Clinical Competencies for the Practice of International Board Certified Lactation Consultants (IBCLCs)
Scope of Practice for International Board Certified Lactation Consultants
Position Paper on the Role and Impact of the IBCLC
Experienced mothers are trained in basic breastfeeding management, modeling optimal breastfeeding practices, and sharing (or facilitating the sharing of) information and experiences with pregnant and breastfeeding women individually and in group settings. Mother-to-mother support gives mothers the opportunity to talk with other women about their concerns in a way that might not otherwise be possible in today’s world. Women are empowered to explore options that are the foundation of a personally satisfying breastfeeding experience. Mothers often find it easier to share their concerns with other mothers; this mutual sharing of experiences and information builds trust and respect. Mother-to-mother support has the following benefits:
- It is community-based and easy to access.
- It provides an essential complement to existing health care and social services systems.
- It counters incorrect or misleading breastfeeding information with accurate, evidence-based information.
- It enables and empowers mothers to make informed choices about breastfeeding and parenting.
- It provides a social outlet for mothers (group meetings).
WIC Breastfeeding Peer Counselor (WIC BFPC or WIC PC)
Through the federal Women, Infants, and Children program, WIC Breastfeeding Peer Counselors provide mothers with breastfeeding information and support from pregnancy through weaning. During pregnancy, they visit with mothers by phone and in person to provide them with basic breastfeeding information, answer questions, and offer anticipatory guidance to help make breastfeeding easier. After a mother’s baby is born, her BFPC will continue to make regular contact with her, answer her questions, and offer practical suggestions to help her reach her breastfeeding goals. Depending on the policies of her state or tribal program, BFPCs may also facilitate support groups, teach breastfeeding classes, dispense breastpumps, certify participants for the WIC program, and make home or hospital visits.
Breastfed for at least 6 months, WIC participant
Education and training:
20-hour on-site training that covers all aspects of the normal course of breastfeeding and human lactation as well as communication skills. Training activities include role play and demonstration of necessary skills including assisting moms with using common breastfeeding tools and equipment (such as breastpumps).
1 hour per month minimum; additional requirements vary by state
Who are Breastfeeding Peer Counselors, and what do they do?
Volunteer Breastfeeding Counselors
The following volunteer organizations offer one-to-one breastfeeding counseling (which may include online or text communication and home visits), group meetings, and online resources. Counselors are educated and mentored within the organization before beginning to work with mothers. They may be supported by a network of professionals in the field of lactation that works as a sounding board for complicated situations.
La Leche League Leader (LLLL)
Breastfed for at least 9 months at time of application; Please see additional requirements here.
Education and training:
Applicants must complete required reading, writing exercises, and role play which covers all aspects of the normal course of breastfeeding and human lactation, as well as communication skills. For full details, please see here.
Leaders are expected to keep up-to-date and are strongly encouraged to continue their education. Proof of completion is not required. To fill the need for continuing education, Chapters, Area Networks, and Regions regularly provide education opportunities such as seminars, conferences, lunch and learns, as well as informative publications such as Leaven and newsletters.
How can I become a LLL Leader?
About La Leche League
Breastfeeding USA Counselor (BfUSA Counselor)
Breastfed for at least 1 year at time of application.
Education and Training:
Training varies based on experience. Includes reading, online training activities, and role playing.
Minimal number of credits every 3 years
Becoming a Breastfeeding Counselor
Nursing Mothers Counsel Counselor (NMC Counselor)
Requirements vary by chapter. Please see the chapter website for specific information.
Nursing Mothers Counsel (California)
BACE: Nursing Mothers’ Council
Nursing Mothers Counsel (Oregon)
The following programs offer similar preparation to individuals who may provide mothers with information about the normal course of breastfeeding and basic breastfeeding support. After completion, they will be prepared to:
- answer questions about common breastfeeding concerns such as prevention of sore nipples, preparing for return to work or school, and milk production issues
- offer practical tips for helping mothers fit breastfeeding into their lifestyle
- provide anticipatory guidance about common breastfeeding situations and problems
- provide education to help mothers prepare to breastfeed or return to work or school
- recognize when breastfeeding is going well and when more help is needed
- recognize when a breastfeeding issue is beyond their scope of practice and refer to the appropriate professionals.Many certificate program graduates use their education in their occupations as nurses, nutritionists, midwives, labor doulas, postpartum doulas, baby boutique and pump rental station employees, or WIC Breastfeeding Peer Counselors. Some work as part of a group practice, usually with an IBCLC as the lead, while others start businesses to support women in their communities directly.
Certification vs. Certificate Programmes: What’s the Difference?
Certified Lactation Counselor (CLC)
Healthy Children’s Project, Inc
Exam, certificate, and renewal administered by Academy of Lactation Policy and Practice, a division of Healthy Children’s Project, Inc. The ALPP certificate is accredited by the American National Standards Institute. ANSI accreditation means that the testing process of the certificate program has been found to be fair, valid, and reliable.
5 day on-site breastfeeding education (45 credit hours), role play, competency check (example: watch a short video and describe what action the CLC would take) and pass a 100 question exam with 75% or better immediately after program; Program information
Renewal: Every 3 years with 18 hours of breastfeeding education, plus required fee
Advanced Lactation Consultant (ALC) and Advanced Nurse Lactation Consultant (ANLC)
Healthy Children’s Project, Inc (please see CLC listing above)
45 hour course; Program information
Prerequisites: RN license and CLC or IBCLC
Prerequisite: CLC or IBCLC
Certified Lactation Specialist (CLS)
Lactation Education Consultants
5 day on-site education and training (45 credit hours), complete assigned homework and readings, and pass final exam immediately after program; Program information
Certified Breastfeeding Counselor (CBC)
Mentored online training, required reading and exercises, create portfolio of local breastfeeding resources, provide 30 hours of breastfeeding support, and complete final open book exam; Program information
Breastfeeding Counselor (BC)
Breastfeeding Support Consultants Center for Lactation
Distance learning course (95 hours), read required text, complete study questions and role plays, and pass final exam; Program information
The following certificate programs prepare candidates to provide breastfeeding education rather than support. Please see the program requirements and accompanying documents for more details, including the scope of practice of the certificated educators for each program.
Certified Lactation Educator (CLE)
Childbirth and Postpartum Professional Association (CAPPA)
Complete all assignments and read all required texts/books, write one-page essay, attend 20-hour training (a distance track is also available), attend 2 breastfeeding support group meetings, attend 1 breastfeeding class, submit 2 letters of recommendation, develop breastfeeding class outlines and handouts, create local breastfeeding resource list for families, complete part 1 of HUG your baby training, and pass final online exam with 85% or better; Program information
Every 3 years with 15 hours of breastfeeding education, required evaluations, reports, reviews, and fee. Details
Lactation Educator (LE)
Evergreen Perinatal Education
5 day on-site education and training (45 hours), written breastfeeding project (homework), write study guide on breast anatomy and physiology, participate in quizzes, case studies and role plays, evaluate program; Program information
Lactation Educator Counselor (LEC)
University of California at San Diego Extension: Breastfeeding Education by Gini Baker, RN, MPH, IBCLC
5 day on-site education and training (45 hours) or online (60 hours). Complete assignments including internet resource, nutrition, clinical, and counseling problems, review 4 research studies, observe a breastfeeding class, develop breastfeeding class curriculum, read required text, satisfactorily complete periodic testing; Program information
For more information about, and a comparison of, the various breastfeeding support specialists in the USA please see The Landscape of Breastfeeding Support by the Massachusetts Breastfeeding Coalition.
Because of the immense importance of breastfeeding to both individuals and public health, it is imperative that our communities support and empower mothers both to initiate breastfeeding after birth and to continue breastfeeding as long as desired, ideally through the first year and beyond.
While it is helpful for mothers and community members to be aware of the diversity in breastfeeding specialists, these practitioners only represent one part of the larger picture of essential support for mothering. Breastfeeding specialists, community advocates, and health-care providers must work together with families in order to ensure that women have access to the accurate, evidence-based information and support they need to develop and meet their own breastfeeding goals.
Thank you to all the colleagues and friends who shared information to make this resource as comprehensive as possible. Special thanks to Adrienne Uphoff, IBCLC for her time and patience while editing and updating this article, as well as for the generous gift of her wordsmithing wizardry.
© Jolie Black Bear, IBCLC 2012– All Rights Reserved