CERTIFIED BREASTFEEDING COUNSELOR EXAM
EXAM PREPARATION PACK 2026 KEY
CONCEPTS AND REVISION NOTES
◉ What are the different care patterns of mammalian mother's and
their babies.
Answer: 1. Nest (eg. puppies, cats) OR cache (deer, rabbit)
2. Carry (monkey), follow (giraffe, bison), or hibernate (bear)
◉ What kind of milk has the highest lactose of all mammalian milk.
Answer: Human milk: high in water, low in protein and fat.
◉ When does paracellular transport occur.
Answer: 1. In the first few days after birth
2. Mother with low prolactin levels
◉ When are cells not plump?.
Answer: During paracellular transport
◉ Transcelluar pathway.
Answer: Substances must go through the milk cell to enter the milk.
,Cells are plump and can no longer go around.
◉ Why is colostrum easier to suck/swallow.
Answer: Because it is thicker and takes longer to express from the
breast.
◉ What are the 3 stages of milk making?.
Answer: 1. Secretory Differentiation: Lactogenesis I
2. Secretory Activation: Lactogensis II
3. Lactation: Lactogenesis III
◉ What happens during Secretory Activation? Lactogensis II.
Answer: Rapid drop in progesterone, mature milk making is
activated
◉ What happens during Secretory Differentiation? Lactogenesis I.
Answer: Cells grow and expand
◉ When does breast milk composition change?.
Answer: Can occur:
1. Within a feeding
2. Within a day
,3. Over course of lactation
◉ What happens during Lactation? Lactogensis III.
Answer: Mature milk is being made. frequent expression of milk
◉ Preterm milk composition is....
Answer: Higher in protein, fat, and electrolytes than mature milk
◉ What is foremilk?.
Answer: first milk excreted at the beginning of feeding. Does not
always mean low fat.
◉ What is hindmilk?.
Answer: Milk at the end of the feed. Not always higher in fat.
◉ When is fat transfer high?.
Answer: When oxytocin levels are high.
◉ Does a mother need to nurse both breasts in one feed?.
Answer: No. Some babies do better on one breast per feeding.
◉ Who regulates the fat intake when feeding?.
, Answer: The baby can regulate his fat intake quickly.
◉ When is fat content higher?.
Answer: When the flow is faster.
◉ Can milk fat be different if the baby is male or female?.
Answer: Yes.. Mother's seem to produce milk that is 25% higher in
fat content for males.
◉ galactorrhea.
Answer: abnormal discharge of milk.
Ex: Men make milk, due to brain tumors or drug side effects (haldol,
Thorazine).
◉ Reasons why BF protects babies from diarrhea?.
Answer: 1. pH of the gut is lower. Bifidus factor promotes growth of
friendly bacteria which maintains lower pH in the gut.
2. Low iron in the gut. Organisms need iron to survive! Lactoferrin
deprives bacteria of iron.
3. Hormones and growth factors stimulate growth, development,
and motility of the gut.
4. Antibodies (e.g. Secretory IgA [SIgA] which bind to microbes in
the digestive tract and prevent them from being absorbed.
EXAM PREPARATION PACK 2026 KEY
CONCEPTS AND REVISION NOTES
◉ What are the different care patterns of mammalian mother's and
their babies.
Answer: 1. Nest (eg. puppies, cats) OR cache (deer, rabbit)
2. Carry (monkey), follow (giraffe, bison), or hibernate (bear)
◉ What kind of milk has the highest lactose of all mammalian milk.
Answer: Human milk: high in water, low in protein and fat.
◉ When does paracellular transport occur.
Answer: 1. In the first few days after birth
2. Mother with low prolactin levels
◉ When are cells not plump?.
Answer: During paracellular transport
◉ Transcelluar pathway.
Answer: Substances must go through the milk cell to enter the milk.
,Cells are plump and can no longer go around.
◉ Why is colostrum easier to suck/swallow.
Answer: Because it is thicker and takes longer to express from the
breast.
◉ What are the 3 stages of milk making?.
Answer: 1. Secretory Differentiation: Lactogenesis I
2. Secretory Activation: Lactogensis II
3. Lactation: Lactogenesis III
◉ What happens during Secretory Activation? Lactogensis II.
Answer: Rapid drop in progesterone, mature milk making is
activated
◉ What happens during Secretory Differentiation? Lactogenesis I.
Answer: Cells grow and expand
◉ When does breast milk composition change?.
Answer: Can occur:
1. Within a feeding
2. Within a day
,3. Over course of lactation
◉ What happens during Lactation? Lactogensis III.
Answer: Mature milk is being made. frequent expression of milk
◉ Preterm milk composition is....
Answer: Higher in protein, fat, and electrolytes than mature milk
◉ What is foremilk?.
Answer: first milk excreted at the beginning of feeding. Does not
always mean low fat.
◉ What is hindmilk?.
Answer: Milk at the end of the feed. Not always higher in fat.
◉ When is fat transfer high?.
Answer: When oxytocin levels are high.
◉ Does a mother need to nurse both breasts in one feed?.
Answer: No. Some babies do better on one breast per feeding.
◉ Who regulates the fat intake when feeding?.
, Answer: The baby can regulate his fat intake quickly.
◉ When is fat content higher?.
Answer: When the flow is faster.
◉ Can milk fat be different if the baby is male or female?.
Answer: Yes.. Mother's seem to produce milk that is 25% higher in
fat content for males.
◉ galactorrhea.
Answer: abnormal discharge of milk.
Ex: Men make milk, due to brain tumors or drug side effects (haldol,
Thorazine).
◉ Reasons why BF protects babies from diarrhea?.
Answer: 1. pH of the gut is lower. Bifidus factor promotes growth of
friendly bacteria which maintains lower pH in the gut.
2. Low iron in the gut. Organisms need iron to survive! Lactoferrin
deprives bacteria of iron.
3. Hormones and growth factors stimulate growth, development,
and motility of the gut.
4. Antibodies (e.g. Secretory IgA [SIgA] which bind to microbes in
the digestive tract and prevent them from being absorbed.
