CERTIFIED LACTATION COUNSELOR
EXAM QUESTIONS AND ANSWERS
GRADED A+ 2025/2026
Predominant Breastfeeding - ANS Babies who receive breastmilk and other liquids (e.g.
water, minerals, vitamins, oral meds).
Breastfeeding - ANS Baby receives human milk, as well as other foods or fluids, including
formula.
Complementary Feeding - ANS Process starts when BM alone or infant formula alone is no
longer sufficient to meet nutritional requirements of infants, therefore other foods or liquids are
introduced. Typically child is between 6-23 months
3 strategies for increasing BF initiation and duration - ANS Promotion, Protection, Support
Promotion - ANS Focuses on advantages of BF on a personal, community, country, or global
level. BF to the community.
Protection - ANS Focuses on government, manufacturer, and social responsibility to assure BF
ability to compete with commercial interests.
Includes state, local, an national laws regarding BF.
International Code of Marketing of Breast-milk Subsitutes - ANS Addresses improper
marketing practices by formula companies. It is not currently a law in the US.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,What does the International Code Prohibit? - ANS Distributing free formula
Giving coupons for formula
What did the AAP resolution state in regards to the International Code? - ANS No distributing
formula, discharge bags, industry written handouts.
Support - ANS Focuses on interaction of helpers with family, as well as program development
and implementation.
10 steps to successful BF - ANS 1. Written BF policy. Skin to Skin immediately after birth.
2. Train healthcare staff
3. Inform pregnant women about benefits and management of BF
4. Help all mothers initiate BF within 1 hour after birth
5. Show mother's how to BF and maintain lactation
6. Exclusive breast milk only
7. Practice rooming in 24 hours a day
8. Encourage BF on demand
9. No artificial teats or pacifiers
10. Establishment of BF support groups
Healthcare staff responsibility for working with lactating mothers include what? - ANS 1.
Training
2. Minimum of 20 hours of training
3. 3 hours of competency verification
What are the indications for providing supplementation other than breast milk? - ANS 1.
Medical condition
2. Parents request after being informed of consequences
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Protocol for calculating Baby's daily needs - ANS Baby's weight x 2.5 (2.7 or 3.0 if Baby needs
to catch up weight) = daily ounces. PCP decides what the multiplier is!!!
What should be assessed 3-5 days after birth by PCP? - ANS Hydration (elimination patterns)
Body weight (no more than 7% loss)
Observe Feeding
Maternal or infant issues
What is a CLC? - ANS Nationally recognized designation awarded by the ALPP. Practice
parameters are designated by professional scope of practice.
How many stools per day should a breast fed newborn have? - ANS 4, some yellow by day 4.
When should a baby be back to birth weight? - ANS 12-14 days post birth
How much weight should a baby gain daily? - ANS Approximately 1 ounce
Why do women supplement with formula when there is no medical need? - ANS 1. Lack of
preparation for what the newborn period would be like.
2. Lack of timely interventions
Alveoli - ANS Small glands in the breast that produce milk
At-Breast Supplementer - ANS a device that allows a supplement to be given while a baby is
actively nursing at the breast,
ex: Supplement Nursing System
Atopy - ANS hypersensitive or allergic state involving an inherited predisposition
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, What is the BFHI Baby Friendly Hospital Initiative - ANS 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 - ANS an orange-yellow pigment formed in the liver by the breakdown of
hemoglobin and excreted in bile.
CCK (cholecystokinin) - ANS Hormone that regulates the emptying of the gallbladder and
secretion of enzymes by the pancreas.
Colostrum - ANS 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 - ANS Classification system for anklyloglossia (tongue-tie)
Dancer Hand Position - ANS 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 - ANS found in the walls of the alveoli, simple squamous epithelial cells, main
sites of gas exchange
myoepithelial cells - ANS contract in response to stimulation by sympathetic nervous system
and squeeze milk up the duct
Montgomery glands - ANS Bumps on breasts (Look like goosebumps)
Produce a unique blend of milk and sebum (skin oil)
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
EXAM QUESTIONS AND ANSWERS
GRADED A+ 2025/2026
Predominant Breastfeeding - ANS Babies who receive breastmilk and other liquids (e.g.
water, minerals, vitamins, oral meds).
Breastfeeding - ANS Baby receives human milk, as well as other foods or fluids, including
formula.
Complementary Feeding - ANS Process starts when BM alone or infant formula alone is no
longer sufficient to meet nutritional requirements of infants, therefore other foods or liquids are
introduced. Typically child is between 6-23 months
3 strategies for increasing BF initiation and duration - ANS Promotion, Protection, Support
Promotion - ANS Focuses on advantages of BF on a personal, community, country, or global
level. BF to the community.
Protection - ANS Focuses on government, manufacturer, and social responsibility to assure BF
ability to compete with commercial interests.
Includes state, local, an national laws regarding BF.
International Code of Marketing of Breast-milk Subsitutes - ANS Addresses improper
marketing practices by formula companies. It is not currently a law in the US.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,What does the International Code Prohibit? - ANS Distributing free formula
Giving coupons for formula
What did the AAP resolution state in regards to the International Code? - ANS No distributing
formula, discharge bags, industry written handouts.
Support - ANS Focuses on interaction of helpers with family, as well as program development
and implementation.
10 steps to successful BF - ANS 1. Written BF policy. Skin to Skin immediately after birth.
2. Train healthcare staff
3. Inform pregnant women about benefits and management of BF
4. Help all mothers initiate BF within 1 hour after birth
5. Show mother's how to BF and maintain lactation
6. Exclusive breast milk only
7. Practice rooming in 24 hours a day
8. Encourage BF on demand
9. No artificial teats or pacifiers
10. Establishment of BF support groups
Healthcare staff responsibility for working with lactating mothers include what? - ANS 1.
Training
2. Minimum of 20 hours of training
3. 3 hours of competency verification
What are the indications for providing supplementation other than breast milk? - ANS 1.
Medical condition
2. Parents request after being informed of consequences
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Protocol for calculating Baby's daily needs - ANS Baby's weight x 2.5 (2.7 or 3.0 if Baby needs
to catch up weight) = daily ounces. PCP decides what the multiplier is!!!
What should be assessed 3-5 days after birth by PCP? - ANS Hydration (elimination patterns)
Body weight (no more than 7% loss)
Observe Feeding
Maternal or infant issues
What is a CLC? - ANS Nationally recognized designation awarded by the ALPP. Practice
parameters are designated by professional scope of practice.
How many stools per day should a breast fed newborn have? - ANS 4, some yellow by day 4.
When should a baby be back to birth weight? - ANS 12-14 days post birth
How much weight should a baby gain daily? - ANS Approximately 1 ounce
Why do women supplement with formula when there is no medical need? - ANS 1. Lack of
preparation for what the newborn period would be like.
2. Lack of timely interventions
Alveoli - ANS Small glands in the breast that produce milk
At-Breast Supplementer - ANS a device that allows a supplement to be given while a baby is
actively nursing at the breast,
ex: Supplement Nursing System
Atopy - ANS hypersensitive or allergic state involving an inherited predisposition
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, What is the BFHI Baby Friendly Hospital Initiative - ANS 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 - ANS an orange-yellow pigment formed in the liver by the breakdown of
hemoglobin and excreted in bile.
CCK (cholecystokinin) - ANS Hormone that regulates the emptying of the gallbladder and
secretion of enzymes by the pancreas.
Colostrum - ANS 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 - ANS Classification system for anklyloglossia (tongue-tie)
Dancer Hand Position - ANS 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 - ANS found in the walls of the alveoli, simple squamous epithelial cells, main
sites of gas exchange
myoepithelial cells - ANS contract in response to stimulation by sympathetic nervous system
and squeeze milk up the duct
Montgomery glands - ANS Bumps on breasts (Look like goosebumps)
Produce a unique blend of milk and sebum (skin oil)
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
