How to become a lactation consultant

Updated 2021 July 24th 

A general term - lactation consultant

The term “lactation consultant” is a little bit generic. It is often used in reference to IBCLCs, but lactation consultants can be professionals of varying levels. I think of it like nursing. We say “nurse” when we are talking about RNs or LPNs or NPs or other types of advanced-practice nurse. The label nurse can be used for an RN with their ADN or BSN or MSN. We use the same broad term for all types of nurses, but we know the education level is different and we know the scope of practice is different for RNs in comparison to a LPN or a NP. They’re all nurses though. An RN ADN working in L&D alongside a CNM are both nurses, but their abilities are different. With lactation consultants, there are IBCLCs. There are also CLCs and CBSs and a few other credentialed professionals. They all offer education and support with the ability to do clinical-level care and may be in private practice. They also have a different scope of practice. Same goal, same team, working together to help mothers and babies.
 
Let’s talk about how to become a lactation consultant and what the scope of practice is for the different types.
 
First, take a look at the blog on different types of lactation professionals.
Also check out the blog on lactation professional training programs.
 
Now that you’ve done that and seen which programs offer training on this level, let’s take a look at how to become a lactation consultant.
 
Lactation consultants are health professionals. Lactation consultancy is a specialty of women’s health. 

To become an IBCLC 

The term IBCLC is a trademarked term that can only be used by those certified through the IBLCE (International Board of Lactation Consultant Examiners). An IBCLC must have college classes and clinical experience before applying for the exam.
 
The website is www.iblce.org
 
How do you become an IBCLC?
 
In brief, you have to

1. take college classes – all are required to have 14 health science courses
2. have lactation education – a minimum of 95 hours
3. and do clinical hours or have work experience – this is where it varies by pathway

 
There are 3 different pathways you can go.
 
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 that are directly supervised by an IBCLC in good standing.
 
Pathway 3
If you are not eligible for pathway 1 or 2, you go a mentorship route. Clinical requirements are 500 hours under the direct supervision of an IBCLC. 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
• 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

 
You’ll chose a lactation training program that is adequate for IBCLC prep. There’s a blog directory of lactation training programs here. They are required to go over all areas of the exam. Here is the outline of things you’ll need to be proficient in. https://iblce.org/wp-content/uploads/2021/07/IBCLC-Detailed-Content-Outline.pdf  
 
Your clinicals will depend on the pathway you go.
 
Your lactation education and clinical hours have to be within the last 5 years before applying to take the exam.
 
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.
 
How much money does it cost to become an IBCLC?
It takes several years and thousands of dollars to become an IBCLC.
Expenses:

• 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’ll also need textbooks for your lactation training and in general - $$$ - expect to spend several hundred dollars
• You may need to pay for your clinicals under a mentor.
• You’ll need to buy study materials to prepare for the exam - $$$ - 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.  

 
Once certified, how do you maintain certification?

• Upon passing the board exam, you will need to recertify every 5 years. You can recertify by retaking the exam or by CEUs. Previously, you had to retake the exam at least every 10 years. Now you are able to recertify through continuing education.

How much does it cost to maintain the credential?

• You’ll need to recertify every 5 years.
• You’ll need CEUs. These can vary in cost quite a bit.
• You’ll attend conferences.
• You should join professional associations such as ILCA and USLCA.
• You may subscribe to journals for this field.
• You should also continue your education and stay abreast the latest information.

 
Where can I work as an IBCLC?

• Hospitals
• Birthing centers
• Doctor’s offices
• WIC or other community support
• Private practice – If you go into private practice, the start-up costs will be several hundred at minimum.

What is the scope of practice?
IBCLCs can work with any type of lactation and infant feeding situation. It is important that they know their own educational background, work experience, and abilities. Even seasoned IBCLCs still need to work together with colleagues and also refer out when that's what's best for the patient. It is important to always seek education and professional growth.

To become a CBS (certified breastfeeding specialist) 

This is the credential from Lactation Education Resources.
 
Lactation Education Resources
www.lactationtraining.com
Hours: Choose the 90 hour or 45-hour Phase 1 and 45-hour Phase 2
Cost: the 90-hour is $975
Location: online, start anytime and work at your own pace (1 year access)
Certification: certified breastfeeding specialist (CBS)
Length of certification: 5 years
Note: This program is unique in that it brings together a large group of teachers with different areas of expertise.
 
About being a certified breastfeeding specialist
https://www.lactationtraining.com/cbs-info
 
Scope of practice:
https://www.lactationtraining.com/images/PDFs/Scope_of_Practice_CBS_revised.pdf
 
They can conduct assessments of mothers and babies and devise a plan of care in uncomplicated situations. They can also problem solve issues that usually don’t lead up to adverse outcomes. When needed, they are to refer to an IBCLC.
 
Code of professional conduct:
https://www.lactationtraining.com/images/PDFs/CBS_standards_of_practice.pdf

To become a CLC

This is the credential offered through Healthy Children’s.
 
Healthy Children’s Project
www.centerforbreastfeeding.org
Hours: 52 hours
Cost: online course is $625 and they charge $120 to take the exam
Location: 5-day course offered throughout the country
With the pandemic, they began offering an online version that can take up to 6 months to complete
Certification: Certified Lactation Counselor (CLC)
Length of certification: 3 years
 
About being a CLC:
https://centerforbreastfeeding.org/lactation-counselor-training-course/clc-certification/
 
Scope of practice:
https://www.alpp.org/scope-of-practice/scope-practice-clc
 
Their scope of practice allows for supporting both uncomplicated and complex dyads.

​Other programs 

UC San Diego also offers training and certification as a lactation consultant. 

​Who can become a lactation consultant?

Anyone who completes the training and passes their exam may become a lactation consultant. The pre-requisites will depend on the school you choose and the certification you want.
 
Some 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. There are midwives and doulas and dieticians who also choose this credential. As well, there are individuals who do not work in healthcare in another role who become lactation consultants.
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 clinical lactation 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. 

Where do lactation consultants work? 

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.
 
Hospitals often require the IBCLC certification. They may also require you to be an RN.
 
Private practice is not regulated as lactation consultants are not state-certified or licensed in most states. A few states have started offering licensure to IBCLCs. You can offer lactation education and support within the scope of practice determined by your certifying body. You can be in private practice as a CLC or CBS. 

​Should you become a lactation consultant? 

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 it’s a mental obstacle such as anxiety or a matter of misinformation
• 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.