IBLCE Anatomy and Physiology of Lactation 2 — Questions and Answers
Question 1: Feedback Inhibitor of Lactation (FIL) is a whey protein that regulates milk supply by:
- Stimulating prolactin release
- Inhibiting milk synthesis when the breast is full (Correct answer)
- Promoting alveolar cell proliferation
- Increasing oxytocin sensitivity
Correct answer: Inhibiting milk synthesis when the breast is full
FIL accumulates in stored milk and locally inhibits further milk synthesis; frequent removal of milk reduces FIL concentration, signaling the breast to produce more.
Question 2: Milk produced in the first several days postpartum is called colostrum. Compared to mature milk, colostrum is:
- Higher in lactose and lower in protein
- Lower in immunoglobulins and higher in fat
- Higher in protein and immunoglobulins and lower in lactose (Correct answer)
- Equal in all macronutrients but higher in volume
Correct answer: Higher in protein and immunoglobulins and lower in lactose
Colostrum is rich in secretory IgA, lactoferrin, and protein while being lower in lactose and fat compared to mature milk, providing immune protection to the newborn.
Question 3: The primary immunoglobulin found in human breast milk that provides passive mucosal immunity to the infant is:
- IgG
- IgM
- IgE
- Secretory IgA (Correct answer)
Correct answer: Secretory IgA
Secretory IgA (sIgA) is the predominant antibody in breast milk; it resists digestion in the infant's gut and coats mucosal surfaces to prevent pathogen attachment.
Question 4: Which anatomical feature of the nipple-areolar complex contains sebaceous glands that secrete lubricating and antimicrobial substances?
- Sinuses of Santorini
- Montgomery glands (Correct answer)
- Lactiferous ampullae
- Cooper's ligaments
Correct answer: Montgomery glands
Montgomery glands (areolar glands) secrete an oily substance that lubricates and protects the nipple-areolar complex and emits an odor that guides the newborn to the breast.
Question 5: Skin-to-skin contact promotes breastfeeding success primarily by releasing which maternal hormone?
- Cortisol
- Adrenaline
- Oxytocin (Correct answer)
- Progesterone
Correct answer: Oxytocin
Skin-to-skin contact stimulates oxytocin release, which promotes milk let-down, maternal calm, and bonding behaviors that support successful breastfeeding initiation.
Question 6: The transition from colostrum to mature milk, known as lactogenesis III or galactopoiesis, is maintained primarily by:
- Rising estrogen levels
- Frequent and effective milk removal (Correct answer)
- Increasing progesterone after 6 weeks postpartum
- Dietary protein intake
Correct answer: Frequent and effective milk removal
Once mature milk is established, supply is maintained by the autocrine (local) mechanism of frequent effective milk removal reducing FIL and sustaining prolactin pulse responses.
Question 7: Which layer of breast tissue contains the glandular structures (lobules and ducts) where milk is produced?
- Superficial fascia
- Cooper's ligament network
- Parenchyma (Correct answer)
- Retromammary space
Correct answer: Parenchyma
The parenchyma is the functional glandular tissue of the breast, composed of lobules, alveoli, and ducts; it is embedded within stromal and fatty tissue.
IBLCE Anatomy and Physiology of Lactation 2
Feedback Inhibitor of Lactation (FIL) is a whey protein that regulates milk supply by: