CERTIFIED BREASTFEEDING COUNSELOR 119
EXAM SCRIPT 2026 FULL SOLUTION PRACTICE
◉ Hypernatremia. Answer: High concentration of sodium in the
blood
◉ Why would a baby develop hyperetremia or malnutrition.
Answer: 1. Not feeding frequently enough (e.g. q3-6 hours/day 5-
10min/side=60-120 min/day)
2. Babies too sleepy (likely due to lack of nutrition)
3. Babies should be fed on demand, not qxxx hours.
◉ What color is meconium stool?. Answer: Dark brown
◉ What color is transitional stool?. Answer: Green
◉ What color is mature breast milk stool?. Answer: Brown
◉ What causes hyperinsulinemia?. Answer: Excess insulin in the
blood, due to overproduction. This might cause the higher weight
gain in formula fed babies. Could also be related to high fat and
protein levels in bovine formula.
,◉ What is a significant protective factor against obesity in children?.
Answer: BF
◉ What does the White House Task Force on Childhood Obesity
recommend?. Answer: Exclusive BF for 6 month, then BF with
complementary foods for 1 year or more.
◉ What are some BF myths?. Answer: 1. Breast size matters.
2. She isn't drinking enough fluids
3. She is exercising too much, working too hard, not resting enough.
4. She is too stressed.
5. It's what she eats or doesn't eat.
◉ How do we assure an adequate milk supply?. Answer: 1.
Understanding of how BF works
2. Early initiation and adequate BF
3. Appropriate BF assessment
4. Improved and early BF support
5. Appropriate HCP/LCP f/u in the postpartum
◉ How much milk does a mother produce?. Answer: 750-
1000mLs/day
,◉ What are some negative influences on milk supply?. Answer: 1.
Long spaces between feedings
2. Long, slow feedings
3. Excessive pressure on the breast
4. Breast surgery/injury
5. Anatomical concerns
6. Altered physiology
7. Physical objects
◉ What could cause pressure on the milk-making cells?. Answer: 1.
Vascular, lymphatic, and third-spacing forces
2. Secretory activation - Lactogenesis II
◉ What are some characteristics of the normal breast?. Answer: -
Soft
-Normal body temp
-Mother feels well
-Breasts may be hot
-Nipple graspable
◉ What are some characteristics of the engorged breast?. Answer: -
Hard
, -Temp normal +
-Mother feels discomfort
-Breast hot, shiny
-Nipple is hard to grasp/latch
◉ When do symptoms of engorgement occur?. Answer: -Between
days 3-5
-Moms with a lot of IV fluids, may have swelling up to day 9
-Women who have had a c-section experience it 24-48 hours later.
◉ What happens to the engorged breast?. Answer: - As pressure
increases, milk production decreases.
◉ What causes pressure in the breast (engorgement)? 4 things....
Answer: 1. Milk left post feed
2. Missed feedings
3. Restrictive bras and clothing
4. Breast implants (storage capacity is less)
◉ What concerns are there with surgery and BF?. Answer: -Damage
to nerves
-Damage to ducts
-The periareolar incision is associated with lactation insufficiency.
EXAM SCRIPT 2026 FULL SOLUTION PRACTICE
◉ Hypernatremia. Answer: High concentration of sodium in the
blood
◉ Why would a baby develop hyperetremia or malnutrition.
Answer: 1. Not feeding frequently enough (e.g. q3-6 hours/day 5-
10min/side=60-120 min/day)
2. Babies too sleepy (likely due to lack of nutrition)
3. Babies should be fed on demand, not qxxx hours.
◉ What color is meconium stool?. Answer: Dark brown
◉ What color is transitional stool?. Answer: Green
◉ What color is mature breast milk stool?. Answer: Brown
◉ What causes hyperinsulinemia?. Answer: Excess insulin in the
blood, due to overproduction. This might cause the higher weight
gain in formula fed babies. Could also be related to high fat and
protein levels in bovine formula.
,◉ What is a significant protective factor against obesity in children?.
Answer: BF
◉ What does the White House Task Force on Childhood Obesity
recommend?. Answer: Exclusive BF for 6 month, then BF with
complementary foods for 1 year or more.
◉ What are some BF myths?. Answer: 1. Breast size matters.
2. She isn't drinking enough fluids
3. She is exercising too much, working too hard, not resting enough.
4. She is too stressed.
5. It's what she eats or doesn't eat.
◉ How do we assure an adequate milk supply?. Answer: 1.
Understanding of how BF works
2. Early initiation and adequate BF
3. Appropriate BF assessment
4. Improved and early BF support
5. Appropriate HCP/LCP f/u in the postpartum
◉ How much milk does a mother produce?. Answer: 750-
1000mLs/day
,◉ What are some negative influences on milk supply?. Answer: 1.
Long spaces between feedings
2. Long, slow feedings
3. Excessive pressure on the breast
4. Breast surgery/injury
5. Anatomical concerns
6. Altered physiology
7. Physical objects
◉ What could cause pressure on the milk-making cells?. Answer: 1.
Vascular, lymphatic, and third-spacing forces
2. Secretory activation - Lactogenesis II
◉ What are some characteristics of the normal breast?. Answer: -
Soft
-Normal body temp
-Mother feels well
-Breasts may be hot
-Nipple graspable
◉ What are some characteristics of the engorged breast?. Answer: -
Hard
, -Temp normal +
-Mother feels discomfort
-Breast hot, shiny
-Nipple is hard to grasp/latch
◉ When do symptoms of engorgement occur?. Answer: -Between
days 3-5
-Moms with a lot of IV fluids, may have swelling up to day 9
-Women who have had a c-section experience it 24-48 hours later.
◉ What happens to the engorged breast?. Answer: - As pressure
increases, milk production decreases.
◉ What causes pressure in the breast (engorgement)? 4 things....
Answer: 1. Milk left post feed
2. Missed feedings
3. Restrictive bras and clothing
4. Breast implants (storage capacity is less)
◉ What concerns are there with surgery and BF?. Answer: -Damage
to nerves
-Damage to ducts
-The periareolar incision is associated with lactation insufficiency.
