How to become a lactation consultant

The term “lactation consultant” is a bit generic. It can be applied to several types of breastfeeding support professionals. In this blog, we will discuss how to become an IBCLC (Internationally Board Certified Lactation Consultant). For more information on all the different types of breastfeeding support professionals and educators, click here.

This blog discusses the following:

• How do you become an IBCLC?
• Once certified, how do you maintain certification?
• Where do IBCLCs work?
• How much money do they make?
• How much money does it cost to become an IBCLC?
• Should I become an IBCLC?

Let’s address some facts and myths before we discuss the path to gaining this credential.
 
5 FACTS

1. The term “IBCLC” is a registered trademark of The International Board of Lactation Consultant Examiners (IBLCE). Only people who are certified through this board are allowed to call themselves IBCLCs.
2. Lactation support is a profession. It is a specialty of women’s health care.
3. To be a lactation consultant, you have to have a college education. You have to have at least 90 hours of lactation education. You also have to do clinicals. Then you have to sit for a board exam to gain certification. You also have to recertify every 5 years.
4. Lactation consultants can work in hospitals, birthing centers, doctor’s offices, WIC offices, or private practice. A lactation professional in private practice may have an office to visit or do house calls.
5. Many birthworkers have multiple credentials. A lactation consultant may also be a labor and delivery nurse, midwife, women’s health nurse practitioner, OB/Gyn, or pediatrician. A lactation consultant can also be a doula, childbirth educator, registered dietician, or other type of professional. Each role has its own scope of practice.

 
5 MYTHS

1. You have to be a nurse to be a lactation consultant. Not true! While many lactation professionals chose to pursue this education after working in labor & delivery/postpartum nursing, this career is not exclusive to nurses.
2. You have to have breastfed exclusively (no formula). Actually, your personal breastfeeding history is a private matter that does not determine your ability to help women. You wouldn’t tell a labor and delivery nurse who had c-sections that she could not take care of patients with vaginal deliveries. Nor should you tell educated, professional lactation support that their breastfeeding experience is a direct reflection of their ability to work in this area of women’s health care. Women’s health care is the only area of health care where you are expected to have been the patient. No one would expect a cardiac nurse to have a heart attack before the nurse can do their job well. For women’s health care to be seen as an equally valid area of health care, we must separate professions from peer support. The people you help are not entitled to your private medical history or family information. Self-disclosure is not necessary.
3. You have to be a mom to be a lactation consultant. Actually, you don’t have to be a mother or a woman. There are some leading IBCLCs who are male. There are male OB/Gyn doctors who choose to pursue additional education in breastfeeding support to better help their patients. The IBCLC field does not discriminate against women who have not yet had children. This is treated as a healthcare profession. It is not peer support. Personal breastfeeding experience is not required and should not be inquired about.
4. Lactation consultants are anti-formula. They’re boob Nazis. This is a myth. A good lactation consultant will help a client reach their breastfeeding goals. It is up to the mother to decide how long she wants to breastfeed. The priority should be a baby getting enough to eat. A good lactation consultant will be 100% okay with necessary supplementation. Ideally, you’d be able to work with a mother to get an adequate milk supply. When that is not possible, partial breastfeeding is better than no breast milk at all.
5. Lactation consultants help people for free. No, services from a small business are not free. This is not a La Leche League meeting. If you are a lactation professional (not peer support), you have every right to charge.

 
 
How do you become an IBCLC?
In brief, you have to

1. take college classes 
2. have lactation education
3. and do clinical hours or have work experience

Your lactation education and clinical hours have to be within the last 5 years before applying to take the exam.
 
What confuses people is there are 3 different pathways. I wish they would make it the same requirements for everyone.
 
Pathway 1
This is for health professionals or peer support leaders from a recognized program. Your work experience counts for your clinical hours. You must have 1,000 hours of experience.
 
Pathway 2
This is for people going through a college program specifically for lactation consulting. You have to have 300 hours of clinicals.
 
Pathway 3
This is for people who are not one of the recognized health professionals or peer support leaders. The educational requirements are the same. The clinical requirements are 500 hours under the supervision of an IBCLC that has been certified at least 5 years. You must submit your clinicals for approval before beginning your hours.
 
The required college classes are

• Biology
• Human Anatomy and Physiology
• Infant and Child Growth and Development
• Introduction to Clinical Research
• Nutrition
• Psychology OR Counseling Skills OR Communication
• Sociology OR Cultural Sensitivity OR Cultural Anthropology  

They also require the following continuing education

• Basic Life Support
• Medical Documentation
• Medical Terminology
• Occupational Safety and Security for Health Professionals
• Professional Ethics for Health Professionals
• Universal Safety Precautions and Infection Control

The lactation hours have to be 90 hours of lactation specific training completed within 5 years prior to applying for the exam. There is a Lactation Education Accreditation and Approval Committee known as LEAARC. They approve lactation training programs taught by IBCLCs designed to train for IBCLC level breastfeeding support. You do not have to go through a program approved by them. However, when choosing a program designed for lower level lactation support you should check with both organizations to ensure it meets the qualifications to sit for the IBLCE.

The clinical hours depend on the pathway you go.
 
To learn more about the requirements, visit the website for the International Board of Lactation Consultant Examiners.
Right click to open links in a new window.   

• Visit www.iblce.org for general information
• The pathways are explained here https://iblce.org/wp-content/uploads/2017/11/Which-IBLCE-Pathway-is-Right-for-Me.pdf
• The recognized health professionals are listed here https://iblce.org/step-1-prepare-for-ibclc-certification/health-sciences-education-2/
• The recognized peer support programs are listed here https://iblce.org/wp-content/uploads/2017/12/recognised-breastfeeding-support-counsellor-organisations.pdf
• Here is more information about the college classes required and continuing education https://iblce.org/wp-content/uploads/2017/05/health-sciences-education-guide.pdf 
  
• Here are the requirements for the lactation education https://iblce.org/step-1-prepare-for-ibclc-certification/lactation-specific-education/

 
Once you meet the qualifications through your chosen pathway, you study and sit for the board exam. The exam is offered twice a year – April and October.
 
Once certified, how do you maintain certification?
Upon passing the board exam, you will need to recertify every 5 years. Every 10 years needs to be by passing the exam. The other times you can recertify through CEUs.   
 
Where do IBCLCs work?
Lactation consultants can work in hospitals, birthing centers, pediatrician offices, obstetrician offices, WIC offices, and in private practice.
 
How much money do they make?
The money you make being an IBCLC is going to depend greatly on your other credentials. If you are a RN adding IBCLC to your name, your investment will definitely pay off. If you are not a nurse, finding employment in a hospital may be challenging. If you’re working as a childbirth educator or doula, it’s up to you if you want to invest the money into becoming an IBCLC or choose another credential. If you are working in a facility, you should be paid by the hour. If you are working in private practice, be sure to charge your worth so you can maintain your business. You have to put money into every client you serve. You also have to pay a hefty amount in taxes. Keep in mind, your startup costs will include all the equipment you have to buy such as dropping nearly $1,000 on a scale alone. You’ll typically have a one or two hour visit the first time with a client, but you’ll spend around 5 hours of work for that visit. Expect to need to charge around $200-$300 for a visit and at least $50 for follow-up visits. That’s just to stay in business. Some insurance companies do cover IBCLCs. In most cases, private practice lactation consultants do not make enough money to live off of that as a sole income.
 
How much money does it cost to become an IBCLC?
It costs thousands of dollars to become an IBCLC. It also costs at least $1,000 every 5 years to maintain your certification.
You’ll need to pay for the following

• Your college classes - $ - varies significantly
• Your lactation education - $ - expect around $1,000 for an online program. Workshop based programs are priced similarly, but require traveling expenses in addition to the workshop.
• You may need to pay for your clinicals under a mentor.
• You’ll definitely need to buy study materials to prepare for the exam - $ - You’re looking at least a few hundred dollars for textbooks. There are also practice exams available.
• If you’re going pathway 3, there is a $100 charge for the submission plan.
• The exam itself is $660 USD for the initial exam.
• The retake exam fee is $330.
• It’s not uncommon to have to travel to take the exam. The exam is offered in person at set locations. Traveling costs will vary.
• If you work in private practice, you will have a lot of startup fees. You’ll need to form an LLC, get a vendor's license if you are selling products in addition to your services, buy all the equipment to do private practice, have contracts made, create a website (may have monthly fees), and invest in marketing. - $ - up to a few thousand
• You should get malpractice insurance. - $ - Monthly costs will vary.
• You’ll need to recertify every 5 years.
• You’ll need CEUs. These can vary in cost quite a bit.
• You should join professional associations. ILCA is $132 a year. The USLCA is $85 for individuals, but $75 each for those going in as a group. Both associations have lower pricing for students.
• You may subscribe to journals for this field.
• You should also continue your education and stay abreast the latest information.

 
Should I become an IBCLC?
If you like supporting women in their breastfeeding obstacles and answering their questions, yes. You should consider becoming a lactation professional. Usually, I hear women say they want to become a lactation consultant because they love breastfeeding. That’s wonderful that they had a good experience, but people don’t call you for help when all is well. To be a lactation professional, you must realize that different people have a wide variety of experiences and preferences. You will be working with women who are  

• Doing fine
• Having problems
• Think they are having problems but are just paranoid about low milk supply
• Having their first baby
• Having their fifth baby
• Have health issues that affect breastfeeding
• Have babies with health problems, birth defects, or are premature

Like all health care workers, you will work with a variety of cultures, religious beliefs, family dynamics, and life experiences. You will work with happy, healthy couples. You will work with women that are survivors of sexual assault. You will work with women that are living in or have survived domestic violence. You will have clients that are on drugs or recovering from substance abuse. You will also work with people who have a variety of health issues. All healthcare workers are exposed to infectious diseases. You may have a mom who is exhausted after a postpartum hemorrhage, is recovering from a c-section, or needs help with milk issues after the death of a baby. You must maintain respect and patient privacy just like every other type of health professional. There will be people you can help and people you can’t. There will be successes and failures in your career. There will be people that meet their breastfeeding goals because of you. There will also be people who decide they don’t want to breastfeed anymore. You must learn how to not take it personally when someone makes a decision differently than you would choose. As a lactation consultant, you have a significant impact on your client’s breastfeeding experience. Be respectful. Be kind. Be a listening ear. Be gentle. Be honest. Do what you can to help them. Don’t be afraid to ask for help from the more seasoned professionals. It takes a team to provide health care. If you’re still interested in becoming a lactation consultant, pick a pathway. You are needed.