IBLCE: Clinical Competencies for the Practice of IBCLCs

April 7, 2021 Written by Mary Foley, RN, BSN, IBCLC

One more review of the initials:

IBCLC = International Board-Certified Lactation Consultant

IBLCE = International Board of Lactation Consultant Examiners

IBLCE facts:1

  • IBLCE was established in 1985. The International Lactation Consultant Association (ILCA), a voluntary international professional membership association, was formed in the same year. ILCA publishes the Journal of Human Lactation.2

  • Three pathways are available for candidates who wish to become certified as a IBCLC.

  • In 2017, the IBCLC certification examination was administered in 17 languages.

  • The IBCLC examination consists of 175 multiple choice questions. The examination is given in two parts, and once you have completed Part One, you may not go back to that part. Most questions in Part Two are associated with an image. The standard IBCLC examination is of four hours duration. (Reference 1)

As you study and gain an in-depth understanding of how breastfeeding works, you are gaining specialized knowledge in the field of lactation. But is that all you need? Is it enough to have “book” knowledge? According to the IBLCE, the answer to that is no. In addition to having this understanding, you also need to have “clinical” or hands-on knowledge which is referred to as “clinical competency.” This is why, in order to even take the exam, you have to show proof of time spent in the actual care of breastfeeding families.

So, with that in mind, IBLCE developed a complete list of the things in which they expect you to be competent in – and this list is found within the IBLCE document, “Clinical Competencies for the Practice of International Board-Certified Lactation Consultants.”3 These competencies are broken down into six “duties.”

The IBCLC has the duty to:

  1. Uphold the standards of the profession

  2. Protect, promote and support breastfeeding

  3. Provide competent services for clients and perform a comprehensive (complete) maternal, child and feeding assessment related to lactation

  4. Report truthfully and fully to the client and/or child’s primary healthcare provider and to the health care system

  5. Preserve client confidence

  6. Act with reasonable diligence (sincere effort)

Under each of these duties, IBLCE has further outlined specific areas in which the IBCLC should have knowledge and experience. As you work towards your IBCLC certification, either for the first time or even as a re-certification, it is important for you to know the areas in which you are expected to have knowledge and skill. 

Without looking at the document – decide if you would answer TRUE or FALSE to the following seven competencies:

The IBCLC Clinical Competencies include the ability to:

  • Provide evidence-based information to the client regarding the use of techniques, appliances and devices.

  • Provide evidence-based information regarding lactation and medications, alcohol, tobacco and addictive drugs including their impact or potential impact on milk production and child safety.

  • Provide evidence-based information regarding complementary and alternative therapies during lactation and their impact on milk production and the effect on the child.

  • Provide information regarding weaning from the breast at any stage of breastfeeding, including breast care.

  • Assess oral anatomy, neurological responses and reflexes of the infant.

  • Promote the principles of the Baby-Friendly Hospital Initiative.

  • Identify risks to lactation associated with pregnancy achieved with Assisted Reproductive Technology (ART).

All TRUE! And these are just a few examples. The clinical competencies are the responsibilities and activities that are a part the IBCLC’s practice. 

Remember, the aim of the Clinical Competencies is not just for the IBCLCs to know the boundaries of their practice, but to inform the public of the field in which IBCLCs can safely provide care. (Reference 3)


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Wambach K, Spence B. Breastfeeding and Human Lactation, 6th edition. Jones & Bartlett Learning. 2021