IBCLC EXAM ACTUAL TEST PAPER 2026
QUESTIONS ANSWERS SOLUTIONS GRADED
A+
◉ Where does the primitive milk streak develop Answer: Bilaterally
from the axilla to the groin
◉ By the 5th week gestation the milk streak becomes what? Answer:
Mammary Milk Ridge (or milk line)
◉ Thickening and inward growth into the chest wall continues
during what weeks gestation? Answer: 7-8 weeks gestation
◉ Between weeks 12 and 16 gestation specialized cells differentiate
into what? Answer: Smooth muscles of the nipple and areola
◉ What forms the mammary pit? Answer: Lactiferous ducts and
their branches open into a shallow epithelial depression
◉ What creates an inverted nipple? Answer: When the Mammary pit
fails to elevate
,◉ What is witches milk? Answer: After birth, a neonate's mammary
tissue (under the influence of maternal hormones) might recreate
colostral like fluid
◉ At what age do the primary and secondary ducts grow and divide
and form the terminal end buds that become the alveoli? Answer:
10-12 years old
◉ When does complete development of mammary function occur?
Answer: During pregnancy
◉ What is superficial fiscia? Answer: Fibrous tissue beneath the skin
◉ Where is the breast located? Answer: In the superficial fascia
between the second rib and sixth intercostal space
◉ What are the two major divisions of the breast? Answer:
Parenchyma and Stroma
◉ What makes up the Parenchyma? Answer: Ducts, lobes, and aveoli
◉ What are alveoli? Answer: Small sacs where milk is secreted
,◉ What makes up the Stroma? Answer: Connective tissue, fat tissue,
blood vessels, nerves, and lymphatics.
◉ What is Cooper's Ligament? Answer: Suspensory ligament that
are the fibrous connections between the inner side of the breast skin
and pectoral muscles. Help to shape the breasts
◉ What does the nipple contain? Answer: 15-25 milk ducts, smooth
muscle fibers, sebaceous and apocrine sweat glands, and dense
innervations of sensory nerve endings
◉ What are Montgomery Tubercles? Answer: Sebaceous glands in
the areola surrounding the nipple
◉ What do the Montgomery Tubercles secrete? Answer: Oily
secretions (lipoid fluid) to keep the areola and the nipple lubricated
and protected
◉ What artery(s) supply blood to the breast? Answer: Internal
mammary artery (60%) and lateral thoracic artery (30%)
◉ Where does the lymphatic system of the breast drain excess fluids
from tissue space, bacteria and cast off cells? Answer: Auxiliary
lymph node
, ◉ Where does the nerves of the breast mainly branch from? Answer:
4th, 5th, and 6th intercostal nerve
◉ What nerve supplies the greatest amount of sensation to the
areola? Answer: 4th intercostal nerve
◉ What part of the breast is most sensitive? Answer: The areola
followed by the general skin of the breast, and then the nipple which
is least sensitive.
◉ What percent of breast milk is carbohydrates? Answer:
Approximately 7%
◉ What are the six infant behavioral "states" Answer: Crying, active
alert, quiet alert, drowsy, active sleep, and quiet sleep
◉ Milk components that protect the infant/lactating breast actively
bind ______, preventing their passage through the permeable infant
_____ _____ Answer: pathogens
gut mucosa
◉ How does the infant get the antibodies produced by mom?
Answer: antibodies are produced in moms blood, targeted SIgA
QUESTIONS ANSWERS SOLUTIONS GRADED
A+
◉ Where does the primitive milk streak develop Answer: Bilaterally
from the axilla to the groin
◉ By the 5th week gestation the milk streak becomes what? Answer:
Mammary Milk Ridge (or milk line)
◉ Thickening and inward growth into the chest wall continues
during what weeks gestation? Answer: 7-8 weeks gestation
◉ Between weeks 12 and 16 gestation specialized cells differentiate
into what? Answer: Smooth muscles of the nipple and areola
◉ What forms the mammary pit? Answer: Lactiferous ducts and
their branches open into a shallow epithelial depression
◉ What creates an inverted nipple? Answer: When the Mammary pit
fails to elevate
,◉ What is witches milk? Answer: After birth, a neonate's mammary
tissue (under the influence of maternal hormones) might recreate
colostral like fluid
◉ At what age do the primary and secondary ducts grow and divide
and form the terminal end buds that become the alveoli? Answer:
10-12 years old
◉ When does complete development of mammary function occur?
Answer: During pregnancy
◉ What is superficial fiscia? Answer: Fibrous tissue beneath the skin
◉ Where is the breast located? Answer: In the superficial fascia
between the second rib and sixth intercostal space
◉ What are the two major divisions of the breast? Answer:
Parenchyma and Stroma
◉ What makes up the Parenchyma? Answer: Ducts, lobes, and aveoli
◉ What are alveoli? Answer: Small sacs where milk is secreted
,◉ What makes up the Stroma? Answer: Connective tissue, fat tissue,
blood vessels, nerves, and lymphatics.
◉ What is Cooper's Ligament? Answer: Suspensory ligament that
are the fibrous connections between the inner side of the breast skin
and pectoral muscles. Help to shape the breasts
◉ What does the nipple contain? Answer: 15-25 milk ducts, smooth
muscle fibers, sebaceous and apocrine sweat glands, and dense
innervations of sensory nerve endings
◉ What are Montgomery Tubercles? Answer: Sebaceous glands in
the areola surrounding the nipple
◉ What do the Montgomery Tubercles secrete? Answer: Oily
secretions (lipoid fluid) to keep the areola and the nipple lubricated
and protected
◉ What artery(s) supply blood to the breast? Answer: Internal
mammary artery (60%) and lateral thoracic artery (30%)
◉ Where does the lymphatic system of the breast drain excess fluids
from tissue space, bacteria and cast off cells? Answer: Auxiliary
lymph node
, ◉ Where does the nerves of the breast mainly branch from? Answer:
4th, 5th, and 6th intercostal nerve
◉ What nerve supplies the greatest amount of sensation to the
areola? Answer: 4th intercostal nerve
◉ What part of the breast is most sensitive? Answer: The areola
followed by the general skin of the breast, and then the nipple which
is least sensitive.
◉ What percent of breast milk is carbohydrates? Answer:
Approximately 7%
◉ What are the six infant behavioral "states" Answer: Crying, active
alert, quiet alert, drowsy, active sleep, and quiet sleep
◉ Milk components that protect the infant/lactating breast actively
bind ______, preventing their passage through the permeable infant
_____ _____ Answer: pathogens
gut mucosa
◉ How does the infant get the antibodies produced by mom?
Answer: antibodies are produced in moms blood, targeted SIgA
