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IBCLC Exam Study Guide (Terms and Questions) Complete Guide for Exam Prep
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IBCLC Exam Study Guide (Terms and Questions) Complete Guide for Exam Prep
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IBCLC Exam Study Guide (Terms andQuestions) Complete Guide for Exam Prep
Fat in breastmilk - ✔✔Triglycerides are the main constituent of milk fat. Fatty acids are low
in lactating women indicating that transfer to breastmilk is at the expense of maternal stores.
Fatty acids - ✔✔affect brain growth, are cytotoxic to parasites (ie giardia lamblia and
entamoeba histolytica)
Dococahexanoic Acid (DHA) and Arachidonic Acid (AA) - ✔✔Are associated with visual and
cognitive ability. DHA is a fatty acid. Breastfed infants accumulate DHA, formula fed infants
maintain birth levels.
Lactose in breastmilk - ✔✔accounts for most of the carbohydrates present in milk.
Metabolizes readily to glucose and galactose which supply energy to the brain.
Lactase - ✔✔necessary to convert lactose to simple sugars. Is present in intestinal mucosa
from birth. Congenital or primary lactase deficiency is exceedingly rare.
Protein in breastmilk - ✔✔0.8 - 0.9gm/dL. Decreases during the first several months. Casein
and Whey are most prevalent.
Whey protein - ✔✔composed of a(alpha)lactalbumin, serum albumin, lactoferrin,
immunoglobulins and lysozyme. The last three play an important role in immune defense
Nitrogen - ✔✔All 10 essential amino acids are present in colostrum and account for
approximately 45% of its total nitrogen content
,Vitamin A in breastmilk - ✔✔Present mainly as retinol. Required for vision and maintenance
of epithelial structures
Vitamin D in breastmilk - ✔✔Exception to the rule that breastmilk micronutrient levels are
protected from the effect of maternal deficiency, supplements may be recommended
Vitamin E in breastmilk - ✔✔breastmilk is particularly rich in vitamin E. A deficiency can
result in hemolytic anemia. Is an antioxidant
Vitamin K - ✔✔Present in human milk in small amounts. A few days after birth, a baby
normally produces vitamin K in sufficient quantities by enteric bacteria
Vitamin B12 in breastmilk - ✔✔Needed for early development of CNS. Deficient in mothers
with vegan diets, mothers who have had gastric bypass. Supplementation needed.
Iron in breastmilk - ✔✔Breastfed infants are rarely iron deficient. Sustained by iron stores
laid down in utero, and by high lactose and vitamin C levels which facilitate iron absorption.
Iron in breastmilk is absorbed 5x as well as cows milk.
Milk Lines - ✔✔Two glandular tissue lines that extend from axilla to medial thigh; beginning
of breast development. Become ridges that eventually become breasts, normally the remainder
of the lines regress
Witches Milk - ✔✔resulting from maternal hormones that cross the placenta, newborn
breasts can secrete a milk like substance following birth
Thelarche - ✔✔breast development
Glandular tissue - ✔✔Comprised of the lobes of the breast, average of 9 per breast
Axillary tail - ✔✔lobes that extend toward the axilla
,Alveolus - ✔✔Functional unit that produces and stores milk. Found in grape-like clusters
called lobules
Lactocytes - ✔✔Columnar secretory cells that line the alveolus. Synthesize milk
Paracellular pathway - ✔✔transport of molecules between the tight junction of cells. These
are not closed tightly in the first few days following birth, allowing larger molecules in(sodium,
chloride, medications etc). Therefore colostrum (and milk during mastitis and weaning) is saltier
Myoepithelial cells - ✔✔Muscle cells surrounding the alveolus. Respond to oxytocin by
contracting and ejecting milk into lumen
Montgomery's follicules/tubules - ✔✔Sebaceous glands found near the areola. Enlarge
during pregnancy and lactation. Provide lubrication, antimicrobial factors, and elicit odors for
preferential head orientation by infant
Internal Mammary Artery - ✔✔62-70% of blood supply to the breasts
Breast Nerve Supply - ✔✔Branches 4,5, and 6 of intercostal nerves. Lowermost branch of the
4th intercostal nerve becomes more superficial near the breast
Milk Ejection Reflex - ✔✔1.Stimulation of nipple
2. Nerve impulse travels to hypothalamus
3. Causes release of oxytocin from posterior pituitary gland
4. Prolactin is released from anterior pituitary gland
5. Myoepithelial cells contract in response to oxytocin
6. Milk is forced into ductal system
, Oxytocin - ✔✔Initiated MER, causes uterine contractility decreasing PPH, increases breast
temperature to help keep infant warm, decreases anxiety/increased calmness, causes thirst
Released in pulses with suckling. Levels rise within one minute of suckling and return to
baseline within 6 minutes of cessation of suckling
Coopers Ligaments - ✔✔Loose structure of connective tissue providing support for glandular
and fatty tissue
hyperadenia/polymastia/hypermastia - ✔✔Presence of additional mammary tissue with or
without nipples, most commonly at the axilla. No anatomical connection to the breasts. May
become engorged at lactation (Tx with NSAIDs, ice packs)
Polythelia - ✔✔Extra nipples with no associated breast tissue
Hyperplasia - ✔✔over developed breasts
Hypoplasia - ✔✔restricted breast development. Wide inter-mammary spaces.
Galactorrhea - ✔✔breast milk secretion not associated with breastfeeding
Intraductal Papillomatosis - ✔✔abnormal proliferation of cells supported by a vascular stalk
in mammary ducts. Stalk can rupture with slight trauma leading to bloody discharge. Benign.
Secretory Differentiation/Lactogenesis I - ✔✔mammary epithelial cells of the alveoli
differentiate into lactocytes capable of synthesizing breast milk
Secretory Activation/Lactogenesis II - ✔✔Initiation of copious milk secretion
Galactopoesis/Lactogenesis III - ✔✔Maintenance of Lactation
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