The Landscape of Breastfeeding SupportA User’s Guide

Program titleSponsoring entityHours oflactationspecificclassroomeducationHours ofrequiredclinicalexperienceAccreditationfrom NCCA*CertificationexamIndependent orproprietaryIndependent orproprietaryAccreditationfrom NationalCommission forCertifyingAgencies(NCCA)Exam is givenat anindependenttesting centerCollege-levelhealth icalexperience,etc)Recertificationprocess90 hourslactationspecificclassroomeducationMust recertifyevery 5 yearswith 75 hours ofcontinuingeducation or byexamScope of practiceIndependent or lCertificationInternational BoardCertified LactationConsultant (IBCLC)International Boardof LactationConsultantExaminerswww.IBLCE.org90 hours300-1000hoursdepending onchosenpathway14 collegelevel healthsciencecoursesIndependentIBLCE and theexam areindependent ofany course,person,business,organization,or group toassure that noconflicts ofinterest exist*National Commission for Certifying Agencies of the Institute for Credentialing Excellence14 college-levelhealth sciencecourses300-1000hours lactationspecific clinicalexperienceScope of Practice is independentof any courses or programsCertificants have demonstratedspecialized knowledge and clinicalexpertise in breastfeeding andhuman 12/scopeof-practice-2018.pdfClinical Competencies inform thepublic of the field in which IBCLCscan provide safe, competent andevidence-based care. Certificantspractice within 83 areas of ads/2018/12/clinicalcompetencies-2018.pdf

Breastfeeding counselors,educators and educationalprograms. Some includecertificates of completionAccreditationfrom endentorproprietaryNoLactation Education ConsultantsExam givenat end Program titleSponsoring entityCertified Lactation Specialist (CLS)Certified Breastfeeding Specialist(CBS)Hours oflactationspecificclassroomeducation46 hours45 and 90houroptionsHours encecoursesNoneNonerequired forCBSNoExam givenat end ofcourseLactation Education eopportunitiesfor 100 & 500clinicalplacementhours ocessNoneEvery 5 yearsNone if IBCLCor retakecourse oracquire 25hourseducation orby take homeexamEvery 5 yearsNoneScope of practiceIndependent or proprietaryComments20 educationhoursEmphasis is placed onpreparation for practice asan IBCLCScope of Practice createdby course e-ofPractice-CBS-revised.pdfQualified to perform dutiesin uncomplicatedbreastfeeding situations

Program titleSponsoring entityCertified Lactation Counselor (CLC)Hours oflactationspecificclassroomeducation52 hoursHealthy Children Project, Inc.Center for tified Lactation EducatorCounselor (CLEC)UC San Diego ograms/lactation-andperinatal-education45 hoursonsite, 60hoursonlineHours ofrequiredclinicalexperienceAccreditationfrom endentorproprietaryCollegelevel healthsciencecoursesNoneAccreditationprovided byAcademy ofLactationPolicy andPractice(ALPP), a partof theHealthyChildrenProject, ies thatALPP niversitybasedprogramExam givenat end perience,etc)RecertificationprocessNoneEvery 3 yearsComments18 hourscontinuingeducationProprietaryScope of practiceIndependent or proprietaryScope of practice created bycourse tice.pdfCourse completion signifiesthe certificant has a firmgrounding in information andcounseling skills required toprovide support tobreastfeeding mothers andtheir childrenPeriodictestingNoneNoneLactation Educator Counselorsare typically entry levelpractitioners and dealprimarily withthe normal process oflactation.Required prerequisite to theLactation Consultant course

Program titleSponsoring entityCertified Lactation Educator (CLE)Hours oflactationspecificclassroomeducation20 hoursChildbirth and PostpartumProfessional Association (CAPPA) ofrequiredclinicalexperienceAccreditationfrom gelevel healthsciencecoursesNo college Nonelevel inicalexperience,etc)ProprietaryNoneEvery 3 yearsComments15 hoursRead 10researchstudies frompeer reviewedjournalsObserve 2supportmeetings4 hoursobservation withIBCLCCertified Breastfeeding Educator(CBE)Lactation Consultant g/index.html23 hoursNoneNoneProprietaryNoneScope of practiceIndependent or proprietaryEvery 5 years5 hoursThe CAPPA CLE does notprescribe, treat, nor diagnosebreastfeeding relatedconditions and is trained torefer clients facingcircumstances that requirethis degree of intervention toa qualified professional, suchas an IBCLC. The CAPPA 20Hour LactationEducator course is not anIBCLC exam prep course, nordoes the CAPPA CLE trainingprepare a student to becomean IBCLC.An educational offering thatprovides a comprehensiveoverview of breastfeedingpromotion and assistancestrategies is available forhealth care providers andbreastfeeding advocates.Certified BreastfeedingEducators are not qualifiedto represent themselves aslactation consultants.

Program titleSponsoring entityCertified Lactation Educator (CLE)Hours oflactationspecificclassroomeducation45 hoursHours ofrequiredclinicalexperienceAccreditationfrom endentorproprietaryCollegelevel healthsciencecoursesNoneProprietaryEvergreen Perinatal xperience,etc)RecertificationprocessQuizes oncontentNoneNoneCandidatesare expectedto completeat least onelesson(typically onetextbookchapter plussome briefonlineactivities) permonth.ProprietaryHave to havebreastfed aninfant for 1yearCompleteminimalcontinuingeducationwithin threeyears afteraccreditationComplete 90hour ncesContinuingEducationPackageEvery 3 Counselor (BC)Breastfeeding USA9 monthonlinecourseNoneProprietary90 d Clinical Lactationist (CCL)Breastfeeding Outlookhttps://breastfeedingoutlook.comScope of practiceIndependent or proprietary30 hourscontinuingeducationThis education is for anyhealthcare professional orindividual who works withnew families and theirnewborns, or as the beginningprocess for becoming anInternational Board CertifiedLactation Consultant (IBCLC).Volunteer lay counselors.Their primary function is tooffer evidence-basedbreastfeeding information andsupport to women through inperson meetings, by phone, oronline as representatives ofBreastfeeding USA.Scope of practice created bycourse /CCL/CCL Terms and Conditions.pdf

Program titleSponsoring entityLa Leche League LeaderLa Leche League InternationalHours dyprogram Peer CounselorsUS Department of AgricultureTypically20 hoursHours ofrequiredclinicalexperienceAccreditationfrom endentorproprietaryCollegelevel ivelyincreasinghelpingskills withothermothers neHasbreastfedinfant for 1year; hasattended aseries of LLLmeetingsLeaders areaccountableto stay currentonbreastfeedinginformationand LLLIpolicies andproceduresNoneHasbreastfed ababy for 1year; past orcurrent WICparticipantNoneRole playexamPersonalexperience6 hoursannuallyProprietaryBreastfed for6 -wic-peer-counselorScope of practiceIndependent or eer lay counselors whogive mother-to-mothersupport on behalf of theorganization. The LLLI trainingprogram focuses on thenormal course ofbreastfeeding from prenatalthrough weaning. Effectivecommunication skills andgroup dynamics for leadingsupport groups are alsoincluded.WIC peer counselors give basicbreastfeeding information.WIC peer counselors refermoms to a WIC DesignatedBreastfeeding Expert forcomplex breastfeedingchallenges.NMC CounselorNursing Mother’s Council Mother’s Counsel hoursShadowson hospitalrounds r lay counselorsVolunteer lay counselors

About this documentBreastfeeding is a public health imperative. While breastfeeding rates continue to increase, significant barriers still exist for many families in spite of efforts atlocal, state and federal levels to improve breastfeeding support. Many mothers are unable to breastfeed for as long as they wish because they lack access toappropriate support services. There are a number of types of lactation support providers, all of whom are necessary to improve breastfeeding initiation,duration, and exclusivity. However, differing education and training, multiple types of certifications, and confusing terminology may be bewildering to families,insurers, employers, policy makers, hospitals, and the general public. This table is designed to help the public navigate the many different lactationqualifications.Certification programs versus certificate programs: There are several important differences between professional certification programs and educationalcertificate programs. Only the IBLCE program is a professional certification program in lactation consulting, granting the IBCLC certification. According to theInstitute for Credentialing Excellence (also known as ICE and formerly known as NOCA), the leader in setting quality standards for credentialing organizations,there are a number of key differences between certification programs and certificate programs. The National Commission for Certifying Agencies (NCCA), part ofICE, is considered the gold standard in accreditation for any certification program. A certification program that is accredited by NCCA has measures in place toeliminate potential conflicts of interest, such as those described above. Its criteria are rigorous. NCCA's precursor, was formed in 1977, in cooperation with thefederal government, to develop standards of excellence for voluntary certification programs. NCCA accredits a broad range of certifying organizations.According to ICE, professional certification is:“a voluntary process by which a non-governmental body grants time-limited recognition and use of a credential to individuals who have demonstrated that theyhave met predetermined and standardized criteria for required knowledge, skills or competencies. To retain the credential, certificants must meet requirementsfor renewal. The credential awarded by the certifier denotes that the participant possesses particular knowledge, skill or competencies.”(ICE 1100: 2010 (E)—Standard for Assessment-Based Certificate Programs, Institute for Credentialing Excellence, Washington, D.C., 2010.)A Certificate program Provides education and training to an individual Is generally associated with a particular course or program Is not independent of any provider of classes, courses or programs Certificate holders “shall not say that they are ‘Certified in. . .” and “shall not use acronyms or letters after their names to reference the certificate they hold”or make “claims or imply that the certificate is a professional certification.”A Certification program Assessment of knowledge or skills (which is completely separate from training) Individuals must meet predetermined criteria (education, professional experience, supervised clinical experience) to be eligible for exam Must pass a professionally developed exam Is time limited and requires periodic renewal

Generally speaking, lactation consultants are paid lactation professionals who help mothers and babies with a wide range of problems, including sick mothersand babies and are a valuable part of the health care team. These types of problems they evaluate might include excessive weight loss in a breastfed infant,questions about medications, and anatomic issues in the mother or baby that might interfere with breastfeeding, and other types of high acuity scenarios.Counselors generally have less extensive training and they help troubleshoot basic problems, recognize when to refer mothers to other health professionals.They provide valuable emotional support, encouragement, and confidence building. Often they are volunteers serving in mother-to-mother support groups, ormay work as WIC peer counselors.Educators may teach breastfeeding classes to pregnant women.Most of these organizations charge fees for the training and/or certification, and again for recertification, if they provide it. If the organization that provides thecertification is also the same organization that provides the training, there may be a potential conflict of interest. Certification programs from NCCA takemeasures to ensure that there is no such conflict of interest.The role of experience:Some organizations require that an individual holding their certificate must have breastfed her own children. This is especially true for peer counselors offeringmother-to-mother support. Be aware that experience breastfeeding o