PCE Certified Breastfeeding Counselor
Exam 2025/2026 Actual Verified Questions
with Correct Detailed Answers | A+
Guaranteed
Question 1 The most appropriate time to initiate skin-to-skin contact after birth is: A. After the
first bath B. Within the first hour of life (golden hour) C. Only if the baby is alert D. After the
vitamin K injection
Answer: B. Within the first hour of life (golden hour) Rationale: Skin-to-skin contact
immediately after birth promotes the first breastfeeding within the first hour, stabilizes the baby’s
temperature, heart rate, and blood sugar, and increases oxytocin release for both mother and baby
(WHO and Baby-Friendly Hospital Initiative recommendation).
Question 2 Which hormone is primarily responsible for milk ejection (let-down reflex)? A.
Prolactin B. Oxytocin C. Estrogen D. Progesterone
Answer: B. Oxytocin Rationale: Oxytocin, released from the posterior pituitary, causes
contraction of myoepithelial cells around the alveoli, resulting in milk ejection. Prolactin is
responsible for milk production.
Question 3 A mother reports her 2-week-old baby is nursing 8–12 times per day. This frequency
is: A. Too frequent – should be limited to 6–8 feeds B. Normal and appropriate C. Too
infrequent – baby should feed every 2 hours D. Concerning for inadequate milk supply
Answer: B. Normal and appropriate Rationale: Newborns typically nurse 8–12 times or more
in 24 hours. Frequent feeding is essential to establish and maintain milk supply and supports
normal weight gain.
Question 4 The most effective way to increase milk supply is: A. Supplementing with formula
after each feed B. Increasing the frequency and/or duration of breastfeeding/pumping C. Taking
fenugreek supplements D. Drinking large amounts of water
Answer: B. Increasing the frequency and/or duration of breastfeeding/pumping Rationale:
Milk supply works on supply-and-demand principle. The more milk removed, the more milk is
produced.
Question 5 A mother asks how to know if her baby is getting enough milk. The best indicator is:
A. The baby has 6–8 wet diapers per day after day 5 B. The baby sleeps for 4 hours between
feeds C. The baby’s cheeks look full after feeding D. The mother feels let-down every feed
, Answer: A. The baby has 6–8 wet diapers per day after day 5 Rationale: Adequate wet
diapers (clear/pale urine) and appropriate number of stools are the most reliable objective signs
of sufficient intake.
Question 6 The most common cause of sore nipples in the first week is: A. Thrush B. Poor
latch/positioning C. Mastitis D. Engorgement
Answer: B. Poor latch/positioning Rationale: Incorrect latch is the leading cause of nipple
pain/trauma in early breastfeeding.
Question 7 A mother reports her 3-week-old has green, frothy stools and is very gassy. This is
most likely due to: A. Foremilk/hindmilk imbalance B. Cow’s milk protein allergy C. Lactose
overload D. Normal newborn stool pattern
Answer: A. Foremilk/hindmilk imbalance Rationale: Too much foremilk (high lactose) and
not enough hindmilk (high fat) causes rapid transit, green frothy stools, and gas.
Question 8 The best way to resolve foremilk/hindmilk imbalance is: A. Switch to formula B.
Pump and dump before feeds C. Feed from one breast per feeding until the baby is satisfied D.
Give the baby water between feeds Answer: C. Feed from one breast per feeding until the
baby is satisfied Rationale: Allows baby to receive more hindmilk from the same breast.
Question 9 A mother with a 4-week-old reports painful feeding and a white patch on the baby’s
tongue. This is most likely: A. Milk residue B. Thrush (oral candidiasis) C. Geographic tongue
D. Normal newborn tongue appearance Answer: B. Thrush (oral candidiasis) Rationale:
Classic white plaques that do not wipe off easily; mother may also have burning nipples (yeast
infection).
Question 10 The most appropriate first-line treatment for thrush in a breastfeeding dyad is: A.
Nystatin oral suspension for baby and fluconazole for mother B. Gentian violet for both C. Stop
breastfeeding for 48 hours D. Miconazole cream for baby only Answer: A. Nystatin oral
suspension for baby and fluconazole for mother Rationale: Treats both baby and mother
simultaneously to prevent reinfection.
Question 11 A mother reports her breasts feel full and painful 3 days postpartum. This is most
likely: A. Mastitis B. Engorgement C. Blocked duct D. Breast abscess Answer: B.
Engorgement Rationale: Physiologic breast fullness occurs around days 3–5 due to milk volume
increase.
Question 12 The best management for breast engorgement is: A. Apply cold packs and limit
feeds B. Frequent breastfeeding or pumping C. Stop breastfeeding until resolved D. Use a breast
pump only Answer: B. Frequent breastfeeding or pumping Rationale: Removal of milk is the
most effective treatment.
Question 13 A mother with mastitis should be advised to: A. Stop breastfeeding on the affected
side B. Continue breastfeeding or pumping frequently C. Apply heat only after feeds D. Take
Exam 2025/2026 Actual Verified Questions
with Correct Detailed Answers | A+
Guaranteed
Question 1 The most appropriate time to initiate skin-to-skin contact after birth is: A. After the
first bath B. Within the first hour of life (golden hour) C. Only if the baby is alert D. After the
vitamin K injection
Answer: B. Within the first hour of life (golden hour) Rationale: Skin-to-skin contact
immediately after birth promotes the first breastfeeding within the first hour, stabilizes the baby’s
temperature, heart rate, and blood sugar, and increases oxytocin release for both mother and baby
(WHO and Baby-Friendly Hospital Initiative recommendation).
Question 2 Which hormone is primarily responsible for milk ejection (let-down reflex)? A.
Prolactin B. Oxytocin C. Estrogen D. Progesterone
Answer: B. Oxytocin Rationale: Oxytocin, released from the posterior pituitary, causes
contraction of myoepithelial cells around the alveoli, resulting in milk ejection. Prolactin is
responsible for milk production.
Question 3 A mother reports her 2-week-old baby is nursing 8–12 times per day. This frequency
is: A. Too frequent – should be limited to 6–8 feeds B. Normal and appropriate C. Too
infrequent – baby should feed every 2 hours D. Concerning for inadequate milk supply
Answer: B. Normal and appropriate Rationale: Newborns typically nurse 8–12 times or more
in 24 hours. Frequent feeding is essential to establish and maintain milk supply and supports
normal weight gain.
Question 4 The most effective way to increase milk supply is: A. Supplementing with formula
after each feed B. Increasing the frequency and/or duration of breastfeeding/pumping C. Taking
fenugreek supplements D. Drinking large amounts of water
Answer: B. Increasing the frequency and/or duration of breastfeeding/pumping Rationale:
Milk supply works on supply-and-demand principle. The more milk removed, the more milk is
produced.
Question 5 A mother asks how to know if her baby is getting enough milk. The best indicator is:
A. The baby has 6–8 wet diapers per day after day 5 B. The baby sleeps for 4 hours between
feeds C. The baby’s cheeks look full after feeding D. The mother feels let-down every feed
, Answer: A. The baby has 6–8 wet diapers per day after day 5 Rationale: Adequate wet
diapers (clear/pale urine) and appropriate number of stools are the most reliable objective signs
of sufficient intake.
Question 6 The most common cause of sore nipples in the first week is: A. Thrush B. Poor
latch/positioning C. Mastitis D. Engorgement
Answer: B. Poor latch/positioning Rationale: Incorrect latch is the leading cause of nipple
pain/trauma in early breastfeeding.
Question 7 A mother reports her 3-week-old has green, frothy stools and is very gassy. This is
most likely due to: A. Foremilk/hindmilk imbalance B. Cow’s milk protein allergy C. Lactose
overload D. Normal newborn stool pattern
Answer: A. Foremilk/hindmilk imbalance Rationale: Too much foremilk (high lactose) and
not enough hindmilk (high fat) causes rapid transit, green frothy stools, and gas.
Question 8 The best way to resolve foremilk/hindmilk imbalance is: A. Switch to formula B.
Pump and dump before feeds C. Feed from one breast per feeding until the baby is satisfied D.
Give the baby water between feeds Answer: C. Feed from one breast per feeding until the
baby is satisfied Rationale: Allows baby to receive more hindmilk from the same breast.
Question 9 A mother with a 4-week-old reports painful feeding and a white patch on the baby’s
tongue. This is most likely: A. Milk residue B. Thrush (oral candidiasis) C. Geographic tongue
D. Normal newborn tongue appearance Answer: B. Thrush (oral candidiasis) Rationale:
Classic white plaques that do not wipe off easily; mother may also have burning nipples (yeast
infection).
Question 10 The most appropriate first-line treatment for thrush in a breastfeeding dyad is: A.
Nystatin oral suspension for baby and fluconazole for mother B. Gentian violet for both C. Stop
breastfeeding for 48 hours D. Miconazole cream for baby only Answer: A. Nystatin oral
suspension for baby and fluconazole for mother Rationale: Treats both baby and mother
simultaneously to prevent reinfection.
Question 11 A mother reports her breasts feel full and painful 3 days postpartum. This is most
likely: A. Mastitis B. Engorgement C. Blocked duct D. Breast abscess Answer: B.
Engorgement Rationale: Physiologic breast fullness occurs around days 3–5 due to milk volume
increase.
Question 12 The best management for breast engorgement is: A. Apply cold packs and limit
feeds B. Frequent breastfeeding or pumping C. Stop breastfeeding until resolved D. Use a breast
pump only Answer: B. Frequent breastfeeding or pumping Rationale: Removal of milk is the
most effective treatment.
Question 13 A mother with mastitis should be advised to: A. Stop breastfeeding on the affected
side B. Continue breastfeeding or pumping frequently C. Apply heat only after feeds D. Take
