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Letters to LLLI
New Requirements
for IBCLC Certification

From: LEAVEN, Vol. 38 No. 5, October-November 2002 p. 112-13.

Dear LLLI,

I decided to take the IBCLC exam this July. I just spent five days taking a preparation course with a room full of nurses. This was quite a different perspective and my head was spinning from all of the numbers. It got me wondering why the requirements to pass the exam have been changed for the 2003 exam year. The new requirements make it much more difficult for the average Leader. I’m surprised at this. I thought that La Leche League started the IBCLC certification and that Leaders would be able and encouraged to qualify.

Heather Kay
Belle Mead NJ USA

Dear Heather,

Thank you for sharing your letter. I’m sure it is of interest to many Leaders. As the Executive Director of the International Board of Lactation Consultant Examiners (IBLCE), I hope to answer your questions.

Organizations that offer certification—and are accredited by the US National Commission for Certifying Agencies -- must do periodic Role Delineation Studies. All those currently certified are surveyed to determine their academic and experiential preparation, their continuing education, and what they actually do in practice. These surveys become the legal basis for eligibility requirements and the exam content outline.

The IBLCE is not permitted to set eligibility criteria wherever we wish. Nor can we create exams containing what we think they ought to cover. The main purpose for the Role Delineation Studies is to prevent artificial barriers -- requirements that might exclude applicants who really are qualified to practice. An example of an artificial barrier would be requiring a health professional degree because there is no evidence that people who possess such degrees are better qualified than people with many other academic backgrounds. But our 1998 Role Delineation Studies showed that most people currently practicing as Board Certified Lactation Consultants have had formal academic training—or formal continuing education—in the scientific disciplines. Most of these individuals have not had full semester courses in each subject area, but they have had survey courses that have covered several topics in one course. Or they have chosen to take non-credit continuing education classes in those subject areas. So this kind of background has been included in the criteria for next year.

This increase in eligibility criteria is an inevitable progression, at least if the history of other fields is used as a model. Ethical practitioners always seek to update their skills and knowledge. By doing so, they gradually increase the standards of formal education that become viewed as the norm for that field. The IBLCE cannot set eligibility requirements higher than is currently the norm, such as requiring a specific degree or even a degree at all, because a large number of our certificants are RNs who have a program diploma but do not hold four-year degrees. Nor can we set requirements lower than those that are currently the norm for the field.

Part of the reason these new requirements are now standard may be because so few LLL Leaders and other mother support group leaders/counselors (who are not also health professionals) take the exam. In the last few years, this number has averaged only about five percent. Many have taught themselves such subjects as medical terminology or general human anatomy by buying textbooks and referring to them frequently while practicing. They have confirmed their knowledge by taking continuing education courses. Medical terminology is increasingly appearing in the articles they write, the courses they teach, and the research they develop. New practitioners will no longer be entry-level without acquiring some background in these subjects before they begin to practice, instead of acquiring it as they go.

Please note that the requirement is for "a background in," not "a course in." The Role Delineation Studies supports the "background in." So a minimum of four clock hours (as opposed to a semester) of instruction in each of the subjects named will satisfy the new requirement—provided that each four hours is designed to be a general overview and not a portion of a longer course. Many people find general courses at community colleges or on the Internet and these are set up as semester courses with academic credit. But demand creates supply. I expect that there will be courses created to meet these guidelines, supplying four hours of instruction in each of the required subjects. La Leche League International is exploring the idea of implementing a course that would be accessible over the Internet.

The data was collected in 1998, analyzed in 1999, and a three-year lead time was provided when the new requirements were first announced. This was to give people already preparing for the exam time to complete their preparations and then take the exam before the new requirements went into effect. It would allow those who would not be ready until after the implementation date to include the needed preparation in their plans. Finally, it would allow course directors time to create new programs if they wished to do so. As is human nature, however, most people didn’t really begin to pay attention until this year. As a result, candidate numbers are probably higher this year, and will probably be lower next year than they would have been otherwise.

The best way to keep La Leche League training and values reflected in the Role Delineation Studies is to encourage Leaders to take the exam. This would increase the percentage of IBCLCs who received their primary preparation through La Leche League—the best possible training for the job!

JoAnne Scott, MA, IBCLC
Executive Director, IBLCE


To sit for the IBLCE, applicants must provide documentation that they have a background, or have completed coursework, in:

  • Anatomy
  • Physiology
  • Sociology
  • Psychology or counseling
  • Child development
  • Nutrition
  • Medical terminology

A degree (including diploma RN) in one of the licensed health care professions is sufficient documentation. For individuals who are not licensed or registered health professionals, they must submit the following documents:

  • official transcript from a college, university, or post secondary institution; or
  • a signed statement from the course provider(s);
  • the course syllabus outline; and
  • the curriculum vitae or resume of course provider(s)

Additionally, all applicants will need to provide evidence of a minimum of 45 documented clock hours of education in lactation, reflecting the Exam Content Outline, in the three years immediately proceeding the exam. The 45 documented clock hours is in place of the 30 hours of education previously required. Applicants will still be required to accumulate the Breastfeeding Consultancy Practice hours for whichever standard pathway they qualify.

Helpful Resources

Free IBLCE Candidate Information Guides and Application Booklets are available from: International Board of Lactation Consultant Examiners (IBLCE), 7309 Arlington Blvd., Suite 300, Falls Church, VA 22042 (USA); 703-560-7330; Email: iblce at; Web site:

The LLLI Web site,, has a wealth of information on:

  • Media releases from LLL Groups from all over the world
  • Breastfeeding articles from our various publications
  • Conference and workshop information
  • Corporate lactation support
  • Breastfeeding and the law articles
  • Professional Information section
  • Center for Breastfeeding Information (CBI) database, a free service for those doing research

Web site discussing common IBCLC questions:

LLLI Continuing Education, which includes:

  • Continuing Education Recognition Points (or CERP credits)
  • Lactation Specialist Workshops
  • Seminars for Physicians
  • Peer Counselor Program Administrator Trainings
  • Area and International Conferences
  • Independent Study Modules
  • LLLI Professional Breastfeeding Resource Center (BRC) memberships, which include:
  • A subscription to BREASTFEEDING ABSTRACTS, our health professional publication, and a subscription to NEW BEGINNINGS, our mother-to-mother sharing magazine
  • A copy of almost every pamphlet and tear-off sheet in our Catalogue
  • 15% discount on most Catalogue items
  • quarterly update mailings
  • up to one hour consultation with the LLLI Center for Breastfeeding Information

The International Lactation Consultant Association (ILCA) is a global organization whose members receive the Journal of Human Lactation. Many chapters form study groups for those preparing to sit for the IBLCE exam. Information is available from: 1500 Sunday Drive, Suite 102, Raleigh, NC 27607 (USA); 919-787-5181; Email: ilca at; Web site:

LACTNET is an informal Internet discussion group for lactation consultants and other professionals interested in lactation who wish to share professional information regarding lactation and case management. Subscribers to LACTNET must follow specific instructions on how to use the service. To join LACTNET go to:

What is IBLCE?

The International Board of Lactation Consultant Examiners (IBLCE) is a nonprofit corporation established in 1985 by La Leche League International to develop and administer professional certification for lactation consultants. An International Board Certified Lactation Consultant (IBCLC) is a person who has passed the exam prepared by the IBLCE. LLLI serves on the IBLCE board, along with other agencies and health care professionals. The exam is held once a year worldwide. Certification is for five years. Re-certification by continuing education or re-examination is required.

The IBLCE examination focuses on lactation and also encompasses many disciplines such as anatomy and physiology, nutrition and biochemistry, immunology and infectious disease, pathology, pharmacology and toxicology, psychology, sociology, anthropology, growth parameters and developmental milestones, research, ethical and legal issues, breastfeeding equipment and technology, techniques, and public health and advocacy. The standards are set at a university level of difficulty, and one must meet specific eligibility criteria before being approved to sit for the certification exam.

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