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What’s Not Fair Game for the IBCLC Exam?

Catcher wearing red uniform in front of umpire.

In a previous post, I described the sorts of questions that would be fair game for the IBCLC exam. Remember – I’ve never been on the IBLCE exam-writing committee. But I do have experience to gauge what is considered fair game, and what would not. I’ve talked about the former; now, it’s time to tackle the latter. What sort of questions would be unlikely to be on the IBCLC exam. That is, what do I consider as something that’s not fair game?

1. National directives, recommendations, or standards

Do not expect to get any questions that relate to the statements, standards, or directives given by the American Academy of Pediatrics, the Centers for Disease Control and Prevention, The Joint Commission, or any other organization that has a national – rather than an international – scope. It’s just not fair game on the IBCLC exam.

However, note that the Academy of Breastfeeding Medicine is an international organization, and their protocols are often published in multiple languages. Make sure you review their recommendations.

2. Judgement about controversial topics

If some experts say one thing and other experts say another, the topic is not fair game for the IBCLC exam. IBLCE won’t put you in a position to choose between them.

That doesn’t mean you won’t see those topics on the exam, but in my experience, they will be presented as a “done deal.” In other words, you might be told that the family is using something or doing something. The exam item will be related to your responsibilities to provide education and support.

3. Medication questions that require a risk-benefit decision

I have never seen an IBCLC exam item about whether a particular medication is safe for the breastfeeding mother. IBLCE recognizes that test-takers are not educated or authorized to prescribe. So, it’s just not fair game for the IBCLC exam.

IBLCE also recognizes that that those with prescriptive privileges weigh the risk/benefit ratio for the situation, the details of the mother’s health history, the details of the infant’s health history, and even some social factors which could affect the risk/benefit decision.

Again, this might be handled more as a “done deal” approach where the mother is already taking a particular medication or using a particular treatment. In that case, the IBCLC’s role is to provide education and support, but not to determine the risk/benefit.

4. Body language is not fair game

Those of us who have worked in health care know from experience the importance of reading body language, but it’s not fair game for the IBCLC exam. Body language is interpreted very differently from culture to culture, and the IBCLC exam is international in scope. As I like to remind people, the “I” in IBLCE stands for “international.”

5. Very recently published research

Writing, vetting, and publishing the exam takes some time, so don’t worry about studies published in the few months immediately before the exam. (Years ago, when the exam was given only in July, IBLCE said the exam would include nothing published after January 1 of that year. I haven’t seen a similar statement since IBLCE went to its current twice-a-year exam schedule, but I assume the same idea would apply.)

6. Author and location details

Attendees at my live courses have often said they feel a little unnerved when I, without my notes, name the lead author of whatever study I’m talking about. They worry that they will be asked to do the same on the exam.

No, no, no worries! The exam might ask about research methods and interpretation. However, it won’t call on you to remember names of specific lead authors or where the studies were conducted.

7. Fads are not fair game

IBLCE might ask you about health care trends – such as about disease prevalence – but not about fads.

For example, “Tarzan pumping” – which I was surprised to be asked about while I was giving a live course – is a fad and not a health care trend.

8. Brand names

Brand names are completely off limits in the IBCLC exam. There’s no need to become an expert in a certain kind of pump, or to know what some particular whatchamacallits are called! It’s not fair game.

But remember this applies to medications, too. On the exam, you will see only the generic name, NOT the trade name.

9. Complicated math problems

People worry about needing a calculator for complicated arithmetic maneuvers.

I do think that a test item related to how much weight a baby had lost or gained, or how much supplement he needs, would be fair game.

You could use the white board they give you for calculating if you needed to. But I can’t recall ever using it for that purpose. I’ve occasionally had to do a simple calculation, but I’ve been able to do it in my head.

I cringe at anything that involves complicated calculations. So, I’m fairly sure that if I had had to calculate anything complicated, I would have remembered it!

10. Anything outside the IBCLC Scope of Practice

Here’s an example: Certainly, because anyone with a health care certification or credential has the obligation to report suspected child abuse, that IS fair game for the exam. But the exam would not expect you to determine if your observation was an indicator of child abuse. More likely, you’d be asked about your role and responsibility in the situation.

How prepared do you feel for the IBCLC exam? Tell me in the comments below!

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