Development + Nutrition
18%of exam
Physiology + Endocrinology
8%of exam
Pathology
20%of exam
Pharmacology + Toxicology
8%of exam
Psychosocial Context
11%of exam
Mental HealthCultureReturn WorkSupport Systems
Techniques
14%of exam
LatchMilk TransferExpressionSupplementation
Clinical Skills
20%of exam
Care PlansDocumentationEthicsCollaboration
Quick Facts
- Exam
- IBCLC
- Questions
- 175 MCQ
- Time
- 4 hours
- Parts
- Two parts
- Images
- Part Two
- Pass
- 600 scaled
- Scale
- 200-800
- Validity
- 5 years
Colostrum vs Mature Milk
Colostrum
- Low volume
- Immune dense
- Early days
Mature milk
- Higher volume
- Stable macros
- Established lactation
Protection vs volume
Infant Growth
- WHO charts
- Breastfed standard
- Birth loss
- Trend matters
- Regain
- Usually 10-14 days
- Weight
- Acute intake
- Length
- Chronic growth
- Head circ
- Brain growth
- LBW
- Under 2500 g
- VLBW
- Under 1500 g
Milk Composition
- Colostrum
- Immune dense
- Transitional
- Rising volume
- Mature milk
- Established composition
- Lactose
- Main carbohydrate
- sIgA
- Mucosal protection
- HMOs
- Prebiotic defense
- Foremilk
- Earlier milk
- Hindmilk
- Higher fat
Output Cues
- Early cues
- Rooting, stirring
- Late cue
- Crying
- Wet diapers
- Hydration clue
- Stools
- Transfer clue
- Audible swallows
- Milk transfer
- Satiety
- Relaxed hands
- Jaundice
- Assess promptly
- Lethargy
- Urgent referral
Preterm Needs
- Late preterm
- Sleepy feeds
- SSB
- Suck-swallow-breathe
- Kangaroo care
- Skin-to-skin
- Fortification
- Extra nutrients
- Corrected age
- Growth context
- Tube feeds
- Bridge feeding
- Readiness cues
- Oral progress
Milk Hormones
Prolactin produces; oxytocin outputs.
ProduceOutputRemovalReflex
Prolactin vs Oxytocin
Prolactin
- Milk synthesis
- Anterior pituitary
- Removal responsive
Oxytocin
- Milk ejection
- Posterior pituitary
- Stress sensitive
Make vs move
Milk Supply Picker
- Low supply→Increase removal
- Delayed onset→Assess risk
- Oversupply→Manage flow
- Induced lactation→Planned protocol
- Relactation→Frequent stimulation
- Multiples→Supply protection
- PPH history→Endocrine screen
- Galactagogue request→Assess first
Lactogenesis
- Stage I
- Pregnancy priming
- Stage II
- Copious onset
- Stage III
- Supply maintenance
- Prolactin
- Milk synthesis
- Oxytocin
- Milk ejection
- FIL
- Local downregulator
- Feedback
- Removal drives supply
Endocrine Flags
- Diabetes
- Delayed lactogenesis
- Thyroid
- Supply impact
- PCOS
- Variable supply
- PPH
- Pituitary risk
- Infertility
- History clue
- Hypoglycemia
- Early feeding priority
- Tandem
- Pregnancy context
Red Flags
Lethargy, no urine, jaundice need escalation.
LethargyAnuriaJaundiceReferral
Engorgement vs Mastitis
Engorgement
- Bilateral fullness
- Edema
- Transfer support
Mastitis
- Inflammation
- Systemic symptoms
- Medical escalation
Congestion vs inflammation
Referral Picker
- Lethargic infant→Medical referral
- No urine→Medical referral
- Chest jaundice→Bilirubin check
- Breast abscess→Medical referral
- Bloody discharge→Medical referral
- Medication conflict→Collaborate prescriber
Infant Pathology
- Ankyloglossia
- Mobility limits
- Cleft palate
- Suction challenge
- GERD
- Symptom cluster
- Hyperbilirubinemia
- Bilirubin risk
- SGA
- Low size
- LGA
- High size
- Cardiac disease
- Fatigue feeds
- Metabolic disease
- Specialized plan
Maternal Pathology
- Mastitis
- Inflammatory breast
- Abscess
- Drainage referral
- Engorgement
- Edema plus milk
- Nipple trauma
- Latch signal
- Oversupply
- Fast flow
- Low supply
- Find cause
- Preeclampsia
- Dyad risk
- Breast surgery
- Anatomy history
Medication Safety
- LactMed
- Medication reference
- RID
- Infant dose
- Half-life
- Exposure duration
- Protein binding
- Milk transfer
- Peak level
- Timing clue
- Prematurity
- Higher caution
- Chemotherapy
- Specialist referral
Substances
- Alcohol
- Time exposure
- Nicotine
- Reduce harm
- Cannabis
- Avoid exposure
- Illicit drugs
- Safety referral
- Herbs
- Evidence varies
- Galactagogues
- After assessment
- Contraception
- Timing matters
Counseling vs Advice
Counseling
- Elicit goals
- Shared plan
- Empower choice
Advice
- Directive
- Provider centered
- May miss context
Partner vs prescribe
Latch Check
Align, attach, assess transfer.
AlignAttachAssessAdjust
Shield vs Supplementer
Shield
- Nipple interface
- Latch aid
- Monitor transfer
Supplementer
- Adds milk
- At breast
- Protects practice
Interface vs intake
Technique Tools
- Deep latch
- Asymmetric mouthful
- Positioning
- Dyad alignment
- First hour
- Skin-to-skin
- Hand expression
- Early colostrum
- Pump fit
- Flange comfort
- At-breast tube
- Supplement nursing
- Cup
- Short-term option
- Shield
- Indicated tool
SMART Plan
Make care goals measurable and timed.
SpecificMeasurableAchievableRelevantTimed
Documentation vs Opinion
Documentation
- Objective facts
- Interventions
- Follow-up
Opinion
- Judgmental wording
- Speculation
- Unmeasured claims
Record facts
Feeding Assessment
- Poor gain→Observe feed(Transfer)
- No swallows→Milk transfer check
- Painful latch→Reposition first
- Sleepy newborn→Wake techniques
- Late preterm→Scheduled reassessment
- Dehydration signs→Urgent referral
- Weight loss high→Supplement plan
- Plan made→Document follow-up
Clinical Practice
- History
- Risk context
- Observation
- Latch evidence
- Assessment
- Clinical judgment
- SMART goals
- Measurable plan
- Documentation
- Objective record
- CPC
- Professional conduct
- Confidentiality
- Privacy duty
- Collaboration
- Shared care
Common Traps
Crying
Early feeding cue ≠ Late feeding cue
Weight
Single weight ≠ Trend over time
Pain
Normal requirement ≠ Latch warning
Galactagogues
First-line fix ≠ After assessment
Medication
Automatic weaning ≠ Evidence review
Image Items
Ignore visuals ≠ Assess visual data
Last Minute
- 1.175 questions; four hours
- 2.Part Two uses images
- 3.Pass is 600 scaled
- 4.Pathology and Clinical largest
- 5.Prolactin makes milk
- 6.Oxytocin ejects milk
- 7.Removal protects supply
- 8.Crying is late cue
- 9.Trend weight, not snapshot
- 10.Refer urgent red flags
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