October 7, 2015

The International Board of Lactation Consultant Examiners (IBLCE) Exam

The International Board of Lactation Consultant Examiners (IBLCE) certification exam tests candidates in 13 disciplines for content knowledge and skills applicable either generally or to specific stages of infant growth. The Blueprint is the document on file for certification exam applicants that provides in- depth information about the information that is likely to be on the test, although the document cautions candidates that it should be read as a guide that sets forth a range of possibilities rather than as a map delineating specific test material.

The first disciple is Maternal and Infant Anatomy. Candidates should be prepared to answer questions on infant reflexes; infant oral anatomy; mammary tissue; the structure and development of breast and nipples; and anatomical variations.
Maternal and Infant Normal Physiology and Endocrinology is the second discipline. These multiple choice questions include induced lactation; infant renal, hepatic and pancreatic function; lactogenesis; the role of hormones; metabolism, digestion; and patterns in stool and urination.

The third discipline is Maternal and Infant Normal Nutrition and Biochemistry. These questions consider the components of milk; the effect of breast milk on infants; a comparison and natural and substitute milk products; feeding patterns; ritual foods and traditional foods consumed during lactation; and introducing a solid diet.

Maternal and Infant Immunology and Infectious Disease are the focus of the fourth discipline. This area looks at cross infection; food sensitivity and food allergies; immune factors such as antibodies; and bacterial or viral presence in milk.

The fifth area of concentration is Maternal and Infant Pathology. This section of the IBLCE examination is concerned with chronic or acute local or systemic abnormalities; pathology in breast and nipple function; endocrine issues; neurological or physical disabilities in the breastfeeding mother or infant; failure to thrive; hypoglycemia; hyperbilirubinemia; oral pathology and congenital irregularities.

The subject of the sixth discipline is Maternal and Infant Pharmacology and Toxicology. Maternal medication use; the effect of social drug use on lactation or the composition of milk and its effect on the baby; drugs used to ease labor; complementary therapies; over the counter medications; and environmental contaminants are the focus of this discipline.

Discipline seven looks at issues of Psychology, Sociology and Anthropology, such as postnatal depression; mother- child relationships; sleep patterns; parenting skills and styles; domestic violence; special needs parents; the ways lifestyle and socio- economic standing influence breastfeeding; and cultural practices.

Growth Parameters and Developmental Milestones is the eighth discipline the IBLCE names in its Blueprint. This area attends to questions of preterm growth; patterns of growth in breastfed infants as well as in those who are not breastfed; normal developmental markers in cognitive, psychological and physical growth; issues in breastfeeding children older than a year, and weaning.

The ninth discipline, Interpretation of Research, examines a candidate’s skills in reading, understanding and elucidating professional writings such as research reports, training materials, and texts written for the public; comprehension of vocabulary specific to lactation and breastfeeding concerns; analysis of graphs, tables and other visually represented data; and understanding of survey data.

Ethical and Legal Issues is the focus of the tenth discipline. Here, candidates are expected to have complete knowledge and understanding of the International Board of Lactation Consultant Examiners’ Code of Ethics; scope of practice; issues of confidentiality; legal and medical responsibilities; record keeping skills; issues of abuse or neglect; making referrals; and conflicts of interest.

Breastfeeding Equipment and Technology is the subject of the 11th discipline. Here, the questions focus on correct technical usage of breastfeeding devices; safe handling of breast milk; and protocols in human milk banks.

The 12th discipline, Techniques, is concerned with positioning the mother and infant to achieve good latch; normal patterns in breastfeeding; expressing milk; and evaluating milk transfer.

The final discipline, Public Health, poses multiple choice questions aimed to determine the degree to which the candidate understands how to promote breastfeeding through community programs and education; supporting populations with lower rates of breastfeeding; applying clinical protocols; surveys and data gathering intended for research; WHO code, and international documents.

International Board Of Lactation Consultant Examiners

The nonprofit International Board of Lactation Consultant Examiners (IBLCE) has certified over 22,000 lactation experts worldwide since 1985 through their International Board of Lactation Consultant Examiners Examination. The first organization to see the importance of lactation education to the health and survival of the world’s children, it is currently considered the international pinnacle of breastfeeding knowledge and care.

The primary purpose of the IBLCE is to certify lactation consultants, bringing measurable standards of excellence to a field that was previously unrecognized. Currently, the IBLCE Examination is offered each year at test centers around the globe in over 20 languages. The test is offered in a paper based format only; however, the IBLCE is investigating conversion to a computer based format in the near future. Also in progress is the establishment of online applications. Both new and recertifying applicants will be offered secure registration by which they can update personal information such as educational background, ongoing education, special considerations, and other information. Secure online payments will also be accepted.

In order to be eligible to take the International Board of Lactation Consultant Examiners Exam, candidates must have previously fulfilled a set of requirements. The must be able to demonstrate evidence of general health sciences education as well as specific lactation and breastfeeding studies. Candidates must also have prior experience in clinical settings working with breastfeeding mothers and their children. A specific number of classroom hours in combination with experience in the field are required; however, there are a number of directions, or Pathways, established by the IBLCE by which an examinee hopeful can qualify.

International Board Certified Lactation Consultants (IBCLCs) are trained to support breastfeeding mothers through education designed to increase social acceptance of breastfeeding; to offer specific guidance to resolve breastfeeding issues; and to expand policy makers’ understanding of the importance of breastfeeding as an urgent and essential priority for international public health. IBCLCs are also tasked with collaborating with doctors, nurses and all other health care team participants to ensure mothers and their nursing babies are given comprehensive care.

In 1988, the National Commission for Certifying Agencies approved the IBLCE as a certifying organization; their accreditation has remained ongoing since that time. Among the requirements the National Commission for Certifying Agencies impose upon their accredited organizations are financial and administrative independence in order to minimize the possibility of outside influences that might compromise agency goals.

The IBLCE, which is governed by a culturally diverse board, is active in over 80 countries through regional offices in Europe, the Americas, and the Asia Pacific. The European office administers tests and programs in North Africa and the Middle East as well as throughout Europe. The American office is responsible for North, Central and South America, and Israel. The Asia Pacific office manages IBLCE projects in Australia, Asia Pacific countries and those areas of Africa not served by the European office. The International Board of Lactation Consultant Examiners’ primary headquarters is located in the United States, in Falls Church, Virginia.

A partner in the mission to establish and maintain a high level of excellence among lactation consultants in order to increase survival rates, health and quality of life in children and their mothers, the Monetary Investment for Lactation Consultant Certification has established scholarships to assist consultants seeking certification. This organization also offers ongoing support to existing members in maintaining active certification.

In conjunction with the International Lactation Consultant Association, the IBCLE offers the Care Award by which birth services, facilities and hospitals are recognized for a high level of excellence. Recipients of the Care Award must be employers of International Board of Lactation Consultant Examiners certified members and must, in addition, have an established lactation program. The International Lactation Consultant Association works in close affiliation with the IBLCE, serving IBLCE certified lactation consultants as their professional organization.

The International Board Of Lactation Consultant Examiners Professional Standards And Code Of Ethics

The International Board of Lactation Consultant Examiners (IBLCE) requires all International Board Certified Lactation Consultants (IBCLCs) to strictly adhere to the organization’s principles of ethical practice. In order to provide communities with the highest quality of service, consultants agree to protect the privacy interests of clients, inspire public trust by providing care at a high level of competence, and behave in ways that support the profession’s good name.

The IBLCE Ethics and Discipline Committee reviews complaints against IBCLCs made by members of the larger health community or by members of the general public. For a complaint to be reviewed, the complainant must have direct knowledge of a potential violation and be willing to attest to it by signing a written complaint.

The written statement should detail the alleged infringement in its entirety. It cannot be largely or entirely based upon heresy or innuendo, as the Committee will not consider cases that are not based upon evidentiary fact. The violation must be against one or more specific principles of ethical practice that the certified consultant promised to uphold.

In cases the Committee deems sufficiently serious to investigate, the respondent will be provided with a copy of the written complaint. In addition, the respondent is invited to answer specific charges or the complaint as a whole, provided that such response is professionally handled and legally defensible.

Next, the IBLCE Ethics and Discipline Committee will select a member to consider the facts as they are presented by both sides. The Committee representative may interview the complainant and respondent for clarification or to solicit additional information. When the representative feels a thorough understanding of the situation has been reached, the Committee will be presented with the facts and make a determination. It should be noted that the Committee’s considerations are confidential.

Both parties will be notified of the Committee’s decision simultaneously. In the event the Committee determines a violation did in fact occur, it will determine the degree of penalty, punishment or sanction depending upon the severity of the infraction. In lesser cases, a reprimand made in private may suffice. In more serious situations, the Committee has to power to rescind the International Board Certified Lactation Consultant’s current certification and ban her from future certification.

The International Board of Lactation Consultant Examiners publishes the names of previously certified consultants who have had a permanent revocation decision. In addition to publically disclosing the name of the individual, details of the infraction that led up to the complaint are also posted. As well, individuals for whom the Committee has determined public reprimand is appropriate will have their names and the details of the violation published on the IBLCE website.

In the event a consultant’s certification is revoked, the public and extended professional community will be notified. Because all IBCLCs agree to adhere to the International Board of Lactation Consultant Examiners’ Code of Ethics and agree to be bound by subsequent disciplinary procedures, there is no avenue open for requesting reconsideration.

The International Board Of Lactation Consultant Examiners Examination

The International Board of Lactation Consultant Examiners (IBLCE) offers the International Board of Lactation Consultant Examiners Examination to lactation and breastfeeding consultants who want to earn international certification. The exam is given only once annually, on the same day worldwide. Currently, over 80 countries offer the exam in more than 20 languages. In order to qualify to sit for the exam for the first time, candidates must have completed a specific combination of education and field experience by one of three Pathways.

The first Pathway requires up to 90 hours of lactation- specific education in combination with 1,000 volunteer or paid professional hours. To fulfill the requirements of the second Pathway, the candidate must have completed an IBLCE- approved course at a college or university. The third Pathway, like the first, combines classroom lactation-specific training, but only requires half as many professional work hours; however, these hours must be supervised by an International Board Certified Lactation Consultant.

Many potential candidates for certification are unsure if their clinical or personal experiences with breastfeeding and lactation will fulfill the IBLCE requirements. Personal breastfeeding experience or supporting family members or friends are not considered as clinical experience and are therefore excluded. Midwives in private practice who can supply two references; hospital employed RNs with experience working directly with breastfeeding families; and La Leche League leaders with more than two full years of service can apply their volunteer or paid hours earned within the last five years to Pathway I or III requirements.

While a breastfeeding WIC peer counselor is permitted to apply her hours, a postpartum support doula that lacks on- site supervision is not. Private independent practice health care professionals who are permitted to work without direct supervision may use their hours; however, employees who are not health care professionals may not.

Other types of professional experience that are not recognized by the IBLCE include work in a related retail field, such as a salesperson for breastfeeding equipment and supplies; clinical experience that is more than five years old; or La Leche League volunteers who spend off- site and unsupervised hours in home visits or manning telephone help lines.

Individuals interested in becoming certified lactation consultants who lack the necessary professional experience might obtain it through volunteering. Birthing centers, maternity groups, public clinics, medical offices and in the United States, the Women, Infant and Children program all work with volunteers.

The IBLCE exam is composed of multiple choice questions only that address specific areas of scholarship and practice that are essential to lactation consultants as well as to the chronological stages breastfeeding infants and their mothers’ experience.

Questions on the IBLCE certification exam will include some that directly address the following chronological stages: preconception; prenatal; perinatal, which begins with the first signs of labor and includes birth; premature birth; the period immediately following birth and lasting for the next 48 hours; the following period, which lasts for the next two weeks; the period that includes days 15-28; days 29 through three months; months four through six; and beyond the age of one year.

The exam poses only multiple choice questions in 13 disciplines. Questions may focus on academic knowledge or on skills, and might narrow the question’s purpose to address a particular stage of development. Disciplines include Anatomy, Physiology/ Endocrinology; Nutrition/ Biochemistry; Immunology/ Infectious Disease; Pathology; Pharmacology/ Toxicology; Psychology/ Sociology and Anthropology; Growth Parameters/ Developmental Milestones; Research Interpretation; Legal and Ethical Issues; Breastfeeding Equipment and Technology; Techniques; and Public Health.

In 2010, the last year for which statistical information is available, the exam was taken by over 4,000 candidates in 46 countries, and given in 14 languages. Of these, nearly 90% passed. In all, over 45,000 examinees have taken the exam.

Eligibility Requirements For The International Board Of Lactation Consultant Examiners Certification Exam

In order to be permitted to take the International Board of Lactation Consultant Examiners (IBLCE) certification exam a number of requirements must be fulfilled. It is important for candidates to know that these requirements are likely to be adjusted in upcoming years; reviewing current requirements at the International Board of Lactation Consultant Examiners is always a good idea. Candidates should also be aware that the IBLCE exam can be taken an unlimited number of times without penalty, although for a number of reasons the goal of every candidate should be to successfully pass the exam in one or two attempts.

The IBLCE recognizes that candidates for certification may be qualified via a number of different avenues. The board has established Pathways; an applicant must fulfill obligations as described for only one of the Pathways in order to be eligible for certification testing.

Previously credentialed individuals who no longer hold active IBCLE certification are permitted to recertify by fulfilling requirements established for former IBCLCs. These requirements are dependent upon the number of years the former member has remained uncertified. Individuals with two years’ lapse in membership must have earned 15 L-Cerps in the previous five years; those with a three year lapse must be able to demonstrate 30 L-Cerps obtained in the previous five years. L-Cerps are earned via participation in approved lactation or breastfeeding educational workshops or programs that offer information based upon currently accepted scientific ideas and that are within the acceptable practices established by IBLCE.

New applicants for the certification exam might quality via Pathway I, which considers the candidate’s work experience. Anyone who has served as a volunteer or paid breastfeeding care professional over the previous five years and can demonstrate education and practice participation will be eligible for the exam. Currently, potential candidates must have 90 hours of education that is lactation- specific as well as 1000 documented clinical practice hours. In upcoming years, a requirement for general education documentation of 14 subjects and an increase in the lactation- specific education is expected.

Another alternative, Pathway II, is available for applicants who have competed an accredited college or university human lactation and breastfeeding program. If requested, transcripts must be provided that demonstrate the program’s curriculum sufficiently covered the same requirements established by the IBCLE for certification eligibility. Applicant hopefuls should understand that the number of academic programs that fulfill IBCLE requirements is limited. Not all programs situated within institutions of higher learning are recognized by the IBCLE; in addition, the only programs that are IBCLE approved for eligibility are all found in the United States.

A third pathway is similar to Pathway I, but limits the number of documented clinical practice hours as long as those hours were supervised by an International Board Certified Lactation Consultant. In addition, Pathway III certification hopefuls are required to submit a Pathway III plan for IBCLE to keep on file. This plan must delineate how the requirements will be fulfilled. In addition, applicant hopefuls should be informed that this option does not become available again until 2013. At that point, projected requirements are that individuals seeking certification must be able to demonstrate general education in 14 subjects as well as 90 hours of education that is lactation- specific. This Pathway accepts 300 hours of clinical practice that was directly supervised to the degree deemed appropriate by professional scope of practice. For example, a nurse practitioner might have 500 hours of clinical experience gained in a clinic wherein her work in the field did not require supervision on- site. At the same time, a breastfeeding peer counselor is not permitted by her scope of practice to work in a situation where no supervisor is available to oversee and assist as needed.

Recertification And Scholarship Support For International Board Certified Lactation Consultants

The International Board of Lactation Consultant Examiners (IBLCE) requires all certified consultants become recertified every five years. International Board Certified Lactation Consultants (IBCLCs) are offered two options to fulfill recertification requirements. Continuing education participation is one option. The other is to retake the examination.

Any IBCLCs who met the obligation for recertification in the previous five year cycle by accumulating continuing education credits, called CERPs, through attendance at workshops, conferences, seminars or other approved methods are required to retest in the following five year cycle. Conversely, consultants who qualified for recertification in the previous five year period by retaking the exam are permitted to accumulate CERPs equal to or greater than the mandatory number in order to satisfy the next cycle’s requirements.

International Board Certified Lactation Consultants who find the financial burden of recertification through continuing education classes, workshops, seminars or other methods have depleted their financial resources can apply for financial aid to pay for exam fees. Monetary Investment for Lactation Consultant Certification (MILCC) offers scholarship aid with monies that have been initially raised and invested for this purpose only. There are two sources of funds. Benefactors make tax deductable donations, and the organization also offers pins and other jewelry for sale, with proceeds earmarked for the scholarship fund. In addition, other fundraising efforts may contribute to scholarship monies in some years.

Because of the nature of their fundraising, an unequal number of candidates may be served with financial aid from one year to the next. Aid is based strictly upon need. Certified consultants, or those seeking certification for the first time, must provide evidence of financial necessity. Among these applicants, MILCC gives priority to those working with breastfeeding families in under- served communities.

Scholarships are offered to applicants seeking certification as well as to currently certified lactation consultants who are in the process of recertifying.

Of particular interest to MILCC, an international foundation, are applicants whose work involves families and communities where access to an International Board Certified Lactation Consultant is not available.

MILCC scholarships are only offered to applicants who meet the IBLCE eligibility requirements for the certifying exam, or those who meet CERP recertification requirements. The amount of scholarship, too, is based upon demonstrable financial need; however, in all cases the scholarship monies are solely for part or full payment of examination fees.

MILCC also administers the JoAnne W. Scott Scholarship. This financial support is made to a mother- to- mother breastfeeding volunteer support leader. Applicants must fulfill all IBLCE requirements for certification.

The Canadian Breastfeeding Foundation Scholarship, also administered by the MILCC, has been established to defray the initial or recertification testing fees of Canadian applicants.

In order to request consideration for scholarship funds, applicants are asked to include a statement of request together with required financial statements and completed application form. Monies cannot be held in reserve; they must be spent during the year for which they were given. Candidates who have not previously been certified by the International Board of Lactation Consultant Examiners will be considered only if field experience, general and specific education and other IBLCE obligations have been completed. Applicants who are in the process of completing these requirements will not be considered.

MILCC reminds applicants to be forthcoming about their personal financial situations. In selecting scholarship recipients, attention is given the familial circumstances, volunteer work, and financial debt and other obligations. These must be documented with proof such as tax returns or forms, statements from current employers or other official financial records. If records are not available, applicants are urged to make a signed statement that has been notarized or certified by a Commissioner for Declarations or other governing body or representative.

Continuing Education Recognition Points

Continuing Education Recognition Points, or CERPs, are assigned to workshops, seminars, classes and other professional continuing education events that the International Board of Lactation Consultant Examiners (IBLCE) has approved as meeting the requirements for maintaining consultant certification. International Board Certified Lactation Consultants (IBCLCs) can earn CERPS via three avenues, L-CERPS, E-CERPTS, and R-CERPTS. The IBLCE requires all recertifying lactation consultants earn a minimum of 75 CERPS per recertification.

Participating in one hour of documentable instruction is awarded with one CERP point. IBCLCs who are requesting that other non- CERP continuing education be accepted as a substitute for some of their required CERP points should be aware that one hour of instruction in another health profession field is not necessarily equivalent to an hour in a CERP- approved training. A request for continuing education that was undertaken through another avenue to be converted to CERPs requires the IBCLC be provided with a completed Individual Application for CERP approval. Recertifying members should also be aware that in order for non- CERP instruction to be considered, it must fall within the IBLCE exam blueprint specifications. While many other types of training may be important to a successful consultant, some examples of studies that are not considered for CERP equivalency include business management, complementary therapies, fetal monitoring, or computer skills. Also specifically disallowed from CERP equivalency are independent studies or instructional programs offered by companies who supply services or equipment to lactating mothers or to professionals within the field. Finally, IBLCE does not recognize workshops or other continuing education offered by anyone who has had their IBLCE certification revoked.

L-CERPS are awarded only for programs that focus on issues and problems regarding lactation and breastfeeding. These sessions, materials or workshops must also directly discuss the role of the lactation consultant. In order to meet IBCLE approval, the course or material must be delivered at a sufficiently high level of knowledge, align with contemporary principles and theories, or be based upon recent research. L-CERPs that focus on clinical or field practices must address those practices that are also within IBLCE published scopes of practice.

Examples of workshop topics that might earn L-CERPS are those that address research projects in breastfeeding; how cultural expectations affect a family’s willingness to breastfeed; or methods of clinical documentation. Certified consultants, who are required to become recertified every five years, must earn 50 L-CERP credits as part of the requirements.

International Board Certified Lactation Consultants can earn R-CERPS by attending classes, workshops or seminars or by participating with other materials approved by the IBLCE that are concerned with the non- breastfeeding- specific professional knowledge of skills of an IBCLC. Educational opportunities that take as their topics infant massage, postpartum depression, cardio- pulmonary resuscitation, or general anatomy, for example, fall into this category. Certified lactation consultants are not required to earn a specific number of R-CERPs; however, the IBLCE will permit 20 R-CERPS as part of recertification.

The final category of CERPS is E-CERPS. Seminars, workshops and continuing education programs that look at professional ethics in the field of lactation and breastfeeding earn E-CERP points. Workshop topics that fall into this category include copyright, informed consent, making referrals, and how to handle conflict of interest. The International Board of Lactation Consultant Examiners requires that all recertifying lactation consultants earn a minimum of five E-CERPS every five years.

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