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Top Confusions of Requirements for Recognized Health Professions

Healthcare professional confused about requirements for recognized professions.

So many people who work in the healthcare field get confused about how to meet the requirements to qualify for the IBCLC® exam. Here I’ll break down the top confusions of requirements for recognized health professions that my staff and I hear from those interested in becoming IBCLCs.

What pathway should I be using?

Anyone can use any pathway to fulfill the requirements to sit for the IBCLC exam. However, there is generally one pathway that makes more sense than the other two for your own situation.

Usually Pathway 1 works best for those on the Recognised Health Professions List. That being said, Pathway 1 is not the only option for those on the health professions list, which is a common misconception. You can still choose any pathway to qualify.

Here’s an example. If you’re an RN working on an orthopedic unit, you won’t have much, if any, interaction with breastfeeding mothers and babies. In that case, you might shy away from Pathway 1.

Pathway 1 requires the candidate to complete:

  • 90 hours of lactation specific education
  • 5 hours focused on communication skills
  • 14 health sciences
  • 1,000 hours of lactation-specific clinical practice within 5 years prior to exam application

Do I need to complete the health sciences requirement?

All candidates must complete the 14 subjects in the Health Sciences Education Guide. However, remember that those courses were part of the basic college preparation for the professions on the recognized list. And, those courses may have been completed decades ago, and that’s okay.

Do I need to be supervised for my clinical hours?

Yes and no. It depends on if you’re asking about the setting, or the supervisor.

Let’s talk setting. You must complete your 1,000 hours in an appropriate supervised setting such as a hospital, birth center, community clinic, etc. Otherwise stated, you may not count hours you logged in an informal or unsupervised setting.

Let’s talk supervision. The IBLCE says, “Whether a Recognised Health Professional or a breastfeeding support counsellor from a Recognised Support Counsellor Organisation, the 1000 hours does not need to be directly supervised.”

While titles and credentials vary by country, this means that if you are authorized to practice on your own as designated by a governmental authority, you do not need an IBCLC to supervise your clinical hours.

In the US, that means that if you are a nurse, your state-issued nursing license authorizes you to provide care to mothers and infants. Hence, you would not need direct supervision from an IBCLC when completing those 1000 hours.

Does my previous experience count toward my clinical hours?

I’m often asked, “When does my clinical hour experience time start?” The requirements for recognized Health Professions mandate an accumulation of a minimum of 1,000 hours in the 5 years prior to your application.

So the bottom line here is that you may have decided today that you’d like to apply for the IBCLC exam, but if you’ve been working for several years in a career on Recognised Health Professions List, you can count hours earned in the 5 years leading up to your application.

Is my profession on the list?

You might think this one is a no-brainer, but it’s actually a very common question, and for good reason!

The IBLCE is a globally-focused organization. And, titles and credentials vary from one country to another. IBLCE uses a broad list for titles included on the List of Recognised Health Professions.

Even here in the United States, I’ve had individuals ask, “I’m an LPN (or LVN) but not an RN. May I still qualify through Pathway 1?” I can’t speak for IBLCE, but I personally know perhaps dozens of LPNs or LVNs who have qualified through Pathway 1. Therefore, I assume that qualifies as “nurse,” which is the title IBLCE uses on that list.

When in doubt if your profession counts, contact the IBLCE office that serves your region.

Remember, though, that qualifying to sit for the exam is one thing. Passing the exam is an entirely different matter!

What I mean is, your profession may be on that list, but that is only how you can qualify through Pathway 1 and count your clinical hours. It does not guarantee that your clinical experience will get you the correct answers on the test.

In my view, everyone who sits for a comprehensive exam needs to complete one comprehensive 95-hour course. Some also need a good review course to prepare for exam questions.

Does the setting or role matter?

The role or setting isn’t specified in the requirements for recognized Health Professions. If your profession is on the list, and if the facility you work in is an appropriate supervised setting, you’re probably okay.  

I recently had a candidate say she was concerned that she had never worked on a postpartum floor. Rather, she had worked in more pediatric-based settings where her main responsibilities were related to babies with jaundice or other “baby” problems. In that role, she helped mothers to breastfeed. She wondered if that “counted.”

I gave her a resounding YES!

If you’re giving feeding-related care, chances are, it counts. For example, consider NICU nurses. Some might seldom see a baby at the breast, but if they are helping mothers pump to feed their babies, those hours count.

Again, this is where I caution that your experience may not prepare you to answer the entire scope of exam questions, so I’d strongly a variety of clinical experiences, and a very intentional approach to gaining your 95 hours of education and then using a review course to get the hang of tackling what will probably be the most difficult exam you’ve ever taken.  

Do you have questions about the requirements for recognized health professions? Our office can help sort through your experiences! Email us at

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