What is an IBCLC?
The International Board Certified Lactation Consultant (IBCLC) credential identifies a
knowledgeable and experienced member of the maternal-child health team who has specialized
skills in breastfeeding management and care. The IBLCE certification program offers the only
credential in lactation consulting and is available globally.
IBCLCs have passed a rigorous examination that demonstrates the ability to provide competent,
comprehensive lactation and breastfeeding care. Attainment of the IBCLC credential signifies
that the practitioner has demonstrated competence to:
Among those who become IBCLCs are nurses, midwives, dietitians, physicians and experienced
breastfeeding support counselors. IBCLCs work in a variety of settings including hospitals,
clinics, physicians' offices, neonatal intensive care units, human milk banks and private practice.
With a focus on preventive health care, IBCLCs encourage self-care, empowering parents to make
their own decisions. IBCLCs use a problem solving approach to provide evidence based information
to pregnant and breastfeeding women and make appropriate referrals to other members of the health
care team. The IBLCE has established Professional Standards for IBCLCs and IBCLCs must renew their
certification every five years, either through continuing education or by re-examination.
- work together with mothers to prevent and solve breastfeeding problems
- collaborate with other members of the health care team to provide comprehensive care
that supports, protects and promotes breastfeeding
- encourage a social environment that supports breastfeeding families
- educate families, health professionals and policy makers about the far-reaching and
long-lasting value of breastfeeding as a global public health imperative
How does a Lactation Consultant help?
Lactation Consultants work in varied settings such as hospitals, clinics, private doctor offices
or private practice. The certified lactation consultant is an expert in Lactation and Breastfeeding
management. The LC role is to enable and empower women to achieve their breastfeeding goals .
LCs work to assist families to prevent and overcome difficulties.
Certified lactation consultants collaborate with the other members of the health care team and
have the knowledge, skill and expertise to work with mothers and their infants in both routine and
A wide range of services are available depending upon the setting in which the LC works. Serivces
can include prenatal consultations, breastfeeding classes, private individual consultations for
routine or specific concerns, support groups and availability of breastfeeding pumps, equipment and supplies.
In consultations, most lactation consultants follow a step by step approach beginning with identifying
and clarifying the mother's stated goals and detailing the concerns which the mother has. Once goals
are established, LC's use their vast array of assessment skills to determine the reasons for the difficulties.
Once the assessment is made the LC then explains why the problem is occurring and offers options for
resolving it. The LC together with the mother then develop an individualized care plan to address the
issues of concern. Instructions for the interventions of the plan are provided, demonstrated, trialed
and practiced. Mother is followed by phone and or follow up visits until all concerns have been resolved
and mother feels she is independently confident on her own.
But isn't Breastfeeding natural?
Yes it is. So, you might think, why would a woman need an expert to be able to successfully breastfeed?
The answer is, that while it is absolutely true that breastfeeding is natural, it is a learned art.
That is to say women have always needed a source of information and instruction about how breastfeeding
works, what to do and how to do it. Historically, that role was commonly filled by the older and
knowledgeable women in their cultures. Women typically learned about breastfeeding from their mothers,
sisters, aunts and grandmothers. Midwives tended births and routinely assisted mothers to begin breastfeeding
right from the start. Additionally, there was always a "wise woman" to turn to when all the usual sources
of information could not resolve concerns. In our busy modern cultures ,when it comes to breastfeeding issues,
lactation consultants have taken on the role of both the " culturally experienced family and care givers"
as well as " the wise woman".
Suggested Guidelines for Calling a Certified Lactation Consultant
Mothers often recognize that a problem exists but do not know who in the health care team is the appropriate
professional to call. Lactation consultants help women before baby is born when they make their decisons on
how to feed their baby, help after the baby is born to get started on the right track right from the
beginning and to continue breastfeeding if there are common concerns or return to work issues. In all
cases the sooner the issue is identified the easier and faster it is resolved. For those situations which
can be addressed prenatally, problems are often prevented and or minimized. Overall, the vast majority of
problems which mothers encounter are temporary and RESOLVABLE . See below for a comprehensive list of suggested
guidelines on just when to call the Certified Lactation Consultant.
- Maternal Indicators
- History of breast surgery
- History of previous personal or familial lactation failure
- Acute illness, chronic illness or handicap
- Minimal/No breast changes during pregnancy and/or by 1st week after birth
- Marked breast or nipple asymmetry
- Breast or nipple pain and/or trauma
- Acute engorgement
- Maternal anxiety related to breastfeeding
- Adolescent or woman having her first child older than 40 years old
- Current necessity for medication re: chronic or acute illness
- Relactation or induced lactation
- Infant Indicators
- History of no latch on within 24 hours of life
- History of persistent latch on difficulty
- No audible swallowing note by 24 hours of age
- Dissatisfied after feed as evidenced by crying, finger sucking, rooting
- Inadequate stool output defined as less than 2-3 stools, per 24 hours, by day 2-3
- Inadequate urine output defined as less than 2 voids, per 24 hours, by day 2; 6-8 voids by day 6-7
- Handicapped infants, LBW infants, premature infants,
- Failure to feed at least 8X per 24 hrs, in the 1st week
- Infants fretful at breast: squirming, crying, pulling, coming off breast
- Inadequate weight gain; (minimum wt. gain of 1/2 to 1 oz. per day)
- Infant weight loss>5% within 24 hours or 10% total weight loss
- Infant receiving pumped breastmilk