PCE CERTIFIED BREASTFEEDING
COUNSELOR EXAM STUDY GUIDE
h Where is the milk produced? - In the alveoli
How long after cessation of breast feeding does milk production (involution) stop? - Approximately 40
days
What are the common signs of milk "let down"? - Tingling, warmth, fullness, dripping and contractions
How is preterm milk different than term milk? - It is higher in protein and immune factors (because the
body KNOWS this is what the preemie needs!)
What component of breast milk is the most variable? - Lipids
What component of human milk is destroyed by freezing? - Macrophages
When is the side-lying position helpful? - In moms that are sleepy or have lacerations/repairs that put
pressure and cause discomfort on the perineal area
What position is centered around the infant attaching themselves to the breast? - The laid back position
(aka the biological position)
When is the Australian/Saddle position helpful? - When moms are experiencing active let-down
What is the dancer hand? - Mom would have hand below the breast in a "U" shape; this is good for
infants who need good jaw support
What are signs of milk transfer? - Swallowing - harsh "Ca" sound; air from nose felt, neck movement
visualized
What are the stool transition colors? - Black to green to yellow
What is the normal weight loss for the infant during the first few days? - 5-7% in first 24 hours
Below 10% after that
How many calories does a lactating mom need? - Moms need approximately 500 extra calories/day
when breastfeeding. Range is between 1,800 and 2,700 with most moms consuming around 2,200!
What type of supplement do most lactating vegans/bariatric patients take? - Vitamin B12
What types of foods (or diet) should lactating moms consume? - Moms should consume a diet of normal
foods - they should eat when they're hungry and drink when they're thirsty. The MyPlate is a good
example - 50% carbs, 15% protein, 20-30% healthy fats
COUNSELOR EXAM STUDY GUIDE
h Where is the milk produced? - In the alveoli
How long after cessation of breast feeding does milk production (involution) stop? - Approximately 40
days
What are the common signs of milk "let down"? - Tingling, warmth, fullness, dripping and contractions
How is preterm milk different than term milk? - It is higher in protein and immune factors (because the
body KNOWS this is what the preemie needs!)
What component of breast milk is the most variable? - Lipids
What component of human milk is destroyed by freezing? - Macrophages
When is the side-lying position helpful? - In moms that are sleepy or have lacerations/repairs that put
pressure and cause discomfort on the perineal area
What position is centered around the infant attaching themselves to the breast? - The laid back position
(aka the biological position)
When is the Australian/Saddle position helpful? - When moms are experiencing active let-down
What is the dancer hand? - Mom would have hand below the breast in a "U" shape; this is good for
infants who need good jaw support
What are signs of milk transfer? - Swallowing - harsh "Ca" sound; air from nose felt, neck movement
visualized
What are the stool transition colors? - Black to green to yellow
What is the normal weight loss for the infant during the first few days? - 5-7% in first 24 hours
Below 10% after that
How many calories does a lactating mom need? - Moms need approximately 500 extra calories/day
when breastfeeding. Range is between 1,800 and 2,700 with most moms consuming around 2,200!
What type of supplement do most lactating vegans/bariatric patients take? - Vitamin B12
What types of foods (or diet) should lactating moms consume? - Moms should consume a diet of normal
foods - they should eat when they're hungry and drink when they're thirsty. The MyPlate is a good
example - 50% carbs, 15% protein, 20-30% healthy fats
