IBCLC Exam
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
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
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
, 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
What is weak lip tone? - ANS-Hypotonic lips result in the inability to seal lips around the
breast impacting the amount of suction created
What is a sucking blister? - ANS-friction abrasions resulting from retracted lips or a
labial frenulum that restricts the lips from flanging
What does weak lip tone look like? - ANS-Milk spilling, smacking sound (breaking
suction), infant tires faster due to increased work of the feedings even though they
aren't efficient feedings
Things to look for when assessing the lips: - ANS-Seal/maintain seal around the
breasts, normal lip tone, stretchy labial frenulum, no breaks in suction, no milk spilling
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
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
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
, 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
What is weak lip tone? - ANS-Hypotonic lips result in the inability to seal lips around the
breast impacting the amount of suction created
What is a sucking blister? - ANS-friction abrasions resulting from retracted lips or a
labial frenulum that restricts the lips from flanging
What does weak lip tone look like? - ANS-Milk spilling, smacking sound (breaking
suction), infant tires faster due to increased work of the feedings even though they
aren't efficient feedings
Things to look for when assessing the lips: - ANS-Seal/maintain seal around the
breasts, normal lip tone, stretchy labial frenulum, no breaks in suction, no milk spilling
