International Board of Certified Lactation Consultant (IBCLC) Practice Exam

What condition is always a contraindication for feeding anything with lactose, including breastmilk?

1. Lactose intolerance

2. Galactosemia

3. Phenylketonuria

4. Milk protein allergy

The correct answer is: Galactosemia

Galactosemia is a genetic disorder that affects the body’s ability to metabolize galactose, a sugar found in lactose, which is present in breast milk and other dairy products. Infants with galactosemia cannot effectively break down galactose due to a deficiency in the enzyme galactose-1-phosphate uridyltransferase (GALT). This results in the accumulation of galactose in the body, which can lead to serious health complications, including liver damage, cataracts, and intellectual disability if not managed properly. Due to the inability to process galactose, it is critical that infants diagnosed with galactosemia avoid all sources of lactose, including breast milk. This makes galactosemia a definitive contraindication for feeding anything that contains lactose. In contrast, lactose intolerance typically involves a deficiency of the enzyme lactase, which affects digestion but does not lead to the harmful consequences seen in galactosemia. Phenylketonuria (PKU) pertains to the metabolism of phenylalanine and has no direct relation to lactose, while a milk protein allergy involves an immune reaction to proteins present in cow's milk and may not necessitate avoiding all lactose-containing foods, particularly breast milk if