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PCE Certified Breastfeeding Counselor Exam QUESTIONS
AND VERIFIED ANSWERS WITH RATIONALES JUST
RELEASED
PCE Certified Breastfeeding Counselor Exam –Practice Questions
10 Most Tested Exam Coverage Areas
1. Standards of Practice & Professionalism – CBC scope, problem-solving (Assessment, Plan,
Implementation, Evaluation), legal considerations
2. Baby-Friendly Hospital Initiative – 10 Steps, initiation within 1 hour, 8-12 feedings/day, cue
feeding, no artificial teats
3. International Code of Marketing of Breast-milk Substitutes – No advertising, no free samples,
scientific information only
4. Breast Anatomy & Physiology – Alveoli, myoepithelial cells, oxytocin (let-down), prolactin, Tail
of Spence
5. Lactogenesis Stages – Embryogenesis, mammogenesis, Lactogenesis I (pregnancy), Lactogenesis
II (after placenta delivery)
6. Infant Weight & Feeding Assessment – Normal weight loss (5-7%, <10%), regain by 10-14 days,
signs of milk transfer (urine output, stool output, swallowing)
7. Maternal Nutrition & Supplementation – 500 extra calories/day, Vitamin B12 for
vegans/bariatric patients, Vitamin D 400 IU/day for infant
8. Common Breastfeeding Challenges – Sore nipples (improper latch), engorgement, plugged
ducts, mastitis, candidiasis, flat/inverted nipples
9. Infant Conditions & Special Feeding – Cleft lip/palate, Down syndrome (Haberman feeder),
preterm milk (higher protein), ankyloglossia (tongue-tie)
10. Contraindications & Special Populations – Antimetabolites, chemotherapy, radioisotopes, illicit
drugs; breast surgery, implants, insufficient glandular tissue (hypoplasia)
Question 1: What is the normal percentage of weight loss for a breastfeeding infant during the first 3-4
days after birth?
A) 1-3%
B) 5-7%
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C) 10-15%
D) 15-20%
Answer: B) 5-7%
Rationale: Normal weight loss in the first 3-4 days is 5-7% of birth weight. Loss should not exceed 10%,
and the infant should regain birth weight by 10-14 days .
Question 2: Which statement about infant weight loss is TRUE regarding when to be concerned?
A) Weight loss of 5% is concerning and requires intervention
B) The infant should regain birth weight by 3 weeks
C) Weight loss should not exceed 10%, and birth weight should be regained by 10-14 days
D) Any weight loss in the first week is abnormal
Answer: C) Weight loss should not exceed 10%, and birth weight should be regained by 10-14 days
Rationale: Normal weight loss is 5-7% and should not exceed 10%. The infant should regain birth weight
by 10-14 days .
Question 3: A breastfeeding counselor observes an infant who has not regained birth weight by 3 weeks
and is below the 10th percentile at 1 month. This is most consistent with which finding?
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A) Normal growth pattern
B) Failure to thrive
C) Benign breast development
D) Expected weight trajectory
Answer: B) Failure to thrive
Rationale: Failure to thrive in infants under 1 month includes: losing weight after 10 days, not regaining
birth weight by 3 weeks, or being below the 10th percentile at 1 month. For older infants: below 30% and
drop in growth of length and head .
Question 4: How many extra calories per day does a breastfeeding mother typically need to support
milk production?
A) 100-200 calories
B) 300-400 calories
C) 500 calories
D) 800-1000 calories
Answer: C) 500 calories
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Rationale: Lactating mothers need approximately 500 extra calories per day for milk production. The
total range is 1,800-2,700 calories, with most mothers consuming around 2,200 calories daily .
Question 5: Which supplement is MOST important for lactating vegans and bariatric patients?
A) Vitamin C
B) Vitamin B12
C) Iron
D) Calcium
Answer: B) Vitamin B12
Rationale: Lactating vegans and bariatric patients are likely deficient in Vitamin B12 and require
supplementation .
Question 6: How much Vitamin D does a breastfed infant need daily, and when should supplementation
begin?
A) 200 IU/day, only if formula-fed
B) 400 IU/day if mother is deficient or infant is exclusively breastfed
PCE Certified Breastfeeding Counselor Exam QUESTIONS
AND VERIFIED ANSWERS WITH RATIONALES JUST
RELEASED
PCE Certified Breastfeeding Counselor Exam –Practice Questions
10 Most Tested Exam Coverage Areas
1. Standards of Practice & Professionalism – CBC scope, problem-solving (Assessment, Plan,
Implementation, Evaluation), legal considerations
2. Baby-Friendly Hospital Initiative – 10 Steps, initiation within 1 hour, 8-12 feedings/day, cue
feeding, no artificial teats
3. International Code of Marketing of Breast-milk Substitutes – No advertising, no free samples,
scientific information only
4. Breast Anatomy & Physiology – Alveoli, myoepithelial cells, oxytocin (let-down), prolactin, Tail
of Spence
5. Lactogenesis Stages – Embryogenesis, mammogenesis, Lactogenesis I (pregnancy), Lactogenesis
II (after placenta delivery)
6. Infant Weight & Feeding Assessment – Normal weight loss (5-7%, <10%), regain by 10-14 days,
signs of milk transfer (urine output, stool output, swallowing)
7. Maternal Nutrition & Supplementation – 500 extra calories/day, Vitamin B12 for
vegans/bariatric patients, Vitamin D 400 IU/day for infant
8. Common Breastfeeding Challenges – Sore nipples (improper latch), engorgement, plugged
ducts, mastitis, candidiasis, flat/inverted nipples
9. Infant Conditions & Special Feeding – Cleft lip/palate, Down syndrome (Haberman feeder),
preterm milk (higher protein), ankyloglossia (tongue-tie)
10. Contraindications & Special Populations – Antimetabolites, chemotherapy, radioisotopes, illicit
drugs; breast surgery, implants, insufficient glandular tissue (hypoplasia)
Question 1: What is the normal percentage of weight loss for a breastfeeding infant during the first 3-4
days after birth?
A) 1-3%
B) 5-7%
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C) 10-15%
D) 15-20%
Answer: B) 5-7%
Rationale: Normal weight loss in the first 3-4 days is 5-7% of birth weight. Loss should not exceed 10%,
and the infant should regain birth weight by 10-14 days .
Question 2: Which statement about infant weight loss is TRUE regarding when to be concerned?
A) Weight loss of 5% is concerning and requires intervention
B) The infant should regain birth weight by 3 weeks
C) Weight loss should not exceed 10%, and birth weight should be regained by 10-14 days
D) Any weight loss in the first week is abnormal
Answer: C) Weight loss should not exceed 10%, and birth weight should be regained by 10-14 days
Rationale: Normal weight loss is 5-7% and should not exceed 10%. The infant should regain birth weight
by 10-14 days .
Question 3: A breastfeeding counselor observes an infant who has not regained birth weight by 3 weeks
and is below the 10th percentile at 1 month. This is most consistent with which finding?
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A) Normal growth pattern
B) Failure to thrive
C) Benign breast development
D) Expected weight trajectory
Answer: B) Failure to thrive
Rationale: Failure to thrive in infants under 1 month includes: losing weight after 10 days, not regaining
birth weight by 3 weeks, or being below the 10th percentile at 1 month. For older infants: below 30% and
drop in growth of length and head .
Question 4: How many extra calories per day does a breastfeeding mother typically need to support
milk production?
A) 100-200 calories
B) 300-400 calories
C) 500 calories
D) 800-1000 calories
Answer: C) 500 calories
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Rationale: Lactating mothers need approximately 500 extra calories per day for milk production. The
total range is 1,800-2,700 calories, with most mothers consuming around 2,200 calories daily .
Question 5: Which supplement is MOST important for lactating vegans and bariatric patients?
A) Vitamin C
B) Vitamin B12
C) Iron
D) Calcium
Answer: B) Vitamin B12
Rationale: Lactating vegans and bariatric patients are likely deficient in Vitamin B12 and require
supplementation .
Question 6: How much Vitamin D does a breastfed infant need daily, and when should supplementation
begin?
A) 200 IU/day, only if formula-fed
B) 400 IU/day if mother is deficient or infant is exclusively breastfed
