IBCLC ExaM
QUESTIONS With
ANSWERS 2023/2024
UPDATE GRADED A+
When does the breast begin to develop in utero? - ANSWER 4th week of gestation
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 which is transported across the mammary
secretory cells and released in the milk.
What is sIgA? - ANSWER Immunoglobulin A is an antibody that coats mucosal
surfaces to prevent adherence and penetration by pathogens
What are the most common food allergies? - ANSWER 1. Cow's milk protein
2. Eggs
3. Peanuts
4. Tree nuts
5. Fish
6. Shellfish
7. Soy
8. Wheat
What are the common symptoms of food allergies? - ANSWER 1. Eczema
2. Hives
3. Digestive or respiratory problems (e.g. mucus or blood in the stool)
The infant uses their _____ to draw in the nipple and ____ it in the mouth - ANSWER
Lips
Stabilize
What is weak lip tone? - ANSWER Hypotonic lips result in the inability to seal lips
around the breast impacting the amount of suction created
What is a sucking blister? - ANSWER friction abrasions resulting from retracted lips or
a labial frenulum that restricts the lips from flanging
What does weak lip tone look like? - ANSWER Milk spilling, smacking sound (breaking
suction), infant tires faster due to increased work of the feedings even though they
aren't efficient feedings
QUESTIONS With
ANSWERS 2023/2024
UPDATE GRADED A+
When does the breast begin to develop in utero? - ANSWER 4th week of gestation
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 which is transported across the mammary
secretory cells and released in the milk.
What is sIgA? - ANSWER Immunoglobulin A is an antibody that coats mucosal
surfaces to prevent adherence and penetration by pathogens
What are the most common food allergies? - ANSWER 1. Cow's milk protein
2. Eggs
3. Peanuts
4. Tree nuts
5. Fish
6. Shellfish
7. Soy
8. Wheat
What are the common symptoms of food allergies? - ANSWER 1. Eczema
2. Hives
3. Digestive or respiratory problems (e.g. mucus or blood in the stool)
The infant uses their _____ to draw in the nipple and ____ it in the mouth - ANSWER
Lips
Stabilize
What is weak lip tone? - ANSWER Hypotonic lips result in the inability to seal lips
around the breast impacting the amount of suction created
What is a sucking blister? - ANSWER friction abrasions resulting from retracted lips or
a labial frenulum that restricts the lips from flanging
What does weak lip tone look like? - ANSWER Milk spilling, smacking sound (breaking
suction), infant tires faster due to increased work of the feedings even though they
aren't efficient feedings
