How to Become a Lactation Consultant

What is a Lactation Consultant?

According to the Centers for Disease Control’s (CDC) Vital Statistics Rapid Release Report, there were 3.66 million babies born in the US in 2021. This is up 1% from the previous year. More than 80% of these babies were breastfed or given expressed breastmilk at some point. Lactation consultants assist these mothers throughout the breastfeeding journey. 

Breastfeeding support for mothers, especially first-time moms, is crucial in ensuring their success in their breastfeeding journey. Through certification, individuals can gain the knowledge and skills needed to support these mothers. 

Types of Lactation Consultants & Counselors

Certified Lactation Counselor (CLC)

The Certified Lactation Counselor (CLC) certification identifies a professional in lactation counseling who has demonstrated the necessary skills, knowledge, and attitudes to provide clinical breastfeeding counseling and management support to families who are thinking about breastfeeding or who have questions or problems during the course of breastfeeding/lactation.

This certification is often seen as a stepping-stone to the International Board Certified Lactation Consultant certification.

Certified Breastfeeding Counselor (CBC)

A Certified Breastfeeding Counselor (CBC) certification is a specialty certification designed for individuals that recognize the specialty role of the nurse as a counselor and educator in lactation management. 

The goal of the CBC certification is to:

• recognize the specialized knowledge, skills, and abilities of the nurse dealing with lactating women
• strengthen the core competencies of the nurse dealing with lactation management
• contribute to nurse educators professional development

International Board Certified Lactation Consultant (IBCLC)

An International Board Certified Lactation Consultant (IBCLC) is a healthcare professional who specializes in the clinical management of breastfeeding. One of the major focuses of an IBCLC is global health and altering the importance, effects, and stigma regarding breastfeeding and breastmilk.

The impact of IBCLCs on global health are:

• Improve breastfeeding outcomes
• Lower health costs
• Improve consumer satisfaction
• Improve the institution’s image
• Improve consumer trust
• Improve breastfeeding programs and policies

An IBCLC works independently and in collaboration to empower mothers, children, and families to meet their breastfeeding goals. This is the most comprehensive lactation certification.

Lactation Consultant Certifications

There are several certifying bodies that offer CBC certification, and one for the CLC certification. This article discusses the most popular courses that are offered and credentialed. When deciding which course to take consider the following,

• Cost
• Location
• Reimbursement possibility from employers
• Credentialing Body
• Are you a Registered Nurse?
• Do you want to become an International Board Certified Lactation Counselor?

How to Become a Lactation Consultant or Counselor

The steps to becoming a lactation consultant will depend on the type you want to become. Here's how to become a CLC, CBC or IBCLC.

How to Become a Certified Lactation Counselor (CLC)

To become a CLC, you must sit for the Certified Lactation Counselor examination. There are three ways to be eligible for the exam.

1. The Aggregate Pathway - Requires a demonstration of completed prerequisites, an application, and subsequent approval.
2. The Alternate Pathway -  For graduates of a Commission on Accreditation of Allied Health Education Programs (CAAHEP) approved, post-secondary, lactation consultant program, who must provide documentation.
3. Online Lactation Counselor Training Course - Due to the recent pandemic, the Healthy Children Project, Inc. – The Center for Breastfeeding, created an online lactation counselor training course. The self-paced program consists of videos, self-check questions, and competency verification. Instructors are available for virtual office hours to answer additional questions for online participants. The course should take 52 hours to complete (just like the in-person version), but you have up to 6 months to complete it.

Typically, students would attend a 5-day in-person training administered by the Healthy Children Project, Inc. – The Center for Breastfeeding at locations throughout the United States with the final comprehensive examination administered by the Academy of Lactation Policy and Practice on the final day.

The CLC course is accredited by the American Nurses Credentialing Center’s Commission on Accreditation and awards 52 continuing education hours at the conclusion of the program.

Tuition is $625 including the cost of the examination. Discounts are offered for early bird registration and group registration.

Who Can Become a CLC?

The CLC certification is open to a wide range of individuals. Most have a nursing or medical background.

• Registered Nurses
• Hospital Staff
• Public Health / WIC employees
• Public Health Nurses
• Childbirth Educators
• Doulas
• Visiting Nurses
• Licensed Practical Nurses
• Pediatricians
• Family Practice Physicians
• OB / GYNs
• Breastfeeding Advocates
• Midwives
• Perinatal Outreach Workers
• Peer Counselors
• IBCLCs earning CERPs
• La Leche League Leaders
• Nursing Mothers Counsel Members
• Speech / Language and Occupational Therapists 

How to Become a CBC

Designed by Prepared Childbirth Educators, Inc. the CBC course is a two-day course that has a final examination and a written assignment. Typically held in person, this course has been converted to a live virtual zoom course instead.

What to Expect in the Online CBC Course

Each day is 8 hours and attendance is monitored and cameras must be on at all times (with the exception of breaks and lunch) This course is approved for 16 contact hours by the Pennsylvania State Nurses Association, which is accredited as an approver of continuing education in nursing by the American Nurses Credentialing Center’s Commission on Accreditation.

Tuition is $300 and does not include the examination fee. Students are emailed a registration form with a discounted off-site exam rate for completing the virtual prep course. If you attend the course the fee for the examination is $150 and you must provide your own proctor.

Eligible individuals are able to take just the exam for a $450 fee.  PCE certification is valid for 3 years. Applicant must obtain 18 contact hours of continuing education related to lactation management in order to receive recertification and maintain the designation of CBC and pay a $50 recertification fee.

Who can Become a CBC?

• Must hold an active Registered Nursing License
• Have a minimum of one year of experience working with pregnant or lactating women
• Have taken a course on lactation management in the past

How to Become an IBCLC

There are three pathways for individuals that want to become an IBCLC. In order to sit for the examination, all criteria in one of the pathways must be met. These pathways are VERY specific and it is important to make sure all aspects of the pathway are met. The examination board will not allow individuals to sit for the IBCLC examination if they are not. 

Pathway 1 (Recognized Health Professionals and Recognized Breastfeeding Support Counselors):

• Minimum of 95 hours of lactation-specific education, including five hours focused on communication skills, within the five years immediately prior to examination application.
• 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.
• Minimum of 1000 hours of lactation-specific clinical practice in an appropriate supervised setting within the five years immediately prior to examination application.
• Clinical practice is to be obtained in an appropriate supervised setting, to include the following:
  • Hospital
  • Birth Centre
  • Community Clinic
  • Lactation Care Clinic/Practice
  • Primary Care Practitioner’s Practice/Office

Pathway 2 (Accredited Lactation Academic Program):

• Minimum of 95 hours of lactation-specific education, including five hours focused on communication skills, within the five years immediately prior to examination application.
  • 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.
• Minimum of 300 hours of directly supervised lactation specific clinical practise within the five years immediately prior to examination application.
  • The IBCLC(s) providing the direct supervision must be currently certified IBCLCs in good standing.
• Pathway 2 IBCLC applicants must have completed the accredited lactation academic program within the five years immediately prior to their examination application.
• Only the following specific programs are eligible. Each academic program has unique admission and completion requirements. You must contact these schools directly for more information about their precise requirements.
  • Drexel University
  • Johnson C. Smith University
  • Portland State University
  • University of North Carolina Gillings School of Global Public Health
  • Union Institute and University
  • University of California San Diego Extension
  • Georgia Northwestern Technical College-Rome
  • Henry Ford College
  • North Carolina Agricultural and Technical State University

Pathway 3 (Mentorship with an IBCLC):

• 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.
  • 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.
• Minimum of 500 hours of directly supervised lactation specific clinical practise 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.

Regardless of the pathway, all IBCLC candidates must take the required healthcare courses. This can be done by either taking the fourteen approved health education courses OR having medical or nursing training.

Who Can Become an IBCLC?

• Dentist
• Dietician
• Midwife
• Nurse
• Occupational Therapist
• Pharmacist
• Physical Therapist or Physiotherapist
• Physician or Medical Doctor
• Speech Pathologist or Therapist

What Does a Lactation Consultant Do?

• Support a breastfeeding parent
• Run breastfeeding classes and support groups
• Provide education on lactation, breastfeeding, and breastmilk
• Work in hospitals, clinics or private practice
• Evaluate the breastfeeding dyad to help a client understand whether the baby is effectively transferring milk from the breast
• Assist in utilizing breastfeeding and pumping supplies
• Explore the options available if they are experiencing breastfeeding problems
• Explain the symptoms for a range of breastfeeding problems
• Provide referrals for medical diagnosis or treatment

Where Can a Lactation Specialist Work?

• Maternity units in hospitals and birth centers
• Neonatal intensive care units
• Special care nurseries
• Outpatient lactation clinics
• WIC programs
• Visiting nurse programs
• Maternal and child health services
• Parenting centers
• Military family support centers
• Physician and midwife offices

What CBCs and CLCs Can't Do

• Give medical advice
• Give a medical diagnosis
• Prescribe medication
• Carry out treatment

Becoming a CBC, CLC, or IBCLC is possible for nurses that have an interest in lactating women and helping change the conversation regarding breastfeeding. According to the CDC Breastfeeding Report Card, 4 out of 5 (83.2%) started to breastfeed, over half (57.6%) were breastfeeding at 6 months, and over one-third (35.9%) were breastfeeding at 12 months in 2015. Compared to rates for infants born in 2014, rates for infants born in 2015 increased for breastfeeding at 6 and 12 months.

Breastfeeding has significant health benefits to both the newborn and the mother. CBCs, CLCs, and IBCLCs assist in improving the health of families through breastfeeding. To reach their breastfeeding goals, mothers need continuity of care, which is achieved by consistent, collaborative, and high-quality breastfeeding services and support.

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