This overview includes information to help you prepare for the International Board Certified Lactation Consultant, or IBCLC®, examination. You’ll find details about eligibility, the test format, registration, costs, test-day expectations, scoring, retakes, and study resources.
Exam Background and Purpose
The lactation consultant certification process uses the IBCLC exam. The Commission on IBCLC creates the IBCLC credential, which is for experts who deliver advanced care on breastfeeding and lactation.
International Board-Certified Lactation Consultants partner with families and healthcare and community-based professionals to offer breastfeeding and lactation services and support and address maternal and child public health concerns.
Test Overview
The IBCLC examination contains 175 multiple-choice questions. Each question has one correct answer, and there is no penalty for a wrong answer. The exam is given in two parts, and most questions in Part Two are associated with an image. The standard testing time is 4 hours, including a 10-minute break between Part One and Part Two.
Once you complete Part One and begin the scheduled break, you cannot return to Part One. Candidates whose primary language is not offered for the examination may receive additional testing time according to current IBCLC Commission rules.
The exam is organized around seven major content areas:
- Development and Nutrition (32 questions) — This area covers infant feeding behaviours, food intolerances and allergies, infant anatomy, complementary foods, low birth weight, milk banking, normal infant behaviour, infant nutrition, preterm development, growth, stooling and voiding, and maternal topics such as breast development, breast surgery, human milk composition, maternal nutrition, and nipple structure.
- Physiology and Endocrinology (14 questions) — This area covers lactation physiology, relactation, infertility, induced lactation, pregnancy and breastfeeding, multiples, hormonal influence on milk production, diabetes, hormonal disorders, autoimmune disorders, and newborn hypoglycemia.
- Pathology (35 questions) — This area covers infant and maternal conditions that may affect lactation, including ankyloglossia, cleft lip and palate, congenital anomalies, reflux, hyperbilirubinemia, neurological disabilities, infections, inborn errors of metabolism, abscess, mastitis, low or oversupply, nipple and breast conditions, postpartum hemorrhage, pre-eclampsia, and cancer-related concerns.
- Pharmacology and Toxicology (14 questions) — This area covers alcohol, nicotine, cannabis, prescription and over-the-counter medications, drugs of abuse, contraception, galactagogues, nipple creams, herbs, supplements, chemotherapy, radiation therapy, and radioactive scans.
- Psychology, Sociology, and Anthropology (20 questions) — This area covers transition to parenthood, birth practices, employment, family lifestyle, support networks, maternal mental health, psychological and cognitive issues, the breastfeeding dyad relationship, safe sleep, weaning, and cultural awareness.
- Techniques (25 questions) — This area covers effective milk transfer, medically indicated supplementation, the first hour after birth, latching, managing supply, milk expression, breastfeeding position, refusal of breast or bottle, and skin-to-skin care.
- Clinical Skills (35 questions) — This area covers feeding devices, handling and storage of human milk, nipple devices, pumps, scales, communication technology, education and communication, ethical and legal issues, research, public health, and advocacy.
Eligibility Requirements
IBCLC examination candidates must meet eligibility requirements in health sciences education, lactation-specific education, lactation-specific clinical experience, and professional conduct.
Candidates must complete lactation-specific education within the required time period before applying. Current requirements include 90 hours of lactation-specific education, including 2 hours focused on the WHO Code, plus 5 hours of education focused on communication skills.
Candidates must also qualify through one of three eligibility pathways:
- Pathway 1 — For recognised health professionals and recognised breastfeeding support counsellors. Candidates must complete the required education and at least 1,000 hours of lactation-specific clinical practice in an appropriate supervised setting.
- Pathway 2 — For candidates who complete an accredited lactation academic programme. Candidates must complete the required education and at least 300 directly supervised lactation-specific clinical practice hours.
- Pathway 3 — For candidates completing a structured mentorship with an IBCLC. Candidates must have a preapproved Pathway 3 plan and complete the required education plus at least 500 directly supervised lactation-specific clinical practice hours.
Eligibility rules can change, so candidates should review the current IBCLC Commission Candidate Information Guide before applying.
Costs and Payment Options
IBCLC examination fees vary by country or region because IBLCE uses a tiered fee structure. Fees are paid in U.S. dollars, and payment options, refund rules, withdrawal rules, and deferral policies can change.
Candidates should review the current IBCLC Programme Fee Guide before submitting an application.
Registration/Times/Locations
Candidates apply for the IBCLC examination through the IBCLC Commission’s online credential management system. The exam is generally offered during scheduled examination administrations.
The April examination is offered in English only. The September examination is offered in multiple examination languages. Candidates may be able to test at a test centre or through live remote proctoring, depending on the exam language, location, technology requirements, and current testing options.
Test Scores
IBCLC examination results are reported using scaled scoring. A scaled score of 600 or higher is passing, while a score below 600 is failing.
Examination results are usually released through the online credential management account approximately 12 weeks after the end of the examination window. Score reports may include performance information by content area, but content-area performance is not used by itself to determine whether a candidate passes or fails.
Retaking the IBCLC Examination
Candidates who do not pass may be able to retake the examination if they meet current eligibility requirements. Current retest rules allow an unsuccessful candidate to retest additional times, but additional requirements apply after multiple failed attempts.
After a fourth failed attempt, a candidate must complete 35 additional hours of lactation-specific education before sitting for the examination again. After a fifth failed attempt, the candidate must wait at least two years before sitting for the examination again and must apply as an initial candidate under the requirements in place at that time.
What Should I Expect on Test Day?
On test day, follow the instructions from the IBCLC Commission and the testing provider. In general, you should be prepared to:
- Arrive or log in before your scheduled appointment time.
- Bring the required identification.
- Follow all check-in and security procedures.
- Use only materials allowed by the testing rules.
- Complete Part One before moving to the scheduled break.
- Remember that you cannot return to Part One after starting the break.
- Manage your time carefully across both parts of the exam.
- Answer every question, since there is no penalty for a wrong answer.
- Follow all examination confidentiality and nondisclosure rules.
Personal items such as phones, bags, notes, study materials, smartwatches, and electronic devices are typically restricted. Candidates testing through live remote proctoring should confirm computer, webcam, room, identification, and workspace requirements before test day.
How Can I Prepare for the IBCLC Examination?
Start by reviewing the current IBCLC Detailed Content Outline. The scope of the exam is extensive, requiring that your study plan includes both areas of clinical lactation knowledge and professional practice areas.
While all areas of the exam must be covered, you should concentrate on development & nutrition, pathology, techniques, and clinical skills as they make up the majority of the exam. You should study pharmacology and toxicology, lactation physiology, the endocrine system, communication and counseling, public health, ethics, legal issues, documentation and research.
Practice questions are useful because they help you apply lactation knowledge the way it may appear on the exam. After each practice session, review missed questions carefully so you understand the clinical issue, counseling principle, safety concern, ethical rule, or lactation-management concept behind the correct answer.
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IBCLC®, IBLCE®, and International Board Certified Lactation Consultant® are terms associated with the International Board of Lactation Consultant Examiners and the IBCLC Commission. The International Board of Lactation Consultant Examiners and the IBCLC Commission are not involved with or affiliated with Mometrix Media LLC or StudyGuideZone.com, nor do they endorse or sponsor any products or services offered by Mometrix Media LLC or StudyGuideZone.com.