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Confused by IBLCE’s Clinical Hour Requirements? You’re Not Alone

Confused About IBLCE's New Clinical Hour Requirements?

A common theme we hear from IBCLC exam candidates, regardless of Pathway, is that the clinical hour requirements are confusing. Here, I hope to shed some light to help you complete your clinical hour requirements.

Basic requirement

It’s important to remember that IBLCE allows anyone to use Pathway 1, Pathway 2, or Pathway. However, in my experience, there is always a “best fit” for one particular person. That “best fit” depends on their past experience, and their future willingness to undertake new endeavors.

Clinical hours must be completed within the five years immediately prior to applying for the exam.

According to IBLCE, during those hours, candidates may “Provide in-person consultations, telephone consultations, or online breastfeeding and lactation care that supports breastfeeding families, including lactation assistance to pregnant and breastfeeding clients and lactation education to families and/or professionals.”

Beyond that, each Pathway has specific clinical hour requirements.

Pathway 1

Recognized health professionals and recognized breastfeeding support counselors qualifying through Pathway 1 must complete 1,000 hours of clinical hours in a supervised setting, though it does not need to be directly supervised.

Clinical practice settings may include hospitals, birth centers, community clinics, lactation clinics, or primary care provider’s offices.

The hours “can be earned through independent practice as a licensed/registered healthcare professional in non-healthcare settings.”

Breastfeeding support counselors

For those completing the clinical hours requirement on an hour-by-hour basis as a counselor at a Recognized Breastfeeding Support Counselor Organization, hours must meet certain criteria.


  • Provide structured training programmes for their counsellors which include comprehensive education in breastfeeding and lactation management
  • Have a Code of Ethics or Professional Conduct
  • Provide structured supervision for counsellors, with an appropriate level of training
  • Provide a continuing education programme for counsellors.

Pathway 2

The clinical hours requirement for Pathway 2 candidates is 300 hours of directly supervised lactation clinical practice.

Remember that Pathway 2 is an accredited lactation academic program. Meaning, it requires the candidate to take on a complete course of study over a period of several months or perhaps years.

Again, these 300 hours need to be completed within the 5 years prior to applying for the exam. The hours must also be directly supervised by an IBCLC currently in good standing.

Pathway 3

Candidates who plan to qualify through Pathway 3 is must complete the clinical hours requirement by having a mentorship with an IBCLC. It is often a good fit for those who

  • do not have a background in health care
  • practice in a health care role but not on the recognized list (e.g., veterinarian, massage therapist)
  • are on the recognize list, but for one reason or another, do not have regular interaction with breastfeeding couplets.

Pathway 3 candidates must acquire a minimum of 500 hours of directly supervised lactation specific clinical practice hours according to the Pathway 3 Plan Guide.

Use of technology

IBLCE has given interim guidance “For a variety of reasons, inclusive of accessibility but most pertinently the onset of the COVID- 19”. It addresses the use of technology to meet all three Pathways.

This guidance has been extended through September 30, 2023.

Telehealth may be an option, but it is dependent on the jurisdiction of the candidate and supervisor, and must align with the Scope of Practice. See the IBLCE Advisory Opinion.

See the interim guidance for technology use for each specific Pathway.

Remember, this only covers the clinical hours requirement.

All 3 Pathways must complete all requirements to be eligible to apply for the IBCLC exam. Consult the Candidate Information Guide and see IBLCE’s website for updates.

Still confused about the clinical hours requirement? We can help! Email us at

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