ALPP CLC Certification Exam — 2026 Page
1
ALPP CLC Certification Exam
100 Multiple-Choice Questions — 2026 Edition
Instructions: Select the single best answer for each question. There is no penalty
for guessing. An answer key with rationales follows the last question.
Domain 1: Anatomy & Physiology (Q1–25)
1. Which hormone is primarily responsible for the let-down reflex during breastfeeding?
A. Estrogen
B. Progesterone
C. Oxytocin
D. Prolactin
2. What is the primary function of prolactin in lactation?
A. Stimulatingmilk ejection
B. Promoting alveolar milk production
C. Regulating mammary gland growth during pregnancy
D. Suppressing ovulation
3. During pregnancy, which hormones work together to inhibit milk production until
after birth?
A. Oxytocin and prolactin
B. Estrogen and progesterone
C. Follicle-stimulating
hormone and luteinizing hormone
D. Thyroid-stimulating hormone and cortisol
4. Which structure in the breast is primarily responsible for milk storage?
A. Lactiferous ducts
, B. Alveoli
C. Areola
D. Nipple pores
5. What characterizes lactogenesis stage I?
A. Initiation
of copious milk secretion after birth
B. Milk production beginning around mid-pregnancy
C. Maintenance of established milk supply
D. Involution of mammary tissue after weaning
,ALPP CLC Certification Exam — 2026 Page
2
6. The Montgomery glands on the areola serve what primary purpose during
breastfeeding?
A. Produce milk directly for the infant
B. Lubricate and protect the nipple and areola
C. Store oxytocin for the let-down reflex
D. Detect the infant’s temperature during feeding
7. Which cells contract during the let-down reflex to move milk through the ducts?
A. Adipose cells
B. Myoepithelial cells
C. Epithelial cells of the alveoli
D. Smooth muscle cells in the nipple
8. What triggers the release of oxytocin during breastfeeding?
A. Stimulation of the cervix during labor
B. Nipple and areola stimulation by the infant’s suckling
C. High levels of prolactin in the bloodstream
D. Decreased progesterone levels postpartum
9. Colostrum is best described as:
A. A transitional milk produced 2 weeks after birth
B. A concentrated, antibody-rich first milk produced in late pregnancy and early
postpartum
C. A low-fat, high-lactose milk appearing after mature milk is established
D. A milk substitute given to infants with allergies
10. How many lactiferous ducts does each breast typically have?
A. 5 to 10
B. 15 to 25
C. 30 to 50
D. 1 or 2
, 11. What role does the Feedback Inhibitor of Lactation (FIL) play in milk production?
A. It stimulates prolactin release when the breast is full
B. It slows milk synthesis when milk accumulates in the alveoli
C. It increases oxytocin production during feeding
D. It signals the body to produce more fat in breast milk
12. The average caloric content of mature human milk is approximately:
1
ALPP CLC Certification Exam
100 Multiple-Choice Questions — 2026 Edition
Instructions: Select the single best answer for each question. There is no penalty
for guessing. An answer key with rationales follows the last question.
Domain 1: Anatomy & Physiology (Q1–25)
1. Which hormone is primarily responsible for the let-down reflex during breastfeeding?
A. Estrogen
B. Progesterone
C. Oxytocin
D. Prolactin
2. What is the primary function of prolactin in lactation?
A. Stimulatingmilk ejection
B. Promoting alveolar milk production
C. Regulating mammary gland growth during pregnancy
D. Suppressing ovulation
3. During pregnancy, which hormones work together to inhibit milk production until
after birth?
A. Oxytocin and prolactin
B. Estrogen and progesterone
C. Follicle-stimulating
hormone and luteinizing hormone
D. Thyroid-stimulating hormone and cortisol
4. Which structure in the breast is primarily responsible for milk storage?
A. Lactiferous ducts
, B. Alveoli
C. Areola
D. Nipple pores
5. What characterizes lactogenesis stage I?
A. Initiation
of copious milk secretion after birth
B. Milk production beginning around mid-pregnancy
C. Maintenance of established milk supply
D. Involution of mammary tissue after weaning
,ALPP CLC Certification Exam — 2026 Page
2
6. The Montgomery glands on the areola serve what primary purpose during
breastfeeding?
A. Produce milk directly for the infant
B. Lubricate and protect the nipple and areola
C. Store oxytocin for the let-down reflex
D. Detect the infant’s temperature during feeding
7. Which cells contract during the let-down reflex to move milk through the ducts?
A. Adipose cells
B. Myoepithelial cells
C. Epithelial cells of the alveoli
D. Smooth muscle cells in the nipple
8. What triggers the release of oxytocin during breastfeeding?
A. Stimulation of the cervix during labor
B. Nipple and areola stimulation by the infant’s suckling
C. High levels of prolactin in the bloodstream
D. Decreased progesterone levels postpartum
9. Colostrum is best described as:
A. A transitional milk produced 2 weeks after birth
B. A concentrated, antibody-rich first milk produced in late pregnancy and early
postpartum
C. A low-fat, high-lactose milk appearing after mature milk is established
D. A milk substitute given to infants with allergies
10. How many lactiferous ducts does each breast typically have?
A. 5 to 10
B. 15 to 25
C. 30 to 50
D. 1 or 2
, 11. What role does the Feedback Inhibitor of Lactation (FIL) play in milk production?
A. It stimulates prolactin release when the breast is full
B. It slows milk synthesis when milk accumulates in the alveoli
C. It increases oxytocin production during feeding
D. It signals the body to produce more fat in breast milk
12. The average caloric content of mature human milk is approximately:
