CLC EXAM 2024 /QUESTIONS WITH 100 % CORRECT
ANSWERS FOR REVISION USE/24/25
1. Which milk is higher in calories - hand expressed milk or pumped
milk?: -
Hand expressed milk
2. Define: Exclusive breastfeeding: Infant receives only mother's milk as its food
source, from 0-6 months
3. What is the only absolute infant contraindication to
breastfeeding?: galac- tosemia
4. Can infants with PKU breastfeed?: Yes, but they need formula supplementation
5. Define: Complementary feeding: Receiving both human milk and solids/semi-
solids. From 6-23 months
6. 9 stages of the first hour after birth: 1. Birth cry
2. Relaxation
3. Awakening
4. Activity
5. Rest (interspersed throughout)
6. Crawling
7. Familiarization
8. Suckling
9. Sleeping
7. Is crying an early or late feeding cute?: Late
8. Clenched hands are a sign that baby...: ... is hungry!
9. When is the fastest drop-off point when people stop breastfeeding?: In the
first 10 days after discharge from hospital
10.What triggers oxytocin pathway to milk production?: 1. Conditioned
let-down reflex (smell, touch, sound)
2. Nipple stretching
3. Baby hand massage
,11.What are the two hormone pathways for milk production?: Oxytocin and
Prolactin
12.How does fat, protein and water content affect the frequency of feedings
between different mammal species?: High fat, high protein, low water = infrequent
feeds
High water = more frequent feeds
13.When does Lactogenesis II start?: complete delivery of the placenta
14.How does preterm milk differ from term milk?: Generally higher in protein,
fat and electrolytes
15. How long does preterm milk production last?: 5-7 weeks
16.Which has higher fat content: hindmilk or foremilk?: Neither. Some say
hindmilk is highest in fat - but this is not supported by research and shouldn't be a
part of counseling
17.Which hormone(s) drive the production of colostrum and where do
they come from?: Progesterone from the placenta
18.Which hormone(s) drive the production of transitional milk and where
do they come from?: Progesterone - left from the placenta and is rapidly dropping
Prolactin - generally already circulating, not yet being released by nipple
stimulation
19.Which hormone(s) drive the production of mature milk and where do
they come from?: Prolactin - comes from nipple stimulation in feeding
20.Describe paracellular vs transcellular pathways: Paracellular: during prog-
esterone-driven lactogenesis, there is free flow of blood/nutrients/etc between milk
cells, increased permeability to some drugs
Transcellular pathway: during prolactin-driven lactogenesis, milk cells
are larger with no pathways between them, which yields more safety
from substances
21.Name 5 instances when breastmilk composition changes: 1. over the
course of entire lactation experience
, 2. time of day (higher caloric concentration at night)
3. within a feeding
4. between feedings (sooner feedings = higher fat content)
5. baby sex (male infants are linked with 25% greater energy content)
22.What does "Four on Four" mean?: Baby should have at least 4 soiled diapers a
day by day 4 - in conjunction with delayed onset of lactation, less than that may indicate
breastfeeding inadequacy
23.What affect does pH of breastmilk have on baby?: pH of breastmilk is lower
(more acidic), which lowers pH in baby's gut and makes it less hospitable for bad bacteria
24.What affect does iron content in breastmilk have on baby?: Breastmilk is
lower in iron, which means less ideal environment for shigella, C.diff, salmonella
25.What is the bifidus factor?: Bifidus factor is a factor secreted in breast milk that
helps promote growth of good bacteria Lactobacillis bifidus and thus crowds out the bad
bacteria
26.What is the importance of maternal IgA in breastmilk?: Prevents NEC by
binding to microbes in the GI tract and preventing them from being absorbed
27.What does the presence of B12 binding factor in breastmilk do for
baby?-
: Reduces the amount of B12 available in baby's gut, which is a key
nutrient for bad bacteria
28.What do human milk oligosaccharides (HMOs) do?: They mimic intestinal
epithelial docking sites and bind to pathogens so they can't bind to the body - are then
excreted
Notable in helping prevent otitis media, UTIs, decreases risk of
asthma/allergies, and possibly protective against digestive diseases
and obesity
ANSWERS FOR REVISION USE/24/25
1. Which milk is higher in calories - hand expressed milk or pumped
milk?: -
Hand expressed milk
2. Define: Exclusive breastfeeding: Infant receives only mother's milk as its food
source, from 0-6 months
3. What is the only absolute infant contraindication to
breastfeeding?: galac- tosemia
4. Can infants with PKU breastfeed?: Yes, but they need formula supplementation
5. Define: Complementary feeding: Receiving both human milk and solids/semi-
solids. From 6-23 months
6. 9 stages of the first hour after birth: 1. Birth cry
2. Relaxation
3. Awakening
4. Activity
5. Rest (interspersed throughout)
6. Crawling
7. Familiarization
8. Suckling
9. Sleeping
7. Is crying an early or late feeding cute?: Late
8. Clenched hands are a sign that baby...: ... is hungry!
9. When is the fastest drop-off point when people stop breastfeeding?: In the
first 10 days after discharge from hospital
10.What triggers oxytocin pathway to milk production?: 1. Conditioned
let-down reflex (smell, touch, sound)
2. Nipple stretching
3. Baby hand massage
,11.What are the two hormone pathways for milk production?: Oxytocin and
Prolactin
12.How does fat, protein and water content affect the frequency of feedings
between different mammal species?: High fat, high protein, low water = infrequent
feeds
High water = more frequent feeds
13.When does Lactogenesis II start?: complete delivery of the placenta
14.How does preterm milk differ from term milk?: Generally higher in protein,
fat and electrolytes
15. How long does preterm milk production last?: 5-7 weeks
16.Which has higher fat content: hindmilk or foremilk?: Neither. Some say
hindmilk is highest in fat - but this is not supported by research and shouldn't be a
part of counseling
17.Which hormone(s) drive the production of colostrum and where do
they come from?: Progesterone from the placenta
18.Which hormone(s) drive the production of transitional milk and where
do they come from?: Progesterone - left from the placenta and is rapidly dropping
Prolactin - generally already circulating, not yet being released by nipple
stimulation
19.Which hormone(s) drive the production of mature milk and where do
they come from?: Prolactin - comes from nipple stimulation in feeding
20.Describe paracellular vs transcellular pathways: Paracellular: during prog-
esterone-driven lactogenesis, there is free flow of blood/nutrients/etc between milk
cells, increased permeability to some drugs
Transcellular pathway: during prolactin-driven lactogenesis, milk cells
are larger with no pathways between them, which yields more safety
from substances
21.Name 5 instances when breastmilk composition changes: 1. over the
course of entire lactation experience
, 2. time of day (higher caloric concentration at night)
3. within a feeding
4. between feedings (sooner feedings = higher fat content)
5. baby sex (male infants are linked with 25% greater energy content)
22.What does "Four on Four" mean?: Baby should have at least 4 soiled diapers a
day by day 4 - in conjunction with delayed onset of lactation, less than that may indicate
breastfeeding inadequacy
23.What affect does pH of breastmilk have on baby?: pH of breastmilk is lower
(more acidic), which lowers pH in baby's gut and makes it less hospitable for bad bacteria
24.What affect does iron content in breastmilk have on baby?: Breastmilk is
lower in iron, which means less ideal environment for shigella, C.diff, salmonella
25.What is the bifidus factor?: Bifidus factor is a factor secreted in breast milk that
helps promote growth of good bacteria Lactobacillis bifidus and thus crowds out the bad
bacteria
26.What is the importance of maternal IgA in breastmilk?: Prevents NEC by
binding to microbes in the GI tract and preventing them from being absorbed
27.What does the presence of B12 binding factor in breastmilk do for
baby?-
: Reduces the amount of B12 available in baby's gut, which is a key
nutrient for bad bacteria
28.What do human milk oligosaccharides (HMOs) do?: They mimic intestinal
epithelial docking sites and bind to pathogens so they can't bind to the body - are then
excreted
Notable in helping prevent otitis media, UTIs, decreases risk of
asthma/allergies, and possibly protective against digestive diseases
and obesity
