CLC PRACTICE EXAM 2026/2027 | Questions and Answers A
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Breastfeeding Physiology & Endocrinology
Q1: The process of breast development during pregnancy, including lobular-alveolar
growth and ductal branching, is called:
A. Lactogenesis II
B. Mammogenesis [CORRECT]
C. Galactopoiesis
D. Involution
Correct Answer: B
Rationale: Mammogenesis is breast development during pregnancy preparing for
lactation. Lactogenesis II (A) is onset of copious milk secretion postpartum.
Galactopoiesis (C) is maintenance of established lactation. Involution (D) is
weaning/cessation of lactation.
Q2: During pregnancy, high levels of progesterone and estrogen:
A. Stimulate copious milk production immediately
B. Prepare the breast for lactation while inhibiting full milk secretion [CORRECT]
C. Have no effect on breast tissue development
,D. Trigger the milk ejection reflex
Correct Answer: B
Rationale: High progesterone/estrogen in pregnancy promote breast development
(mammogenesis) but inhibit full lactation. Progesterone withdrawal after delivery
triggers Lactogenesis II. Not immediate production (A), not no effect (C), not MER
trigger (D—oxytocin does).
Q3: Lactogenesis I begins:
A. Immediately after delivery
B. During mid-pregnancy (approximately 16 weeks gestation) [CORRECT]
C. When the infant first suckles at the breast
D. 72 hours postpartum
Correct Answer: B
Rationale: Lactogenesis I (secretory differentiation) begins mid-pregnancy (~16 weeks),
producing colostrum. After delivery (A) is Lactogenesis II. First suckling (C) stimulates
ongoing production. 72 hours (D) is typical Lactogenesis II timing.
Q4: The onset of copious milk secretion, commonly called "milk coming in," is known as:
A. Lactogenesis I
B. Lactogenesis II [CORRECT]
C. Lactogenesis III
,D. Galactopoiesis
Correct Answer: B
Rationale: Lactogenesis II is onset of copious milk secretion, typically 30-40 hours
postpartum (range 24-72 hours), triggered by progesterone withdrawal. Lactogenesis I
(A) is prenatal preparation. Lactogenesis III (C) is autocrine maintenance.
Galactopoiesis (D) is ongoing milk production.
Q5: Lactogenesis III is primarily regulated by:
A. Maternal prolactin levels alone
B. Autocrine control through milk removal and the presence of FIL (Feedback Inhibitor
of Lactation) [CORRECT]
C. Oxytocin release during each feeding
D. The infant's birth weight
Correct Answer: B
Rationale: Lactogenesis III is autocrine control—milk synthesis regulated by removal.
Accumulated milk contains FIL that inhibits production; frequent removal decreases FIL
and increases production. Not prolactin alone (A), not oxytocin (C—MER), not birth
weight (D).
Q6: The milk ejection reflex (let-down) is primarily mediated by:
A. Prolactin release from the anterior pituitary
B. Oxytocin release from the posterior pituitary [CORRECT]
, C. Estrogen surge postpartum
D. Progesterone withdrawal
Correct Answer: B
Rationale: Milk ejection reflex is oxytocin-mediated (posterior pituitary), causing
myoepithelial cell contraction. Prolactin (A) is synthesis, not ejection. Estrogen (C) and
progesterone (D) are not MER mediators.
Q7: Which factor can INHIBIT the milk ejection reflex?
A. Hearing the baby cry
B. Thinking about the baby
C. Stress, pain, or embarrassment [CORRECT]
D. Skin-to-skin contact
Correct Answer: C
Rationale: MER is neurohormonal and sensitive to inhibition by stress, pain, anxiety,
embarrassment. Triggers include baby cues (A, B) and skin-to-skin (D), not inhibitors.
Q8: Colostrum is characterized by all of the following EXCEPT:
A. High concentration of immunoglobulins (IgA)
B. Laxative effect to help pass meconium
C. Small volume (5-10 mL per feed on day 1)
D. High lactose content similar to mature milk [CORRECT]
Graded | Certified Lactation Consultant Prep | Pass
Guaranteed - A+ Graded
Breastfeeding Physiology & Endocrinology
Q1: The process of breast development during pregnancy, including lobular-alveolar
growth and ductal branching, is called:
A. Lactogenesis II
B. Mammogenesis [CORRECT]
C. Galactopoiesis
D. Involution
Correct Answer: B
Rationale: Mammogenesis is breast development during pregnancy preparing for
lactation. Lactogenesis II (A) is onset of copious milk secretion postpartum.
Galactopoiesis (C) is maintenance of established lactation. Involution (D) is
weaning/cessation of lactation.
Q2: During pregnancy, high levels of progesterone and estrogen:
A. Stimulate copious milk production immediately
B. Prepare the breast for lactation while inhibiting full milk secretion [CORRECT]
C. Have no effect on breast tissue development
,D. Trigger the milk ejection reflex
Correct Answer: B
Rationale: High progesterone/estrogen in pregnancy promote breast development
(mammogenesis) but inhibit full lactation. Progesterone withdrawal after delivery
triggers Lactogenesis II. Not immediate production (A), not no effect (C), not MER
trigger (D—oxytocin does).
Q3: Lactogenesis I begins:
A. Immediately after delivery
B. During mid-pregnancy (approximately 16 weeks gestation) [CORRECT]
C. When the infant first suckles at the breast
D. 72 hours postpartum
Correct Answer: B
Rationale: Lactogenesis I (secretory differentiation) begins mid-pregnancy (~16 weeks),
producing colostrum. After delivery (A) is Lactogenesis II. First suckling (C) stimulates
ongoing production. 72 hours (D) is typical Lactogenesis II timing.
Q4: The onset of copious milk secretion, commonly called "milk coming in," is known as:
A. Lactogenesis I
B. Lactogenesis II [CORRECT]
C. Lactogenesis III
,D. Galactopoiesis
Correct Answer: B
Rationale: Lactogenesis II is onset of copious milk secretion, typically 30-40 hours
postpartum (range 24-72 hours), triggered by progesterone withdrawal. Lactogenesis I
(A) is prenatal preparation. Lactogenesis III (C) is autocrine maintenance.
Galactopoiesis (D) is ongoing milk production.
Q5: Lactogenesis III is primarily regulated by:
A. Maternal prolactin levels alone
B. Autocrine control through milk removal and the presence of FIL (Feedback Inhibitor
of Lactation) [CORRECT]
C. Oxytocin release during each feeding
D. The infant's birth weight
Correct Answer: B
Rationale: Lactogenesis III is autocrine control—milk synthesis regulated by removal.
Accumulated milk contains FIL that inhibits production; frequent removal decreases FIL
and increases production. Not prolactin alone (A), not oxytocin (C—MER), not birth
weight (D).
Q6: The milk ejection reflex (let-down) is primarily mediated by:
A. Prolactin release from the anterior pituitary
B. Oxytocin release from the posterior pituitary [CORRECT]
, C. Estrogen surge postpartum
D. Progesterone withdrawal
Correct Answer: B
Rationale: Milk ejection reflex is oxytocin-mediated (posterior pituitary), causing
myoepithelial cell contraction. Prolactin (A) is synthesis, not ejection. Estrogen (C) and
progesterone (D) are not MER mediators.
Q7: Which factor can INHIBIT the milk ejection reflex?
A. Hearing the baby cry
B. Thinking about the baby
C. Stress, pain, or embarrassment [CORRECT]
D. Skin-to-skin contact
Correct Answer: C
Rationale: MER is neurohormonal and sensitive to inhibition by stress, pain, anxiety,
embarrassment. Triggers include baby cues (A, B) and skin-to-skin (D), not inhibitors.
Q8: Colostrum is characterized by all of the following EXCEPT:
A. High concentration of immunoglobulins (IgA)
B. Laxative effect to help pass meconium
C. Small volume (5-10 mL per feed on day 1)
D. High lactose content similar to mature milk [CORRECT]
