Becoming an International Board Certified Lactation Consultant: Education, Pathways, and Impact

Breastfeeding is often perceived as a natural process, yet many mothers and newborns encounter challenges that require expert guidance. International Board Certified Lactation Consultants (IBCLCs) are healthcare professionals specializing in breastfeeding and lactation care, playing a vital role in maternal-child health. They work collaboratively with families, policymakers, and communities to provide expert care and promote global public health. This article explores the education requirements, various pathways to becoming an IBCLC, and the significant impact these professionals have on breastfeeding outcomes and family well-being.

The Role of an IBCLC

An International Board Certified Lactation Consultant (IBCLC) is a healthcare professional dedicated to supporting mothers and their babies in achieving a successful breastfeeding experience. The IBCLC is the “only internationally certified healthcare professional in the clinical management of breastfeeding and human lactation.” IBCLCs possess comprehensive knowledge and skills to address a wide range of lactation needs, from latching techniques and breastfeeding positions to selecting the right breast pump and creating a pumping schedule for working mothers.

IBCLCs work in diverse settings, including hospitals, physician offices, community healthcare clinics, and private practices. They provide education, clinical support, and advocacy for breastfeeding families, addressing common challenges such as sore nipples, engorgement, low milk supply, and infant weight gain concerns.

Why Become an IBCLC?

Many individuals are drawn to the field of lactation consulting due to their passion for supporting breastfeeding families. The role offers autonomy and the opportunity to make a direct, positive impact on the lives of mothers and infants. As Kristina Chamberlain, Clinical Program Director and Lead Faculty for the Lactation Program at the UC San Diego Division of Extended Studies, and International Board Certified Lactation Consultant (IBCLC) shares, “One of the things that I think a lot of people really love about being a lactation consultant is that we are pretty autonomous”. Chamberlain also stated that “It's an honor for most of us. You might not necessarily fix everything but you're supporting them in a vulnerable moment. You’re able to help create a more positive feeling and better outcomes."

The utilization of an IBCLC has been shown to significantly improve breastfeeding outcomes and lower health costs. IBCLCs advocate for the right to provide human milk, recognizing it as a human rights issue.

Read also: Comprehensive Lactation Guide

IBCLC vs. CLC

In the realm of lactation care, the Certified Lactation Counselor (CLC) certification often arises. A CLC is a professional who provides breastfeeding advice and education, often serving as a stepping stone towards becoming an IBCLC. While both certifications demonstrate a commitment to supporting breastfeeding families, the IBCLC is the highest credentialed lactation expert with the only internationally recognized certification in the field of lactation.

Education and Training Requirements

Becoming an IBCLC requires a significant commitment to education and clinical experience. The International Board of Lactation Consultant Examiners (IBLCE) sets the standards for certification, ensuring that IBCLCs possess the necessary knowledge and skills to provide expert care. There are several paths to becoming an IBCLC that all involve developing a strong background in the health sciences, clinical experience with breastfeeding, lactation specific education and taking the IBCLE exam.

To be eligible to sit for the IBCLE exam, candidates must meet specific requirements in three key areas:

Health Sciences Education: Completion of 14 health science courses, covering subjects such as:
- Biology
- Human Anatomy
- Physiology
- Child Development
- Nutrition
- Psychology
Lactation-Specific Education: A minimum of 95 hours of lactation-specific education within the five years prior to applying for the exam, including five hours of education focused on communication skills. Preferably the five hours of education focused on communication skills will be directly related to lactation and breastfeeding care, but this is not a requirement. This education must cover a range of topics related to breastfeeding management and lactation support.
Clinical Experience: Completion of supervised clinical practice in lactation and breastfeeding care. The required hours vary depending on the chosen pathway:
- Pathway 1: 1,000 hours of clinical practice in lactation and breastfeeding care in the previous 5 years for current healthcare professionals and recognized mother support counselors. The clinical experience does not need to be directly supervised and may be accumulated through one’s routine job responsibilities.
- Pathway 2: 300 hours of directly supervised lactation specific clinical experience in an accredited academic program.
- Pathway 3: 500 hours of directly supervised lactation specific clinical experience under the mentorship of a currently practicing IBCLC.

Pathways to Becoming an IBCLC

The IBLCE recognizes three distinct pathways for candidates to qualify for the IBCLC examination, as described below. Candidates must choose and complete one of the following pathways before applying for the IBCLC certification examination.

Pathway 1: For Healthcare Professionals and Recognized Mother Support Counselors

Pathway 1 is designed for current healthcare providers who are already working with breastfeeding dyads, such as nurses, pediatricians, and dietitians, and mother support counselors. It requires the same base of lactation-specific course work, but since the applicant is already working in healthcare, they most likely have already completed the other health science prerequisite courses. Candidates following this pathway must have 1,000 hours of clinical practice in lactation and breastfeeding care in the previous 5 years.

Pathway 2: Comprehensive Lactation Education Programs

Pathway 2 is tailored for individuals without a healthcare background. IBCLC applicants must complete a comprehensive academic program in human lactation and breastfeeding that is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or another accrediting body with equivalent accreditation standards for lactation academic programs. Candidates for this pathway need to ensure they’ve fulfilled the health science prerequisite courses before beginning the program. Course topics include biology, human anatomy, psychology, human development, or other similar courses from accredited colleges or universities that are approved by the International Board of Lactation Consultant Examiners (IBCLE). Pathway Two candidates will also have to ensure completion of six required continuing education healthcare courses such as basic life support (CPR), occupational safety and security for health professionals, and others; as well as the completion of a lactation education training program. This pathway will include the same lactation-specific coursework as other pathways, and will also require 300 hours of supervised clinical experience.

Pathway 3: Mentorship

Pathway 3 applicants are mentored and supervised by an IBCLC, in accordance with the specifications in the Pathway 3 Plan Guide. Candidates who wish to complete the requirements for the IBCLC exam without enrolling in an academic program may do so under the mentorship of a currently practicing IBCLC. They will still need to complete 14 health science courses and 90 hours of lactation specific education in addition to 500 hours of directly supervised lactation specific clinical experience. A common candidate for this route would be someone who already works in healthcare and wants to switch careers. They have much of the required medical training but still need breastfeeding-specific education, clinical hours, and mentorship.

Pathway 3 mentorship is a structured, defined relationship between an applicant and IBCLC(s) which must be preapproved. The mentorship must be developed according to the specifications found in the Pathway 3 Plan Guide, and the certification status of the IBCLCs serving as mentors must be verified prior to beginning the mentorship. All Pathway 3 Plans MUST be verified through an application process (which includes a fee) PRIOR to earning clinical hours for this Pathway.

In addition to the Health Sciences Education courses, Pathway 3 candidates must complete:

Minimum of 95 hours of lactation specific education, including five hours of education focused on communication skills, within the five years immediately prior to examination application.
Minimum of 500 hours of directly supervised lactation specific clinical practice as described in the Pathway 3 Plan Guide and obtained within the five years immediately prior to examination
The IBCLC(s) who provide the direct supervision must be currently certified IBCLCs in good standing.
Adherence to, with attestation, the Code of Professional Conduct for IBCLCs.

The IBCLC Examination

Once candidates have met the eligibility requirements through one of the pathways, they can apply to take the IBCLC examination. The IBCLC exam is administered by the International Board of Lactation Consultant Examiners and is given twice a year (April and October). The exam comprises 175 multiple-choice questions, given in two parts. This typically takes four hours to complete.

The exam covers seven subject areas related to breastfeeding and lactation care. In order to take the exam, you must apply using the online portal. You will be notified about two weeks after submitting the application and all necessary documentation if you have been approved to take the exam.

Maintaining Certification

IBCLCs are to re-certify every 5 years. To maintain their certification, IBCLCs must:

Complete Basic Life Support education
Complete 250 hours of clinical practice
Apply for the IBCLC examination
Take the CE Self-Assessment
Complete required CERPs

Addressing Barriers and Promoting Accessibility

The time and financial requirements to become an IBCLC can be barriers, potentially limiting opportunities for individuals from marginalized communities who aspire to work in lactation care. Recognizing this challenge, organizations like The Lactation Network (TLN) are working to make the path to becoming an IBCLC more accessible. The TLN grant program provides financial assistance to aspiring IBCLCs who may not have the financial resources to pursue a career in lactation care.

The Impact of IBCLCs

IBCLCs make a significant difference in the lives of breastfeeding families. They provide expert guidance, education, and support, helping mothers overcome challenges and achieve their breastfeeding goals. By promoting breastfeeding, IBCLCs contribute to improved infant and maternal health outcomes, reduced healthcare costs, and a healthier society overall.

According to a report issued by the Georgia Health Policy Center, it would require a minimum of 763 full-time IBCLCs to provide the services recommended by the Surgeon General at the service rate of 8.6 per 1000 births.

Career Paths for IBCLCs

As an IBCLC, you can work in several settings helping breastfeeding families, including hospitals and physician offices. As an IBCLC, we’ll help with insurance billing, marketing materials, and provide a custom IBCLC portal (just to name a few benefits).

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