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Do I Have Enough Clinical Hours to Sit for the IBCLC Exam?

Woman in yellow sweater frowning at a computer screen with mug on desk.

After more than a decade of getting calls about IBCLC eligibility, I thought I’d “heard it all” but on this particular day, I heard a very different story. I suspected the caller had misinformation on clinical hours. It seemed that she was really wondering if she had enough clinical hours to sit for the IBCLC exam.    

Fears versus facts

She was fearful because, according to her unnamed source, she did not have enough clinical hours to sit for the IBCLC exam.

Having been in practice as a certified nurse midwife (CNM) for more than 25 years, she works part-time in a clinic. She spends her days doing what you’d expect any CNM would do, including but not limited to:

  • diagnosing (including lactation-related conditions),
  • prescribing medications (including medications for such ailments as mastitis),
  • counseling mothers about prenatal nutrition and breastfeeding,
  • determining whether the breastfed baby is making adequate weight gains
  • assessing infant’s achievement of developmental milestones.

I listened carefully to her story, but I failed to see why she wouldn’t have enough clinical hours to sit for the exam.

Calculating hours

I’m not a CNM myself, but I imagined that a CNM in that setting would spend at least 50% of her time with breastfeeding mothers, especially in her state where breastfeeding rates are high.

Using rough numbers, I calculated that if she worked 25 hours a week for 50 weeks a year, she would have accumulated over 1,200 work hours in one year. I further calculated that even if she spent only half of her workday helping breastfeeding mothers or couplets, she would still have accumulated some 600 hours during one year, and some 1,200 hours in two years.

In either case, that means that within 2 years, she could have exceeded IBLCE’s 1,000-hour requirement for Pathway 1 within 5 years. IBLCE’s requirement is: “Minimum of 1,000 hours of lactation specific clinical practice in an appropriate supervised setting within the five years immediately prior to examination application.”   

I was stumped, and by now, I felt that she had misinformation on clinical hours. So I simply asked her, “What makes you think you don’t have enough hours?”

Some pesky 10% number

Someone had told her that only 10% of the hours worked in a clinic counted as “breastfeeding” hours.

I have never read or heard that.

Despite a thorough search of the IBLCE’s website, I could not find such a rule.

Even if I could have, I would have questioned it. One person’s role in a clinic might be very different from another person’s role, and hence the number of hours that would “count.”

Difference between academic requirements and exam requirements

Somewhere in this discussion, the caller said she had been denied admission to an education course because of her lack of clinical hours. That led me to believe that she might have confused academic course admission requirements with application requirements. Those are two completely different things.

Over the years, we have admitted hundreds or maybe thousands of IBCLC exam candidates to our 95-hour Lactation Education Course. Indeed, some have amassed hundreds of hours before coming to the course. However, we don’t require any specific number of clinical hours to sit in the educational course.

Some — perhaps many — candidates have come to my course even though they have accumulated no clinical hours at all. 

Lessons to be learned

There are a few lessons to be learned here about what qualifies as enough clinical hours to sit for the IBCLC exam.  

First, requirements for admission to a course may be different than requirements to sit for the IBCLC exam.

Second, it’s best to go the primary source for information; a friend, colleague, or other person might unknowingly mislead you.

Finally, don’t hesitate to call my office at 703-787-9894, even if you think you’ve been stopped in your tracks. We’re here to help you land your dream job.   

What has confused you about whether you have enough clinical hours to sit for the IBCLC exam?    

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  1. Kim Cook

    I also thought I wouldn’t have enough clinical hours for many years until an IBCLC assured me I had plenty. I work as a NFP Nurse so it encompasses prenatal to 2 years. I found that I had more than 2 times enough hours in 5 years when you think about nutrition in pregnancy and many other areas that affect breastfeeding. I was not audited but would not have been worried about it if I was. In my first time around as I passed in September of 2020.

    • Marie Biancuzzo

      Kim, TOTALLY agree! And I have heard that story sooooooooo many times! The “more than 2 time enough hours” is, in my experience, is not at all unusual. But thank you, thank you for confirming what I’m always saying!

  2. Jenn

    I am looking into getting my IBCLC. I have been a BSN- RN for 14 years and worked full time for all 14 years in labor/delivery, antepartum, postpartum, and with outpatients. I am assuming that all those clinical hours with postpartum and outpatient mom/baby appointments I would have more than enough hours under pathway 1?

    • Marie Biancuzzo

      Jenn, YES! Presuming that you’ve had direct interactions with breastfeeding families (e.g., helping with latch, helping with pumping, and more) then yes, most definitely, you have more than enough clinical hours to qualify! Meanhile, I would strongly encourage you to download my free Unofficial Guide and accompanying checklist!

      Let me know if you still have questions, I’m. here to help!

  3. Kiley

    I work with WIC as a Breastfeeding Counselor. I help women in person with latching their infant, doing weighted feedings, assessing goals and assuring mom of her milk supply due to diaper outputs and weight gain, and making necessary referrals when baby is underweight, etc, do a lot of phone consultations and teaching classes. I work with infants primarily 4 months and younger. I work a maximum of 29 hours a week – most of my work day is counseling/latch assistance, etc. What is the best way for me to keep track of my hours? Do I need to log the time and length of each appointment I have in person and through the phone?

    • Marie Biancuzzo

      It sounds like you’re pursuing eligibility through Pathway 1. I’m tempted to say that in your role as a Counselor, you wouldn’t need to document your hours, you’d just need to be able to say that a boss or supervisor at your place of employment could, if need be, vouch for the fact that you have worked those hours you just mentioned. HOWEVER, and this is a big however, I’m not sure of that. I can tell you this: What you’re doing definitely qualifies as specific, relevant experience in lactation.

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