CERTIFIED LACTATION COUNSELOR 2026 EXAM
QUESTIONS AND ANSWERS RATED A+
✔✔How do you develop a relationship with women who are constructed knowers? -
✔✔-Must be empathetic, feel connected to another person despite differences
-Many women experience loneliness and discouragement due to difficulty finding
companionable and supportive partners.
✔✔When BF is non-exclusive research shows: - ✔✔1. Infant at greater risk for negative
health outcomes
2. Did not results in lower risks for respiratory infections and GI problems
✔✔FFB are more at risk for: - ✔✔-AOM (Acute Otitus Media) Increased risk
-Non-specific gastroenteritis
-Atopic dermatitis
-Asthma
-Obesity
-Diabetes
-Childhood Leukemia
-NEC
-Increased risk of SIDS
✔✔Women who not BF are at greater risk for what cancers? - ✔✔Breast, Endometrial,
Ovarian
-The longer, the more protected against cancer.
✔✔Hierarchy of Infant feeding choices for the Term Baby (WHO) - ✔✔1. Breast
2. Milk Expression
3. Milk from Human Milk Banking Association of North America or State Licensed Milk
Bank
4. Cow Formula
5. Soy Formula
✔✔Milk Expression by Hand - ✔✔-always available
-higher fat content
-promotes continued BF
-cleanest way to collect milk
✔✔Benefits of donor milk - ✔✔-Preventative
-Cost Effective
-Safe
✔✔Is informal milk sharing recommended in the US? - ✔✔No. Concerns are raised with
Wet nursing or borrowing/buying milk from a non-licensed donor (e.g. HMBANA
,member or local licensed milk bank). Increased risk of contamination. It is illegal to
distribute milk if mom knows she is ineligible as a milk bank donor.
✔✔Women who do not BF are at risk for what other diseases? - ✔✔Type 2 Diabetes
Myocardial Infarction
Metabolic Syndrome
Hypertension
Hyperlipidemia
✔✔PPAD Postpartum adjustment disorder - ✔✔85% of women experience mood
changes with hormonal changes, lack of support, and many life changes
✔✔Weight loss and BF - ✔✔Not significant. Research shows women who BF loss
approximately 3lbs more after 6 months of EBF
✔✔Research regarding Babies who have been BF indicate: - ✔✔1. Increase odds of
upward mobility
2. Higher IQ's, more years of education, high income at age 30
✔✔How does breastmilk impact the NICU? - ✔✔-Chances of sepsis decreased by 19%
(10mL/day of human milk)
-NICU costs lower
-Lower risk of getting NEC
-Better scores on the Bayley
✔✔Do milk banks heat treat milk? - ✔✔Yes, Destroys bacteria/viruses (e.g. HIV,
Herpes, CMV). Retains 90% of nutrients
✔✔What are some problems with using formula? - ✔✔-Sometimes they are recalled
-Can be contaminated (e.g. Botulism)
✔✔What are other routes for contamination? - ✔✔-Contaminated breast pumps
-Water used to dilute formula
-Additives such as melamine
-Contaminated bottles
-Dirty bottle nipples
✔✔What other feeding issues are associated with formula feeding? - ✔✔-Reflux (can be
due to mechanics, food, and/or physiologic immaturity)
-Colic (3 hours of inconsolable crying for 3 days between 3 weeks and 3 months of age)
May be related to microbiome.
-Anaphylaxis (relented to cow's milk based formula)
-Allergies (to soy or cow's milk based formulas). Can cause gut bleeding.
-Formula intolerance
, ✔✔What are some marketing claims that the formula companies use to increase sales?
- ✔✔Adding Long Chain Polyunsaturated Fatty Acids (LCPUFAs) to formula
✔✔What about homemade formulas? - ✔✔Animal milks and plant-based drinks. Can
cause electrolyte imbalances, scurvy, and other problems.
✔✔Contraindication to BF or feeding EBM - ✔✔-Infant diagnosed with galactosemia.
-Mother has HIV
-Mother has HTLV1 or 2 (Human T-Cell Lympphotrophic Virus) [Japan]
-Mother using drugs.
-Mother has Ebola
✔✔When should a mother not breastfeed, but can express milk for use? - ✔✔-Active
tuberculosis (mother can resume, once treated for 2 weeks and is no longer contagious)
-Active chicken pox (Varicella)
✔✔What does the research say about a woman's decision to BF? - ✔✔-Influenced by
embodied knowledge (from observing BF)
-Does not come from prenatal education
-Providers are not adequately addressing women's concerns about BF
✔✔Why do women choose formula over BF? - ✔✔-More comfortable with idea of FF.
-It's easier. BF seems hard.
-Other people's negative experiences.
✔✔What do women want from a Lactation Care Provider? - ✔✔-Education with truth
-Validating for confidence
-Countering negativity
-Supporting with solutions
✔✔Does when babies are born impact chances of supplementation? - ✔✔Yes. Babies
born between 10pm and 9am are more at risk.
Lack of support?
✔✔Effects of psychosocial support (Doula) during labor and childbirth on BF - ✔✔-BF
rates higher in women who received support.
✔✔What is the impact of pharmacological pain relief methods during childbirth? - ✔✔-
May need extra BF support
-May have a delayed onset of "milk coming in"
-Separation for the 1st 1-2 hours after birth have a negative affect on milk production.
-Some drugs have more profound effect (e.g. Fentanyl)
✔✔How can Pitocin impact feeding? - ✔✔-May result in less oxytocin release in the first
2 days
QUESTIONS AND ANSWERS RATED A+
✔✔How do you develop a relationship with women who are constructed knowers? -
✔✔-Must be empathetic, feel connected to another person despite differences
-Many women experience loneliness and discouragement due to difficulty finding
companionable and supportive partners.
✔✔When BF is non-exclusive research shows: - ✔✔1. Infant at greater risk for negative
health outcomes
2. Did not results in lower risks for respiratory infections and GI problems
✔✔FFB are more at risk for: - ✔✔-AOM (Acute Otitus Media) Increased risk
-Non-specific gastroenteritis
-Atopic dermatitis
-Asthma
-Obesity
-Diabetes
-Childhood Leukemia
-NEC
-Increased risk of SIDS
✔✔Women who not BF are at greater risk for what cancers? - ✔✔Breast, Endometrial,
Ovarian
-The longer, the more protected against cancer.
✔✔Hierarchy of Infant feeding choices for the Term Baby (WHO) - ✔✔1. Breast
2. Milk Expression
3. Milk from Human Milk Banking Association of North America or State Licensed Milk
Bank
4. Cow Formula
5. Soy Formula
✔✔Milk Expression by Hand - ✔✔-always available
-higher fat content
-promotes continued BF
-cleanest way to collect milk
✔✔Benefits of donor milk - ✔✔-Preventative
-Cost Effective
-Safe
✔✔Is informal milk sharing recommended in the US? - ✔✔No. Concerns are raised with
Wet nursing or borrowing/buying milk from a non-licensed donor (e.g. HMBANA
,member or local licensed milk bank). Increased risk of contamination. It is illegal to
distribute milk if mom knows she is ineligible as a milk bank donor.
✔✔Women who do not BF are at risk for what other diseases? - ✔✔Type 2 Diabetes
Myocardial Infarction
Metabolic Syndrome
Hypertension
Hyperlipidemia
✔✔PPAD Postpartum adjustment disorder - ✔✔85% of women experience mood
changes with hormonal changes, lack of support, and many life changes
✔✔Weight loss and BF - ✔✔Not significant. Research shows women who BF loss
approximately 3lbs more after 6 months of EBF
✔✔Research regarding Babies who have been BF indicate: - ✔✔1. Increase odds of
upward mobility
2. Higher IQ's, more years of education, high income at age 30
✔✔How does breastmilk impact the NICU? - ✔✔-Chances of sepsis decreased by 19%
(10mL/day of human milk)
-NICU costs lower
-Lower risk of getting NEC
-Better scores on the Bayley
✔✔Do milk banks heat treat milk? - ✔✔Yes, Destroys bacteria/viruses (e.g. HIV,
Herpes, CMV). Retains 90% of nutrients
✔✔What are some problems with using formula? - ✔✔-Sometimes they are recalled
-Can be contaminated (e.g. Botulism)
✔✔What are other routes for contamination? - ✔✔-Contaminated breast pumps
-Water used to dilute formula
-Additives such as melamine
-Contaminated bottles
-Dirty bottle nipples
✔✔What other feeding issues are associated with formula feeding? - ✔✔-Reflux (can be
due to mechanics, food, and/or physiologic immaturity)
-Colic (3 hours of inconsolable crying for 3 days between 3 weeks and 3 months of age)
May be related to microbiome.
-Anaphylaxis (relented to cow's milk based formula)
-Allergies (to soy or cow's milk based formulas). Can cause gut bleeding.
-Formula intolerance
, ✔✔What are some marketing claims that the formula companies use to increase sales?
- ✔✔Adding Long Chain Polyunsaturated Fatty Acids (LCPUFAs) to formula
✔✔What about homemade formulas? - ✔✔Animal milks and plant-based drinks. Can
cause electrolyte imbalances, scurvy, and other problems.
✔✔Contraindication to BF or feeding EBM - ✔✔-Infant diagnosed with galactosemia.
-Mother has HIV
-Mother has HTLV1 or 2 (Human T-Cell Lympphotrophic Virus) [Japan]
-Mother using drugs.
-Mother has Ebola
✔✔When should a mother not breastfeed, but can express milk for use? - ✔✔-Active
tuberculosis (mother can resume, once treated for 2 weeks and is no longer contagious)
-Active chicken pox (Varicella)
✔✔What does the research say about a woman's decision to BF? - ✔✔-Influenced by
embodied knowledge (from observing BF)
-Does not come from prenatal education
-Providers are not adequately addressing women's concerns about BF
✔✔Why do women choose formula over BF? - ✔✔-More comfortable with idea of FF.
-It's easier. BF seems hard.
-Other people's negative experiences.
✔✔What do women want from a Lactation Care Provider? - ✔✔-Education with truth
-Validating for confidence
-Countering negativity
-Supporting with solutions
✔✔Does when babies are born impact chances of supplementation? - ✔✔Yes. Babies
born between 10pm and 9am are more at risk.
Lack of support?
✔✔Effects of psychosocial support (Doula) during labor and childbirth on BF - ✔✔-BF
rates higher in women who received support.
✔✔What is the impact of pharmacological pain relief methods during childbirth? - ✔✔-
May need extra BF support
-May have a delayed onset of "milk coming in"
-Separation for the 1st 1-2 hours after birth have a negative affect on milk production.
-Some drugs have more profound effect (e.g. Fentanyl)
✔✔How can Pitocin impact feeding? - ✔✔-May result in less oxytocin release in the first
2 days
