use in pregnancy. Among pregnant women cannabis use was
significantly associated with an increased risk of preterm birth and low birth weight
The high fat solubility of cannabinoids make them difficult to analyze in breast milk. THC (delta-9-
tetrahydrocannabinol) is measurable in milk 6 days after maternal use
Colic ans: An easily identifiable childhood problem that has no clearly identified treatment
Does not seem to be associated with GERD
Colicky babies had more than double the abundance of microbia in the gut
Constructed Knowing ans: The position at which truth is understood to be contextual, knowledge is
tentative, and it is understood that the knower is part of the known
Have abandoned either/or thinking
Have learned to live with conflict and have high tolerance for internal contradiction and ambiguity
Believe all knowledge is constructed and the knower is an intimate part of the known
Want to avoid compartmentalizing thought and feeling, home and work, self and other
Want to embrace all the pieces of the self in some ultimate sense of the whole: mother-daughter-wifeartist
Aspire to work that contributes to the empowerment and improvement in the quality of life of others
Believe that ideas and values must be nurtured
Have a unique and authentic voice
Engorgement ans: Breasts hard, hot, and shiny
Temp above normal
Feels discomfort in the breast
Certified Lactation Consultant exam Questions
and Answers
Nipple difficult to grasp, makes difficult for baby to latch
Occurs most commonly day 3-5
As the pressure builds up inside the breast milk production decreases, this is natures early dry up
mechanism
Failure to effectively resolve prolonged symptomatic engorgement may have a negative impact on
continued adequate milk supply
Placing breasts in a bowl of warm water will stimulate the milk to flow out to relieve some pressure so
you can then feed
Fat content in breast milk ans: Longer times in between feedings made for a lower fat content but faster
feedings made for a higher fat content where as feedings lasting longer than 30 mins made for a lower
fat content
Breastfed babies can regulate fat intake quickly and thus mothers should be encouraged to practice
baby led feeding
Maximum fat levels were obtained 30 mins post-feed
Focuses on advantages of breastfeeding on a personal (personal connection), community, country
(amount spent on healthcare), or global level (waste from formula & formula products)
Focuses on the good “advantages” of breastfeeding ans: Breastfeeding Promotion
Focuses on government, manufacturer, and social responsibility to assure breast feeding’s ability to
compete with commercial interests.
Includes addressing improper marketing practices
Addressing breastfeeding in public, at work, jury duty, family law, mothers in prison, etc.. ans:
Breastfeeding Protection
Focuses on the interaction of “helpers” with family as well as program development and
implementation ans: Breastfeeding Support
Formula preparation and storing ans: Formula needs to be mix with water that is at least 70ºC or 158ºF
in order to kill Enerobacter Sakazakii
Formula made with hot water need to be cooled quickly to body temperature if it is being fed to the
baby immediately
If the formula is not being fed immediately, refrigerate it right away and keep refrigerated until feeling
Hierarchy of infant feeding choices ans: 1. Baby at mothers breast
- Mother’s own expressed milk
- Milk from a milk bank
- Cows milk forumla
- Soy formula
How do I know my baby is getting enough milk? ans: One wet diaper for how old the baby is (however
this can be skewed by the diuresing process and is not a good indicator of adequate hydration)
4 wets on day 4 and each day after
Multiple poops each day that change in consistency and color
How do we assure an adequate milk supply? ans: Universal understanding of how breastfeeding works
Early initiation and adequate breastfeeding (10-12x per day)
CLC- Certified Lactation Counselor Exam
What duration of breastfeeding is associated with significantly reduced incidence of acute
otits media (AOM)? A) Any breastfeeding B) Up to 3 mos C) More than 4-6 months –
ANSWER C) More than 4-6 months
Breastfeeding lowers the risk for the incidence of dental caries compared to children fed
nonhuman milk from a bottle. True of False? – ANSWER True
Does breastfeeding lower the risk of NEC in preterm infants? – ANSWER Yes
Is there a difference in the protective effect against SIDS between babies that are
exclusively breastfed vs. non-exclusively? – ANSWER Yes, babies that are exclusively
breastfed have a stronger protective effect against SIDS
Does breastfeeding lower the risk for the incidence of malocclusion (misalignment of
teeth)? – ANSWER Yes
True of False. Lactational amenorrhea, or the delay in return of menses after birth, is not
associated with exclusive breastfeeding. – ANSWER False
What are the physical benefits of breastfeeding to the lactating parent? – ANSWER Lower
risk of breast cancer, lower risk of ovarian cancer, reduced risk of Type 2 diabetes,
reduced risk of cardiovascular disease
What are the 3 main steps of Evidence-Based Practice (EBP)? – ANSWER Best available
clinical evidence, Clinical expertise, Patient concerns and needs
What are the benefits of breastfeeding for infants? – ANSWER Protective against
respiratory infections, asthma, gastrointestinal infections and diarrhea, ear infections,
dental caries, teeth misalignment, NEC and SIDS, obesity, diabetes, higher performance
on intelligence tests
What are hypotonic lips in an infant? – ANSWER Abnormally LOW muscle tone or
weakness in lips- may impact amount of suction, increase work of feeding, can contribute
to milk loss and fatigue during feedings
What are hypertonic lips in an infant? – ANSWER Abnormally HIGH muscle tone or
overuse of lips- increased lip activity to hold breast in mouth
What can hypertonic lips be an indication of? – ANSWER 1. Neurological abnormality or
injury of the tongue, jaws, or facial nerves. 2. Can also be compensating for muscular
weakness in the cheeks, jaw, or tongue or reduced lingual or labial mobility secondary to
a tight labial frenulum or ankyloglossia (tongue-tie) 3. May be sensory in nature (hypo- or
hypersensitive)
CLC- CERTIFIED LACTATION COUNSELOR EXAM QUESTIONS
AND ANSWERS
2022 International Board Certified Lactation
Consultant (IBCLC) Certification Exam
1 gram of weight gain = 1ml of milk intake. The use of this formula for test weighing infants before and
after feedings: ans: helps determine adequate intake in special situations of concern [p344-346]
A breastfeeding mother comes into your office with a lump in her right breast. She reports that she has
a hx of plugged ducts. Her doctor diagnosed a galactocele by US. You explain to her that a galactocele is
a benign cyst in the ducts of the breast and ans: can be aspirated and refilled with milk [p301]
A breastfeeding mother is going on vacation and is considering purchasing breastmilk from an internet
website. Which statement is correct: ans: pasteurized breastmilk from a reputable milk bak is only
available by physician prescription [443-444]
A breastfeeding mother tells yo u that she is lactose intolerant. You inform her that _ ans: primary
lactose intolerance is rare in newborns & that she should continue to breastfeed [p 658-659]
A LC is helping a mother with a 37 wk gestation baby who is 35 hours old and has a bilirubin of 10 and
weight loss of 7%. The mother reports that the baby will not wake up and continues to sleep and will not
latch onto the breast. Your immediate plan of care would include: ans: teach the mother wake up
techniques, spoon feed colostrum, and attempt to breastfeed
A mother comes to your new nothers support group and you observe her infant after a breastfeeding.
You recommend that she: ans: make an appt with pedi for possible thrush [291]
A mother of a 2 year old and a newborn contacts you about tandem nursing. The 2 year old wants to
nurse frequently. You suggest: ans: breastfeed the infant 1st, then the toddler
A mother who is 8 wk PP reports that she has had 2 episodes of mastitis. The following factors could
contribute to this reoccurrence: ans: the mother stopped her antibiotics when she felt better
a mother with diabetes IDDM should be advised ans: to breastfeed early and often and supplement with
expressed breastmilk if neeed [516]
a new mother asks you for suggestions about breastmilk storage recommendations for her full term
infant. This new mother plans to collect as much extra breastmilk as possible as she must return to work
in 2 weeks. Ideally, she’d like to use some of the collected pumped/expressed milk so that her relatives,
who will be helping care for the child, can feed the baby too. You tell mom: ans: breastmilk, cleanly
collected, can be left for up to 6 hrs w/o refrigeration [p 559]
A new mother of twins would like to start tandem nursing before hospital discharge. A key point to
discuss with the mother would be ans: each baby has to individually learn how to breastfeed and the
mother needs to recognize that each baby is feeding effectively
International board certified lactation consultant
(IBCLC) CERTIFICATION EXAM QUESTIONS AND
ANSWERS
A new mother tells her nurse that she has had breast reduction surgery. In her care plan, you would
advise the mother : ans: to frequently feed her newborn and monitor the babys weight loss, urine, and
stool output
A new mother tells you that she has implants as she is beginning to breastfeed her infant. One of the
most important factors in her health hx to predict successful breastfeeding is ans: the location of the
implant did not damage any nerves to the breast [p 299-300]
A new mother tells you that she is returning to work full time at 6 wks and that she wants to continue to
breastfeed her baby. She has a pump for work and is already pumping and giving bottles of milk to her
baby. Your 1st question to her would be: ans: What are your goals for breastfeeding after you return to
work? [552]
A parent of a 3 wk old baby born at 38 wks gestation is concerned because her baby spits up after every
feeding. She reports that is seems to be “the entire feeding”. The babys weight gain is approx an ounce
per day. The baby is nursing in cross cradle position at most feedings. The parents has begun to give the
baby a bottle once q 3-4 days. What is the 1st suggestion to this parent? ans: suggest different
positioning of the baby when nursing
a professional relationship is established when a LC discusses a breastfeeding issue with a mother: ans:
whether or not the LC is being paid [p.8]
After breastfeeding this mother complains of extreme pain in both of her nipples. You may discuss with
her the following causes: ans: she likely has Raynaud’s syndrome
after reviewing this growth chart, you would give the mother the following advice: ans: breastfeed while
increasing your milk supply and use temporarily supplementation [pg 347-348]
Amy is concerned that her 3 month old may have lactose intolerance and is wondering about trying a
lactose free formula instead of breastfeeding. You inquire what symptoms led her to this conclusion.
Amy relates that her mother said she was lactose intolerant as an infant. Her baby is gassy and has loose
stools. You best response to this mother would be: ans: Babies under 3 y/o rarely have lactose
intolerance. Tell me more about your baby’s behavior. [p 658-659]
before a new mother begins to pump, you would recommend that she wash her hands, use a clean
pump kit have available an appropriate storage container and ans: gently massage her breasts and begin
pumping [pg 379]
By placing this infant on his mothers chest, all of the following are true except: ans: you will lower the
infants core temp [p 178-181]
characteristic of a quantitative study are: ans: There are controlled variables [pg 683-685]
domperidone and metoclopramide are galactagogues. both medications significantly: ans: raise
prolactin levels by inhibiting the action of dopamine at its receptors
During a prenatal breast exam, the expectant mother presents with widely spaced small breasts with
mark asymmetry. This anatomical “red flag” is often associated with: ans: Insufficient lactation [p. 338]
Certified Lactation Consultant Exam
Study Guide
A staff member is fond of telling mothers how expensive it is to formula feed infants and
how inexpensive it is to breastfeed. What is she doing when she talks to mothers on this
topic?
Prolonging breastfeeding Promoting breastfeeding Protecting breastfeeding Supporting
breastfeeding – ANSWER Promoting breastfeeding
Who currently collects the most comprehensive breastfeeding statistics in the United
States?
The United States Breastfeeding Committee Ross Laboratories The Centers for
Disease Control (CDC) The US Department of Agriculture (WIC) – ANSWER CDC
Which of the following statements about prolactin is TRUE?
Prolactin is a great laxative. Prolactin causes milk to be released.
Prolactin causes milk to be made. Prolactin is produced in the renal gland. – ANSWER
Prolactin causes milk to be made.
Which of the following mechanisms cause oxytocin to be released? Complete delivery
of the placenta Elevated levels of gastrointestinal hormones
Frequent feeding and milk removal Nipple stretching with appropriate latch-on –
ANSWER Nipple stretching with appropriate latch-on
Lactogenesis III requires which of the following to succeed?
Frequent milk removal and nipple stimulation.
Adequate rest and alternating starting breast at each feed. Adequate protein and
carbohydrates for the mother. Adequate maternal hydration and lack of maternal stress.
- ANSWER Frequent milk removal and nipple stimulation.
One way the fat content of milk suckled by the baby is determined is:
The number of feedings in 24 hours The speed/efficiency with which the baby removes
milk
The amount of fat in the mother’s diet
The amount of liquid in the mother’s diet – ANSWER The speed/efficiency with which
the baby removes milk
Which of the following is the MOST effective at increasing gastrin and CCK and
decreasing somatostatin in the baby?
Increasing stress/anxiety
Crying before sleep
Focusing on objects 8-12 inches away
Feeding with species-specific milk – ANSWER Feeding with species-specific milk
According to the AAP regarding weight loss in the breastfeeding newborn:
Weight loss of more than 7% from birth weight requires formula supplementation.
Weight loss of more than 7% from birth weight indicates possible breastfeeding
problems.
Weight loss of less than 7% from birth weight is a sign of hypernatremia.
Weight loss of more than 7% from birth weight is not a concern after day 5. – ANSWER
Weight loss of more than 7% from birth weight indicates possible breastfeeding
problems.
When undernourished mothers were supplemented with extra energy in their diet, they:
Had babies that gained weight slightly better
Produced more nutritious milk
Had babies that gained weight significantly better
Responded to their infants more appropriately – ANSWER Responded to their infants
more appropriately
Harmful bacteria have difficulty growing in the breastfed infants’ gut because the
composition of breastmilk:
Raises the pH of the gut to a basic level
Provides too much iron for harmful bacteria to grow
Fosters the growth of good bacteria that crowd out other organisms
Fosters the growth of B12 in the large intestine – ANSWER Fosters the growth of good
bacteria that crowd out other organisms
Colostrum is made after there is a complete delivery of the placenta. True
False – ANSWER F
Lactogenesis 2 occurs after the complete delivery of the placenta. True
False – ANSWER T
Lactogenesis 3 is also called Galactocemia.
True
False – ANSWER F
It is called galactopoiesis
The following statement about Lactogenesis 3 is NOT true:
It is also called Galactopoiesis. Prolactin levels rise because of nipple stimulation.
Frequency of removal of milk decreases milk in the breast.
It is driven by the nursing parent’s fluid intake. – ANSWER It is driven by the nursing
parent’s fluid intake.
Engorgement is physiologically normal and is a marker for an excellent future of milk
supply.
True
False – ANSWER F
The more time spent breastfeeding in the first 48 hours, the less chance there is for
engorgement.
True
False – ANSWER T
For all breastfeeding individuals, bras are essential for comfort during lactation.
True
False – ANSWER F
Breast surgery can potentially impact breastfeeding.
True
False – ANSWER T
Peri-areolar incisions with breast surgery are least significantly associated with milk
insufficiency. True
False – ANSWER False.
Peri-areolar incisions are MOST likely associated w/ milk insufficiency
When considering both chest masculinization surgery and breast reduction surgery:
The likelihood of breastfeeding is unknown.
Assessment and close nutritional follow up is key.
It is important to assure nutrition of the infant.
All of the above – ANSWER All of the above
Suboptimal breast anatomy can potentially impact breastfeeding and should be seen as
a “red flag” for close assessment and follow up. True
False – ANSWER T
Hypoplastic breasts always make ample milk.
True
False – ANSWER F
There is no concern when a client reports a breast implant on only one side.
True
False – ANSWER F
This could indicate history of discrepant breast size.
With flat and inverted nipples, there will be inadequate production of milk-making
hormones because prolactin involves nipple stretching while oxytocin involves nipple
stroking.
True
False – ANSWER F
Prolactin = nipple stroking
Oxytocin = nipple stretching
The nipple stretches to four times its resting length in the baby’s mouth, according to
Smith’s research.
True
False – ANSWER F
Stretches to 2x its length
An everted nipple is necessary for babies to attach to the breast. Unlike other
mammals, they cannot form a teat.
True
False – ANSWER F
When counseling someone who has had a breast surgery, it is important to consider:
If the milk ducts are patent
If the nipple pores are patent
The need to monitor the baby’s weight gain very closely
All of the above – ANSWER All of the above
Grade 3 inverted nipples are difficult or impossible to pull out/evert.
True
False – ANSWER T
You can tell looking at a nipple at rest how it will function.
True
False – ANSWER F
One concern about Grade 3 inverted nipples involves:
Prolactin levels
Oversupply issues
Engorgement
All of the above – ANSWER Prolactin levels (decreased nipple stroking/stretching)
Almost all mothers have grade 3 inverted nipples.
True
False – ANSWER F
Prenatal nipple preparation should be recommended for all women. True
False – ANSWER F
No research supports, in fact research showed that the non-treatment group BF for
longer duration
Jo Alexander’s research indicates that 1 out of 5 women have inverted nipples.
True
False – ANSWER F
3/5 mothers has inverted nipples.
International Board Certified Lactation Consultant
Practice/Possible 2022 Questions and Answers
While breastfeeding, when does the peak volume of the infant intra-oral vacuum occur?
Correct answer- When the posterior tongue and soft palate are at the lowest point.
The withdrawal of what hormone is the trigger that initiates lactogenesis II? Correct
answer- Progesterone
On average, how long does it take for an undisturbed baby to find the breast and self
attach. Correct answer- 60 mins
What would be the cause of thick, clear discharge from nipples during pregnancy?
Correct answer- Rising prolactin levels
Compared to her non-pregnant state, the lactating mother’s basal metabolic rate is …
Correct answer- The same.
What is the average, full term, newborn infant’s stomach capacity at birth? Correct
answer- 5-20ml
A mother who has a retained placenta will have a poor initiation of lactation because of
what? Correct answer- Progesterone levels have remained elevated.
What hormone has the greatest effect on the ductal-lobular alveolar growth of the breast
during pregnancy? Correct answer- Human placental lactogen
What is the primary function of the small whey protein known as the Feedback Inhibitor
of Lactation? Correct answer- Provides a negative feedback mechanism controlling the
rate of milk synthesis.
What effect does the increasing serum prolactin have on the breasts during pregnancy?
Correct answer- Initiates functional activity including formation of colostrum.
What situation calls for the dancer hold? Correct answer- Helping infants with low
neuromuscular tone.
A baby controls the flow of breastmilk by… Correct answer- Compressing the tip of the
nipple with his tongue.
International Board Certified
Lactation Consultant Practice
Questions and Answers
Anthropologically, what is the minimum natural age of complete weaning from the
breast? Correct answer- 2.5 years
Stimulation of the lower branch of the 4th intercostal nerve causes a nerve impulse that
results in oxytocin being released from the posterior pituitary gland. Correct answerMilk ejection reflex.
Breastmilk protein that has anti-inflammatory properties and causes the walls of certain
bacteria to split. It’s concentration in breastmilk increases from about 6mos. Correct
answer- Lysozyme
Cytotoxic to parasites such as giardia lamblia and entamoeba histolytica. Correct
answer- Fatty acids
Specific to tumor cells Correct answer- HAMLET
Human Alpha-lactalbumin Made Lethal to Tumor Cells Correct answer- HAMLET – Fatty
acid
This hold is helpful for infants who have down syndrome and are hypotonic. Correct
answer- The dancer hold
Present throughout lactation. Concentration highest in colostrum. Provides targeted,
specific protection to whatever the mom and baby come in contact with. Correct
answer- IgA
A-lactalbumin, lactoferrin, secretory immunoglobulin (IgA), and lysozyme are all…
Correct answer- Proteins in breastmilk.
What is the best type of formula for an infant who requires supplementation whose
family has a strong history of asthma. Correct answer- Casein hydrolysate artificial
infant milk. P
What does a galactogogue do? Correct answer- Increases the prolactin in the mother’s
milk stream.
Lactose intolerance is most prevalent in… Correct answer- Adults
Iron binding protein Correct answer- Lactoferrin
A young baby’s mouth is filled by his tongue, making mouth breathing difficult, though
possible if the nose is blocked. This makes them… Correct answer- Nose breathers.
Average amount of of breastmilk produced and consumed in the first 24 hrs. Correct
answer- 37ml (1.25 ounces)
Certified Lactation Course Exam
weaning Correct Answer: the addition of adding other foods to a diet, but not
completely stopping or ceasing breastfeeding
when did breastfeeding rates start to initially decline (i.e. in Britain), particularly
among the wealthy population? Correct Answer: 16th-17th century and through
the 18th century
which month did women historically think was the most important to breastfeed
during? Correct Answer: the summer (due to food spoilage)
what three ingredients made up the first commercial formula? (early 1800’s/19th
century) Correct Answer: -wheat flour
-cows milk
-sugar
what was, and still is today, one of the biggest reasons why mothers quit
breastfeeding? Correct Answer: mothers report not producing enough milk
when did bottle feeding become the “new norm”, thus, causing breastfeeding rates
to continue to decline? Correct Answer: 20th century (particularly, mid 1900’s)
(1950’s-1970’s)
what is the WHO code? Correct Answer: an attempt to prevent excessive
marketing of ABM (artificial baby milk) and to bring awareness of benefits of
breastfeeding (although this code is not law in many countries as it interferes with
marketing & freedom)
breastfeeding education to pubic is critical!
what are some other breastfeeding barriers mothers have? Correct Answer: -sexual
vs functional aspects of breasts
-women in the workplace
-“im not producing enough milk”
-lack of support from medical profession
Certified Lactation Course Exam
Questions and Answers
where are the breasts specifically located on the body? Correct Answer: -between
2nd & 6th rib
-from sternum to mid axillary line
-only gland in not fully functioning at birth
*may contain hair, sweat, and oil glands
hypoplastic breasts Correct Answer: -insufficient glandular tissues
-usually only extend from 3rd to 5th rib
-typically have more spacing between breasts (1.5 inches or more)
montgomery glands/tubercles Correct Answer: “small bumps” located around
areola that become more prominent (hypertrophy) during pregnancy & are thought
to secrete substance during pregnancy/lactation & contain scent glands to help
guide infant to nipple, while also helping kill pathogens that try to enter the body
areola Correct Answer: vary in shape & color; usually circular; become darker
during pregnancy and do not return to pre-pregnancy color
nipple Correct Answer: contain smooth muscle fibers for erectness and
graspability; normally found at 4th intercostal space that typically contain between
4-18 openings (9 on average) for milk to be expressed through during lactation
nipple/areola complex Correct Answer: thought of as one entity; both elongate up
to 2-3 times resting length during breastfeeding;
areola = most sensitive part of breast
nipples = least sensitive
everted nipples Correct Answer: most common type of nipples; protrudes slightly
at rest & everts well with stimulation
flat nipples Correct Answer: soft, but pliable & graspable
pseudo-inverted nipples Correct Answer: appear to be inverted but will evert with
stimulation or compression
retracted nipples Correct Answer: type of inverted nipples that appear to be
graspable but retracts, rather than everts, with compression
Certified Lactation Counselor 2023-
2024 /396 Questions And Answers (A+)
Quiz :Predominant Breastfeeding – √Answer :Babies who
receive breastmilk and other liquids (e.g. water, minerals,
vitamins, oral meds).
Quiz :Breastfeeding – √Answer :Baby receives human milk, as
well as other foods or fluids, including formula.
Quiz :Complementary Feeding – √Answer :Process starts when
BM alone or infant formula alone is no longer sufficient to meet
nutritional requirements of infants, therefore other foods or
liquids are introduced. Typically child is between 6-23 months
Quiz :3 strategies for increasing BF initiation and duration –
√Answer :Promotion, Protection, Support
Quiz :Promotion – √Answer :Focuses on advantages of BF on a
personal, community, country, or global level. BF to the
community.
Quiz :Protection – √Answer :Focuses on government,
manufacturer, and social responsibility to assure BF ability to
compete with commercial interests.
Includes state, local, an national laws regarding BF.
Quiz :International Code of Marketing of Breast-milk Subsitutes
- √Answer :Addresses improper marketing practices by formula
companies. It is not currently a law in the US.
Quiz :What does the International Code Prohibit? – √Answer
:Distributing free formula
Giving coupons for formula
Certified Lactation Counselor
Questions and Answers
Quiz :What did the AAP resolution state in regards to the
International Code? – √Answer :No distributing formula,
discharge bags, industry written handouts.
Quiz :Support – √Answer :Focuses on interaction of helpers
with family, as well as program development and
implementation.
Quiz :10 steps to successful BF – √Answer :1. Written BF
policy. Skin to Skin immediately after birth.
- Train healthcare staff
- Inform pregnant women about benefits and management of
BF - Help all mothers initiate BF within 1 hour after birth
- Show mother’s how to BF and maintain lactation
- Exclusive breast milk only
- Practice rooming in 24 hours a day
- Encourage BF on demand
- No artificial teats or pacifiers
- Establishment of BF support groups
Quiz :Healthcare staff responsibility for working with lactating
mothers include what? – √Answer :1. Training - Minimum of 20 hours of training
- 3 hours of competency verification
Quiz :What are the indications for providing supplementation
other than breast milk? – √Answer :1. Medical condition - Parents request after being informed of consequences
Quiz :Protocol for calculating Baby’s daily needs – √Answer
:Baby’s weight x 2.5 (2.7 or 3.0 if Baby needs to catch up
weight) = daily ounces. PCP decides what the multiplier is!!!
Quiz :What should be assessed 3-5 days after birth by PCP? –
√Answer :Hydration (elimination patterns)
Body weight (no more than 7% loss)
Observe Feeding
Maternal or infant issues
Quiz :What is a CLC? – √Answer :Nationally recognized
designation awarded by the ALPP. Practice parameters are
designated by professional scope of practice.
Quiz :How many stools per day should a breast fed newborn
have? – √Answer :4, some yellow by day 4.
Quiz :When should a baby be back to birth weight? – √Answer
:12-14 days post birth
Quiz :How much weight should a baby gain daily? – √Answer
:Approximately 1 ounce
Quiz :Why do women supplement with formula when there is
no medical need? – √Answer :1. Lack of preparation for what
the newborn period would be like.
- Lack of timely interventions
Quiz :Alveoli – √Answer :Small glands in the breast that
produce milk
Quiz :At-Breast Supplementer – √Answer :a device that allows a
supplement to be given while a baby is actively nursing at the
breast,
ex: Supplement Nursing System
Quiz :Atopy – √Answer :hypersensitive or allergic state involving
an inherited predisposition
Quiz :What is the BFHI Baby Friendly Hospital Initiative –
√Answer :Initiative by UNICEF and WHO (1991) to support
breastfeeding in hospitals and maternity centers. “The 10
Steps”.
Unicef. Baby-Friendly Hospital Initiative. Available online:
http://www.unicef.org/programme/breastfeeding/baby.htm.
Quiz :Bilirubin – √Answer :an orange-yellow pigment formed in
the liver by the breakdown of hemoglobin and excreted in bile.
Quiz :CCK (cholecystokinin) – √Answer :Hormone that
regulates the emptying of the gallbladder and secretion of
enzymes by the pancreas.
Quiz :Colostrum – √Answer :Thick, milky fluid secreted by the
breast during pregnancy and during the first days after birth
before lactation begins. Causes a laxative effect which helps
the baby pass meconium.
Quiz :Coryllos type – √Answer :Classification system for
anklyloglossia (tongue-tie)
Quiz :Dancer Hand Position – √Answer :Technique used to
support Baby’s chin and mother’s breast. Use Thumb and index
finger under chin, remaining 3 fingers to support breast.
Quiz :Alveolar Cells – √Answer :found in the walls of the alveoli,
simple squamous epithelial cells, main sites of gas exchange
Quiz :myoepithelial cells – √Answer :contract in response to
stimulation by sympathetic nervous system and squeeze milk
up the duct
Quiz :Montgomery glands – √Answer :Bumps on breasts (Look
like goosebumps)
Produce a unique blend of milk and sebum (skin oil)
Quiz :Modern study of the structure of the breast reveals what?
- √Answer :-Fat is mixed throughout the breast
-Uneven spacing of the ducts
-3-5 functioning nipple pores (May have 5-9, but not all work)