Becoming an IBCLC
Excerpted from Lactation Private Practice: From Start to Strong by Annie Frisbie, IBCLC.
Figuring out how to become an International Board Certified Lactation Consultant (IBCLC) is often the most challenging part of the whole process. Unlike other related healthcare fields (such as clinical social work, physical and occupational therapy, speech-language pathology, and counseling), there are only a handful of established university programs that include the education component along with the clinical component in an organized and structured way. In other words, you’re not likely to be able to get a master’s in lactation and have your department chair help you land an internship at an outpatient lactation clinic.
IBLCE, the credentialing body for IBCLCs, requires education and clinical training in order to qualify to take the exam, and I’ll explain more in an upcoming section. I highly recommend joining an online support group, such as Want to Be an IBCLC? on Facebook, which is a great resource for finding free or low-cost courses to meet the educational requirement. It can also be helpful to connect with the nearest local chapter of USLCA.
If cost is an issue for you, I have included some resources below for a handful of scholarship opportunities for meeting the educational requirements. I wish there were more.
Health Sciences Education
If you are not already a licensed clinical healthcare provider, you will need to supply transcripts showing college or university credits in the following areas:
Infant Child Growth and Development
Introduction to Clinical Research
Psychology or Counseling Skills or Communication Skills
Sociology or Cultural Sensitivity or Cultural Anthropology
And these courses can be taken through continuing education or as a university level course:
Basic Life Support
Occupational Safety and Security for Health Professionals
Professional Ethics for Health Professionals
Universal Safety Precautions and Infection Control
Distance learning is an acceptable option, provided that the course is offered through an accredited institution. Independent study followed by a test from an accredited organization can also provide you with credits. A for-profit educational institution may be able to provide you with the courses you need; however, please be aware that there are many bad actors in this field, so it’s important to research carefully.
If you are unsure whether your desired educational offering will satisfy its requirements contact IBLCE directly.
Lactation Specific Education
IBLCE requires you to show proof of completion of 90 hours of education that covers the lactation-specific areas listed in their detailed content outline.
Starting with the April 2021 exam, applicants will also be asked to earn 5 additional hours of education specifically focused on communications skills.
Starting in February 2021, you can earn 45 hours of lactation-specific education directly focused on private practice through the Lactation Private Practice Essential Course. The course also includes an additional 5 hours of communications skills. Combine this with a 45-hour offering on lactation anatomy and physiology through a provider like the ones listed below.
You must document and be prepared to submit proof that you have performed supervised clinical hours working with breastfeeding families, and IBLCE recognizes three pathways for obtaining those hours. Each pathway requires the educational requirements listed above.
As of May 2020, IBLCE has made it possible to earn clinical hours virtually. Candidates in Pathways 2 & 3 can now earn 100% of their hours virtually! For information on virtual consults, including best practices for incorporating interns, read this article.
Lactation Specific Clinical Practice Calculator– this will download an .xls spreadsheet
Pathway One—Health Professionals and Volunteers
Pathway One is for people who are already working or volunteering in some capacity with breastfeeding families. This pathway is relatively straightforward for doctors and registered nurses; less so for paid/unpaid breastfeeding helpers.
In order for your paid/unpaid work with breastfeeding families to qualify as an “appropriate supervised setting,” IBLCE requires that following elements be in place at the training source (source: Certification FAQs):
“Provide structured training programs for their counsellors which includes comprehensive education in breastfeeding and lactation management.”
“Have a Code of Ethics or Professional Conduct.”
“Provide structured supervision for counsellors, with an appropriate level of training.”
“Provide a continuing education program for counsellors.”
The FAQ states, “The following healthcare delivery settings meet this criteria and clinical hours can be earned through paid or volunteer work on an hour-for-hour basis in these settings: hospital, birth centre, community clinic, lactation care clinic/practice, primary care practitioner practice/office.”
If you work with a volunteer organization on IBLCE’s list, then you can get credit for your volunteer work. You get more credit for in-person work; less if you are only providing phone support, but both count. Look for your volunteer organization on the list provided by IBLCE.
Note that supervision is necessary in this pathway. You cannot set up your own breastfeeding café and get credit for that. The idea is that you are accountable to someone with a higher level of experience and qualifications who will offer you guidance as you work with families.
Remember this is a learning opportunity, and you may need to seek out opportunities to develop skills that you may not be using day-to-day. For example, if you are providing peer-to-peer breastfeeding support, you may not have the opportunity to touch breasts or babies, so you would need to locate opportunities to develop these skills. If you are an RN on a postpartum floor working with newborns before discharge, you may never have the opportunity to observe how much babies change between three days and three weeks, let alone meet a distractible four-month-old. The adage “you don’t know what you don’t know” is so true for this pathway. Step outside your environment to discover what else you will need to learn.
Volunteer work is, by its nature, unpaid, and some volunteer organizations may prohibit you from taking tips, stipends, or grants to help subsidize your costs. If you have a paid position in a clinical setting, a benefit of Pathway 1 is the ability to earn income while qualifying for the exam.
Pathway Two—University Degree
In Pathway Two, you are completing an academic program that includes the 90 hours of lactation-specific education and provide a supervised clinical experience totaling 300 hours. At the time of writing, IBLCE lists only a handful of programs that meet their requirements.
If you are considering a program not on this list, check with IBLCE before enrolling. IBLCE states, “Beginning January 1, 2017, academic programs purporting to prepare students to qualify for the IBLCE exam through Pathway 2 must be accredited by the Commission on Accreditation of Allied Health Education Programs or an equivalent accrediting body. In 2016, IBLCE extended this deadline to January 1, 2018 for Pathway 2 programs that were in the formal application process with CAAHEP, which is equivalent to having submitted the program’s self-study report.” A program may advertise that they train lactation consultants, and it would be so frustrating and disappointing to pay money and then find that IBLCE does not accept that program.
The primary benefit of Pathway Two is coordination between your coursework and your clinical hours. This is probably the most complete pathway. The downside is that you must physically attend the program, and relocating may not be an option for you. Scholarship funds, grants, or financial aid may be available to cover a portion or even all of your tuition and fees when you are accepted into a university program.
Under Pathway Three, you are responsible for finding an appropriate IBCLC mentor or mentors to supervise the clinical portion of your training for 500 total hours. You must conform to IBLCE’s guidelines, complete an online application, and pay a fee to IBLCE. You are also responsible for the educational portion, which will need to be obtained separately.
Your mentor will be required to create a plan for your mentorship that “covers all of the duties listed on the Clinical Competencies for the Practice of International Board Certified Lactation Consultants,” provide you with opportunities to observe clinical work (does not count towards hours) and perform clinical work (does count towards hours), and provide a report to IBLCE. Additionally, they will oversee any other mentors you may choose to work with while acquiring skills in settings other than your mentor’s primary practice setting. The mentor will also assign reading and may require you to undertake projects or take tests to evaluate progress.
As you can see, mentorship may be the most rewarding way to meet the exam requirements, but also the most challenging. You will need to live or reside in an area where you have access to an IBCLC who can serve as a primary mentor, and you must be in a practice setting where you are permitted to do hands-on work with dyads. Some mentors will charge a fee to supervise mentees; this is entirely at your discretion.
Because you will be creating this plan independent of an educational institution, financial aid and scholarships will not be accessible to you. However, look into small business grants or loans because you never know where you might find funding that may even cover education.
To find a mentor, start with your local branch of ILCA or your local breastfeeding coalition. Here is a sample letter to send to a potential mentor, which you should adapt and personalize (don’t just copy):
I hope this finds you well. By way of introduction, I am ___________________, and I am contacting you to inquire about your interest and availability in serving as my mentor under Pathway Three to qualify for the IBLCE exam.
*Include 1-2 sentences describing your background
*Include 1-2 sentences explaining your plans to obtain the required educational hours
*Include 1-2 sentences on why you have written to this particular person (if applicable)
I am available to dedicate _________ hours a week to my internship and understand that not all of those hours will count towards my supervised clinical hours. I have attached my resume.
If you are currently available to work with interns, please let me know how I may apply to work with you.
If you live in an area with a lot of IBCLCs, you may be tempted to cast a wide net and just cold email every single one of them. While you may still potentially find a mentor this way, a more targeted approach is often more fruitful. A personal appeal, rather than a form letter, is more likely to trigger a response.
Don’t expect an immediate response. If you don’t hear back within a few days, you can send a short follow up:
I reached out to you a few days ago to inquire about the possibility of interning with you to obtain my clinical hours for the IBLCE exam. If you are unavailable, would you possibly be able to recommend someone?
Many thanks for your time and consideration.
If you don’t hear back after that, do not take it personally. The IBCLC may be busy, she may be dealing with personal issues, or she may be on a much-needed vacation and not responding to emails. Move on to the next person and just keep trying.
Preparing for the Exam
At the time of writing, IBLCE offers the certifying exam twice a year. You must submit an application and pay a fee by a certain date. Your clinical hours and education must be completed by the application date. Exam results are not released right away. The most current list of fees and dates can be found on the IBLCE website.
The exam is multiple-choice and administered by computer, and a portion will require the interpretation of images.
Exam prep and study guides:
Core Curriculum for Lactation Consultant Practice by ILCA– the latest edition is due out in 2018