CLC CERTIFICATION EXAM TEST BANK | 2025/2026
Actual Certified Lactation Counselor Exam with Complete Questions & Verified Answers |
ALPP & IBLCE Aligned
Overview
This 2025/2026 updated resource contains the actual Certified Lactation Counselor (CLC)
certification exam test bank with the exact 120 questions and verified answers, following
current Academy of Lactation Policy and Practice (ALPP) and International Board of
Lactation Consultant Examiners (IBLCE) standards.
Key Features
✓ Actual ALPP CLC exam format with the official 120 questions
✓ Complete coverage of lactation counseling competencies
✓ Evidence-based breastfeeding management strategies
✓ Updated 2025 WHO/UNICEF guidelines and clinical protocols
✓ Cultural competency and counseling techniques scenarios
Core Content Areas (120 Total Questions)
• Anatomy, Physiology & Endocrinology of Lactation (18 Qs)
• Clinical Breastfeeding Assessment & Management (30 Qs)
• Counseling Techniques & Communication Skills (20 Qs)
• Maternal/Infant Challenges & Complications (25 Qs)
• Public Health & Community Lactation Support (12 Qs)
• Ethics, Legal Issues & Professional Standards (10 Qs)
• Pumping, Milk Storage & Special Situations (5 Qs)
Answer Format
Correct answers are marked in bold green and include:
• Specific WHO/UNICEF Baby-Friendly Hospital Initiative references
• Evidence-based clinical guidelines (Academy of Breastfeeding Medicine, etc.)
• Counseling approach rationales using OARS (Open-ended questions, Affirmations,
Reflections, Summaries)
• Cultural humility and health equity considerations
Updates for 2025/2026
Reflects 2025 WHO updated breastfeeding recommendations
New protocols for preterm and late preterm infant feeding
Updated guidelines on medications and lactation
Enhanced emphasis on trauma-informed lactation care
Revised standards for virtual lactation support
ANATOMY, PHYSIOLOGY & ENDOCRINOLOGY OF LACTATION (Questions 1–
18)
,1. The milk-secreting cells of the alveolus are called:
a) Myoepithelial cells
b) Lactocytes
c) Ductal epithelium
d) Fibroblasts
b) Lactocytes
Rationale: Lactocytes (alveolar epithelial cells) synthesize and secrete milk
constituents; myoepithelial cells contract to eject milk.
2. Prolactin release from the anterior pituitary is primarily stimulated by:
a) Infant suckling
b) High estrogen
c) Low progesterone
d) Oxytocin surge
a) Infant suckling
Rationale: Suckling activates the afferent neural pathway → hypothalamus →
prolactin release within minutes.
3. The “let-down” reflex is mediated by:
a) Prolactin
b) Oxytocin
c) Estrogen
d) Cortisol
b) Oxytocin
Rationale: Oxytocin causes myoepithelial cell contraction, increasing intramammary
pressure and milk ejection.
4. Colostrum is highest in which immunoglobulin?
a) IgA
b) IgG
c) IgM
d) IgE
a) IgA
Rationale: Secretory IgA provides passive mucosal immunity; levels >12 g/L in
colostrum vs. 1 g/L in mature milk.
5. Milk production increases most rapidly during which postpartum days?
a) 1–2
b) 3–5
c) 7–10
d) 14–21
b) 3–5
Rationale: Lactogenesis II; progesterone withdrawal triggers copious milk (“milk
coming in”).
6. Average daily mature milk intake for a 1-month-old is:
a) 200–400 mL
b) 500–600 mL
c) 750–800 mL
d) 1000–1200 mL
c) 750–800 mL
Rationale: Range 570–900 mL; 150 mL/kg/day (25 oz) average.
, 7. The milk fat content is lowest in:
a) Fore-milk
b) Hind-milk
c) Night milk
d) Colostrum
a) Fore-milk
Rationale: Fat increases 2–3-fold from beginning to end of feed due to milk fat
globule retention.
8. Which hormone inhibits lactation during pregnancy?
a) Progesterone
b) Prolactin
c) Oxytocin
d) Insulin
a) Progesterone
Rationale: High placental progesterone blocks prolactin receptors; withdrawal at
delivery lifts inhibition.
9. Milk synthesis is primarily regulated at the:
a) Alveolar level (autocrine)
b) Hypothalamic level (neuroendocrine)
c) Thyroid level
d) Adrenal level
a) Alveolar level (autocrine)
Rationale: Feedback inhibitor of lactation (FIL) peptide adjusts local production to
demand.
10. The average breast storage capacity (maximum milk volume before discomfort) is:
a) 50 mL
b) 100 mL
c) 150 mL
d) 300 mL
b) 100 mL
Rationale: Wide variation 60–200 mL; larger capacity associated with longer
between-feed intervals.
11. Oxytocin release is enhanced by:
a) Stress
b) Warm compresses
c) Cold shower
d) Bright light
b) Warm compresses
Rationale: Thermal stimulation increases maternal oxytocin and milk ejection.
12. Milk calcium concentration is highest during which feeding?
a) Night feed
b) Morning feed
c) Afternoon feed
d) No variation
a) Night feed
Rationale: Circadian rhythm; prolactin peaks at 03:00–05:00 increase calcium and
fat.
Actual Certified Lactation Counselor Exam with Complete Questions & Verified Answers |
ALPP & IBLCE Aligned
Overview
This 2025/2026 updated resource contains the actual Certified Lactation Counselor (CLC)
certification exam test bank with the exact 120 questions and verified answers, following
current Academy of Lactation Policy and Practice (ALPP) and International Board of
Lactation Consultant Examiners (IBLCE) standards.
Key Features
✓ Actual ALPP CLC exam format with the official 120 questions
✓ Complete coverage of lactation counseling competencies
✓ Evidence-based breastfeeding management strategies
✓ Updated 2025 WHO/UNICEF guidelines and clinical protocols
✓ Cultural competency and counseling techniques scenarios
Core Content Areas (120 Total Questions)
• Anatomy, Physiology & Endocrinology of Lactation (18 Qs)
• Clinical Breastfeeding Assessment & Management (30 Qs)
• Counseling Techniques & Communication Skills (20 Qs)
• Maternal/Infant Challenges & Complications (25 Qs)
• Public Health & Community Lactation Support (12 Qs)
• Ethics, Legal Issues & Professional Standards (10 Qs)
• Pumping, Milk Storage & Special Situations (5 Qs)
Answer Format
Correct answers are marked in bold green and include:
• Specific WHO/UNICEF Baby-Friendly Hospital Initiative references
• Evidence-based clinical guidelines (Academy of Breastfeeding Medicine, etc.)
• Counseling approach rationales using OARS (Open-ended questions, Affirmations,
Reflections, Summaries)
• Cultural humility and health equity considerations
Updates for 2025/2026
Reflects 2025 WHO updated breastfeeding recommendations
New protocols for preterm and late preterm infant feeding
Updated guidelines on medications and lactation
Enhanced emphasis on trauma-informed lactation care
Revised standards for virtual lactation support
ANATOMY, PHYSIOLOGY & ENDOCRINOLOGY OF LACTATION (Questions 1–
18)
,1. The milk-secreting cells of the alveolus are called:
a) Myoepithelial cells
b) Lactocytes
c) Ductal epithelium
d) Fibroblasts
b) Lactocytes
Rationale: Lactocytes (alveolar epithelial cells) synthesize and secrete milk
constituents; myoepithelial cells contract to eject milk.
2. Prolactin release from the anterior pituitary is primarily stimulated by:
a) Infant suckling
b) High estrogen
c) Low progesterone
d) Oxytocin surge
a) Infant suckling
Rationale: Suckling activates the afferent neural pathway → hypothalamus →
prolactin release within minutes.
3. The “let-down” reflex is mediated by:
a) Prolactin
b) Oxytocin
c) Estrogen
d) Cortisol
b) Oxytocin
Rationale: Oxytocin causes myoepithelial cell contraction, increasing intramammary
pressure and milk ejection.
4. Colostrum is highest in which immunoglobulin?
a) IgA
b) IgG
c) IgM
d) IgE
a) IgA
Rationale: Secretory IgA provides passive mucosal immunity; levels >12 g/L in
colostrum vs. 1 g/L in mature milk.
5. Milk production increases most rapidly during which postpartum days?
a) 1–2
b) 3–5
c) 7–10
d) 14–21
b) 3–5
Rationale: Lactogenesis II; progesterone withdrawal triggers copious milk (“milk
coming in”).
6. Average daily mature milk intake for a 1-month-old is:
a) 200–400 mL
b) 500–600 mL
c) 750–800 mL
d) 1000–1200 mL
c) 750–800 mL
Rationale: Range 570–900 mL; 150 mL/kg/day (25 oz) average.
, 7. The milk fat content is lowest in:
a) Fore-milk
b) Hind-milk
c) Night milk
d) Colostrum
a) Fore-milk
Rationale: Fat increases 2–3-fold from beginning to end of feed due to milk fat
globule retention.
8. Which hormone inhibits lactation during pregnancy?
a) Progesterone
b) Prolactin
c) Oxytocin
d) Insulin
a) Progesterone
Rationale: High placental progesterone blocks prolactin receptors; withdrawal at
delivery lifts inhibition.
9. Milk synthesis is primarily regulated at the:
a) Alveolar level (autocrine)
b) Hypothalamic level (neuroendocrine)
c) Thyroid level
d) Adrenal level
a) Alveolar level (autocrine)
Rationale: Feedback inhibitor of lactation (FIL) peptide adjusts local production to
demand.
10. The average breast storage capacity (maximum milk volume before discomfort) is:
a) 50 mL
b) 100 mL
c) 150 mL
d) 300 mL
b) 100 mL
Rationale: Wide variation 60–200 mL; larger capacity associated with longer
between-feed intervals.
11. Oxytocin release is enhanced by:
a) Stress
b) Warm compresses
c) Cold shower
d) Bright light
b) Warm compresses
Rationale: Thermal stimulation increases maternal oxytocin and milk ejection.
12. Milk calcium concentration is highest during which feeding?
a) Night feed
b) Morning feed
c) Afternoon feed
d) No variation
a) Night feed
Rationale: Circadian rhythm; prolactin peaks at 03:00–05:00 increase calcium and
fat.
