PCE CERTIFIED BREASTFEEDING COUNSELOR EXAM
ACTUAL EXAM 2024 QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
Different stages of breast development
- Embryogenesis
- Mammogensis
- Lactogenesis 1
- Lactogenesis 2
- Lactogenesis 3 - (correct answer) Embryogenesis: mammary gland devo while 5
wk embryo
Mammogenesis: @ puberty, estrogen influences growth of ducts and buds
Lactogenesis 1: completion of mammary development from placenta stimulation; ducts
stimulated + colostrum secretion at 16 wks
Lactogenesis 2: Secretory activation when placenta out --> decr progesterone --> inc
prolactin --> inc milk supply
Lactogenesis 3: Milk removal --> mature milk prod; Infant sucking= ^ oxytocin= let
down.
Estrogen
Progesterone
Prolactin
Oxytocin
TSH - (correct answer) Estrogen - ^ during pregnancy; stim growth in ductile system
Progesterone - ^ during pregnancy; stim alveoli and lobes
Prolactin - frm ant pituitary gland; lands on prolactin receptor sites to start milk prod
Oxytocin - from post pituitary gland; cause LETDOWN
TSH - ^ responsiveness of mammary cells
Tail of spence: What is it, symptoms - (correct answer) Mammary gland tissue that
extends to axillary area, connected to milk ducts --> can cause swollen armpits &
mastitis
Accessory tissue: Where are they found? Can they lactate? - (correct answer)
Diagonal line from axilla to groin area
- can lactate & undergo malignant change
Flat nipples
Pseudo inverted nipple
Retracted nipple
Inverted nipple
- possible issues, short shank, solutions - (correct answer) Flat - remains flat after
stimulation or retract with compression (short shank) --> diff w/ latch
Pseudo - seems inverted but erect upon stimulation
Retracted - retracts upon stimulation
Inverted - retracted at rest &s stimulation
, Nipple shield may help.
Hypoplasia, what is it? - (correct answer) Underdevelopment, insufficient glandular
tissue --> can lead to insufficient milk
Active let down
- How is milk ejected into ducts from alveoli? aka let down
- signs of let down
- postions that are helpful for let down - (correct answer) Myoepitheal cells encase
the aveoli, contract in response to oxytocin. In response to sucking oxytocin increases
Tingling, warmth, fullness, dripping, contractions
helpful in australian/saddle
What is breast milk composed of? - (correct answer) - Fats: most variable, help
brain devo, hi in evenings
-Protein: Casein- allows for iron to be absorbed, mature milk. Whey- hi in colostrum,
contains IGA; has lysozyme that kills bacteria
Carbs: creates acidic environment in gut & has lactose that reg milk vol
Vitamins: A,D,E,K,C, thiamin, riboflavin, b's that influenced by mom.
Minerals: calcium, phosphorus, magnesium, not affected by diet. + 88% water
Impact of breast surgery on lactation
- Implants
- hyaluronic acid injections
- breast reduction - (correct answer) Implants
- compress milk ducts --> impede milk flow --> compromise reaching max milk vol
Hyaluronic acid injections
- no risk of being absorbed in baby's GI tract
Reduction
- BF might not be possible after
- BF early + stim bm early
Signs of milk transfer - (correct answer) Swallowing, air from nose, ca sound,
movement seen
Feeding patterns 24-48 hrs & 48 and further - (correct answer) 24-48hr --- > Cluster
feeding (feed freq over short amt of time) , must stimulate breast
48 and further --> on demand (cue based feeding) ; offer q 3 hrs
How does poop transform?
ACTUAL EXAM 2024 QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
Different stages of breast development
- Embryogenesis
- Mammogensis
- Lactogenesis 1
- Lactogenesis 2
- Lactogenesis 3 - (correct answer) Embryogenesis: mammary gland devo while 5
wk embryo
Mammogenesis: @ puberty, estrogen influences growth of ducts and buds
Lactogenesis 1: completion of mammary development from placenta stimulation; ducts
stimulated + colostrum secretion at 16 wks
Lactogenesis 2: Secretory activation when placenta out --> decr progesterone --> inc
prolactin --> inc milk supply
Lactogenesis 3: Milk removal --> mature milk prod; Infant sucking= ^ oxytocin= let
down.
Estrogen
Progesterone
Prolactin
Oxytocin
TSH - (correct answer) Estrogen - ^ during pregnancy; stim growth in ductile system
Progesterone - ^ during pregnancy; stim alveoli and lobes
Prolactin - frm ant pituitary gland; lands on prolactin receptor sites to start milk prod
Oxytocin - from post pituitary gland; cause LETDOWN
TSH - ^ responsiveness of mammary cells
Tail of spence: What is it, symptoms - (correct answer) Mammary gland tissue that
extends to axillary area, connected to milk ducts --> can cause swollen armpits &
mastitis
Accessory tissue: Where are they found? Can they lactate? - (correct answer)
Diagonal line from axilla to groin area
- can lactate & undergo malignant change
Flat nipples
Pseudo inverted nipple
Retracted nipple
Inverted nipple
- possible issues, short shank, solutions - (correct answer) Flat - remains flat after
stimulation or retract with compression (short shank) --> diff w/ latch
Pseudo - seems inverted but erect upon stimulation
Retracted - retracts upon stimulation
Inverted - retracted at rest &s stimulation
, Nipple shield may help.
Hypoplasia, what is it? - (correct answer) Underdevelopment, insufficient glandular
tissue --> can lead to insufficient milk
Active let down
- How is milk ejected into ducts from alveoli? aka let down
- signs of let down
- postions that are helpful for let down - (correct answer) Myoepitheal cells encase
the aveoli, contract in response to oxytocin. In response to sucking oxytocin increases
Tingling, warmth, fullness, dripping, contractions
helpful in australian/saddle
What is breast milk composed of? - (correct answer) - Fats: most variable, help
brain devo, hi in evenings
-Protein: Casein- allows for iron to be absorbed, mature milk. Whey- hi in colostrum,
contains IGA; has lysozyme that kills bacteria
Carbs: creates acidic environment in gut & has lactose that reg milk vol
Vitamins: A,D,E,K,C, thiamin, riboflavin, b's that influenced by mom.
Minerals: calcium, phosphorus, magnesium, not affected by diet. + 88% water
Impact of breast surgery on lactation
- Implants
- hyaluronic acid injections
- breast reduction - (correct answer) Implants
- compress milk ducts --> impede milk flow --> compromise reaching max milk vol
Hyaluronic acid injections
- no risk of being absorbed in baby's GI tract
Reduction
- BF might not be possible after
- BF early + stim bm early
Signs of milk transfer - (correct answer) Swallowing, air from nose, ca sound,
movement seen
Feeding patterns 24-48 hrs & 48 and further - (correct answer) 24-48hr --- > Cluster
feeding (feed freq over short amt of time) , must stimulate breast
48 and further --> on demand (cue based feeding) ; offer q 3 hrs
How does poop transform?
