The share of breastfeeding mothers is skyrocketing, but according to a 2014 report from the Centers for Disease Control and Prevention (CDC), most stop well short of the recommended 12 months. The CDC says professional lactation support from a lactation consultant boosts breastfeeding success and, in turn, maternal-infant health. A lactation consultant educates current and future mothers in the areas of lactation and nutrition, troubleshooting challenges and reinforcing good health habits. Proper training is a must, and though educational requirements vary, states and employers increasingly prefer to hire formally trained and certified lactation consultants, especially in clinical settings.
What does a lactation consultant do?
Lactation consultants can work in private practice, hospitals, or birth centers. In a typical day, a lactation consultant offers mothers or soon-to-be mothers tips and advice for encouraging their child to breastfeed. Lactation consultants working in hospital settings may be asked to see as few as three or as many as 18 mothers in their shift. Private practice lactation consultants can oftentimes be as busy as they choose. That said, most lactation professionals' workload is somewhat dependent on the current birth rates.
Most of the time, consultants just need to see their client once and can follow up with phone calls or emails as necessary. Sometimes a problem exists that cannot be fixed during the first visit. For instance, if a baby is tongue-tied, this will need to be fixed by a specialist before the mother and baby are able to come back to fine-tune their latch and learn tongue exercises with a lactation consultant.
Lactation consultants cannot prescribe herbs or other supplements unless they are a nurse or have the proper credentials. They can suggest resources to provide information regarding various herbs and supplements, but cannot outright recommend these. They also cannot diagnose patients, so must be very careful when describing a condition of a mother and/or child.
How to become a lactation consultant
The path to becoming a lactation consultant is shifting rapidly. State and employer training requirements are steeper than ever, yet dedicated lactation consultant degree programs remain rare. The International Board of Certified Lactation Examiners (IBCLE) maintains a complete list of board-recognized health-related fields that offer relevant training and experience, like nursing, midwifery, and nutrition consultation.
Training in these areas can prepare future lactation consultants to identify and manage medical problems that might interfere with breastfeeding, such as mastitis and thrush. They also help candidates meet IBCLE requirements for taking their certification exam. Knowledge in the following topics can be particularly beneficial:
- Psychology and counseling
- Medical terminology
- Child development
The IBCLE's clinical hours and education requirements may help lactation consultants get the technical training they need to support mothers and their babies, but they also need active listening skills, strong oral and written communication, critical thinking ability, social perceptiveness, and deductive and inductive reasoning.
There are a couple of viable avenues by which to pursue a career as a lactation consultant. Most aspiring lactation consultants choose to earn a bachelor's degree while gaining their registered nurse status. However, those who chose not to pursue a career in nursing as either an LPN or RN can earn a bachelor's degree in another health-related field that would be well-suited to this career. Earning LPN or RN status is the path most frequently chosen because it is a convenient way to obtain the number of contact hours required to qualify for the IBCLE exam.
Aspiring lactation consultants who have earned a bachelor's degree in something other than nursing will still have an opportunity to acquire the necessary contact hours. The La Leche League organization facilitates the acquisition of contact hours by allowing aspiring lactation consultants the opportunity to work as WIC peer counselors. There are also ample opportunities for field experience and exposure to the daily duties involved in lactation consultation by simply job shadowing another International Board Certified Lactation Consultant (IBCLC).
Lactation consultant certification
The two organizations offering certification in this field are the International Board of Certified Lactation Examiners (IBCLE) and the Academy of Lactation Policy and Practice (AALP). The IBCLE's certification process is more rigorous and clinical than that of the AALP, preparing professionals for what the CDC calls clinical (think: medically-inclined) lactation management roles.
In order to sit for the IBCLE certification exam, candidates must meet certain educational and professional requirements through one of three pathways:
- Completion of 14 health science courses in areas like anatomy, nutrition, and child development
- At least 90 hours of online or classroom-based lactation-specific education
- At least 1000 hours of lactation-specific clinical practice as a recognized health professional or mother support counselor, at least 500 of which must be completed in-person; up to 250 hours can be by phone, email, or over the Internet
- Graduation from any one of five academic lactation consultation programs accredited by the Commission on Accreditation of Allied Health Education Programs
- Completion of 14 health sciences courses in areas like anatomy, nutrition, and child development
- At least 90 hours of didactic training in human lactation
- At least 300 hours of directly supervised clinical practice in breastfeeding care
- Completion of 14 health sciences courses in areas like anatomy, nutrition, and child development.
- At least 90 hours of didactic training in human lactation
- At least 500 hours of clinical lactation practice under the direct supervision of an approved IBCLE mentor
The ALPP requires that exam candidates complete an evidence-based, comprehensive lactation course, and successfully pass an additional nursing skills competency program.
Certification offers lactation consultants an opportunity to develop and certify skills at a time when formal degree programs remain rare. This formal training, and the continuing education courses required for certification renewal, keep consultants abreast of new research, technological advances, and other trends that impact the field.
Another good reason to consider certification: It is increasingly necessary. Several states have proposed or passed legislation requiring lactation consultants to be certified and licensed to practice, and thanks to CDC recommendations, others are likely to follow suit.
Career and salary information
The Bureau of Labor Statistics (BLS) does not offer specific information about this career, however they do track salary information for nurse midwives, who sometimes may double as lactation consultants. The mean annual wage for nurse midwives in the U.S. was $97,700 in 2014, according to the latest BLS data. The states with the highest mean annual salaries for nurse midwives are:
- Iowa: $128,120 per year
- California: $127,940 per year
- North Dakota: $121,790 per year
- Oregon: $113,480 per year
- New Hampshire: $111,700 per year
And the job outlook for nurse midwives is strong. The BLS predicts an additional 1,300 jobs will be added in this field between 2014 and 2024, which amounts to a 25 percent increase in employment.
- Breastfeeding Report Card: United States/2014, Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, The Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 2014,
- Bureau of Labor Statistics, Nurse Midwives, Occupational Education Statistics, http://www.bls.gov/oes/current/oes291161.htm
- Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners, Occupational Outlook Handbook, http://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
- The CLC - Certified Lactation Counselor, Certification, Academy of Lactation Policy and Practice,http://talpp.org/certification.html
- List of Recognized Health Professionals, International Board of Lactation Consultant Examiners, August, 2013, http://iblce.org/wp-content/uploads/2013/08/recognised-health-professions.pdf
- Pathways, Certification, The International Board of Lactation Consultant Examiners, 2014,http://iblce.org/certify/pathways/
- Preparing for IBCLC Certification, International Board of Lactation Consultant Examiners, 2014, http://iblce.org/certify/preparing-for-ibclc-certification/
- Professional Standards, International Board of Lactation Consultant Examiners, http://iblce.org/resources/professional-standards/
- Student Resources, International Lactation Consultant Association, http://www.ilca.org/i4a/pages/index.cfm?pageid=3911