Pathway 1

Pathway 1 exam candidates typically gain their clinical experience through paid or volunteer work as a Recognized Health Professional or Recognized Breastfeeding Support Counselor. If you do not fall into one of those two categories, you may want to consider Pathway 2 or Pathway 3.

Requirements to Sit for the Exam Using Pathway 1

For specifics, always refer to the IBLCE Candidate Guide and other documents on their website,

Recognized Health Professionals - as defined by the IBLCE

  • Health Sciences Education: Your state license (RN, RD, MD, etc.) is all you need.
  • Lactation Education: You'll need 90 hours of lactation-specific education
  • Clinical Experience: You need to accumulate 1000 hours of lactation-specific clinical experience within the 5 years immediately preceding your application for the exam. You will need contact information for two individuals who can testify to your experience.

Breastfeeding Support Counselors (La Leche League; WIC Peer Counselors, Community Clinics, etc.) - as defined by the IBLCE

  • Health Sciences Education: You will need the required health sciences college and continuing education courses
  • Lactation Education: You'll need 90 hours of lactation-specific education
  • Clinical Experience: You need to accumulate 1000 hours of lactation-specific clinical experience within the 5 years immediately preceding your application for the exam. You can use your volunteer or work hours toward those clinical hours within the limits defined by the IBLCE. On your exam application, you will be required to provide contact info for 2 individuals who can testify to your experience.

Next Steps

Complete Your Health Sciences Education

If you are not a Recognized Health Professional, the IBLCE requires that you complete several college-level health sciences courses as well as a few continuing education health sciences courses. Read the IBLCE's Health Sciences Education Guide for more information and review their Health Sciences Summary Page.

You will need the following courses from an accredited institution of higher learning:

  • Biology
  • Human Anatomy
  • Human Physiology
  • Infant Child Growth & Development
  • Introduction to Clinical Research
  • Nutrition
  • Psychology or Counseling Skills or Communication Skills
  • Sociology or Cultural Sensitivity or Cultural Anthropology

And these courses from either an accredited institution of higher learning or a continuing education provider:

  • Basic Life Support
  • Medical Documentation
  • Medical Terminology
  • Occupational Safety & Security for Health Professionals
  • Professional Ethics for Health Professionals
  • Universal Safety Precautions & Infection Control

Breastfeeding Outlook has a Health Sciences Continuing Education Package that covers all of these except for Basic Life Support for just $99!

Get Started on your Health Sciences Continuing Education Today

Get Your 90 Hours of Lactation-Specific Education

The very best way to get your 90 hours of lactation education is to take a Comprehensive Lactation Course. You can be assured that these courses will properly prepare your to take and pass the IBCLC exam and to have a successful career as an IBCLC.

Get Your Clinical Hours

If you spend any part of your work day on lactation management issues, you may count that time towards your clinical hours. You first need to determine what percentage of your daily or weekly hours is spent doing lactation management work. Then, using that percentage determine how many hours you have and how many you need. All 1000 of your clinical hours must be accumulated in the 5 years immediately preceding your application for the exam . You will need the names and contact information of two people who will attest that your clinical hours are correct. The IBLCE's Candidate Information Guide has more detailed information on accruing and counting lactation-specific clinical hours.

Questions? Read Marie's blogs on Clinical Hours

3. Complete Your Application for the Exam

Know your application deadline

Applications are due at least FIVE MONTHS prior to the exam and you must have ALL of your requirements completed BEFORE you apply. So this means you need to start early! If you still need to complete some college courses, you need to start even earlier. Give yourself at least a year to get your clinical hours and sign up for your 90 hours of lactation education about a year before you plan to test.

See the IBCLC Exam Dates & Deadlines

Be prepared to spend some money

The exam itself currently costs about $660 in the United States, due when you apply. Completing your exam requirements may also be costly, especially if you need to take some college courses or need a mentor for your clinical hours. So determine the potential costs, start saving or clear off a credit card. Look into available scholarships (Yes! We have one!) and don't be afraid to ask for support from relatives and friends. This is a career, not a job, and it is worth the investment of your time and resources.

Breastfeeding Outlook offers a scholarship for our 90-hour programs each year. Click here to get more information or apply. We also have gift certificates. Just ask for them for your birthday or the holidays.

Be prepared for an audit

The IBLCE automatically audits a certain percentage of all applications. After you submit your application, you will be immediately notified if you will be audited. So have all of your back-up documentation available when you submit your application so an audit will not threaten your hard work and preparation.

4. Prepare for the Exam

About the Exam

The IBCLC exam is a computerized, timed exam that consists of 175 multiple-choice questions. Questions on the exam cover the content in these IBLCE Documents:

Four hours are allowed to complete the exam. A portion of the questions (currently about 50%) are image-based. This means you will be shown a photograph, drawing, or chart and will be asked a question about that image. This part of the exam is tricky and tends to be the most difficult for people. Test items have a high degree of clinical relevance but cover global issues. You may well be asked questions about issues you have never seen in practice. The global scope of the exam is another reason candidates struggle and many fail. You simply cannot rely on your clinical knowledge and experience regardless of how many years you have worked in lactation because you will be required to know things that you may have never addressed. If you are wondering what it might be like, get our Free Practice Lactation Exam Demo, to give you an idea.

Recognize that this is a tough exam

Once you've fulfilled all your requirements and submitted your application, now it is time to prepare to take that exam. This is not an easy exam. We hear from smart people every year that failed. And we often hear statements like, "That was the hardest exam I have every taken!" and "That was harder than my nursing boards!" So be prepared. You will need to spend a significant amount of time studying and you will need to practice taking computerized, timed, multiple-choice test questions, and make sure some of those are image-based questions.

Don't assume you know everything

This is especially important for candidates that have been working in lactation for a while. As Marie often says, "This is a GLOBAL exam!" And, because it is global, you must be prepared to answer questions about topics you may never face in your practice. Additionally, you must know the standard recommendations for dealing with lactation management issues, not the way your hospital or clinic does it. You must be able to sort out the right "exam response" vs. what is right in your day-to-day practice. Keep this in mind as you prepare.

Be smart, be prepared

When you are ready, there are many companies out there with exam prep materials. Do your research and find the best one for you. We offer our own selection of review courses, practice exams, drill questions, and Marie's live one-day seminar, Picture Perfect, which helps you learn how to analyze those pesky images on the exam.

5. After the Exam

Wait for your score

Scores are released about 3 months after the exam and are highly anticipated. Know when your scores are due and watch for the notice. If you pass, you are immediately an IBCLC and your dream is complete!

If you fail, try again

Every year, approximately 500 people fail the exam. So, if this happens to you, remember that you are not alone. Don't give up and don't be afraid to reach out for help. Go back to the company that provided your exam prep tools and let them know you did not pass. Some companies, like Breastfeeding Outlook, have programs to help their clients get back on their feet and try again. Marie puts a lot of effort into helping those that have failed the exam, whether they were our customers, or not. Remember how much time, energy, effort, and money you have put into your dream already and don't give up on it easily.

Here at Breastfeeding Outlook, we strive to help all of our clients reach their dream, whether they do on the first try, or the third. We are here to support you from the initial stages of gathering information all the way to passing the exam and beyond. Your Success is our Goal!

For specifics, always refer to the IBLCE Candidate Guide and other documents on their website,

Unsure? Attend one of our free webinars, Six Steps to Becoming a Lactation Consultant.

Becoming a Lactation Consultant

Need Help? Call us at 703-787-9894 or e-mail us at