The International Board of Lactation Consultant Examiners examination, commonly known as the IBLCE exam, is a comprehensive and challenging examination for men and women hoping to enter this field of healthcare. The disciplines covered in the exam are anatomy; physiology and endocrinology; nutrition and biochemistry; immunology and infectious disease; pathology; pharmacology and toxicology; psychology, sociology, and anthropology; growth parameters and developmental milestones; interpretation of research; ethical and legal issues; breastfeeding equipment and technology; techniques; and public health.
Some of the topics included in the anatomy section are breast and nipple structure and development; infant oral anatomy and reflexes; and blood, lymph, innervations, and mammary tissue. In the physiology and endocrinology section, however, you are likely to encounter questions related to hormones; lactogenesis; endocrine/autocrine control of milk supply; induced lactation; fertility; infant hepatic, pancreatic, and renal function; effect of complementary feeds; and voiding and stooling patterns. The nutrition and biochemistry section of the IBLCE exam may include questions related to breastmilk synthesis and composition; milk components, function, and effects on a baby; comparison with other products/milks; feeding patterns; maternal diet variations; ritual and traditional foods; and the introduction of solids. In the immunology and infectious disease section, you are likely to see questions related to antibodies and other immune factors, cross-infection, bacteria and viruses in milk, allergies and food sensitivity, and long-term protective factors. The pathology section may include questions related to acute/chronic abnormalities and diseases, breast and nipple problems and pathology, endocrine pathology, congenital abnormalities, mother/child physical and neurological disabilities, failure to thrive, hyperbilirubinemia and hypoglycemia, and the impact of pathology on breastfeeding. The pharmacology and toxicology section of the IBLCE exam is likely to include questions related to environmental contaminants, use of medications and recreational drugs, galactagogues/suppressants, contraceptives, medications used in labor, and complementary therapies. The psychology, sociology, and anthropology sections are likely to include questions about counseling and adult education skills, postnatal depression and psychosis, maternal-infant relationship, maternal role adaptation, parenting skills, domestic violence, mothers with special needs, sleep patterns, and support systems. The growth parameters and developmental milestones section includes questions related to fetal and preterm growth, breastfed and artificially-fed growth patterns, breastfeeding behaviors to 12 months and beyond, and weaning. The IBLCE Exam was developed by the International Board of Lactation Consultant Examiners.
IBLCE Exam Video Review
IBLCE Practice Questions
1. The pituitary hormone prolactin stimulates and maintains the production of milk. What hormones directly affect the production of prolactin?
A. Prolactin-inhibiting factor (PIF) and thyrotropic-releasing hormone (TRH)
C. Estrogen and dopamine
D. A and C
2. You are discussing contraception with a new mother. She states that she is going back to work when her newborn reaches six weeks of age, and that she will only be able to breastfeed infrequently. She will be supplementing her feedings. Which of the following are factual statements concerning contraceptive use during lactation?
A. Contraceptive use during lactation does not change the composition of milk, but it can suppress the yield
B. Most of the time lactating mothers are only started on contraception if they are bleeding, feeding infrequently, using supplementation, and have been tested for pregnancy
C. High-dosage hormone contraceptives must be used to guarantee contraception
D. A and B
E. B and C
3. The growth and development of the newborn is directly affected by the mineral content of the milk from the lactating mother. Which of the following statements regarding human milk and cow’s milk are true?
A. Cow’s milk contains lower concentrations of sodium, potassium, and chloride
B. Cow’s milk contains nearly three to four times the salt content of human milk
C. The mean ratio of calcium to phosphorus is higher in human breast milk than in cow’s milk
D. A and C
E. B and C
4. There are several water-soluble vitamins found in human milk. Which of the following are included?
A. Thiamine, folic acid
B. Riboflavin, niacin, vitamin B6, B12
C. Vitamin A, vitamin E
D. Vitamin C
E. A and C
F. A, B, and D
5. The newborn has an immature immune system. What are the immunological advantages of breast milk over cow’s milk or formula?
A. Increases the lymphocyte production of the newborn
B. Protection against infection, shielding the GI mucous membrane against pathogens
C. Enhances development of the newborn’s immune system
D. A and B
E. B and C
Answers & Explanations
1. D: Prolactin is a pituitary hormone that is influenced by the levels of other substances in the blood. Prolactin-inhibiting factor (PIF) reduces prolactin levels. Thyrotropic-releasing hormone (TRH) has a powerfully stimulating effect on the production of prolactin. Pharmacological agents, such as estrogen, stimulate production, while dopamine inhibits it. Progesterone is a hormone that acts to prepare the uterus for implantation by a fertilized ovum for maintenance of pregnancy, and it aids in mammary gland development.
2. D: Milk composition is unaffected by the use of contraceptives during lactation; however, the amount of milk produced may be suppressed. The concentration of hormones in the contraceptives should be kept to a minimal dosage. The lactating mother may be given contraceptives if she is experiencing vaginal bleeding, feeding infrequently, using supplemental feedings, and only if she has had pregnancy testing.
3. E: Cow’s milk has between three and four times as much sodium as human milk. The mean ratio of calcium to phosphorus is higher in human breast milk than in cow’s milk. Cow’s milk contains higher concentrations of sodium, potassium, and chloride.
4. F: Water-soluble vitamins that are present in human milk include thiamine, niacin, riboflavin, folic acid, vitamins B6 and B12, and vitamin C.
5. E: Breast milk contains several bioactive components that defend the newborn infant against infection and boost the development of the immune system. Human milk and colostrum contain secretory IgA, immunologically specific cells, enzymes, carrier proteins, and hormones. Secretory immunoglobulin A (sIgA) and secretory immunoglobin M (sIgM) protect the gastrointestinal tract mucous membrane against the invasion of pathogens. There is no evidence of breast milk influencing the lymphocyte production of the newborn.