IBCLC EXAM QUESTIONS AND
ANSWERS GRADED A+ 2025/2026
When does the breast begin to develop in utero? - ANS 4th week of gestation
Where does the primitive milk streak develop - ANS Bilaterally from the axilla to the groin
By the 5th week gestation the milk streak becomes what? - ANS Mammary Milk Ridge (or
milk line)
Thickening and inward growth into the chest wall continues during what weeks gestation? -
ANS 7-8 weeks gestation
Between weeks 12 and 16 gestation specialized cells differentiate into what? - ANS Smooth
muscles of the nipple and areola
What forms the mammary pit? - ANS Lactiferous ducts and their branches open into a
shallow epithelial depression
What creates an inverted nipple? - ANS When the Mammary pit fails to elevate
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,What is witches milk? - ANS After birth, a neonate's mammary tissue (under the influence of
maternal hormones) might recreate colostral like fluid
At what age do the primary and secondary ducts grow and divide and form the terminal end
buds that become the alveoli? - ANS 10-12 years old
When does complete development of mammary function occur? - ANS During pregnancy
What is superficial fiscia? - ANS Fibrous tissue beneath the skin
Where is the breast located? - ANS In the superficial fascia between the second rib and sixth
intercostal space
What are the two major divisions of the breast? - ANS Parenchyma and Stroma
What makes up the Parenchyma? - ANS Ducts, lobes, and aveoli
What are alveoli? - ANS Small sacs where milk is secreted
What makes up the Stroma? - ANS Connective tissue, fat tissue, blood vessels, nerves, and
lymphatics.
What is Cooper's Ligament? - ANS Suspensory ligament that are the fibrous connections
between the inner side of the breast skin and pectoral muscles. Help to shape the breasts
What does the nipple contain? - ANS 15-25 milk ducts, smooth muscle fibers, sebaceous and
apocrine sweat glands, and dense innervations of sensory nerve endings
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,What are Montgomery Tubercles? - ANS Sebaceous glands in the areola surrounding the
nipple
What do the Montgomery Tubercles secrete? - ANS Oily secretions (lipoid fluid) to keep the
areola and the nipple lubricated and protected
What artery(s) supply blood to the breast? - ANS Internal mammary artery (60%) and lateral
thoracic artery (30%)
Where does the lymphatic system of the breast drain excess fluids from tissue space, bacteria
and cast off cells? - ANS Auxiliary lymph node
Where does the nerves of the breast mainly branch from? - ANS 4th, 5th, and 6th intercostal
nerve
What nerve supplies the greatest amount of sensation to the areola? - ANS 4th intercostal
nerve
What part of the breast is most sensitive? - ANS The areola followed by the general skin of
the breast, and then the nipple which is least sensitive.
What percent of breast milk is carbohydrates? - ANS Approximately 7%
What are the six infant behavioral "states" - ANS Crying, active alert, quiet alert, drowsy,
active sleep, and quiet sleep
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Milk components that protect the infant/lactating breast actively bind ______, preventing their
passage through the permeable infant _____ _____ - ANS pathogens
gut mucosa
How does the infant get the antibodies produced by mom? - ANS antibodies are produced in
moms blood, targeted SIgA which is transported across the mammary secretory cells and
released in the milk.
What is sIgA? - ANS Immunoglobulin A is an antibody that coats mucosal surfaces to prevent
adherence and penetration by pathogens
What are the most common food allergies? - ANS 1. Cow's milk protein
2. Eggs
3. Peanuts
4. Tree nuts
5. Fish
6. Shellfish
7. Soy
8. Wheat
What are the common symptoms of food allergies? - ANS 1. Eczema
2. Hives
3. Digestive or respiratory problems (e.g. mucus or blood in the stool)
The infant uses their _____ to draw in the nipple and ____ it in the mouth - ANS Lips
Stabilize
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
ANSWERS GRADED A+ 2025/2026
When does the breast begin to develop in utero? - ANS 4th week of gestation
Where does the primitive milk streak develop - ANS Bilaterally from the axilla to the groin
By the 5th week gestation the milk streak becomes what? - ANS Mammary Milk Ridge (or
milk line)
Thickening and inward growth into the chest wall continues during what weeks gestation? -
ANS 7-8 weeks gestation
Between weeks 12 and 16 gestation specialized cells differentiate into what? - ANS Smooth
muscles of the nipple and areola
What forms the mammary pit? - ANS Lactiferous ducts and their branches open into a
shallow epithelial depression
What creates an inverted nipple? - ANS When the Mammary pit fails to elevate
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,What is witches milk? - ANS After birth, a neonate's mammary tissue (under the influence of
maternal hormones) might recreate colostral like fluid
At what age do the primary and secondary ducts grow and divide and form the terminal end
buds that become the alveoli? - ANS 10-12 years old
When does complete development of mammary function occur? - ANS During pregnancy
What is superficial fiscia? - ANS Fibrous tissue beneath the skin
Where is the breast located? - ANS In the superficial fascia between the second rib and sixth
intercostal space
What are the two major divisions of the breast? - ANS Parenchyma and Stroma
What makes up the Parenchyma? - ANS Ducts, lobes, and aveoli
What are alveoli? - ANS Small sacs where milk is secreted
What makes up the Stroma? - ANS Connective tissue, fat tissue, blood vessels, nerves, and
lymphatics.
What is Cooper's Ligament? - ANS Suspensory ligament that are the fibrous connections
between the inner side of the breast skin and pectoral muscles. Help to shape the breasts
What does the nipple contain? - ANS 15-25 milk ducts, smooth muscle fibers, sebaceous and
apocrine sweat glands, and dense innervations of sensory nerve endings
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,What are Montgomery Tubercles? - ANS Sebaceous glands in the areola surrounding the
nipple
What do the Montgomery Tubercles secrete? - ANS Oily secretions (lipoid fluid) to keep the
areola and the nipple lubricated and protected
What artery(s) supply blood to the breast? - ANS Internal mammary artery (60%) and lateral
thoracic artery (30%)
Where does the lymphatic system of the breast drain excess fluids from tissue space, bacteria
and cast off cells? - ANS Auxiliary lymph node
Where does the nerves of the breast mainly branch from? - ANS 4th, 5th, and 6th intercostal
nerve
What nerve supplies the greatest amount of sensation to the areola? - ANS 4th intercostal
nerve
What part of the breast is most sensitive? - ANS The areola followed by the general skin of
the breast, and then the nipple which is least sensitive.
What percent of breast milk is carbohydrates? - ANS Approximately 7%
What are the six infant behavioral "states" - ANS Crying, active alert, quiet alert, drowsy,
active sleep, and quiet sleep
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Milk components that protect the infant/lactating breast actively bind ______, preventing their
passage through the permeable infant _____ _____ - ANS pathogens
gut mucosa
How does the infant get the antibodies produced by mom? - ANS antibodies are produced in
moms blood, targeted SIgA which is transported across the mammary secretory cells and
released in the milk.
What is sIgA? - ANS Immunoglobulin A is an antibody that coats mucosal surfaces to prevent
adherence and penetration by pathogens
What are the most common food allergies? - ANS 1. Cow's milk protein
2. Eggs
3. Peanuts
4. Tree nuts
5. Fish
6. Shellfish
7. Soy
8. Wheat
What are the common symptoms of food allergies? - ANS 1. Eczema
2. Hives
3. Digestive or respiratory problems (e.g. mucus or blood in the stool)
The infant uses their _____ to draw in the nipple and ____ it in the mouth - ANS Lips
Stabilize
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
