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The LLL Leader and the IBCLC - A Partnership in Breastfeeding History

Betty Ann Countryman, BA, RN, MN Indianapolis,Indiana, USA and
Heidi S. Roibal, BS Albuquerque, New Mexico USA
with assistance from JoAnne Scott, Virginia USA
From: LEAVEN, Vol. 36 No. 3, June-July 2000, pp. 52-53

IBLCE & the IBCLC - What and Who?

The International Board of Lactation Consultant Examination (IBLCE) is a nonprofit corporation comprised of representatives from LLLI and other disciplines who develop and administer a voluntary certification program for lactation consultants.

International Board Certified Lactation Consultants (IBCLCs) are allied health care providers who meet eligibility requirements, pass an independent examination, and possess the necessary skills, knowledge, and attitudes to provide quality breastfeeding care and services to babies and mothers. Certification is intended for health professionals experienced in lactation consultation, graduates of lactation consultant education programs, and breastfeeding counselors, including LLL Leaders.

Candidates who successfully pass the exam earn the designated credential, International Board Certified Lactation Consultant (IBCLC). The IBCLC credential certifies attainment of the gold standard in lactation consultant certification as set by experts in the lactation field.

In the Beginning

Nearly 20 years ago the Board of Directors of La Leche League International recognized a growing interest among Leaders in finding opportunities to professionalize their breastfeeding skills. As a result, early in 1982, the LLLI Board mandated the establishment of a lactation consultant program. Judy Good, a member of the Board, was appointed as chair of the committee to select a director for the new program. With the Executive Director, Betty Wagner, and the Board Chair, Betty Ann Countryman, a decision was made to invite JoAnne Scott, a longtime LLL Leader, to assume this role. Within a few months, JoAnne had assembled a committee who began to develop the program. LLLI provided a loan of $40,000 to get the project going.

As work progressed, it became clear that the program should meet the strict accreditation standards of the National Commission for Health Certifying Agencies (NCHCA), a regulatory body set up by a grant from the United States Department of Health, Education & Welfare to provide voluntary oversight for allied health professions. Accreditation by the NCHCA was essential to establish credibility with physicians and hospitals, the primary sources of employment for lactation consultants. Membership in the National Commission also acted as protection to the program from the potential development of less credible programs. In 1984 application was made for Category B membership in the National Commission. Accreditation was achieved in 1987 after the exam had been administered nationally for three consecutive years.

To date, the exam has been administered in 35 countries and has been translated into Arabic, Dutch, French, German, Italian, Korean, Portuguese, and Spanish. A Japanese translation is planed for 2001. IBCLCs renew their certification every five years, therefore being able to offer a credential to their clients that verifies their continuing education and current knowledge. The number of currently certified International Board Certified Lactation Consultants has grown from the original 249 to over 10,000 around the world.

Experienced LLL Leaders consistently score higher on the exam than any other group because a Leader's focus and experience cover the broad range of breastfeeding.

As the number of Leaders who also serve as IBCLCs grew, so did the questions regarding a Leader's dual role. In October, 1989 the LLLI Board of Directors provided guidelines for Leaders who are also IBCLCs. Appendix 21 of the LLLI Policy and Standing Rules Notebook reads, "The Leader who maintains a dual role as a Leader/Lactation Consultant will observe guidelines for Leader/Lactation Consultants." (see box)

Benefits of Board Certification

The primary purpose of International Board Certification is to benefit the public by setting standards for the lactation consultant profession. Board Certification provides a credential for lactation consultants that validates their expertise, knowledge, and skills. Employers, colleagues, and consumers can be assured that the designation "IBCLC" identifies a member of the health care team who can provide substantive breastfeeding care and services as well as skilled technical management for breastfeeding problems.

As a service to the public, to employers, and to coordinating and supervising professionals, the IBLCE has created a National Registry of Registered Lactation Consultants (patent pending)/IBCLCs that provides a state-by-state listing for all current IBCLCs in the US, Australia, Asia, Canada, the South Pacific, Southern Africa, Great Britain, Ireland, Europe, the Middle East, and Northern Africa. The public may access this registry to confirm the current IBCLC status of a potential employee or health care provider.

There are now many specially designated employment positions for IBCLCs in hospitals, clinics, nutrition programs, and in private practice. Those who become IBCLCs include LLL Leaders, dietitians, educators, midwives, nurses, physicians, social workers, and physical and occupational therapists. The IBCLC credential identifies them as qualified to help their facilities to:

  • provide quality breastfeeding care;
  • develop and implement a breastfeeding protocol;
  • improve lactation knowledge and skills of other staff; and
  • become accredited under the Baby Friendly Hospital Initiative.

LLLI is proud to have been a partner in this pioneering action to establish a new allied health care profession. Leaders who wish to do so now have the opportunity to move from a volunteer to a career position that allows them to continue helping mothers breastfeed their babies with the skills they have gained as LLL Leaders.

Opportunities for Experienced Leaders

IBLCE recognizes the valuable contributions LLL Leaders have made to the field of lactation management. For the Leader who is considering becoming an IBCLC, several pathways are in place that recognize the experience of Leaders within the context of IBLCE eligibility requirements and exam preparation.

Candidates for the exam are required to submit an application that includes documented breastfeeding consultancy hours. These hours include time spent helping mothers and babies with breastfeeding, usually through one-to-one consultations in person or phone counseling.

The suggested reading list for exam preparation contains many books that may already be familiar to Leaders, including THE BREASTFEEDING ANSWER BOOK, Breastfeeding and Human Lactation, Medications and Mothers' Milk, the LACTATION CONSULTANT SERIES, and Breastfeeding: A Guide for the Medical Profession. All these books can be ordered from LLLI.

The IBLCE Candidate Information Guide lists suggested activities for exam preparation. Among the suggestions are to attend one or more mother support groups and to attend a series of training sessions on counseling skills.

Leaders who are thinking about applying to take the exam can do so with confidence and assurance that the skills they developed for leadership are the very same skills necessary to enter the field of paid lactation consulting.

When and Where Is the Exam Held?

The exam is held once each year on the last Monday of July. Applications are accepted between January 1 and May 15. The exam is offered in approximately 55 countries at over 100 sites around the world. For more information please contact the IBLCE or refer to the current Application Booklet, which accompanies the Candidate Information Guide for current site, fee, and deadline information.

To order a Candidate Information Guide, call or write to: IBLCE International Office, 7309 Arlington Blvd, Suite 300, Falls Church, VA 22042 USA, Phone 703-560-7330, Fax 703-560-7332. Or log on to iblce at or

Guidelines for Leader/ Lactation Consultants

LLLI Policies and Standing Rules, Appendix 21, October 1989.
  1. An active Leader who is also a lactation consultant cannot make referrals to herself for pay.
  2. An active Leader who is also a lactation consultant cannot advertise herself as a lactation consultant on LLL phone recordings or at LLL Group meetings.
  3. The Leader discount on purchasing materials from LLLI is intended to produce revenue for the local Group or Area. The Leader/Lactation Consultant is expected to return such profits to LLLI, her Group, or Area. However, she may purchase materials at a commercial bulk rate and retain the profit as any business may do.
  4. A Leader/Lactation Consultant using LLLI materials and resources to help a paying client is expected to reimburse LLLI for the cost of those materials or resources, or to make a donation to LLLI, her Group or Area.
  5. A Leader/Lactation Consultant may advertise in written LLL materials or exhibit at LLL functions to the same extent as other individual organizations which promote breastfeeding information and support. Free exchange of information promotes cooperation and harmony, and benefits everyone in the long run. Exclusion promotes lack of cooperation.
For more information, please see the "Guidelines for Active Leaders Who Also Work as Paid Lactation Consultants." LEAVEN, May-June 1990.
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