IBCLC Exam Questions and Answers
Micrognathia - ✔ Condition where jaw is undersized; common but can interfere with
feeding and breathing
PKU (phenylketonuria) - ✔ Body does not produce enzyme to break-down amino acid
phenylalanine and this builds-ups in blood; need low phe formula and CAN breastfeed
Maple Syrup Disease - ✔ Body is unable to break-down certain proteins/amino acids
(leucine); sweet smelling urine. Need low protein diet/special formula i.e. Ketonex-1.
*BF CONTRAINDICATED*
Galactosemia - ✔ Rare genetic (metabolic) disorder; cannot metabolize galactose. BM
is Lactose (galactose/glucose) - need soy-based formula - *BF CONTRAINDICATED*
Wessel's Rule of 3 (Colic) - ✔ 3 hours per day
3 x per week
for 3 weeks
Down Syndrome - ✔ Marked hypotonia; decreased suck-swallow-breathe coordination,
large tongue with poor control, poor gape and mouth control -
*Dancer Hold for BFing*
Hypotonia - ✔ Decreased muscle tone; "floppy"
difficulty coordinating suck-swallow-breathe
poor gape and mouth control
poor search and tongue extension
loss of suction
long/slow feeds
*Dancer Hold for BFing w/ upright positioing; tube at breast prn - switch nursing &
compressions*
Hypertonia - ✔ High, rigid muscle tone; rigid
tight jaw, clamping down on breast
restricted tongue movement
*Finger feeding in prone position over the arm of an adult before BFing - use prone
(tummy down) position; increased SSC, swing in blanket, colic hold*
Hypoglycemia - ✔ DOES NOT occur in healthy full-term infants
*at 8 hrs after birth, whether fed or not, a normal full-term infant will have a normal blood
sugar level*
Routine blood glucose testing IS NOT recommended
S&S = jittery, lethary, high-pitch cry, exaggerated MORO, hypotonia, inadequate
sucking reflex
S&S + <45mg/dL - clinical intervention needed
, Risks but no S&S + <36 mg/dL - close surveillance
+++SSC, early, frequent BFing
Hyperbilirubinemia (Jaundice) - ✔ Most common in first week (physiologic jaundice)
accumulation of unconjugated bilirubin
Caused by inadequate intake in first days of life; prolonged intestinal transit and delay in
passing meconium - weight loss of >7%
*BFing management, SSC - increase feeding*
Kernicterus - ✔ Untreated jandice - bilirubin moves from bloodstream into brain tissue -
brain damage or death.
Warning signs of poor intake: - ✔ Scant/dark/concentrated urine
No urine
<4 stools/day after day 3
Stools not transitioned after day 6
Low Birth Weight (LBW) - ✔ Infant with BW <2500g
Very Low Birth Weight (VLBW) - ✔ Infant with BW <1500g
Extremely Low Birth Weight (ELBW) - ✔ Infant with BW <1000g
Normal Birth Weight - ✔ Infant with BW 2500 - 4200g
LGA (Large Gestational Age) - ✔ Weight, length or head circumference >90th %tile at
birth
SGA (Small gestational age) - ✔ Weight, length or head circumference <10th %tile at
birth
Acrocyanosis - ✔ Very common; bluish discoloration of hands and feet for first 24 hours
after birth
Dehydration - ✔ Results from inadequate intake
decreased output, weak cry, lethargy, dry MM, sunken fontanelles >14% weight loss
Require IV fluids and BF management
Erythema Toxicum Neonatorum - ✔ Very common, benign newborn rash
Comes and goes
Breastmilk Jaundice - ✔ Breast milk jaundice can last for 3-12 weeks after birth, but as
long as the baby is feeding well and bilirubin levels are monitored, it rarely leads to
serious complications.
Micrognathia - ✔ Condition where jaw is undersized; common but can interfere with
feeding and breathing
PKU (phenylketonuria) - ✔ Body does not produce enzyme to break-down amino acid
phenylalanine and this builds-ups in blood; need low phe formula and CAN breastfeed
Maple Syrup Disease - ✔ Body is unable to break-down certain proteins/amino acids
(leucine); sweet smelling urine. Need low protein diet/special formula i.e. Ketonex-1.
*BF CONTRAINDICATED*
Galactosemia - ✔ Rare genetic (metabolic) disorder; cannot metabolize galactose. BM
is Lactose (galactose/glucose) - need soy-based formula - *BF CONTRAINDICATED*
Wessel's Rule of 3 (Colic) - ✔ 3 hours per day
3 x per week
for 3 weeks
Down Syndrome - ✔ Marked hypotonia; decreased suck-swallow-breathe coordination,
large tongue with poor control, poor gape and mouth control -
*Dancer Hold for BFing*
Hypotonia - ✔ Decreased muscle tone; "floppy"
difficulty coordinating suck-swallow-breathe
poor gape and mouth control
poor search and tongue extension
loss of suction
long/slow feeds
*Dancer Hold for BFing w/ upright positioing; tube at breast prn - switch nursing &
compressions*
Hypertonia - ✔ High, rigid muscle tone; rigid
tight jaw, clamping down on breast
restricted tongue movement
*Finger feeding in prone position over the arm of an adult before BFing - use prone
(tummy down) position; increased SSC, swing in blanket, colic hold*
Hypoglycemia - ✔ DOES NOT occur in healthy full-term infants
*at 8 hrs after birth, whether fed or not, a normal full-term infant will have a normal blood
sugar level*
Routine blood glucose testing IS NOT recommended
S&S = jittery, lethary, high-pitch cry, exaggerated MORO, hypotonia, inadequate
sucking reflex
S&S + <45mg/dL - clinical intervention needed
, Risks but no S&S + <36 mg/dL - close surveillance
+++SSC, early, frequent BFing
Hyperbilirubinemia (Jaundice) - ✔ Most common in first week (physiologic jaundice)
accumulation of unconjugated bilirubin
Caused by inadequate intake in first days of life; prolonged intestinal transit and delay in
passing meconium - weight loss of >7%
*BFing management, SSC - increase feeding*
Kernicterus - ✔ Untreated jandice - bilirubin moves from bloodstream into brain tissue -
brain damage or death.
Warning signs of poor intake: - ✔ Scant/dark/concentrated urine
No urine
<4 stools/day after day 3
Stools not transitioned after day 6
Low Birth Weight (LBW) - ✔ Infant with BW <2500g
Very Low Birth Weight (VLBW) - ✔ Infant with BW <1500g
Extremely Low Birth Weight (ELBW) - ✔ Infant with BW <1000g
Normal Birth Weight - ✔ Infant with BW 2500 - 4200g
LGA (Large Gestational Age) - ✔ Weight, length or head circumference >90th %tile at
birth
SGA (Small gestational age) - ✔ Weight, length or head circumference <10th %tile at
birth
Acrocyanosis - ✔ Very common; bluish discoloration of hands and feet for first 24 hours
after birth
Dehydration - ✔ Results from inadequate intake
decreased output, weak cry, lethargy, dry MM, sunken fontanelles >14% weight loss
Require IV fluids and BF management
Erythema Toxicum Neonatorum - ✔ Very common, benign newborn rash
Comes and goes
Breastmilk Jaundice - ✔ Breast milk jaundice can last for 3-12 weeks after birth, but as
long as the baby is feeding well and bilirubin levels are monitored, it rarely leads to
serious complications.
