PCE CERTIFIED BREASTFEEDING COUNSELOR EXAM
ACTUAL EXAM 2024 QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
What is the normal weight loss for the infant during the first few days ? - - (correct answer) 5-7% in the first
24hrs and below 10% in the first week
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 mons consuming around 2,200
What type of supplement do most lactating vegans / bariatric patients take ? - - (correct answer) supplement
Vitamin B12
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 .
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
When would a Habermen feeder be indicated ? - (correct answer) with Down's Syndrome or a Cleft Lip / Palate
What medications are contraindicated in breastfeeding mothers ? - (correct answer) Antimetabolite drugs or
chemotherapy , radioisotopes ( not IV contrast dye ) and illicit drugs
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 .
What happens to estrogen and progesterone during pregnancy and after birth ? - - (correct answer) They
increase during pregnancy and then decrease after birth .
How many stages of the " Magic Hour " are there ? What are they ? - (correct answer) There are nine stages of
the " Magic Hour " or " Golden Hour , " they are : 1. Birth cry 2. Relaxation 3. Awakening 4. Activity 5. Rest 6. Crawling
7. Familiarization 8. Suckling 9. Sleep
What is the stomach size of the baby at birth ? - - (correct answer) The baby's stomach is only the size of a
marble , button or grape at birth . It can only hold 1-7 mL or 1-2 teaspoons at this time .
Standards of of practice for CBC - - (correct answer) Help families define and achieve goals
-Problem solving : Assessment , plan , implementation , evaluation
-Education and counseling
-Professionalism
-Legal considerations
Where is the milk produced ? - (correct answer) ANSWER- In the alveoli
How long after cessation of breast feeding does milk production ( involution ) stop ? - - (correct answer)
Approximately 40 days
What are the common signs of milk " let down " ? - (correct answer) Tingling , warmth , fullness , dripping and
contractions
How is preterm milk different than term milk ? - - (correct answer) It is higher in protein and immune factors (
because the body KNOWS this is what the preemie needs ! )
, What component of breast milk is the most variable ? - (correct answer) Lipids
What component of human milk is destroyed by freezing ? - (correct answer) Macrophages
When is the side - lying position helpful ? - (correct answer) In moms that are sleepy or have lacerations /
repairs that put pressure and cause discomfort on the perineal area
What position is centered around the infant attaching themselves to the breast ? - - (correct answer) The laid
back position ( aka the biological position )
When is the Australian / Saddle position helpful ? - (correct answer) When moms are experiencing active let -
down
What is the dancer hand ? - (correct answer) Mom would have hand below the breast in a " U " shape ; this is
good for infants who need good jaw support
What are signs of milk transfer ? - (correct answer) Swallowing - harsh " Ca " sound ; air from nose felt , neck
movement visualized
What are the stool transition colors ? - (correct answer) Black to green to yellow
What can affect a hc professionals presentation about breastfeeding ? - (correct answer) Experience ,
philosophy , credentials
What are responsibilities of staff ? - (correct answer) Provide education and foster environment -Baby friendly
practices -Evidence based knowledge - Help preterms w / moms milk or donor -Culturally and developmentally
sensitive -WHO growth charts -Legislation
International code of marketing substitutes - (correct answer) -No advertising -No free sample - Scientific info
Not law but should be use
Baby friendly 10 steps - (correct answer) -- Written policy -Proper training -Proper education -Initiation w in 1
hr -Maintain lactation even if separated -Breastmilk only unless medically required -Rooming in -Cue feeding , 8-
12x -No artificial teats -Support groups
Where is milk produced ? - (correct answer) Alveoli
How is milk ejected into ducts from alveoli ? aka let down - (correct answer) Myoepitheal cells encase the aveoli
, contract in response to oxytocin . In response to sucking oxytocin increases
Different stages of breast development - (correct answer) embryogenesis : Mammary gland while embryo
- Mammogenesis : @ puberty , estrogen influences growth of ducts and buds
-Lactogensesis 1 : Fullness and tenderness while pregnant . Ducts stimulated .
Lactogenesis 2 : Secretory activation when placenta out . D / t increase of prolactin when progestrone decreases .
Lactogenesis 3 : Milk removal =production . Infant sucking- oxytocin = let down .
How long after cessation of breast feeding does milk production stop ? - - (correct answer) 40 days
What happens to estrogen and progesterone during pregnancy and birth ? - (correct answer) Increase during
pregnancy , decreases after birth Helps development of lobes .
Signs of letdown ? - (correct answer) Tingling , warmth , fullness , dripping , contractions
Accessory tissue : Where are they found ? - (correct answer) Diagonal line from axilla to groin area . Can lactate
and undergo malignant change .
Flat / inverted nipples : possible issues and solutions ? What is short shank ? - (correct answer) Difficulty w /
latch . Nipple shield may help . Short shank- retraction w / stimulation
ACTUAL EXAM 2024 QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
What is the normal weight loss for the infant during the first few days ? - - (correct answer) 5-7% in the first
24hrs and below 10% in the first week
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 mons consuming around 2,200
What type of supplement do most lactating vegans / bariatric patients take ? - - (correct answer) supplement
Vitamin B12
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 .
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
When would a Habermen feeder be indicated ? - (correct answer) with Down's Syndrome or a Cleft Lip / Palate
What medications are contraindicated in breastfeeding mothers ? - (correct answer) Antimetabolite drugs or
chemotherapy , radioisotopes ( not IV contrast dye ) and illicit drugs
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 .
What happens to estrogen and progesterone during pregnancy and after birth ? - - (correct answer) They
increase during pregnancy and then decrease after birth .
How many stages of the " Magic Hour " are there ? What are they ? - (correct answer) There are nine stages of
the " Magic Hour " or " Golden Hour , " they are : 1. Birth cry 2. Relaxation 3. Awakening 4. Activity 5. Rest 6. Crawling
7. Familiarization 8. Suckling 9. Sleep
What is the stomach size of the baby at birth ? - - (correct answer) The baby's stomach is only the size of a
marble , button or grape at birth . It can only hold 1-7 mL or 1-2 teaspoons at this time .
Standards of of practice for CBC - - (correct answer) Help families define and achieve goals
-Problem solving : Assessment , plan , implementation , evaluation
-Education and counseling
-Professionalism
-Legal considerations
Where is the milk produced ? - (correct answer) ANSWER- In the alveoli
How long after cessation of breast feeding does milk production ( involution ) stop ? - - (correct answer)
Approximately 40 days
What are the common signs of milk " let down " ? - (correct answer) Tingling , warmth , fullness , dripping and
contractions
How is preterm milk different than term milk ? - - (correct answer) It is higher in protein and immune factors (
because the body KNOWS this is what the preemie needs ! )
, What component of breast milk is the most variable ? - (correct answer) Lipids
What component of human milk is destroyed by freezing ? - (correct answer) Macrophages
When is the side - lying position helpful ? - (correct answer) In moms that are sleepy or have lacerations /
repairs that put pressure and cause discomfort on the perineal area
What position is centered around the infant attaching themselves to the breast ? - - (correct answer) The laid
back position ( aka the biological position )
When is the Australian / Saddle position helpful ? - (correct answer) When moms are experiencing active let -
down
What is the dancer hand ? - (correct answer) Mom would have hand below the breast in a " U " shape ; this is
good for infants who need good jaw support
What are signs of milk transfer ? - (correct answer) Swallowing - harsh " Ca " sound ; air from nose felt , neck
movement visualized
What are the stool transition colors ? - (correct answer) Black to green to yellow
What can affect a hc professionals presentation about breastfeeding ? - (correct answer) Experience ,
philosophy , credentials
What are responsibilities of staff ? - (correct answer) Provide education and foster environment -Baby friendly
practices -Evidence based knowledge - Help preterms w / moms milk or donor -Culturally and developmentally
sensitive -WHO growth charts -Legislation
International code of marketing substitutes - (correct answer) -No advertising -No free sample - Scientific info
Not law but should be use
Baby friendly 10 steps - (correct answer) -- Written policy -Proper training -Proper education -Initiation w in 1
hr -Maintain lactation even if separated -Breastmilk only unless medically required -Rooming in -Cue feeding , 8-
12x -No artificial teats -Support groups
Where is milk produced ? - (correct answer) Alveoli
How is milk ejected into ducts from alveoli ? aka let down - (correct answer) Myoepitheal cells encase the aveoli
, contract in response to oxytocin . In response to sucking oxytocin increases
Different stages of breast development - (correct answer) embryogenesis : Mammary gland while embryo
- Mammogenesis : @ puberty , estrogen influences growth of ducts and buds
-Lactogensesis 1 : Fullness and tenderness while pregnant . Ducts stimulated .
Lactogenesis 2 : Secretory activation when placenta out . D / t increase of prolactin when progestrone decreases .
Lactogenesis 3 : Milk removal =production . Infant sucking- oxytocin = let down .
How long after cessation of breast feeding does milk production stop ? - - (correct answer) 40 days
What happens to estrogen and progesterone during pregnancy and birth ? - (correct answer) Increase during
pregnancy , decreases after birth Helps development of lobes .
Signs of letdown ? - (correct answer) Tingling , warmth , fullness , dripping , contractions
Accessory tissue : Where are they found ? - (correct answer) Diagonal line from axilla to groin area . Can lactate
and undergo malignant change .
Flat / inverted nipples : possible issues and solutions ? What is short shank ? - (correct answer) Difficulty w /
latch . Nipple shield may help . Short shank- retraction w / stimulation
