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Certified Breastfeeding Counselor (CBC)
Exam| Breastfeeding Counseling,
Lactation, Maternal-Child Health | Open-
Ended Q&A with Rationales
Exam Structure:
Subject: Breastfeeding Counseling / Lactation / Maternal-Child Health
Source: Certified Breastfeeding Counselor (CBC) Exam
Format: Open-ended questions with Correct Answers and rationales
1. What is the normal weight loss for the infant during the first few
days?
Correct Answer: 5-7% in the first 24 hours and below 10% in the first
week
Rationale:
1. Newborns typically lose 5-7% of birth weight in the first 24-48 hours
due to fluid shifts and limited intake.
2. Weight loss exceeding 10% of birth weight warrants evaluation for feeding
problems or medical issues.
3. Birth weight is usually regained by 10-14 days of age.
2. How many calories does a lactating mom need?
Correct Answer: Moms need approximately 500 extra calories/day when
breastfeeding. Range is 1,800-2,700 with most moms consuming around
2,200
Rationale:
1. Milk production requires approximately 500 additional calories per day.
2. Total caloric needs vary based on activity level, weight, and milk
production volume.
3. Most breastfeeding women consume around 2,200 calories daily, which is
sufficient for adequate milk supply.
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3. What type of supplement do most lactating vegans / bariatric
patients take?
Correct Answer: supplement Vitamin B12
Rationale:
1. Vitamin B12 is found naturally only in animal products, making vegans at
risk for deficiency.
2. Bariatric surgery reduces absorption of B12 due to altered gastrointestinal
anatomy.
3. B12 deficiency can cause neurological symptoms in the mother and
developmental delays in the infant.
4. How much vitamin D does a baby need? When do they need to be
supplemented?
Correct Answer: Babies need 400 IU of Vitamin D per day. They should be
supplemented if moms are deficient; there is vitamin D in formula, so if
they are being formula-fed they do NOT require additional vitamin D
supplementation.
Rationale:
1. Breast milk contains minimal vitamin D, regardless of maternal intake.
2. The American Academy of Pediatrics recommends 400 IU daily for all
breastfed and partially breastfed infants.
3. Formula-fed infants receive adequate vitamin D from fortified formula
(usually 400 IU per liter).
5. What types of foods (or diet) should lactating moms consume?
Correct Answer: Moms should consume a diet of normal foods – they
should eat when they're hungry and drink when they're thirsty. The
MyPlate is a good example – 50% carbs, 15% protein, 20-30% healthy fats
Rationale:
1. Breast milk composition is remarkably stable regardless of maternal diet.
2. Hunger and thirst cues are reliable guides for intake.
3. A balanced diet with adequate carbohydrates, protein, and healthy fats
supports maternal health and energy.
6. When would a Haberman feeder be indicated?
Correct Answer: with Down's Syndrome or a Cleft Lip/Palate
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Rationale:
1. Infants with cleft lip/palate cannot create adequate suction for standard
bottle feeding.
2. Down syndrome infants may have hypotonia and poor oral motor
coordination.
3. The Haberman feeder allows the infant to compress the nipple rather than
suck, enabling feeding despite oral structural differences.
7. What medications are contraindicated in breastfeeding mothers?
Correct Answer: Antimetabolite drugs or chemotherapy, radioisotopes
(not IV contrast dye), and illicit drugs
Rationale:
1. Antimetabolites and chemotherapy drugs are cytotoxic and can harm the
infant.
2. Radioisotopes may accumulate in breast tissue and be excreted into milk.
3. IV contrast dye is safe because very little transfers to milk.
4. Illicit drugs cause sedation, poor feeding, and developmental harm.
8. What is the Tail of Spence? What are the symptoms? How do you
treat it?
Correct Answer: The Tail of Spence refers to mammary gland tissue that
extends to the axillary area that is connected to the milk ducts. Symptoms
include swollen armpits and even mastitis. Moms can apply cold
compresses to the area and take Motrin/Tylenol as needed for discomfort.
Rationale:
1. The Tail of Spence is an extension of breast tissue into the axilla
(underarm).
2. During lactation, this tissue can engorge, swell, and become painful.
3. Cold compresses reduce inflammation; NSAIDs relieve pain.
4. Mastitis in the Tail of Spence requires the same treatment as breast
mastitis.
9. What happens to estrogen and progesterone during pregnancy and
after birth?
Correct Answer: They increase during pregnancy and then decrease after
birth
Certified Breastfeeding Counselor (CBC)
Exam| Breastfeeding Counseling,
Lactation, Maternal-Child Health | Open-
Ended Q&A with Rationales
Exam Structure:
Subject: Breastfeeding Counseling / Lactation / Maternal-Child Health
Source: Certified Breastfeeding Counselor (CBC) Exam
Format: Open-ended questions with Correct Answers and rationales
1. What is the normal weight loss for the infant during the first few
days?
Correct Answer: 5-7% in the first 24 hours and below 10% in the first
week
Rationale:
1. Newborns typically lose 5-7% of birth weight in the first 24-48 hours
due to fluid shifts and limited intake.
2. Weight loss exceeding 10% of birth weight warrants evaluation for feeding
problems or medical issues.
3. Birth weight is usually regained by 10-14 days of age.
2. How many calories does a lactating mom need?
Correct Answer: Moms need approximately 500 extra calories/day when
breastfeeding. Range is 1,800-2,700 with most moms consuming around
2,200
Rationale:
1. Milk production requires approximately 500 additional calories per day.
2. Total caloric needs vary based on activity level, weight, and milk
production volume.
3. Most breastfeeding women consume around 2,200 calories daily, which is
sufficient for adequate milk supply.
, 2|Page
3. What type of supplement do most lactating vegans / bariatric
patients take?
Correct Answer: supplement Vitamin B12
Rationale:
1. Vitamin B12 is found naturally only in animal products, making vegans at
risk for deficiency.
2. Bariatric surgery reduces absorption of B12 due to altered gastrointestinal
anatomy.
3. B12 deficiency can cause neurological symptoms in the mother and
developmental delays in the infant.
4. How much vitamin D does a baby need? When do they need to be
supplemented?
Correct Answer: Babies need 400 IU of Vitamin D per day. They should be
supplemented if moms are deficient; there is vitamin D in formula, so if
they are being formula-fed they do NOT require additional vitamin D
supplementation.
Rationale:
1. Breast milk contains minimal vitamin D, regardless of maternal intake.
2. The American Academy of Pediatrics recommends 400 IU daily for all
breastfed and partially breastfed infants.
3. Formula-fed infants receive adequate vitamin D from fortified formula
(usually 400 IU per liter).
5. What types of foods (or diet) should lactating moms consume?
Correct Answer: Moms should consume a diet of normal foods – they
should eat when they're hungry and drink when they're thirsty. The
MyPlate is a good example – 50% carbs, 15% protein, 20-30% healthy fats
Rationale:
1. Breast milk composition is remarkably stable regardless of maternal diet.
2. Hunger and thirst cues are reliable guides for intake.
3. A balanced diet with adequate carbohydrates, protein, and healthy fats
supports maternal health and energy.
6. When would a Haberman feeder be indicated?
Correct Answer: with Down's Syndrome or a Cleft Lip/Palate
, 3|Page
Rationale:
1. Infants with cleft lip/palate cannot create adequate suction for standard
bottle feeding.
2. Down syndrome infants may have hypotonia and poor oral motor
coordination.
3. The Haberman feeder allows the infant to compress the nipple rather than
suck, enabling feeding despite oral structural differences.
7. What medications are contraindicated in breastfeeding mothers?
Correct Answer: Antimetabolite drugs or chemotherapy, radioisotopes
(not IV contrast dye), and illicit drugs
Rationale:
1. Antimetabolites and chemotherapy drugs are cytotoxic and can harm the
infant.
2. Radioisotopes may accumulate in breast tissue and be excreted into milk.
3. IV contrast dye is safe because very little transfers to milk.
4. Illicit drugs cause sedation, poor feeding, and developmental harm.
8. What is the Tail of Spence? What are the symptoms? How do you
treat it?
Correct Answer: The Tail of Spence refers to mammary gland tissue that
extends to the axillary area that is connected to the milk ducts. Symptoms
include swollen armpits and even mastitis. Moms can apply cold
compresses to the area and take Motrin/Tylenol as needed for discomfort.
Rationale:
1. The Tail of Spence is an extension of breast tissue into the axilla
(underarm).
2. During lactation, this tissue can engorge, swell, and become painful.
3. Cold compresses reduce inflammation; NSAIDs relieve pain.
4. Mastitis in the Tail of Spence requires the same treatment as breast
mastitis.
9. What happens to estrogen and progesterone during pregnancy and
after birth?
Correct Answer: They increase during pregnancy and then decrease after
birth
