CLC Exam 2024
Which milk is higher in calories - hand expressed milk or pumped milk? - (correct Answer) - Hand
expressed milk
Define: Exclusive breastfeeding - (correct Answer) - Infant receives only mother's milk as its food source,
from 0-6 months
What is the only absolute infant contraindication to breastfeeding? - (correct Answer) - galactosemia
Can infants with PKU breastfeed? - (correct Answer) - Yes, but they need formula supplementation
Define: Complementary feeding - (correct Answer) - Receiving both human milk and solids/semisolids.
From 6-23 months
9 stages of the first hour after birth - (correct Answer) - 1. Birth cry
2. Relaxation
3. Awakening
4. Activity
5. Rest (interspersed throughout)
6. Crawling
7. Familiarization
8. Suckling
9. Sleeping
Is crying an early or late feeding cute? - (correct Answer) - Late
Clenched hands are a sign that baby... - (correct Answer) - ... is hungry!
When is the fastest drop-off point when people stop breastfeeding? - (correct Answer) - In the first 10
days after discharge from hospital
What triggers oxytocin pathway to milk production? - (correct Answer) - 1. Conditioned let-down reflex
(smell, touch, sound)
2. Nipple stretching
3. Baby hand massage
What are the two hormone pathways for milk production? - (correct Answer) - Oxytocin and Prolactin
How does fat, protein and water content affect the frequency of feedings between different mammal
species? - (correct Answer) - High fat, high protein, low water = infrequent feeds
, High water = more frequent feeds
When does Lactogenesis II start? - (correct Answer) - complete delivery of the placenta
How does preterm milk differ from term milk? - (correct Answer) - Generally higher in protein, fat and
electrolytes
How long does preterm milk production last? - (correct Answer) - 5-7 weeks
Which has higher fat content: hindmilk or foremilk? - (correct Answer) - Neither. Some say hindmilk is
highest in fat - but this is not supported by research and shouldn't be a part of counseling
Which hormone(s) drive the production of colostrum and where do they come from? - (correct Answer) -
Progesterone from the placenta
Which hormone(s) drive the production of transitional milk and where do they come from? - (correct
Answer) - Progesterone - left from the placenta and is rapidly dropping
Prolactin - generally already circulating, not yet being released by nipple stimulation
Which hormone(s) drive the production of mature milk and where do they come from? - (correct
Answer) - Prolactin - comes from nipple stimulation in feeding
Describe paracellular vs transcellular pathways - (correct Answer) - Paracellular: during progesterone-
driven lactogenesis, there is free flow of blood/nutrients/etc between milk cells, increased permeability
to some drugs
Transcellular pathway: during prolactin-driven lactogenesis, milk cells are larger with no pathways
between them, which yields more safety from substances
Name 5 instances when breastmilk composition changes - (correct Answer) - 1. over the course of entire
lactation experience
2. time of day (higher caloric concentration at night)
3. within a feeding
4. between feedings (sooner feedings = higher fat content)
Which milk is higher in calories - hand expressed milk or pumped milk? - (correct Answer) - Hand
expressed milk
Define: Exclusive breastfeeding - (correct Answer) - Infant receives only mother's milk as its food source,
from 0-6 months
What is the only absolute infant contraindication to breastfeeding? - (correct Answer) - galactosemia
Can infants with PKU breastfeed? - (correct Answer) - Yes, but they need formula supplementation
Define: Complementary feeding - (correct Answer) - Receiving both human milk and solids/semisolids.
From 6-23 months
9 stages of the first hour after birth - (correct Answer) - 1. Birth cry
2. Relaxation
3. Awakening
4. Activity
5. Rest (interspersed throughout)
6. Crawling
7. Familiarization
8. Suckling
9. Sleeping
Is crying an early or late feeding cute? - (correct Answer) - Late
Clenched hands are a sign that baby... - (correct Answer) - ... is hungry!
When is the fastest drop-off point when people stop breastfeeding? - (correct Answer) - In the first 10
days after discharge from hospital
What triggers oxytocin pathway to milk production? - (correct Answer) - 1. Conditioned let-down reflex
(smell, touch, sound)
2. Nipple stretching
3. Baby hand massage
What are the two hormone pathways for milk production? - (correct Answer) - Oxytocin and Prolactin
How does fat, protein and water content affect the frequency of feedings between different mammal
species? - (correct Answer) - High fat, high protein, low water = infrequent feeds
, High water = more frequent feeds
When does Lactogenesis II start? - (correct Answer) - complete delivery of the placenta
How does preterm milk differ from term milk? - (correct Answer) - Generally higher in protein, fat and
electrolytes
How long does preterm milk production last? - (correct Answer) - 5-7 weeks
Which has higher fat content: hindmilk or foremilk? - (correct Answer) - Neither. Some say hindmilk is
highest in fat - but this is not supported by research and shouldn't be a part of counseling
Which hormone(s) drive the production of colostrum and where do they come from? - (correct Answer) -
Progesterone from the placenta
Which hormone(s) drive the production of transitional milk and where do they come from? - (correct
Answer) - Progesterone - left from the placenta and is rapidly dropping
Prolactin - generally already circulating, not yet being released by nipple stimulation
Which hormone(s) drive the production of mature milk and where do they come from? - (correct
Answer) - Prolactin - comes from nipple stimulation in feeding
Describe paracellular vs transcellular pathways - (correct Answer) - Paracellular: during progesterone-
driven lactogenesis, there is free flow of blood/nutrients/etc between milk cells, increased permeability
to some drugs
Transcellular pathway: during prolactin-driven lactogenesis, milk cells are larger with no pathways
between them, which yields more safety from substances
Name 5 instances when breastmilk composition changes - (correct Answer) - 1. over the course of entire
lactation experience
2. time of day (higher caloric concentration at night)
3. within a feeding
4. between feedings (sooner feedings = higher fat content)
