Certified Lactation Consultant Exam
A staff member is fond of telling mothers how expensive it is to formula feed infants and how
inexpensive it is to breastfeed. What is she doing when she talks to mothers on this topic?
Prolonging breastfeeding Promoting breastfeeding Protecting breastfeeding Supporting
breastfeeding - correct answer-Promoting breastfeeding
Who currently collects the most comprehensive breastfeeding statistics in the United States?
The United States Breastfeeding Committee Ross Laboratories The Centers for Disease
Control (CDC) The US Department of Agriculture (WIC) - correct answer-CDC
Which of the following statements about prolactin is TRUE?
Prolactin is a great laxative. Prolactin causes milk to be released.
Prolactin causes milk to be made. Prolactin is produced in the renal gland. - correct
answer-Prolactin causes milk to be made.
Which of the following mechanisms cause oxytocin to be released? Complete delivery of the
placenta Elevated levels of gastrointestinal hormones
Frequent feeding and milk removal Nipple stretching with appropriate latch-on - correct
answer-Nipple stretching with appropriate latch-on
Lactogenesis III requires which of the following to succeed?
Frequent milk removal and nipple stimulation.
Adequate rest and alternating starting breast at each feed. Adequate protein and
carbohydrates for the mother. Adequate maternal hydration and lack of maternal stress. -
correct answer-Frequent milk removal and nipple stimulation.
One way the fat content of milk suckled by the baby is determined is:
The number of feedings in 24 hours The speed/efficiency with which the baby removes milk
The amount of fat in the mother's diet
The amount of liquid in the mother's diet - correct answer-The speed/efficiency with which
the baby removes milk
Which of the following is the MOST effective at increasing gastrin and CCK and decreasing
somatostatin in the baby?
Increasing stress/anxiety
Crying before sleep
Focusing on objects 8-12 inches away
Feeding with species-specific milk - correct answer-Feeding with species-specific milk
According to the AAP regarding weight loss in the breastfeeding newborn:
Weight loss of more than 7% from birth weight requires formula supplementation.
Weight loss of more than 7% from birth weight indicates possible breastfeeding problems.
Weight loss of less than 7% from birth weight is a sign of hypernatremia.
,Weight loss of more than 7% from birth weight is not a concern after day 5. - correct
answer-Weight loss of more than 7% from birth weight indicates possible breastfeeding
problems.
When undernourished mothers were supplemented with extra energy in their diet, they:
Had babies that gained weight slightly better
Produced more nutritious milk
Had babies that gained weight significantly better
Responded to their infants more appropriately - correct answer-Responded to their infants
more appropriately
Harmful bacteria have difficulty growing in the breastfed infants' gut because the composition
of breastmilk:
Raises the pH of the gut to a basic level
Provides too much iron for harmful bacteria to grow
Fosters the growth of good bacteria that crowd out other organisms
Fosters the growth of B12 in the large intestine - correct answer-Fosters the growth of good
bacteria that crowd out other organisms
Colostrum is made after there is a complete delivery of the placenta. True
False - correct answer-F
Lactogenesis 2 occurs after the complete delivery of the placenta. True
False - correct answer-T
Lactogenesis 3 is also called Galactocemia.
True
False - correct answer-F
It is called galactopoiesis
The following statement about Lactogenesis 3 is NOT true:
It is also called Galactopoiesis. Prolactin levels rise because of nipple stimulation.
Frequency of removal of milk decreases milk in the breast.
It is driven by the nursing parent's fluid intake. - correct answer-It is driven by the nursing
parent's fluid intake.
Engorgement is physiologically normal and is a marker for an excellent future of milk supply.
True
False - correct answer-F
The more time spent breastfeeding in the first 48 hours, the less chance there is for
engorgement.
True
False - correct answer-T
For all breastfeeding individuals, bras are essential for comfort during lactation.
True
False - correct answer-F
,Breast surgery can potentially impact breastfeeding.
True
False - correct answer-T
Peri-areolar incisions with breast surgery are least significantly associated with milk
insufficiency. True
False - correct answer-False.
Peri-areolar incisions are MOST likely associated w/ milk insufficiency
When considering both chest masculinization surgery and breast reduction surgery:
The likelihood of breastfeeding is unknown.
Assessment and close nutritional follow up is key.
It is important to assure nutrition of the infant.
All of the above - correct answer-All of the above
Suboptimal breast anatomy can potentially impact breastfeeding and should be seen as a
"red flag" for close assessment and follow up. True
False - correct answer-T
Hypoplastic breasts always make ample milk.
True
False - correct answer-F
There is no concern when a client reports a breast implant on only one side.
True
False - correct answer-F
This could indicate history of discrepant breast size.
With flat and inverted nipples, there will be inadequate production of milk-making hormones
because prolactin involves nipple stretching while oxytocin involves nipple stroking.
True
False - correct answer-F
Prolactin = nipple stroking
Oxytocin = nipple stretching
The nipple stretches to four times its resting length in the baby's mouth, according to Smith's
research.
True
False - correct answer-F
Stretches to 2x its length
An everted nipple is necessary for babies to attach to the breast. Unlike other mammals,
they cannot form a teat.
True
False - correct answer-F
When counseling someone who has had a breast surgery, it is important to consider:
, If the milk ducts are patent
If the nipple pores are patent
The need to monitor the baby's weight gain very closely
All of the above - correct answer-All of the above
Grade 3 inverted nipples are difficult or impossible to pull out/evert.
True
False - correct answer-T
You can tell looking at a nipple at rest how it will function.
True
False - correct answer-F
One concern about Grade 3 inverted nipples involves:
Prolactin levels
Oversupply issues
Engorgement
All of the above - correct answer-Prolactin levels (decreased nipple stroking/stretching)
Almost all mothers have grade 3 inverted nipples.
True
False - correct answer-F
Prenatal nipple preparation should be recommended for all women. True
False - correct answer-F
No research supports, in fact research showed that the non-treatment group BF for longer
duration
Jo Alexander's research indicates that 1 out of 5 women have inverted nipples.
True
False - correct answer-F
3/5 mothers has inverted nipples.
The best way to prepare and inverted nipple for breastfeeding is: Doing nothing to the nipple
during pregnancy
Stretching the nipple and areola during pregnancy
Using a breast shell during pregnancy
Stretching the nipple and using a breast shell during pregnancy - correct answer-Doing
nothing to the nipple during pregnancy
The women who used a breast shell had the best breastfeeding outcomes at 6 weeks in the
Alexander study.
True
False - correct answer-F
The Alexander study has implications for postpartum care. Sometimes true
Always true
Sometimes false
A staff member is fond of telling mothers how expensive it is to formula feed infants and how
inexpensive it is to breastfeed. What is she doing when she talks to mothers on this topic?
Prolonging breastfeeding Promoting breastfeeding Protecting breastfeeding Supporting
breastfeeding - correct answer-Promoting breastfeeding
Who currently collects the most comprehensive breastfeeding statistics in the United States?
The United States Breastfeeding Committee Ross Laboratories The Centers for Disease
Control (CDC) The US Department of Agriculture (WIC) - correct answer-CDC
Which of the following statements about prolactin is TRUE?
Prolactin is a great laxative. Prolactin causes milk to be released.
Prolactin causes milk to be made. Prolactin is produced in the renal gland. - correct
answer-Prolactin causes milk to be made.
Which of the following mechanisms cause oxytocin to be released? Complete delivery of the
placenta Elevated levels of gastrointestinal hormones
Frequent feeding and milk removal Nipple stretching with appropriate latch-on - correct
answer-Nipple stretching with appropriate latch-on
Lactogenesis III requires which of the following to succeed?
Frequent milk removal and nipple stimulation.
Adequate rest and alternating starting breast at each feed. Adequate protein and
carbohydrates for the mother. Adequate maternal hydration and lack of maternal stress. -
correct answer-Frequent milk removal and nipple stimulation.
One way the fat content of milk suckled by the baby is determined is:
The number of feedings in 24 hours The speed/efficiency with which the baby removes milk
The amount of fat in the mother's diet
The amount of liquid in the mother's diet - correct answer-The speed/efficiency with which
the baby removes milk
Which of the following is the MOST effective at increasing gastrin and CCK and decreasing
somatostatin in the baby?
Increasing stress/anxiety
Crying before sleep
Focusing on objects 8-12 inches away
Feeding with species-specific milk - correct answer-Feeding with species-specific milk
According to the AAP regarding weight loss in the breastfeeding newborn:
Weight loss of more than 7% from birth weight requires formula supplementation.
Weight loss of more than 7% from birth weight indicates possible breastfeeding problems.
Weight loss of less than 7% from birth weight is a sign of hypernatremia.
,Weight loss of more than 7% from birth weight is not a concern after day 5. - correct
answer-Weight loss of more than 7% from birth weight indicates possible breastfeeding
problems.
When undernourished mothers were supplemented with extra energy in their diet, they:
Had babies that gained weight slightly better
Produced more nutritious milk
Had babies that gained weight significantly better
Responded to their infants more appropriately - correct answer-Responded to their infants
more appropriately
Harmful bacteria have difficulty growing in the breastfed infants' gut because the composition
of breastmilk:
Raises the pH of the gut to a basic level
Provides too much iron for harmful bacteria to grow
Fosters the growth of good bacteria that crowd out other organisms
Fosters the growth of B12 in the large intestine - correct answer-Fosters the growth of good
bacteria that crowd out other organisms
Colostrum is made after there is a complete delivery of the placenta. True
False - correct answer-F
Lactogenesis 2 occurs after the complete delivery of the placenta. True
False - correct answer-T
Lactogenesis 3 is also called Galactocemia.
True
False - correct answer-F
It is called galactopoiesis
The following statement about Lactogenesis 3 is NOT true:
It is also called Galactopoiesis. Prolactin levels rise because of nipple stimulation.
Frequency of removal of milk decreases milk in the breast.
It is driven by the nursing parent's fluid intake. - correct answer-It is driven by the nursing
parent's fluid intake.
Engorgement is physiologically normal and is a marker for an excellent future of milk supply.
True
False - correct answer-F
The more time spent breastfeeding in the first 48 hours, the less chance there is for
engorgement.
True
False - correct answer-T
For all breastfeeding individuals, bras are essential for comfort during lactation.
True
False - correct answer-F
,Breast surgery can potentially impact breastfeeding.
True
False - correct answer-T
Peri-areolar incisions with breast surgery are least significantly associated with milk
insufficiency. True
False - correct answer-False.
Peri-areolar incisions are MOST likely associated w/ milk insufficiency
When considering both chest masculinization surgery and breast reduction surgery:
The likelihood of breastfeeding is unknown.
Assessment and close nutritional follow up is key.
It is important to assure nutrition of the infant.
All of the above - correct answer-All of the above
Suboptimal breast anatomy can potentially impact breastfeeding and should be seen as a
"red flag" for close assessment and follow up. True
False - correct answer-T
Hypoplastic breasts always make ample milk.
True
False - correct answer-F
There is no concern when a client reports a breast implant on only one side.
True
False - correct answer-F
This could indicate history of discrepant breast size.
With flat and inverted nipples, there will be inadequate production of milk-making hormones
because prolactin involves nipple stretching while oxytocin involves nipple stroking.
True
False - correct answer-F
Prolactin = nipple stroking
Oxytocin = nipple stretching
The nipple stretches to four times its resting length in the baby's mouth, according to Smith's
research.
True
False - correct answer-F
Stretches to 2x its length
An everted nipple is necessary for babies to attach to the breast. Unlike other mammals,
they cannot form a teat.
True
False - correct answer-F
When counseling someone who has had a breast surgery, it is important to consider:
, If the milk ducts are patent
If the nipple pores are patent
The need to monitor the baby's weight gain very closely
All of the above - correct answer-All of the above
Grade 3 inverted nipples are difficult or impossible to pull out/evert.
True
False - correct answer-T
You can tell looking at a nipple at rest how it will function.
True
False - correct answer-F
One concern about Grade 3 inverted nipples involves:
Prolactin levels
Oversupply issues
Engorgement
All of the above - correct answer-Prolactin levels (decreased nipple stroking/stretching)
Almost all mothers have grade 3 inverted nipples.
True
False - correct answer-F
Prenatal nipple preparation should be recommended for all women. True
False - correct answer-F
No research supports, in fact research showed that the non-treatment group BF for longer
duration
Jo Alexander's research indicates that 1 out of 5 women have inverted nipples.
True
False - correct answer-F
3/5 mothers has inverted nipples.
The best way to prepare and inverted nipple for breastfeeding is: Doing nothing to the nipple
during pregnancy
Stretching the nipple and areola during pregnancy
Using a breast shell during pregnancy
Stretching the nipple and using a breast shell during pregnancy - correct answer-Doing
nothing to the nipple during pregnancy
The women who used a breast shell had the best breastfeeding outcomes at 6 weeks in the
Alexander study.
True
False - correct answer-F
The Alexander study has implications for postpartum care. Sometimes true
Always true
Sometimes false
