IBCLC COMPLETE QUESTIONS AND
ANSWERS (VERIFIED)
Milk Lines - ANSWER>>Two glandular tissue lines that extend from axilla to medial thigh;
beginning of breast development. Become ridges that eventually become breasts, normally the
remainder of the lines regress
Witches Milk - ANSWER>>resulting from maternal hormones that cross the placenta, newborn
breasts can secrete a milk like substance following birth
Thelarche - ANSWER>>breast development
Glandular tissue - ANSWER>>Comprised of the lobes of the breast, average of 9 per breast
Axillary tail - ANSWER>>lobes that extend toward the axilla
Alveolus - ANSWER>>Functional unit that produces and stores milk. Found in grape-like clusters
called lobules
Lactocytes - ANSWER>>Columnar secretory cells that line the alveolus. Synthesize milk
Paracellular pathway - ANSWER>>transport of molecules between the tight junction of cells.
These are not closed tightly in the first few days following birth, allowing larger molecules
in(sodium, chloride, medications etc). Therefore colostrum (and milk during mastitis and
weaning) is saltier
Myoepithelial cells - ANSWER>>Muscle cells surrounding the alveolus. Respond to oxytocin by
contracting and ejecting milk into lumen
Montgomery's follicules/tubules - ANSWER>>Sebaceous glands found near the areola. Enlarge
during pregnancy and lactation. Provide lubrication, antimicrobial factors, and elicit odors for
preferential head orientation by infant
Internal Mammary Artery - ANSWER>>62-70% of blood supply to the breasts
,Breast Nerve Supply - ANSWER>>Branches 4,5, and 6 of intercostal nerves. Lowermost branch
of the 4th intercostal nerve becomes more superficial near the breast
Milk Ejection Reflex - ANSWER>>1.Stimulation of nipple
2. Nerve impulse travels to hypothalamus
3. Causes release of oxytocin from posterior pituitary gland
4. Prolactin is released from anterior pituitary gland
5. Myoepithelial cells contract in response to oxytocin
6. Milk is forced into ductal system
Oxytocin - ANSWER>>Initiated MER, causes uterine contractility decreasing PPH, increases
breast temperature to help keep infant warm, decreases anxiety/increased calmness, causes
thirst
Released in pulses with suckling. Levels rise within one minute of suckling and return to
baseline within 6 minutes of cessation of suckling
Coopers Ligaments - ANSWER>>Loose structure of connective tissue providing support for
glandular and fatty tissue
hyperadenia/polymastia/hypermastia - ANSWER>>Presence of additional mammary tissue with
or without nipples, most commonly at the axilla. No anatomical connection to the breasts. May
become engorged at lactation (Tx with NSAIDs, ice packs)
Polythelia - ANSWER>>Extra nipples with no associated breast tissue
Hyperplasia - ANSWER>>over developed breasts
Hypoplasia - ANSWER>>restricted breast development. Wide inter-mammary spaces.
Galactorrhea - ANSWER>>breast milk secretion not associated with breastfeeding
Intraductal Papillomatosis - ANSWER>>abnormal proliferation of cells supported by a vascular
stalk in mammary ducts. Stalk can rupture with slight trauma leading to bloody discharge.
Benign.
Secretory Differentiation/Lactogenesis I - ANSWER>>mammary epithelial cells of the alveoli
differentiate into lactocytes capable of synthesizing breast milk
, Secretory Activation/Lactogenesis II - ANSWER>>Initiation of copious milk secretion
Galactopoesis/Lactogenesis III - ANSWER>>Maintenance of Lactation
Colostrum - ANSWER>>High concentrations of sodium, chloride, protein, immunoglobulins,
lactoferrin.
It is believed that in the first two days an infant has greater need for immune protection than
volume, until the kidneys can excrete the excess fluid present from birth
Lactose in colostrum - ANSWER>>Lactose escapes from milk when paracellular pathway is open
into the blood stream. Cannot be metabolized by the mother and is therefore excreted in her
urine.
Breast milk following start of LGII - ANSWER>>Decrease in total sodium and total protein.
Increase in lactose and citrate. Occurs 30-40 hours after delivery of placenta.
Lactose secretion by lactocyte increases, extra fluid is drawn into alveolus with it by osmotic
transfer
Hormonally driven, women will lactate regardless of breastfeeding status
Breastfeeding during pregnancy - ANSWER>>Breastfeeding is under autocrine control.
increased progesterone has no affect on breast milk secretion
Preglandular lactation insufficiency - ANSWER>>Absent hormone function
Glandular lactation insufficiency - ANSWER>>abnormal breast structure
Postglandular lactation insufficiency - ANSWER>>poor breastfeeding management
Reasons for suppressed prolactin - ANSWER>>May be as a result of pharmacological
(cabergoline, bromocriptine) Sheehan's Syndrome, or a genetic absence of prolactin
Functional Retained Placenta - ANSWER>>Higher levels of progesterone with no imitation of
LGII
Delayed secretory activation - ANSWER>>absence of noticeable fullness/heaviness by 72 hours
postpartum
ANSWERS (VERIFIED)
Milk Lines - ANSWER>>Two glandular tissue lines that extend from axilla to medial thigh;
beginning of breast development. Become ridges that eventually become breasts, normally the
remainder of the lines regress
Witches Milk - ANSWER>>resulting from maternal hormones that cross the placenta, newborn
breasts can secrete a milk like substance following birth
Thelarche - ANSWER>>breast development
Glandular tissue - ANSWER>>Comprised of the lobes of the breast, average of 9 per breast
Axillary tail - ANSWER>>lobes that extend toward the axilla
Alveolus - ANSWER>>Functional unit that produces and stores milk. Found in grape-like clusters
called lobules
Lactocytes - ANSWER>>Columnar secretory cells that line the alveolus. Synthesize milk
Paracellular pathway - ANSWER>>transport of molecules between the tight junction of cells.
These are not closed tightly in the first few days following birth, allowing larger molecules
in(sodium, chloride, medications etc). Therefore colostrum (and milk during mastitis and
weaning) is saltier
Myoepithelial cells - ANSWER>>Muscle cells surrounding the alveolus. Respond to oxytocin by
contracting and ejecting milk into lumen
Montgomery's follicules/tubules - ANSWER>>Sebaceous glands found near the areola. Enlarge
during pregnancy and lactation. Provide lubrication, antimicrobial factors, and elicit odors for
preferential head orientation by infant
Internal Mammary Artery - ANSWER>>62-70% of blood supply to the breasts
,Breast Nerve Supply - ANSWER>>Branches 4,5, and 6 of intercostal nerves. Lowermost branch
of the 4th intercostal nerve becomes more superficial near the breast
Milk Ejection Reflex - ANSWER>>1.Stimulation of nipple
2. Nerve impulse travels to hypothalamus
3. Causes release of oxytocin from posterior pituitary gland
4. Prolactin is released from anterior pituitary gland
5. Myoepithelial cells contract in response to oxytocin
6. Milk is forced into ductal system
Oxytocin - ANSWER>>Initiated MER, causes uterine contractility decreasing PPH, increases
breast temperature to help keep infant warm, decreases anxiety/increased calmness, causes
thirst
Released in pulses with suckling. Levels rise within one minute of suckling and return to
baseline within 6 minutes of cessation of suckling
Coopers Ligaments - ANSWER>>Loose structure of connective tissue providing support for
glandular and fatty tissue
hyperadenia/polymastia/hypermastia - ANSWER>>Presence of additional mammary tissue with
or without nipples, most commonly at the axilla. No anatomical connection to the breasts. May
become engorged at lactation (Tx with NSAIDs, ice packs)
Polythelia - ANSWER>>Extra nipples with no associated breast tissue
Hyperplasia - ANSWER>>over developed breasts
Hypoplasia - ANSWER>>restricted breast development. Wide inter-mammary spaces.
Galactorrhea - ANSWER>>breast milk secretion not associated with breastfeeding
Intraductal Papillomatosis - ANSWER>>abnormal proliferation of cells supported by a vascular
stalk in mammary ducts. Stalk can rupture with slight trauma leading to bloody discharge.
Benign.
Secretory Differentiation/Lactogenesis I - ANSWER>>mammary epithelial cells of the alveoli
differentiate into lactocytes capable of synthesizing breast milk
, Secretory Activation/Lactogenesis II - ANSWER>>Initiation of copious milk secretion
Galactopoesis/Lactogenesis III - ANSWER>>Maintenance of Lactation
Colostrum - ANSWER>>High concentrations of sodium, chloride, protein, immunoglobulins,
lactoferrin.
It is believed that in the first two days an infant has greater need for immune protection than
volume, until the kidneys can excrete the excess fluid present from birth
Lactose in colostrum - ANSWER>>Lactose escapes from milk when paracellular pathway is open
into the blood stream. Cannot be metabolized by the mother and is therefore excreted in her
urine.
Breast milk following start of LGII - ANSWER>>Decrease in total sodium and total protein.
Increase in lactose and citrate. Occurs 30-40 hours after delivery of placenta.
Lactose secretion by lactocyte increases, extra fluid is drawn into alveolus with it by osmotic
transfer
Hormonally driven, women will lactate regardless of breastfeeding status
Breastfeeding during pregnancy - ANSWER>>Breastfeeding is under autocrine control.
increased progesterone has no affect on breast milk secretion
Preglandular lactation insufficiency - ANSWER>>Absent hormone function
Glandular lactation insufficiency - ANSWER>>abnormal breast structure
Postglandular lactation insufficiency - ANSWER>>poor breastfeeding management
Reasons for suppressed prolactin - ANSWER>>May be as a result of pharmacological
(cabergoline, bromocriptine) Sheehan's Syndrome, or a genetic absence of prolactin
Functional Retained Placenta - ANSWER>>Higher levels of progesterone with no imitation of
LGII
Delayed secretory activation - ANSWER>>absence of noticeable fullness/heaviness by 72 hours
postpartum
