CERTIFIED BREASTFEEDING COUNSELOR 119
FINAL PAPER 2026 COMPLETE ANSWERS
VERIFIED
◉ Atopy. Answer: hypersensitive or allergic state involving an
inherited predisposition
◉ What is the BFHI Baby Friendly Hospital Initiative. Answer:
Initiative by UNICEF and WHO (1991) to support breastfeeding in
hospitals and maternity centers. "The 10 Steps".
Unicef. Baby-Friendly Hospital Initiative. Available online:
http://www.unicef.org/programme/breastfeeding/baby.htm.
◉ Bilirubin. Answer: an orange-yellow pigment formed in the liver
by the breakdown of hemoglobin and excreted in bile.
◉ CCK (cholecystokinin). Answer: Hormone that regulates the
emptying of the gallbladder and secretion of enzymes by the
pancreas.
◉ Colostrum. Answer: Thick, milky fluid secreted by the breast
during pregnancy and during the first days after birth before
lactation begins. Causes a laxative effect which helps the baby pass
meconium.
,◉ Coryllos type. Answer: Classification system for anklyloglossia
(tongue-tie)
◉ Dancer Hand Position. Answer: Technique used to support Baby's
chin and mother's breast. Use Thumb and index finger under chin,
remaining 3 fingers to support breast.
◉ Alveolar Cells. Answer: found in the walls of the alveoli, simple
squamous epithelial cells, main sites of gas exchange
◉ myoepithelial cells. Answer: contract in response to stimulation
by sympathetic nervous system and squeeze milk up the duct
◉ Montgomery glands. Answer: Bumps on breasts (Look like
goosebumps)
Produce a unique blend of milk and sebum (skin oil)
◉ Modern study of the structure of the breast reveals what?.
Answer: -Fat is mixed throughout the breast
-Uneven spacing of the ducts
-3-5 functioning nipple pores (May have 5-9, but not all work)
-No lactiferous sinus
,◉ What are the 2 hormones pathways that control lactation?.
Answer: Prolactin and Oxytocin
◉ Prolactin (4 details related to milk production). Answer: 1. is
triggered by touch (pregnant and non pregnant women). Higher
levels when stimulating breast/nipples vs breast alone.
2. Lengthening time between feeding leads to lower baseline levels.
(Weaning)
3. levels go down between nursings and rise during nursing.
4. Infrequent nursing leads to lowering of this hormone
◉ Average number of feeds in a day?. Answer: 8-12
◉ What produces colostrum?. Answer: Progesterone in the receptor
sites
◉ What produces more mature milk?. Answer: Prolactin in the
receptor sites
◉ What happened when infants suckled in the first 2 hours of birth?.
Answer: Ingested significantly more milk on day 4
◉ What happened to mother of preemies who initiated milk
expression within 1 hour of birth?. Answer: Had significantly more
, milk when measured on days 7 and 42. Better to stimulate breasts
throughout the day right after birth to continue to stimulate
production.
◉ Oxytocin. Answer: A hormone released by the posterior pituitary
that stimulates uterine contractions during childbirth and milk
ejection during breastfeeding.
◉ What 3 things can trigger Oxytocin?. Answer: 1. Conditioned
response
2. Nipple stretching
3. Hand massage
◉ Conditioned Response from Milk Ejection (Let down). Answer: -
Example- Mother lets down when not near baby, but hears a baby
cry.
-Conditioned over time
-Faster for women who have BF in the past
-To condition the response can use any sense-smell, touch, sound
◉ Nipple stretching. Answer: Only happens with a proper latch
FINAL PAPER 2026 COMPLETE ANSWERS
VERIFIED
◉ Atopy. Answer: hypersensitive or allergic state involving an
inherited predisposition
◉ What is the BFHI Baby Friendly Hospital Initiative. Answer:
Initiative by UNICEF and WHO (1991) to support breastfeeding in
hospitals and maternity centers. "The 10 Steps".
Unicef. Baby-Friendly Hospital Initiative. Available online:
http://www.unicef.org/programme/breastfeeding/baby.htm.
◉ Bilirubin. Answer: an orange-yellow pigment formed in the liver
by the breakdown of hemoglobin and excreted in bile.
◉ CCK (cholecystokinin). Answer: Hormone that regulates the
emptying of the gallbladder and secretion of enzymes by the
pancreas.
◉ Colostrum. Answer: Thick, milky fluid secreted by the breast
during pregnancy and during the first days after birth before
lactation begins. Causes a laxative effect which helps the baby pass
meconium.
,◉ Coryllos type. Answer: Classification system for anklyloglossia
(tongue-tie)
◉ Dancer Hand Position. Answer: Technique used to support Baby's
chin and mother's breast. Use Thumb and index finger under chin,
remaining 3 fingers to support breast.
◉ Alveolar Cells. Answer: found in the walls of the alveoli, simple
squamous epithelial cells, main sites of gas exchange
◉ myoepithelial cells. Answer: contract in response to stimulation
by sympathetic nervous system and squeeze milk up the duct
◉ Montgomery glands. Answer: Bumps on breasts (Look like
goosebumps)
Produce a unique blend of milk and sebum (skin oil)
◉ Modern study of the structure of the breast reveals what?.
Answer: -Fat is mixed throughout the breast
-Uneven spacing of the ducts
-3-5 functioning nipple pores (May have 5-9, but not all work)
-No lactiferous sinus
,◉ What are the 2 hormones pathways that control lactation?.
Answer: Prolactin and Oxytocin
◉ Prolactin (4 details related to milk production). Answer: 1. is
triggered by touch (pregnant and non pregnant women). Higher
levels when stimulating breast/nipples vs breast alone.
2. Lengthening time between feeding leads to lower baseline levels.
(Weaning)
3. levels go down between nursings and rise during nursing.
4. Infrequent nursing leads to lowering of this hormone
◉ Average number of feeds in a day?. Answer: 8-12
◉ What produces colostrum?. Answer: Progesterone in the receptor
sites
◉ What produces more mature milk?. Answer: Prolactin in the
receptor sites
◉ What happened when infants suckled in the first 2 hours of birth?.
Answer: Ingested significantly more milk on day 4
◉ What happened to mother of preemies who initiated milk
expression within 1 hour of birth?. Answer: Had significantly more
, milk when measured on days 7 and 42. Better to stimulate breasts
throughout the day right after birth to continue to stimulate
production.
◉ Oxytocin. Answer: A hormone released by the posterior pituitary
that stimulates uterine contractions during childbirth and milk
ejection during breastfeeding.
◉ What 3 things can trigger Oxytocin?. Answer: 1. Conditioned
response
2. Nipple stretching
3. Hand massage
◉ Conditioned Response from Milk Ejection (Let down). Answer: -
Example- Mother lets down when not near baby, but hears a baby
cry.
-Conditioned over time
-Faster for women who have BF in the past
-To condition the response can use any sense-smell, touch, sound
◉ Nipple stretching. Answer: Only happens with a proper latch
