ALPP CLC ACTUAL EXAM 2026/2028 CERTIFIED
LACTATION COUNSELOR EXAM (2026/2028)
QUESTIONS AND ANSWETRS WITH COMPLETE
SOLUTIONS
What duration of breastfeeding is associated with significantly reduced
incidence of acute otits media (AOM)? A) Any breastfeeding B) Up to 3 mos C)
More than 4-6 months
C) More than 4-6 months
Breastfeeding lowers the risk for the incidence of dental caries compared to
children fed nonhuman milk from a bottle. True of False?
True
Does breastfeeding lower the risk of NEC in preterm infants?
Yes
Is there a difference in the protective effect against SIDS between babies that
are exclusively breastfed vs. non-exclusively?
Yes, babies that are exclusively breastfed have a stronger protective effect against
SIDS
Does breastfeeding lower the risk for the incidence of malocclusion
(misalignment of teeth)?
Yes
True of False. Lactational amenorrhea, or the delay in return of menses after
birth, is not associated with exclusive breastfeeding.
False
What are the physical benefits of breastfeeding to the lactating parent?
,Lower risk of breast cancer, lower risk of ovarian cancer, reduced risk of Type 2
diabetes, reduced risk of cardiovascular disease
What are the 3 main steps of Evidence-Based Practice (EBP)?
Best available clinical evidence, Clinical expertise, Patient concerns and needs
What are the benefits of breastfeeding for infants?
Protective against respiratory infections, asthma, gastrointestinal infections and
diarrhea, ear infections, dental caries, teeth misalignment, NEC and SIDS, obesity,
diabetes, higher performance on intelligence tests
What are hypotonic lips in an infant?
Abnormally LOW muscle tone or weakness in lips- may impact amount of suction,
increase work of feeding, can contribute to milk loss and fatigue during feedings
What are hypertonic lips in an infant?
Abnormally HIGH muscle tone or overuse of lips- increased lip activity to hold
breast in mouth
What can hypertonic lips be an indication of?
1. Neurological abnormality or injury of the tongue, jaws, or facial nerves. 2. Can
also be compensating for muscular weakness in the cheeks, jaw, or tongue or
reduced lingual or labial mobility secondary to a tight labial frenulum or
ankyloglossia (tongue-tie) 3. May be sensory in nature (hypo- or hypersensitive)
What is a tethered maxillary frenulum?
Referred to as upper or superior labial frenulum- a tightness or thickness in the
band of tissue that attaches the upper lip to the upper gum
What is a cleft lip?
A fissure or opening in the upper lip, may extend into the nose, may be unilateral
or bilateral
What is the second most common birth defect?
Cleft lip
, What is a sign of a possible tight maxillary frenulum?
Blanching of the frenulum when gently lifting the upper lip, reduced lip
movement
What may cause sucking blisters?
Friction from retracted lips, a tight maxillary frenulum restricting upper lip
mobility, can be secondary cause of tight lingual frenulum (tongue-tie) or
hypertonia
When observing a feeding, what signs can indicate an issue with the infant's
lips?
Breaks in the seal with the breast, lip retraction and lip tremors, leaking milk
What are 2 ways to help improve tone and strengthen the lip seal for infants
with abnormal lip tone?
1. Provide firm pressure stimulus (i.e. tapping) on the lips prior to feeding. 2.
Insert clean finger or round, somewhat firm pacifier, then partially pull it out of
infant's mouth to induce the infant to pull it back.
How can parents help infant with cleft lip breastfeed?
By using finger or shape of the breast tissue to seal the cleft.
What are buccal pads?
Subcutaneous fat deposits in cheeks
What can cause low facial tone or poorly developed buccal pads in an infant?
Prematurity or low birth weight
What are possible issues due to facial hypotonia?
Decreased cheek stability hindering seal on the breast, infant needs to create a
greater vacuum to generate and sustain suction, this increases the work of
feeding and can cause fatigue before feeding is complete.
How do you assess cheeks on an infant?
LACTATION COUNSELOR EXAM (2026/2028)
QUESTIONS AND ANSWETRS WITH COMPLETE
SOLUTIONS
What duration of breastfeeding is associated with significantly reduced
incidence of acute otits media (AOM)? A) Any breastfeeding B) Up to 3 mos C)
More than 4-6 months
C) More than 4-6 months
Breastfeeding lowers the risk for the incidence of dental caries compared to
children fed nonhuman milk from a bottle. True of False?
True
Does breastfeeding lower the risk of NEC in preterm infants?
Yes
Is there a difference in the protective effect against SIDS between babies that
are exclusively breastfed vs. non-exclusively?
Yes, babies that are exclusively breastfed have a stronger protective effect against
SIDS
Does breastfeeding lower the risk for the incidence of malocclusion
(misalignment of teeth)?
Yes
True of False. Lactational amenorrhea, or the delay in return of menses after
birth, is not associated with exclusive breastfeeding.
False
What are the physical benefits of breastfeeding to the lactating parent?
,Lower risk of breast cancer, lower risk of ovarian cancer, reduced risk of Type 2
diabetes, reduced risk of cardiovascular disease
What are the 3 main steps of Evidence-Based Practice (EBP)?
Best available clinical evidence, Clinical expertise, Patient concerns and needs
What are the benefits of breastfeeding for infants?
Protective against respiratory infections, asthma, gastrointestinal infections and
diarrhea, ear infections, dental caries, teeth misalignment, NEC and SIDS, obesity,
diabetes, higher performance on intelligence tests
What are hypotonic lips in an infant?
Abnormally LOW muscle tone or weakness in lips- may impact amount of suction,
increase work of feeding, can contribute to milk loss and fatigue during feedings
What are hypertonic lips in an infant?
Abnormally HIGH muscle tone or overuse of lips- increased lip activity to hold
breast in mouth
What can hypertonic lips be an indication of?
1. Neurological abnormality or injury of the tongue, jaws, or facial nerves. 2. Can
also be compensating for muscular weakness in the cheeks, jaw, or tongue or
reduced lingual or labial mobility secondary to a tight labial frenulum or
ankyloglossia (tongue-tie) 3. May be sensory in nature (hypo- or hypersensitive)
What is a tethered maxillary frenulum?
Referred to as upper or superior labial frenulum- a tightness or thickness in the
band of tissue that attaches the upper lip to the upper gum
What is a cleft lip?
A fissure or opening in the upper lip, may extend into the nose, may be unilateral
or bilateral
What is the second most common birth defect?
Cleft lip
, What is a sign of a possible tight maxillary frenulum?
Blanching of the frenulum when gently lifting the upper lip, reduced lip
movement
What may cause sucking blisters?
Friction from retracted lips, a tight maxillary frenulum restricting upper lip
mobility, can be secondary cause of tight lingual frenulum (tongue-tie) or
hypertonia
When observing a feeding, what signs can indicate an issue with the infant's
lips?
Breaks in the seal with the breast, lip retraction and lip tremors, leaking milk
What are 2 ways to help improve tone and strengthen the lip seal for infants
with abnormal lip tone?
1. Provide firm pressure stimulus (i.e. tapping) on the lips prior to feeding. 2.
Insert clean finger or round, somewhat firm pacifier, then partially pull it out of
infant's mouth to induce the infant to pull it back.
How can parents help infant with cleft lip breastfeed?
By using finger or shape of the breast tissue to seal the cleft.
What are buccal pads?
Subcutaneous fat deposits in cheeks
What can cause low facial tone or poorly developed buccal pads in an infant?
Prematurity or low birth weight
What are possible issues due to facial hypotonia?
Decreased cheek stability hindering seal on the breast, infant needs to create a
greater vacuum to generate and sustain suction, this increases the work of
feeding and can cause fatigue before feeding is complete.
How do you assess cheeks on an infant?
