StorkNet interview with
Anne Smith, IBCLC
International Board Certified Lactation Consultant

Be sure to visit Anne Smith's website for more breastfeeding information and wonderful products. Also, read her articles on StorkNet.

Q's and A's:

BECOMING A LACTATION CONSULTANT

Rachele: Hi Anne! I first became familiar with you on the boards at Baby University where you have offered me advice once before. I have a 3 year old son I nursed until he was 17 months old and I was 4 months pregnant with my daughter. My daughter is now 19 months old and still nursing all the time. I don't have any plans to wean her at the moment, especially since she doesn't seem to have any plans to wean herself any time soon!

Anyway, my question is more geared towards becoming a lactation consultant. I've given it a lot of thought over the past few years but never knew where to get started, as where I live, breastfeeding is just starting to get big. In fact, many people looked down on me for nursing for quite some time. Anyway, I've been able to help quite a few friends with their questions about nursing and feel like I might make a pretty good LC upon proper training.

Where do I start? Once I figure out if this is what I want to do, how would I go about finding work?

Anne: (see correction to this reply at the bottom) Hi, Rachele. IBCLCs (International Board Certified Lactation Consultants) are allied health care providers who are trained to prevent, recognize, and solve breastfeeding problems and to focus exclusively on the needs of the nursing mother and infant. Lactation consulting is a really good field to enter because more and more hospitals and doctor's offices are hiring lactation consultants each year. The IBCLC designation is really the only professional certification that counts as far as hospitals are concerned. Anyone can call themselves a "breastfeeding consultant" or a "lactation specialist," sometimes after taking a workshop or two, but to become an IBCLC requires a lot of hard work, long hours, and very specialized training.

Up until 1985, there was no professional certification for lactation specialists. In that year, ILCA (International Lactation Consultant Association) developed a formal process to establish minimum standards for professional competence and to certify qualified individuals as IBCLCs. The process involves many thousands of hours of clinical experience related to breastfeeding, a number of hours of credits obtained by attending breastfeeding workshops, and passing a rigorous all day exam that is administered once a year at different sites around the world.

ILCA keeps making the requirements harder and harder each year. It's really difficult to get enough clinical hours to even take the exam unless you are already a nurse working in a hospital or doctor's office. Most hospitals prefer to hire IBCLCs who are also RNs, because they can do extra things like administering medications and doing postpartum care in addition to lactation related activities. Almost all IBCLCs are women, and the majority of them are also nurses.

Beginning in 2003, an applicant for the IBCLC exam must document completion of courses in anatomy and physiology, sociology, psychology or counseling, child development, nutrition, and medical terminology and, in the three years immediately preceding the exam, a minimum of 45 documented clock hours of education in lactation reflecting the exam blueprint.

To find out more about becoming a lactation consultant, go to the ILCA (International Lactation Consultant Association) website (www.ilca.org). It is a very rewarding profession, but currently it is very difficult to earn your certification unless you are already a health care professional in a field related to maternal child nursing.

I got into it not for the money (I don't know of any rich LCs) but because I had loved nursing my babies so much and wanted to help others experience the same joy. In the first few years after the exam was developed, ILCA gave 500 hours credit for each year that applicants were active LLL Leaders. That's how I met the requirements for clinical hours, because I wasn't a nurse and had never worked in a hospital or doctor's office. As time went by, the focus of lactation consulting became more and more hospital based, and ILCA eliminated this pathway for certification.

For mothers who aren't nurses, but have breastfed their babies and want to experience the rewards of helping other nursing mothers, becoming a La Leche League Leader is an option to consider. There is no financial compensation, but thousands of dedicated volunteers around the world have the satisfaction of knowing that they are providing much needed support to mothers and babies, and you can't put a price on that. For more information on becoming a La Leche League Leader, visit lalecheleague.org.

Correction: A member very thoughtfully let Anne know that some of the information she posted here was not quite correct. She said, "I am a LLL Leader and also on the pathway to becoming an IBCLC, and from the communication I have received from the IBLCE, this pathway is still applicable." And she pointed us in the right direction. Anne was very relieved to hear this and responded:

Anne: "Thanks for bringing this to my attention. I had looked extensively through ILCA's website trying to find info about pathways for certification, and could find no reference to credit being given for La Leche League Leader's hours. I asked another LC and they told me that ILCA no longer gave credit for hours earned in this way.

I was apparently misinformed, and should have done some more research to make certain before I answered that question. I do know that the requirements are much more stringent now that they were in 1990 when I first took the exam, and that there is a definite trend toward making the exam more medically oriented than it was in the past.

There is also a trend toward hospitals preferring to hire LCs who are also RNs, and it is harder and harder for LCs who have League training but not medical training to sit for the exam, pass it, and find jobs in the field.

I think that this is a very unfortunate trend that has resulted in many women with medical training but not practical experience becoming certified as LCs. The training that LLL Leaders get in dealing with all aspects of breastfeeding is invaluable. For example, many nurses who have gotten their clinical hours by working in labor and delivery units have experience in dealing with mothers and babies immediately post partum, but very little experience working with nursing couples in the months/years following the birth. I feel that LLL Leaders are well grounded in aspects of lactation management at all stages, and I am very happy to hear that this pathway is still alive and well.

I certainly don't want to discourage any mother who wants to pursue this pathway to LC certification! I feel very strongly that the field needs more LLL Leaders, and I am glad to stand corrected on this point. I'm sorry for presenting the incorrect information, and thank you once again for clarifying this issue. Anne

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