IBCLC EXAM AND PRACTICE QUESTIONS NEWEST 2026 ACTUAL EXAM
COMPLETE 300 QUESTIONS AND CORRECT DETAILED ANSWERS/NEWEST
UPDATE!!!
What is the first question to consider when helping a breastfeeding mother with a medication
question?
A) What is the relative infant dose of the medication?
B) What is the protein binding of the medication?
C) What is the molecular weight of the medication?
D) Is the medication really necessary to take now? - (Correct Answer)-D
Which drug property results in more transfer of the drug into the mother's milk?
A) Molecular weight >800 Daltons
B) High protein binding
C) High lipid solubility
D) Low maternal plasma concentration - (Correct Answer)-C
When it comes to medications and breastfeeding, drugs with a shorter half-life are preferred.
How many half-lives until it is generally considered that the drug is eliminated from the system?
A) 3
B) 5
C) 7
D) 9 - (Correct Answer)-B
If a woman is given 80 mg of a drug to treat a urinary tract infection - and the drug has a half-life
of 3 hours - how much will be left in her system after 3 half-lives?
A) 40 mg
B) 20 mg
C) 10 mg
D) 5 mg - (Correct Answer)-C
, 2
What is considered a high enough molecular weight that the medication will be too big to easily
get into the breast milk compartment?
A) 200 Daltons
B) 300 Daltons
C) 400 Daltons
D) More than 800 Daltons - (Correct Answer)-D
Drugs can be highly bound to albumin, a large protein in the blood circulation, and therefore too
big to get into the breast milk space. What percentage of protein binding is considered high and
therefore preferred?
A) 40%
B) 60%
C) 80%
D) >90% - (Correct Answer)-D
While most drugs are compatible with breastfeeding, a few are not. Which type of drug is usually
contraindicated for breastfeeding?
A) Antibiotic
B) Antidepressant
C) Chemotherapy
D) Diabetic therapy - (Correct Answer)-C
A Relative Infant Dose (RID) of _____ indicates compatibility with breastfeeding.
A) <10%
B) >10% - (Correct Answer)-A) <10%
A good resource to use to figure out if a medicine is compatible with breastfeeding is:
, 3
A) The Physician Desk Reference (PDR)
B) The medicine package insert
C) Google
D) LactMed - (Correct Answer)-D) LactMed
In Hale's Medications and Mothers' Milk, which lactation risk category is the safest?
A) L1
B) L2
C) L4
D) L5 - (Correct Answer)-A
In Hale's Medications and Mothers' Milk, what lactation risk category does a medication go into
if there is absolutely no published data about the medication, even if it is considered safe?
A) L2
B) L3
C) L4
D) L5 - (Correct Answer)-B
In which lactation risk category in Medications and Mothers' Milk is this the recommendation:
"The drug is contraindicated in women who are breastfeeding an infant."
A) L2
B) L3
C) L4
D) L5 - (Correct Answer)-D) L5
Many antibiotics are safe for the breastfeeding mother to take. However, caution needs to be
taken with this antibiotic, ________, about which Hale's Medications and Mothers' Milk says,
, 4
"This antibiotic can be extremely toxic, particularly in neonates, and should not be used for
trivial infections."
A) Ampicillin
B) Chloramphenicol
C) Gentamicin
D) Metronidazole - (Correct Answer)-B) Chloramphenicol
Plasma levels of most topical and ophthalmic preparations are virtually nil and are not likely to
produce milk levels at all.
A) True
B) False - (Correct Answer)-A) True
Some drug pumping systems exist in the alveolar cell (the cells that line the milk sac). For
example, iodine is readily pumped into the milk compartment. Therefore, any form of
radioactive iodine should be avoided while breastfeeding.
A) True
B) False - (Correct Answer)-A) True
Although there are many exceptions, in general, _______ of the maternal dose finds its way into
the milk and, subsequently, to the baby. ***(Do not confuse this with Relative Infant Dose)
A) <1%
B) 5%
C) 10%
D) 12.5% - (Correct Answer)-A
What is the AVERAGE volume of milk consumed per 24 hours by a breastfed baby around age
2-4 weeks?
A) 550-600ml (18-20oz)
COMPLETE 300 QUESTIONS AND CORRECT DETAILED ANSWERS/NEWEST
UPDATE!!!
What is the first question to consider when helping a breastfeeding mother with a medication
question?
A) What is the relative infant dose of the medication?
B) What is the protein binding of the medication?
C) What is the molecular weight of the medication?
D) Is the medication really necessary to take now? - (Correct Answer)-D
Which drug property results in more transfer of the drug into the mother's milk?
A) Molecular weight >800 Daltons
B) High protein binding
C) High lipid solubility
D) Low maternal plasma concentration - (Correct Answer)-C
When it comes to medications and breastfeeding, drugs with a shorter half-life are preferred.
How many half-lives until it is generally considered that the drug is eliminated from the system?
A) 3
B) 5
C) 7
D) 9 - (Correct Answer)-B
If a woman is given 80 mg of a drug to treat a urinary tract infection - and the drug has a half-life
of 3 hours - how much will be left in her system after 3 half-lives?
A) 40 mg
B) 20 mg
C) 10 mg
D) 5 mg - (Correct Answer)-C
, 2
What is considered a high enough molecular weight that the medication will be too big to easily
get into the breast milk compartment?
A) 200 Daltons
B) 300 Daltons
C) 400 Daltons
D) More than 800 Daltons - (Correct Answer)-D
Drugs can be highly bound to albumin, a large protein in the blood circulation, and therefore too
big to get into the breast milk space. What percentage of protein binding is considered high and
therefore preferred?
A) 40%
B) 60%
C) 80%
D) >90% - (Correct Answer)-D
While most drugs are compatible with breastfeeding, a few are not. Which type of drug is usually
contraindicated for breastfeeding?
A) Antibiotic
B) Antidepressant
C) Chemotherapy
D) Diabetic therapy - (Correct Answer)-C
A Relative Infant Dose (RID) of _____ indicates compatibility with breastfeeding.
A) <10%
B) >10% - (Correct Answer)-A) <10%
A good resource to use to figure out if a medicine is compatible with breastfeeding is:
, 3
A) The Physician Desk Reference (PDR)
B) The medicine package insert
C) Google
D) LactMed - (Correct Answer)-D) LactMed
In Hale's Medications and Mothers' Milk, which lactation risk category is the safest?
A) L1
B) L2
C) L4
D) L5 - (Correct Answer)-A
In Hale's Medications and Mothers' Milk, what lactation risk category does a medication go into
if there is absolutely no published data about the medication, even if it is considered safe?
A) L2
B) L3
C) L4
D) L5 - (Correct Answer)-B
In which lactation risk category in Medications and Mothers' Milk is this the recommendation:
"The drug is contraindicated in women who are breastfeeding an infant."
A) L2
B) L3
C) L4
D) L5 - (Correct Answer)-D) L5
Many antibiotics are safe for the breastfeeding mother to take. However, caution needs to be
taken with this antibiotic, ________, about which Hale's Medications and Mothers' Milk says,
, 4
"This antibiotic can be extremely toxic, particularly in neonates, and should not be used for
trivial infections."
A) Ampicillin
B) Chloramphenicol
C) Gentamicin
D) Metronidazole - (Correct Answer)-B) Chloramphenicol
Plasma levels of most topical and ophthalmic preparations are virtually nil and are not likely to
produce milk levels at all.
A) True
B) False - (Correct Answer)-A) True
Some drug pumping systems exist in the alveolar cell (the cells that line the milk sac). For
example, iodine is readily pumped into the milk compartment. Therefore, any form of
radioactive iodine should be avoided while breastfeeding.
A) True
B) False - (Correct Answer)-A) True
Although there are many exceptions, in general, _______ of the maternal dose finds its way into
the milk and, subsequently, to the baby. ***(Do not confuse this with Relative Infant Dose)
A) <1%
B) 5%
C) 10%
D) 12.5% - (Correct Answer)-A
What is the AVERAGE volume of milk consumed per 24 hours by a breastfed baby around age
2-4 weeks?
A) 550-600ml (18-20oz)
