IBLCE: Scope of Practice

April 12, 2021 Written by Mary Foley, RN, BSN, IBCLC

This is the final post written by Mary Foley. Mary’s bio is posted below for those who may not have seen it. Thank you so very much, Mary!1

The curriculum for the rest of this week will be as follows:

  • Monday / today: IBLCE Scope of Practice

  • Tuesday: IBLCE Test Your Knowledge

  • Wednesday: Lactation Physiology

  • Friday: Lactation Physiology

The Scope of Practice for IBCLCs, as stated by IBLCE, “encompasses the activities for which IBCLC certificants are educated and in which they are authorized to engage.”2

First, IBCLCs should follow the previously reviewed Clinical Competencies and Code of Professional Conduct. Furthermore, the document states that IBCLC certificants have the duty to:

I. Uphold the standards of the IBCLC profession

II. Protect, promote and support breastfeeding

III. Provide competent services for clients and families

IV. Support the client and infant

V. Preserve client confidence

VI. Act with reasonable diligence

As with the previous documents, details are provided on how to fulfill each of these six duties. Let’s look specifically at III - Providing competent services for clients and families. Below is a condensed version of what is expected:

  1. Acknowledge mental health in the context of breastfeeding.

  2. Perform comprehensive assessments related to breastfeeding.

  3. Develop individualized feeding plans in consultation with the client.

  4. Provide evidence-based information regarding use of medications, alcohol, tobacco and addictive drugs, herbs or supplements, and their potential impact on lactation.

  5. Provide evidence-based information regarding complementary and alternative therapies during lactation.

  6. Integrate cultural, psycho social and nutritional aspects of breastfeeding.

  7. Provide support and encouragement to help families meet breastfeeding goals.

  8. Use effective counseling skills.

  9. Use the principles of family-centered care.

  10. Use principles of adult education.

IBLCE states that these are the topics in which IBCLCs have been educated and deemed competent, and it is the expectation that each IBCLC will maintain knowledge related to these steps. So, for example, if your client asks you about chiropractic care for her baby, is it within your scope of practice to discuss this? Yes!  Look at number 5. It is expected that you will provide evidence-based information. Not that you are recommending or rejecting these services, but that you are providing the best evidence around the impact that chiropractic services may have in relation to breastfeeding. We are the educators, parents are the decision-makers. 

The Scope of Practice is a three-page document that you want to be aware of as you begin or continue in your role as an IBCLC.  It is a helpful tool to inform your decision-making and practice-building. 

In addition to the three documents we’ve reviewed, IBLCE also occasionally publishes “Advisory Opinions,” on certain “hot” or newer topics:

  • Advisory Opinion on Education for IBCLC Eligibility and Re-certification

  • Advisory Opinion on Telehealth

  • Advisory Opinion on Assessment, Diagnosis, and Referral

  • Advisory Opinion on Frenulotomy

  • Advisory Opinion on Professionalism in the Social Media Age

Have a question about “diagnosing” a tongue-tie?  Read the Advisory Opinion on Assessment, Diagnosis, and Referral.   Have a question about your breastfeeding page on Facebook?  Read the Advisory Opinion on Professionalism in the Social Media Age.  These are important guiding documents for you. In fact, plan to review these documents at least once each year.  How about on the anniversary date of passing your exam? 

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Mary Foley, RN, BSN, IBCLC

Ms. Foley is the Lactation Program Coordinator for the Maternal and Newborn Service at Melrose-Wakefield Hospital in Massachusetts, USA. She has held this position for 20 years. Mary first became credentialed as an IBCLC in 1987 and has taken and passed the certifying examination three times. Previously, she worked in numerous maternity settings including: obstetrics, postpartum, labor and delivery, home care, and as a lactation consultant in private practice. In 2012, with Mary championing the cause, Melrose-Wakefield Hospital became the 4th Baby-Friendly hospital in Massachusetts and was re-designated in 2017.

Ms. Foley served as a faculty member for MotherBaby Summits held in West Virginia (2013, 2015), Detroit MI (2013), Traverse City MI (2013), and Louisiana (2014). She is a member of the Mother Baby Summit Mock Site Visit Team, a consultant for the Massachusetts Department of Public Health Baby-Friendly Initiative, and a contributor to Bella Breastfeeding, a 3-hour training course for providers, on OPENPediatrics. Mary is also a contributor to the Community Health Training Institute Breastfeeding Training Tutorials and The Lactation College.

Ms. Foley is a BSN graduate of the University of Massachusetts.