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What’s the Difference Between a Lactation Consultant and a Breastfeeding Counselor?

Smiling woman looking off into distance in front of a window.

For years, we’ve had people call and ask, “What’s the difference between a lactation consultant and a breastfeeding counselor?”

Here’s the short answer: It depends on who you ask!

The longer answer is this: If you’re really asking whether you should pursue certification as a breastfeeding counselor, or a lactation consultant, you need to consider your

  • past education and clinical experience,
  • present settings, roles, and responsibilities,
  • future opportunities, aspirations, and goals.

Viewing your questions through that lens, you’ll gain some clarity. Then, ask yourself the more specific questions I’m about to pose.

Full disclosure here, I offer courses for people to become an International Board Certified Lactation Consultant (IBCLC®). I’ve held that certification myself since 1993. I’ve never been certified in any type of counseling, breastfeeding or otherwise.

Where is the certification based or recognized?

Several organizations grant certification as a breastfeeding counselor. Some are here in the United States. Other countries have such programs, too. For example, a previous winner of our Felix Biancuzzo Memorial Scholarship earned her certification as a breastfeeding counselor in Australia. (Listen to her amazing story on my podcast.)

To my knowledge, the counselor programs are recognized only in the countries where the program is based. The IBCLC certification is recognized throughout the world.

Recognition in a particular location might not be an issue as you look at the difference between a lactation consultant and a breastfeeding counselor. You may be sitting in Missouri and feel sure you’ll never be working in Zimbabwe. But what about if you live in Detroit and want to cross the border for a job in Windsor?

What type of test is involved?

The IBCLC must pass an exam that’s written by the International Board of Lactation Examiners (IBLCE). In other words, a board-created, comprehensive examination is not intended to test your knowledge of a specific course you attended.

Typically, breastfeeding counselors attend a training course, and at the end of the course, they take and hopefully pass the exam that has been prepared by the instructor and/or the organization.

That means that they’re being tested on material that has been covered in the curriculum.

However, a board-prepared comprehensive exam tests a your wider understanding. (See my post on what’s fair game and what isn’t fair game for the IBCLC exam).

In short, a major difference between a lactation consultant and a breastfeeding counselor is that:

  • The IBCLC exam is administered twice a year by an independent board that tests your knowledge of broader base of knowledge acquired (including international standards), not on a specific course curriculum.
  • A counselor exam is administered at the end of a course and tests your comprehension of the material that was presented during the course.

What are the roles and responsibilities?

Again, this varies substantially from one employer to another. In general, however, you might find that it depends on whether you’re in a situation that addresses one of more of these factors:

  • Giving direct care for one-to-one situations, versus working at a leadership and/or indirect or system-level situations.
  • Taking responsibility for assisting in mostly healthy situations, versus those with more complex issues (e.g., very preterm or seriously compromised infants.)
  • Being in a setting where there’s mostly dependent or interdependent responsibilities (e.g., doctor’s offices, hospitals, or clinics) versus those where there’s mostly independent responsibilities (e.g., private practice).

I won’t say I’ve “done it all” but I’ve done enough of it to know that I needed as much education, experience, and courage as I could possibly acquire in order to work in multiple roles with multiple responsibilities and in multiple settings over the years.

What are the clinical experience requirements?

The IBCLC certification requires hundreds of hours of clinical experience before the individual can apply to take the IBCLC exam. (The number of hours required depends on the pathway you select.)

If you’re pursuing a breastfeeding counselor certification, your program may require significantly fewer hours of clinical experience – perhaps even no clinical experience whatsoever. 

What are the general academic requirements?

The IBCLC certification as a lactation consultant requires completion of several health sciences courses. In many (maybe all?) cases, this is a major difference between a lactation consultant and a breastfeeding counselor.

Have you already completed those courses? Are you a nurse, a dietitian, or some other recognized health care professional as defined by IBLCE? If so, you’ve already completed that requirement.

To my knowledge, there is no breastfeeding counselor program that requires such a rigorous preparation. (I’ll cheerfully take correction if you can prove I’m wrong.)

What are the lactation specific academic requirements?

As always, you’ll need 90 hours of lactation specific education. More recently, the candidate must also complete 5 hours of communication.

To my knowledge, there’s no breastfeeding counselor course that requires this. I’m betting the number of academic hours is a major difference between a lactation consultant and a breastfeeding counselor.

What does your employer mandate?

Some employers require you to hold the IBCLC certification. Others are satisfied with the breastfeeding counselor certification.

In my experience, this tends to vary substantially from state to state and even from facility to facility.

What else is there to know about the difference between a lactation consultant and a breastfeeding counselor?

Well, I get these questions so frequently that they’re worth addressing here.

No, you do not need to be a nurse in order to be an IBCLC.

No, you do not need to be a breastfeeding counselor before you are eligible to become a lactation consultant. This is similar to:

  • you do not need to be an LPN before you become an RN.
  • you do not need to be a bookkeeper before you become a certified public accountant.
  • you do not need to be paralegal before you come an attorney.

Does such prior experience help? I’d say, yes, absolutely! But those jobs or experiences aren’t “required.” And having had those jobs or experiences won’t necessarily predict whether or not you’ll pass the IBCLC exam.

For a better understanding of the difference between a lactation consultant and a breastfeeding counselor, and other certifications, check out the most recent USLCA guide

Can you help me to complete my requirements for IBCLC?

Yes! My 95-hour Lactation Education Course will give you the specific education you need. (including the Communication requirement.) And, I can help you to complete some or many of your health sciences courses.

If you’ve already earned about half of the lactation specific hours needed, my Step Up to Lactation Leadership will speed you on your way to completion.

Do you have other questions about the difference between a lactation consultant and a breastfeeding counselor? Leave a comment below. I promise I’ll personally respond!  

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