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IBCLC Requirement: What Counts for Clinical Hours

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It’s easy for me to tell people they need to provide hours of clinical care before they’re eligible to sit for the IBCLC exam. It’s a little more difficult to give an exact response when they ask: “What counts for clinical hours?”

As I often remind readers, I’m not an official voice for IBLCE. But here I’ll give my understanding of what does or doesn’t count for clinical hours, based on what the IBLCE publishes.

Where can you earn clinical hours?

I’d guess that many or most candidates acquire their clinical hours in a hospital, clinic, or a private office/practice. But as you consider what counts for clinical hours, consider other settings, too.

The key is to be in compliance with what IBLCE spells out in the Candidate Information Guide:

“All reported lactation specific clinical experience must be supervised. Depending upon the eligibility pathway a candidate follows, clinical experience may need to be directly supervised.”

IBLCE has a list of recognized organizations that are acceptable for clinical practice for those obtaining their clinical lactation experience as a paid or volunteer breastfeeding support counselor in certain settings, or as a volunteer at listed organizations. For example, if you’re a La Leche League leader, or you do counseling for an organization such as Baby Café USA, those hours would count. See IBLCE’s Recognised Breastfeeding Support Counsellor Organisations list for more information.

And no, you don’t need to be getting a paycheck at that facility or organization. Volunteer work also counts.

What activities count?

Here’s a common misconception. There is no need to have “babe on breast” to count for clinical hours. That’s one, but not the only, possibility for what counts for clinical hours.

Teaching a breastfeeding class to prenatal or postnatal parents or doing telephone counseling counts. Shortly after COVID-19 erupted, IBLCE recognized online counseling, but you should always check IBLCE’s website and the current Candidate Information Guide.

Individual counseling about maternal nutrition or the feeding decision certainly counts. (And let me remind you, that’s why a communication course is required.)

You might even find yourself teaching about how to pump when the baby is weeks or months away from direct breastfeeding. That teaching still counts.

What doesn’t count

If you have an administrative or managerial role, that doesn’t count. So, if your day is filled with budgeting, staffing, and those sorts of responsibilities, even if performed in a healthcare setting, that doesn’t count.

Selling or renting pumps at a depot or a pharmacy doesn’t count.

“Observing” or “shadowing.” Not doing actual care or counseling, but just watching someone else do it, does not count for clinical hours.

When? What’s the timeline?

Let me remind you that ALL of your requirements must be met before you apply for the exam, not before you sit for the exam.

However, your clinical experience can’t be from the dinosaur age.

What counts for clinical hours includes what you’ve accumulated within the last 5 years. However, nearly all IBCLC-hopefuls I’ve met have grossly underestimated their clinical hours. That happens largely because they aren’t counting all of the above-mentioned clinical activities or experiences.

Here’s a related question. People ask me, “Do you need to take your 95-hour course before you get your clinical hours?” The short answer is, no.

But here’s my caution. If you are not on IBLCE’s list of recognized healthcare professionals, or if you have not had special training as a breastfeeding support counselor, you are giving information and support with very little or possibly no formal education. Personally, I think it’s irresponsible to do that. I wouldn’t hire people to wire my house or install my septic tank unless they had had special training, would you?

What I’ve described here might not be everything related to what counts for clinical hours. Be sure to read the guidance from IBLCE.

Still confused about what counts for clinical hours? We can help! Email us at

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