There are many different levels of support when it comes to lactation. It is confusing to figure out who is what. It is even more confusing because unlike a doctor or a nurse, anyone can call themselves a Lactation Consultant because it is not a protected title.
There are a few things to know about all healthcare professionals.
1. If they are licensed, then there is a state board that is responsible for protecting the public. They hold the individual accountable for their practice and for staying up to date. They are also the place where reports should be made if someone is practicing unsafely or outside of their scope of practice.
2. Certifications and Certificates are not the same. If a healthcare professional is “Board Certified” or holds another certification, that means that after completing a specific number of practice hours and education they can pay to take an exam from an accredited organization (which is usually not the place they attended for the education) and if they pass, they have demonstrated the level of skill and knowledge required for that certification. Certifications come with a public registry. This means that you can go on to the certifying organization’s website and look up a person’s certification. Professionals can also be reported to their certifying board if the public has a concern about their practice. Some healthcare professionals are not licensed, but hold a certification, like Internationally Board Certified Lactation Consultants (IBCLCs)
3. Certificates are awarded to those who take some type of continuing education and then take a test administered by the same organization that taught the course.
IBCLC – This certification requires 8 college courses, 95 hours of lactation specific education, and is the only one that requires documented clinical hours. That means IBCLCs spend somewhere between 300-1000 hours under supervision by either another IBCLC or by a healthcare professional like a Registered Nurse, Physician, Speech Language Pathologist, Occupational Therapist, etc. If the supervision is not done through a mentoring program the candidate needs 1000 clinical hours. This is a certification which means an independent organization (not where they went to school) administers the test and maintains a registry where the public and look up if someone holds that certification. IBCLCs are trained to clinically assess and provide intervention for basic and complex breastfeeding issues. These issues include failure to thrive (poor weight gain), prematurity, cardiac issues, orofacial/cleft palate defects, tongue ties, and more.
CLC – This is a 45 hour course with classroom training where those who want to help with breast/chest feeding can go to learn about lactation, positioning, latch, and communication skills to help lactating families. This course is now offered online as well. There is no clinical supervision requirement. There is a test at the end of the course that is taken to verify the knowledge learned. This test is administered by the organization that teaches the course. This is a lactation certificate. There is no registry. CLCs are trained to provide education and support for families with basic breastfeeding issues e.g. latching discomfort due to positioning, shallow latch, when to introduce solids, how often babies should eat and how much, etc.
CBS - This is a 45 or 90 hour online course (120 hours of classroom education) where those who want to help with breast/chest feeding can go to learn about lactation, positioning, latch, and communication skills to help lactating families. There is no clinical supervision requirement. There is a test at the end of the course that is taken to verify the knowledge learned. This test is administered by the organization that teaches the course. This is a lactation certificate. There is no registry. The CBS is trained to provide education and support for families with basic breastfeeding issues e.g. latching discomfort due to positioning, shallow latch, when to introduce solids, how often babies should eat and how much, etc.
LLL and Peer Support - Provide breastfeeding information, encouragement, and support to those in their community. They have some knowledge and education about lactation/breastfeeding and typically have personal experience with breast/chest feeding.
There are other certificate holders that may you may encounter, but the CLC and CBS are most common in our region.
It is important for parents and healthcare professionals to understand the differences in lactation credentials so that they can make informed choices and referrals to the level of care families need. Some may only need peer support, let’s face it, we ALL need peer support! Others may need increased support and education for uncomplicated trouble shooting and problem solving (CLC, CBS, CLE, CLSP). Not every family will need an IBCLC, but those who have complex problems that are not solved with education, expert positioning help, or have known medical conditions should be seen by an IBCLC.