ALPP Certified Lactation Counselor (CLC)
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,───────────────────────────────────────────────────────
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1. Which hormone is primarily responsible for milk production
(galactopoiesis)?
A) Oxytocin
B) Prolactin
C) Estrogen
D) Progesterone
Answer: B
Rationale: Prolactin is secreted by the anterior pituitary gland and is
responsible for milk synthesis. Oxytocin is responsible for milk
ejection (let-down).
2. The let-down reflex is mediated by the release of which hormone?
A) Prolactin
B) Estrogen
C) Oxytocin
D) Relaxin
Answer: C
Rationale: Oxytocin is released from the posterior pituitary and
causes the myoepithelial cells around the alveoli to contract,
pushing milk into the ducts.
3. Which of the following is a critical factor in establishing an
abundant milk supply?
A) Limiting feeding times to 5 minutes per side
B) Feeding on a strict 4-hour schedule
C) Frequent and effective milk removal
D) Giving routine formula supplementation
Answer: C
,Rationale: Milk supply is driven by supply and demand. Frequent
and effective milk removal (via breastfeeding or pumping) is
essential to establish a robust supply.
4. What is the name of the carbohydrate-digesting enzyme found in
breast milk?
A) Lipase
B) Amylase
C) Lactase
D) Protease
Answer: B
Rationale: Amylase is present in breast milk to help infants digest
carbohydrates, which is particularly important before their own
pancreatic amylase production matures.
5. Which immunoglobulin is most abundant in breast milk and
provides major mucosal immunity?
A) IgA
B) IgG
C) IgM
D) IgE
Answer: A
Rationale: Secretory Immunoglobulin A (sIgA) is the predominant
antibody in human milk. It coats the infant's gut and blocks
pathogens from entering the bloodstream.
6. Colostrum is produced during which stage of lactogenesis?
A) Lactogenesis I
B) Lactogenesis II
C) Lactogenesis III
D) Lactogenesis IV
Answer: A
, Rationale: Lactogenesis I occurs during pregnancy and continues for
the first few days postpartum, producing colostrum. Lactogenesis II
is the onset of copious milk production.
7. A breastfeeding mother complains of sharp, shooting breast pain.
Upon examination, her nipples are pink and shiny. What is the most
likely cause?
A) Bacterial infection
B) Raynaud’s phenomenon
C) Tongue-tie
D) Candidiasis (Thrush)
Answer: D
Rationale: Pink, shiny nipples accompanied by shooting, burning
pain are classic signs of a candidal (yeast) infection. Raynaud's
typically presents as blanching of the nipple.
8. How many calories per day does exclusively breastfeeding
typically add to a mother’s energy expenditure?
A) 200-300 kcal/day
B) 300-500 kcal/day
C) 500-700 kcal/day
D) 700-900 kcal/day
Answer: B
Rationale: Full lactation requires an additional 300 to 500 calories
per day to support milk production.
9. Which of the following is NOT a sign of a good latch?
A) Lips flanged outward
B) More areola visible above the baby's top lip than below the
bottom lip
C) Clicking or smacking sounds
D) Chin touching the breast
Answer: C
Test Questions and Answers with
rationales, (A+ Guarantee)
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. Which hormone is primarily responsible for milk production
(galactopoiesis)?
A) Oxytocin
B) Prolactin
C) Estrogen
D) Progesterone
Answer: B
Rationale: Prolactin is secreted by the anterior pituitary gland and is
responsible for milk synthesis. Oxytocin is responsible for milk
ejection (let-down).
2. The let-down reflex is mediated by the release of which hormone?
A) Prolactin
B) Estrogen
C) Oxytocin
D) Relaxin
Answer: C
Rationale: Oxytocin is released from the posterior pituitary and
causes the myoepithelial cells around the alveoli to contract,
pushing milk into the ducts.
3. Which of the following is a critical factor in establishing an
abundant milk supply?
A) Limiting feeding times to 5 minutes per side
B) Feeding on a strict 4-hour schedule
C) Frequent and effective milk removal
D) Giving routine formula supplementation
Answer: C
,Rationale: Milk supply is driven by supply and demand. Frequent
and effective milk removal (via breastfeeding or pumping) is
essential to establish a robust supply.
4. What is the name of the carbohydrate-digesting enzyme found in
breast milk?
A) Lipase
B) Amylase
C) Lactase
D) Protease
Answer: B
Rationale: Amylase is present in breast milk to help infants digest
carbohydrates, which is particularly important before their own
pancreatic amylase production matures.
5. Which immunoglobulin is most abundant in breast milk and
provides major mucosal immunity?
A) IgA
B) IgG
C) IgM
D) IgE
Answer: A
Rationale: Secretory Immunoglobulin A (sIgA) is the predominant
antibody in human milk. It coats the infant's gut and blocks
pathogens from entering the bloodstream.
6. Colostrum is produced during which stage of lactogenesis?
A) Lactogenesis I
B) Lactogenesis II
C) Lactogenesis III
D) Lactogenesis IV
Answer: A
, Rationale: Lactogenesis I occurs during pregnancy and continues for
the first few days postpartum, producing colostrum. Lactogenesis II
is the onset of copious milk production.
7. A breastfeeding mother complains of sharp, shooting breast pain.
Upon examination, her nipples are pink and shiny. What is the most
likely cause?
A) Bacterial infection
B) Raynaud’s phenomenon
C) Tongue-tie
D) Candidiasis (Thrush)
Answer: D
Rationale: Pink, shiny nipples accompanied by shooting, burning
pain are classic signs of a candidal (yeast) infection. Raynaud's
typically presents as blanching of the nipple.
8. How many calories per day does exclusively breastfeeding
typically add to a mother’s energy expenditure?
A) 200-300 kcal/day
B) 300-500 kcal/day
C) 500-700 kcal/day
D) 700-900 kcal/day
Answer: B
Rationale: Full lactation requires an additional 300 to 500 calories
per day to support milk production.
9. Which of the following is NOT a sign of a good latch?
A) Lips flanged outward
B) More areola visible above the baby's top lip than below the
bottom lip
C) Clicking or smacking sounds
D) Chin touching the breast
Answer: C
