ALPP CLC EXAM 2025 CERTIFIED LACTATION COUNSELOR
REAL/AUTHENTIC PROCTORED EXAM COMPLETE 3
VERSIONS EXAM EACH 100 QUESTIONS GRADED A+ (300
QUESTIONS)
1
Which hormone is primarily responsible for milk production in the mammary
glands?
A) Estrogen
B) Progesterone
C) Oxytocin
D) Prolactin
E) Human Chorionic Gonadotropin (hCG)
Correct Answer: D) Prolactin
Rationale: Prolactin is the hormone released from the anterior
pituitary gland that stimulates the alveolar cells in the breast to
produce milk.
2
Which hormone is responsible for the milk ejection reflex (let-down)?
A) Prolactin
B) Estrogen
C) Oxytocin
D) Progesterone
E) Luteinizing Hormone (LH)
Correct Answer: C) Oxytocin
Rationale: Oxytocin, released from the posterior pituitary gland,
causes the myoepithelial cells around the alveoli to contract,
pushing milk through the ducts toward the nipple.
3
During which stage of lactogenesis do the breasts begin to produce
colostrum?
A) Lactogenesis I
B) Lactogenesis II
,C) Lactogenesis III
D) Involution
E) Galactopoiesis
Correct Answer: A) Lactogenesis I
Rationale: Lactogenesis I begins around mid-pregnancy (16-20 weeks
gestation) with the differentiation of alveolar cells and the
production of colostrum, though milk secretion is inhibited by high
progesterone levels.
4
A mother states her baby is 3 days old and has had one wet diaper in the last
24 hours. What is the most appropriate initial recommendation for the CLC to
make?
A) Advise immediate supplementation with formula.
B) Recommend waking the baby to feed more frequently, at least 8-12 times
in 24 hours.
C) Suggest using a breast pump to increase milk supply.
D) Tell the mother that this is normal for a 3-day-old.
E) Refer the mother to a pediatric gastroenterologist.
Correct Answer: B) Recommend waking the baby to feed more
frequently, at least 8-12 times in 24 hours.
Rationale: A 3-day-old infant should have at least 3-4 wet diapers in
24 hours. Infrequent voiding suggests insufficient milk intake.
Increasing feeding frequency is crucial to stimulate milk supply and
ensure adequate intake.
5
What is the primary benefit of colostrum for a newborn?
A) It contains high levels of fat for rapid weight gain.
B) It acts as a laxative, helping the baby pass meconium.
C) It is rich in antibodies and immune factors to protect against infection.
D) It helps to regulate the baby's body temperature.
,E) It is a clear fluid that prevents jaundice.
Correct Answer: C) It is rich in antibodies and immune factors to
protect against infection.
Rationale: Colostrum is often called "liquid gold" due to its high
concentration of immunoglobulins (especially IgA), white blood
cells, and other protective factors that provide passive immunity to
the newborn.
6
Which of the following is an ideal indicator of a good latch?
A) The baby's lips are tucked in.
B) The baby's cheeks are dimpling inwards.
C) The baby's mouth is wide open, covering a significant portion of the
areola.
D) The mother feels pain throughout the feeding.
E) The baby makes loud clicking sounds.
Correct Answer: C) The baby's mouth is wide open, covering a
significant portion of the areola.
Rationale: A wide gape allows the baby to take in enough breast
tissue for effective milk transfer. Lips should be flanged outwards,
no dimpling, and feeding should be comfortable for the mother.
7
A mother complains of severe, sharp, shooting pain in her breast during and
after feedings, with glossy, flaky nipples. What might the CLC suspect?
A) Engorgement
B) Mastitis
C) Thrush (Candida infection)
D) Plugged duct
E) Raynaud's phenomenon
Correct Answer: C) Thrush (Candida infection)
Rationale: Sharp, shooting pain, especially radiating into the breast,
, along with flaky or glossy nipples, are classic signs of a Candida
albicans (thrush) infection in both mother and baby. The baby may
also have white patches in their mouth.
8
What is the recommended duration of exclusive breastfeeding, according to
the World Health Organization (WHO)?
A) Until 3 months of age
B) Until 4 months of age
C) Until 6 months of age
D) Until 12 months of age
E) Until 24 months of age
Correct Answer: C) Until 6 months of age
Rationale: The WHO recommends exclusive breastfeeding for the first
six months of life, followed by continued breastfeeding with
appropriate complementary foods for up to two years or beyond.
9
A new mother is concerned her 5-day-old baby is not getting enough milk.
What is the least reliable indicator of adequate milk intake?
A) The baby has 6-8 wet diapers in 24 hours.
B) The baby has 3-4 bowel movements (yellow and seedy) in 24 hours.
C) The baby seems satisfied and falls asleep at the breast.
D) The baby is gaining weight appropriately.
E) The mother feels a strong let-down sensation.
Correct Answer: E) The mother feels a strong let-down sensation.
Rationale: While many mothers feel let-down, some do not, and the
intensity of the sensation does not directly correlate with the
amount of milk transferred to the baby. Objective measures like
wet/dirty diapers and weight gain are more reliable.
10
Which feeding position is often recommended for mothers who have had a C-
REAL/AUTHENTIC PROCTORED EXAM COMPLETE 3
VERSIONS EXAM EACH 100 QUESTIONS GRADED A+ (300
QUESTIONS)
1
Which hormone is primarily responsible for milk production in the mammary
glands?
A) Estrogen
B) Progesterone
C) Oxytocin
D) Prolactin
E) Human Chorionic Gonadotropin (hCG)
Correct Answer: D) Prolactin
Rationale: Prolactin is the hormone released from the anterior
pituitary gland that stimulates the alveolar cells in the breast to
produce milk.
2
Which hormone is responsible for the milk ejection reflex (let-down)?
A) Prolactin
B) Estrogen
C) Oxytocin
D) Progesterone
E) Luteinizing Hormone (LH)
Correct Answer: C) Oxytocin
Rationale: Oxytocin, released from the posterior pituitary gland,
causes the myoepithelial cells around the alveoli to contract,
pushing milk through the ducts toward the nipple.
3
During which stage of lactogenesis do the breasts begin to produce
colostrum?
A) Lactogenesis I
B) Lactogenesis II
,C) Lactogenesis III
D) Involution
E) Galactopoiesis
Correct Answer: A) Lactogenesis I
Rationale: Lactogenesis I begins around mid-pregnancy (16-20 weeks
gestation) with the differentiation of alveolar cells and the
production of colostrum, though milk secretion is inhibited by high
progesterone levels.
4
A mother states her baby is 3 days old and has had one wet diaper in the last
24 hours. What is the most appropriate initial recommendation for the CLC to
make?
A) Advise immediate supplementation with formula.
B) Recommend waking the baby to feed more frequently, at least 8-12 times
in 24 hours.
C) Suggest using a breast pump to increase milk supply.
D) Tell the mother that this is normal for a 3-day-old.
E) Refer the mother to a pediatric gastroenterologist.
Correct Answer: B) Recommend waking the baby to feed more
frequently, at least 8-12 times in 24 hours.
Rationale: A 3-day-old infant should have at least 3-4 wet diapers in
24 hours. Infrequent voiding suggests insufficient milk intake.
Increasing feeding frequency is crucial to stimulate milk supply and
ensure adequate intake.
5
What is the primary benefit of colostrum for a newborn?
A) It contains high levels of fat for rapid weight gain.
B) It acts as a laxative, helping the baby pass meconium.
C) It is rich in antibodies and immune factors to protect against infection.
D) It helps to regulate the baby's body temperature.
,E) It is a clear fluid that prevents jaundice.
Correct Answer: C) It is rich in antibodies and immune factors to
protect against infection.
Rationale: Colostrum is often called "liquid gold" due to its high
concentration of immunoglobulins (especially IgA), white blood
cells, and other protective factors that provide passive immunity to
the newborn.
6
Which of the following is an ideal indicator of a good latch?
A) The baby's lips are tucked in.
B) The baby's cheeks are dimpling inwards.
C) The baby's mouth is wide open, covering a significant portion of the
areola.
D) The mother feels pain throughout the feeding.
E) The baby makes loud clicking sounds.
Correct Answer: C) The baby's mouth is wide open, covering a
significant portion of the areola.
Rationale: A wide gape allows the baby to take in enough breast
tissue for effective milk transfer. Lips should be flanged outwards,
no dimpling, and feeding should be comfortable for the mother.
7
A mother complains of severe, sharp, shooting pain in her breast during and
after feedings, with glossy, flaky nipples. What might the CLC suspect?
A) Engorgement
B) Mastitis
C) Thrush (Candida infection)
D) Plugged duct
E) Raynaud's phenomenon
Correct Answer: C) Thrush (Candida infection)
Rationale: Sharp, shooting pain, especially radiating into the breast,
, along with flaky or glossy nipples, are classic signs of a Candida
albicans (thrush) infection in both mother and baby. The baby may
also have white patches in their mouth.
8
What is the recommended duration of exclusive breastfeeding, according to
the World Health Organization (WHO)?
A) Until 3 months of age
B) Until 4 months of age
C) Until 6 months of age
D) Until 12 months of age
E) Until 24 months of age
Correct Answer: C) Until 6 months of age
Rationale: The WHO recommends exclusive breastfeeding for the first
six months of life, followed by continued breastfeeding with
appropriate complementary foods for up to two years or beyond.
9
A new mother is concerned her 5-day-old baby is not getting enough milk.
What is the least reliable indicator of adequate milk intake?
A) The baby has 6-8 wet diapers in 24 hours.
B) The baby has 3-4 bowel movements (yellow and seedy) in 24 hours.
C) The baby seems satisfied and falls asleep at the breast.
D) The baby is gaining weight appropriately.
E) The mother feels a strong let-down sensation.
Correct Answer: E) The mother feels a strong let-down sensation.
Rationale: While many mothers feel let-down, some do not, and the
intensity of the sensation does not directly correlate with the
amount of milk transferred to the baby. Objective measures like
wet/dirty diapers and weight gain are more reliable.
10
Which feeding position is often recommended for mothers who have had a C-
