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CLC EXAM 2025/2026 NEWEST ACTUAL EXAM COMPLETE 250 QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS) / ALPP CLC EXAM
STUDY GUIDE UPDATED VERSION ACTUAL EXAM /ALREADY GRADED A+
When considering both chest masculinization surgery and breast reduction surgery: -
ANSWER - The likelihood of breastfeeding is unknown, assessment and close nutrition
follow up is key, it is important to assure the nutrition of infant
True or False: Suboptimal breast anatomy can potentially impact breastfeeding and should
be seen as a red flag for close assessment and follow-up. - ANSWER - True
True or False: Hypoplastic breast always make ample milk. - ANSWER - False
True or False: There is no concern when a client reports a breast implant on only one side. -
ANSWER - False
True or False: With flat inverted nipples, there will be inadequate production of milk-
making hormones because prolactin involves nipple stretching while oxytocin involves
nipple stroking. - ANSWER - False: prolactin is nipple stroking and oxytocin is nipple
stretching
True or False: the nipple stretches to 4x its resting length in the baby's mouth, according to
Smith's research. - ANSWER - False, it's only 2x
True or False: An everted nipple is necessary for babies to attach to the breast, unlike other
mammals who can form teat. - ANSWER - False
True or False: Grade 3 inverted nipples are difficult or impossible to pull/evert. - ANSWER -
True
When counseling someone who has had a breast surgery, it is important to consider: -
ANSWER - If the milk ducts are patent, the nipple pores are patent, monitoring baby's
weight gain very closely
True or False: you can tell looking at a nipple at rest how it will function - ANSWER - False
One concern about Grade 3 inverted nipples involves: - ANSWER - prolactin levels
True or False: almost all mothers have grade 3 inverted nipples - ANSWER - False
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True or False: Prenatal nipple preparation should be recommended for all women -
ANSWER - False, can induce contractions
True or False: According to research, women who do NOT breastfeed are at a greater risk of
several cancers. - ANSWER - True - breast, ovarian, endometrial
Bottles/binkies can cause _____ _____ - ANSWER - nipple confusion
True or False: Children who do not exclusively breastfeed in the first 4-6 months of life are
sicker than the kids who do. - ANSWER - True
Why is breastfeeding so difficult for some parents [according to research]? - ANSWER -
Unrealistic expectations
When looking at breastfeeding rates, the fastest drop off is within __ days of discharge? -
ANSWER - 10 days
True or False: Research shows within the first week parents give up breastfeeding because
the baby won't latch. - ANSWER - True, especially in the first 7-10 days
True or False: According to the CDC, one reason that there is such a disparity in white and
black breastfeeding rates is that "hospitals in neighborhoods with many black residents do
less to promote nursing than those in areas with more white residents". - ANSWER - True
True or False: The inside of Alveolar cells is a potential space, called the Lumen, that will
be filled with milk. - ANSWER - True
The Alveolar cells are surrounded by: - ANSWER - myoepithelial cells
The _____ _____ are smooth muscle cells that contract and push the milk out of the alveolar
space into the ducts and toward the front of the breast. - ANSWER - myoepithelial cells
True or False: The milk ducts are evenly spaced - ANSWER - False
How many nipple pores are functioning in each breast during lactation? - ANSWER - 3-5
The pathway for prolactin is: - ANSWER - anterior pituitary gland
The pathway for oxytocin is: - ANSWER - the posterior pituitary gland
True or False: prolactin is circulated everywhere, not only in the breast and not only in
pregnant people. - ANSWER - True, non-pregnant and non-lactating people have prolactin
, 3 of 31
When does the prolactin hormone increase? - ANSWER - During nipple stimulation
When the frequency of breastfeeding decreases, prolactin levels go: - ANSWER - Down,
because of the lack of nipple stimulation
True or False: Several different mechanisms can cause the stimulation of oxytocin. -
ANSWER - True
What is another oxytocin release mechanism? - ANSWER - Nipple stretching that happens
with a proper latch
Prolactin is stimulated by multiple factors, whereas oxytocin primarily relies on nipple
stimulation. - ANSWER - False, this is backwards. Everyone has oxytocin and only lactating
people have prolactin.
True or False: Mammal milk is the same for every species. - ANSWER - False, it is species
specific.
Mammal species with higher water content - ANSWER - Feed more frequently, especially
human milk which is extremely dilute.
What organ is the most rapidly developing in human newborns? - ANSWER - The brain,
which human milk is ideal for
True or False: Colostrum is made under the influence of the hormones of pregnancy -
ANSWER - True, part of lactogenesis I
What triggers lactogenesis II? - ANSWER - Complete delivery of the placenta
In general, preterm milk appears to be higher in ___ than mature milk. - ANSWER - protein,
fat, and electrolytes
When are prolactin levels the highest? - ANSWER - during the nighttime, this is also when
the nutrient content is the highest
When does the composition of breastmilk change? - ANSWER - over the course of
lactation, within the day, within feedings
What are prostaglandins? - ANSWER - they help stimulate growth and development of the
GI tract and GI motility
What is dysbiosis? - ANSWER - an imbalance of the good and bad bacteria in the intestine.
, 4 of 31
What are cholecystokinin and gastrin? - ANSWER - gastrointestinal hormones
Gastrin and cholecystokinin ____ glucose induced insulin release and exert growth
promoting effects in the gut? - ANSWER - promote
True or False: a species own milk decreases somatostatin - ANSWER - true, since other
hormones like oxytocin do as well
Suckling ___ gastrin and ___ somatostatin (in babies). - ANSWER - increases, decreases
The AAP advises that weight loss in a newborn greater than ___% is problematic and
requires immediate evaluation. - ANSWER - 7%
There should be no further weight-loss by day ___. - ANSWER - 5
By how many weeks, at the latest, should baby have regained to its birth weight? - ANSWER
- 2 weeks
When do babies lose more weight? - ANSWER - when there is no labor prior to cesarean
What is a good indicator of a baby's intake? - ANSWER - baby's stool
How much is a baby expected to gain in ounces per day as a newborn? - ANSWER - one
ounce, or more if it is a special circumstance
True or False: A sleepy baby is a well-fed baby - ANSWER - False, baby needs to be fed 10-
12 times minimum.
AAP recommendations for all breastfeeding newborn infants is that they should be seen by
a pediatrician at ___ days of age? - ANSWER - 3-5 days
____ increases to protect lactation under conditions of negative energy balance. - ANSWER
- Maternal plasma prolactin concentration
What are the most important requirements of lactogenesis III? - ANSWER - frequent milk
removal and nipple stimulation
What is the nickname for prolactin? - ANSWER - The milk making hormone
Who currently collects the most comprehensive breastfeeding statistics in the US? -
ANSWER - The CDC
CLC EXAM 2025/2026 NEWEST ACTUAL EXAM COMPLETE 250 QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS) / ALPP CLC EXAM
STUDY GUIDE UPDATED VERSION ACTUAL EXAM /ALREADY GRADED A+
When considering both chest masculinization surgery and breast reduction surgery: -
ANSWER - The likelihood of breastfeeding is unknown, assessment and close nutrition
follow up is key, it is important to assure the nutrition of infant
True or False: Suboptimal breast anatomy can potentially impact breastfeeding and should
be seen as a red flag for close assessment and follow-up. - ANSWER - True
True or False: Hypoplastic breast always make ample milk. - ANSWER - False
True or False: There is no concern when a client reports a breast implant on only one side. -
ANSWER - False
True or False: With flat inverted nipples, there will be inadequate production of milk-
making hormones because prolactin involves nipple stretching while oxytocin involves
nipple stroking. - ANSWER - False: prolactin is nipple stroking and oxytocin is nipple
stretching
True or False: the nipple stretches to 4x its resting length in the baby's mouth, according to
Smith's research. - ANSWER - False, it's only 2x
True or False: An everted nipple is necessary for babies to attach to the breast, unlike other
mammals who can form teat. - ANSWER - False
True or False: Grade 3 inverted nipples are difficult or impossible to pull/evert. - ANSWER -
True
When counseling someone who has had a breast surgery, it is important to consider: -
ANSWER - If the milk ducts are patent, the nipple pores are patent, monitoring baby's
weight gain very closely
True or False: you can tell looking at a nipple at rest how it will function - ANSWER - False
One concern about Grade 3 inverted nipples involves: - ANSWER - prolactin levels
True or False: almost all mothers have grade 3 inverted nipples - ANSWER - False
, 2 of 31
True or False: Prenatal nipple preparation should be recommended for all women -
ANSWER - False, can induce contractions
True or False: According to research, women who do NOT breastfeed are at a greater risk of
several cancers. - ANSWER - True - breast, ovarian, endometrial
Bottles/binkies can cause _____ _____ - ANSWER - nipple confusion
True or False: Children who do not exclusively breastfeed in the first 4-6 months of life are
sicker than the kids who do. - ANSWER - True
Why is breastfeeding so difficult for some parents [according to research]? - ANSWER -
Unrealistic expectations
When looking at breastfeeding rates, the fastest drop off is within __ days of discharge? -
ANSWER - 10 days
True or False: Research shows within the first week parents give up breastfeeding because
the baby won't latch. - ANSWER - True, especially in the first 7-10 days
True or False: According to the CDC, one reason that there is such a disparity in white and
black breastfeeding rates is that "hospitals in neighborhoods with many black residents do
less to promote nursing than those in areas with more white residents". - ANSWER - True
True or False: The inside of Alveolar cells is a potential space, called the Lumen, that will
be filled with milk. - ANSWER - True
The Alveolar cells are surrounded by: - ANSWER - myoepithelial cells
The _____ _____ are smooth muscle cells that contract and push the milk out of the alveolar
space into the ducts and toward the front of the breast. - ANSWER - myoepithelial cells
True or False: The milk ducts are evenly spaced - ANSWER - False
How many nipple pores are functioning in each breast during lactation? - ANSWER - 3-5
The pathway for prolactin is: - ANSWER - anterior pituitary gland
The pathway for oxytocin is: - ANSWER - the posterior pituitary gland
True or False: prolactin is circulated everywhere, not only in the breast and not only in
pregnant people. - ANSWER - True, non-pregnant and non-lactating people have prolactin
, 3 of 31
When does the prolactin hormone increase? - ANSWER - During nipple stimulation
When the frequency of breastfeeding decreases, prolactin levels go: - ANSWER - Down,
because of the lack of nipple stimulation
True or False: Several different mechanisms can cause the stimulation of oxytocin. -
ANSWER - True
What is another oxytocin release mechanism? - ANSWER - Nipple stretching that happens
with a proper latch
Prolactin is stimulated by multiple factors, whereas oxytocin primarily relies on nipple
stimulation. - ANSWER - False, this is backwards. Everyone has oxytocin and only lactating
people have prolactin.
True or False: Mammal milk is the same for every species. - ANSWER - False, it is species
specific.
Mammal species with higher water content - ANSWER - Feed more frequently, especially
human milk which is extremely dilute.
What organ is the most rapidly developing in human newborns? - ANSWER - The brain,
which human milk is ideal for
True or False: Colostrum is made under the influence of the hormones of pregnancy -
ANSWER - True, part of lactogenesis I
What triggers lactogenesis II? - ANSWER - Complete delivery of the placenta
In general, preterm milk appears to be higher in ___ than mature milk. - ANSWER - protein,
fat, and electrolytes
When are prolactin levels the highest? - ANSWER - during the nighttime, this is also when
the nutrient content is the highest
When does the composition of breastmilk change? - ANSWER - over the course of
lactation, within the day, within feedings
What are prostaglandins? - ANSWER - they help stimulate growth and development of the
GI tract and GI motility
What is dysbiosis? - ANSWER - an imbalance of the good and bad bacteria in the intestine.
, 4 of 31
What are cholecystokinin and gastrin? - ANSWER - gastrointestinal hormones
Gastrin and cholecystokinin ____ glucose induced insulin release and exert growth
promoting effects in the gut? - ANSWER - promote
True or False: a species own milk decreases somatostatin - ANSWER - true, since other
hormones like oxytocin do as well
Suckling ___ gastrin and ___ somatostatin (in babies). - ANSWER - increases, decreases
The AAP advises that weight loss in a newborn greater than ___% is problematic and
requires immediate evaluation. - ANSWER - 7%
There should be no further weight-loss by day ___. - ANSWER - 5
By how many weeks, at the latest, should baby have regained to its birth weight? - ANSWER
- 2 weeks
When do babies lose more weight? - ANSWER - when there is no labor prior to cesarean
What is a good indicator of a baby's intake? - ANSWER - baby's stool
How much is a baby expected to gain in ounces per day as a newborn? - ANSWER - one
ounce, or more if it is a special circumstance
True or False: A sleepy baby is a well-fed baby - ANSWER - False, baby needs to be fed 10-
12 times minimum.
AAP recommendations for all breastfeeding newborn infants is that they should be seen by
a pediatrician at ___ days of age? - ANSWER - 3-5 days
____ increases to protect lactation under conditions of negative energy balance. - ANSWER
- Maternal plasma prolactin concentration
What are the most important requirements of lactogenesis III? - ANSWER - frequent milk
removal and nipple stimulation
What is the nickname for prolactin? - ANSWER - The milk making hormone
Who currently collects the most comprehensive breastfeeding statistics in the US? -
ANSWER - The CDC
