Updated Questions & Answers With Rationale
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The ALPP Certified Lactation Counselor (CLC) Examination is administered by the
Academy of Lactation Policy and Practice (ALPP). The CLC credential identifies a
clinical, professional lactation care provider who has demonstrated the skills,
knowledge, and abilities to provide safe, evidence-based counseling for pregnant,
lactating, and breastfeeding families.
Candidates must complete a minimum of 95 hours of training based
upon the WHO/UNICEF Breastfeeding Counseling Training Course and
pass a criterion-referenced examination .
The examination assesses knowledge and skills that underlie competent
practice in lactation counseling. The purpose of the CLC certification is to protect the
public by identifying individuals who are competent in lactation management skills and
knowledge .
DOMAINS COVERED
1. Anatomy and Physiology of Human Lactation
2. Breastfeeding Assessment and Management
3. Counseling, Communication, and Education Skills
4. Public Health, Ethics, and Professional Practice
5. Maternal and Infant Nutrition
6. Nipple and Breast Problems
7. Latch-On and Positioning
8. Milk Supply and Supplementation
9. Special Circumstances (Maternal and Infant)
10. Promotion, Protection, and Support of Breastfeeding
,SECTION 1: ANATOMY AND PHYSIOLOGY OF LACTATION
1. Which hormone is primarily responsible for milk ejection
(the let-down reflex)?
A) Progesterone
B) Estrogen
C) Prolactin
D) Oxytocin
Answer: D
Rationale: Oxytocin triggers the milk ejection reflex by causing
myoepithelial cells to contract, expelling milk from the alveoli
into the ducts. Prolactin is responsible for milk production,
while progesterone and estrogen inhibit lactation postpartum [citation:2].
2. Which structure is the primary site of milk synthesis?
A) Alveoli
B) Lactiferous ducts
C) Lactiferous sinuses
D) Montgomery glands
,Answer: A
Rationale: Alveoli are the grape-like clusters of milk-producing
cells (lactocytes) where milk synthesis occurs in response to
prolactin. Lactiferous ducts transport milk, and Montgomery
glands secrete lubricating oils [citation:8].
3. Lactogenesis Stage II (secretory activation) is triggered
primarily by:
A) Increased maternal caloric intake
B) The sudden drop in progesterone following placental delivery
C) Prolactin release from the anterior pituitary
D) Infant suckling
Answer: B
Rationale: Lactogenesis II is triggered by the abrupt withdrawal
of progesterone following delivery of the placenta. This allows
prolactin to exert its full effect on milk synthesis, typically
occurring 48-72 hours postpartum [citation:10].
, 4. When does Lactogenesis Stage I (secretory differentiation)
typically begin?
A) Immediately after the baby's first feeding
B) Around mid-pregnancy (16-22 weeks gestation)
C) At the moment of placental delivery
D) During the first 24 hours postpartum
Answer: B
Rationale: Lactogenesis Stage I begins around mid-pregnancy when
the breasts become capable of milk secretion. Colostrum
production begins during this stage, though high progesterone
levels inhibit full milk secretion until after delivery [citation:10].
5. The primary hormone responsible for milk synthesis is:
A) Oxytocin
B) Prolactin
C) Estrogen
D) Progesterone
Answer: B