By Nathan Young
Welcoming a new child into the world can be a profound and joyous experience, especially for first-time parents.
Yet despite how amazing the experience can be, not every aspect of rearing a newborn comes as easily or automatically as we might hope. An example of this can be breastfeeding.
Although many of us would assume breastfeeding is a behavior that comes naturally to mothers and newborns alike, that’s not always the case. The infant might have trouble latching or the mother may experience pain or low milk flow. Doing everything possible to help the baby suckle is crucial to providing them the nutrients they’ll need to get a healthy start on life.
Certified lactation consultants specialize in helping to ensure that the initial mother-baby bond of breastfeeding is set up for the highest chance of success possible. They can be there to offer important help to new mothers, both as an educational resource and clinical support when needed.
“Trouble with breastfeeding can be a very vulnerable experience for new families,” said Kristina Chamberlain, Clinical Program Director and Lead Faculty for the Lactation Program at the UC San Diego Division of Extended Studies, and International Board Certified Lactation Consultant (IBCLC). “Their biggest joy of having a baby has suddenly become a difficult challenge. They think breastfeeding is going to be so easy and perfect, but it doesn’t always go that way. Breastfeeding is a learned behavior, the parent and the baby have to learn new skills.”
In today's ever-evolving world of healthcare, lactation consultants are emerging as indispensable pillars of support for new parents.
In addition to helping new mothers with breastfeeding challenges, lactation consultants also play a crucial role in educating expecting mothers, as well as advocating in the culture at large for greater understanding and awareness about the importance of breastfeeding for newborn health.
For these reasons and more, becoming a lactation consultant can be a valuable and rewarding profession for a person to choose.
We talked to Chamberlain about how to become a lactation consultant, including the education, career paths, and day-to-day work of being a lactation consultant.
What does it take to become a lactation consultant?
People who pursue careers in lactation consulting often come from other roles in health care and child birthing, such as being a registered nurse or midwife. Yet, those without a medical background should not be discouraged from pursuing a career as a lactation specialist.
“I always say that lactation consulting is both a science and an art,” said Chamberlain. “The person who's going to be successful will have the clinical curiosity to really dive into the science, ask questions, and have good critical thinking skills. But they're also going to understand that these are real people that we’re helping. We have to approach them with empathy and without bias to understand what they most need from us too.”
Chamberlain shares that it’s not uncommon for new people to come to the field without any prior medical experience. They may be looking for a career change or were inspired by an experience working with a lactation consultant in their own lives.
“It's fun to have a mix of people in the classes,” said Chamberlain. “We learn from each other no matter what their previous experience is.”
Pursuing a certification in lactation consulting can also be confusing, with a literal “alphabet soup” of credentials to pursue. However, there is one certification that stands above the rest, the International Board Certified Lactation Consultant (IBCLC).
"The IBCLC is really the gold standard. It is a lactation professional who either has another healthcare background or comes from a non-healthcare background but meets all the requirements to sit for the exam and get the certification."
What do lactation consultants do?
Lactation consultants wear multiple hats in their day-to-day work. Chamberlain describes their role as encompassing three main aspects: education, advocacy, and clinical support.
The first and perhaps most primary aspect of lactation consulting is education. This is both to educate new and expecting mothers or families, but also to engage in a wider cultural education too.
“People think ‘well, you just plop the baby on and it's natural,’” said Chamberlain. “But natural doesn't mean that it's easy and also doesn't mean that it comes naturally to everybody. There are things that the parent has to learn in terms of the physiology and practice around lactation.”
Common challenges include sore nipples, engorgement, low milk supply, or infant weight gain concerns. Chamberlain emphasizes that being able to address these concerns as early as possible is an important way to keep small challenges from becoming bigger problems later down the line.
Lactation consultants also aim to combat misinformation and promote evidence-based practices around the benefits of human milk over formula, ensuring families make informed choices.
“A lot of people think lactation consultants are against babies getting formula altogether but that’s not always the case,” said Chamberlain. “We recognize that formula can be medically necessary sometimes, but it's not equal to human milk. That part gets lost, especially around the marketing strategies that formula companies use.”
Another pivotal role that lactation consultants play is advocating for the rights and well-being of new mothers, both within hospital settings and beyond.
Hospitals are often the first point of contact for mothers on their breastfeeding journey. Much of the advocacy work of lactation consultants is to encourage hospitals and healthcare providers to create breastfeeding-friendly policies within their facilities, such as properly educating their staff and helping mothers initiate breastfeeding within an hour of birth.
Advocacy also extends beyond the immediate postpartum period, and into public acceptance and accommodation for breastfeeding out in the world.
“We advocate for the right to provide human milk. We think of it as a human rights issue.” said Chamberlain. “Now in the United States all 50 states have something on the books that allow for breastfeeding in public, But we still don't have great parental leave. How can we better support new parents so they don’t have to go back to work at 8 or 12 weeks? The baby still needs their care.”
The third aspect of being a lactation consultant is providing essential clinical support to babies and new mothers.
“It's common for people to have some obstacles with breastfeeding but they don't all become big issues,” said Chamberlain. “If you can see a lactation consultant early on to get support, many issues resolve themselves quickly. It's when people don't have the support they need that those small issues become big problems. Now, you've got a mother with nipple wounds or a baby that's not gaining weight.”
The postpartum mental health of the mother is another important aspect of the clinical support that lactation consultants can provide. They can be cognizant of mood disorders and other factors where the mother may be struggling and not getting the support she needs.
“We need to better identify our clients who are really struggling with their mental health in the postpartum period so we can give them the extra support they need,” said Chamberlain. “Whether that's finding ways to help them lighten the load at home, helping them solve their lactation issues, or helping them find a therapist if that’s what’s needed too.”
What are lactation consultant career paths?
IBCLCs have diverse career options and can work in various settings, depending on their background and interests.
“A lot of our lactation consultants work in the hospital where they'll visit the parents in the postpartum unit to make sure that feeding is going well before they're discharged. They'll also do the breastfeeding classes if that's something that the hospital provides.”
Lactation consultants can also work at outpatient or other community healthcare clinics to be available for mothers who need help after they’ve been discharged. This can be their own private practice or as part of a larger facility. Some lactation consultants will also visit patients at their own homes rather than asking them to come to a clinic location.
Additionally, lactation consultants also often partner with pediatricians or other healthcare providers to offer ongoing support when needed. They may even be a registered nurse who works at the facility in other capacities but is certified to provide lactation consulting support as well.
“One of the things that I think a lot of people really love about being a lactation consultant is that we are pretty autonomous,” said Chamberlain. “That often allows for more freedom to choose how we work and more job satisfaction.”
Yet even with this autonomy, Chamberlain emphasizes the importance of working in collaboration with the healthcare providers.
“When somebody's working in private practice, it's really important for them to keep that relationship with pediatricians and other healthcare providers to ensure there is continuity of care,” said Chamberlain. “I think it's really important to remind other healthcare providers that lactation consultants are an important part of postpartum care.”
How to Become a Lactation Consultant?
There are three specific pathways toward becoming a certified lactation consultant. Each pathway requires the completion of fourteen health science prerequisite courses, 95 hours of lactation-specific coursework, and 300-1000 hours of supervised clinical experience. This is all structured to prepare you for the IBCLC exam which is available twice a year.
The primary difference between which pathway will be best for you will depend on your previous education and experience with healthcare and lactation support. UCSD offers a Pathway One and Pathway Two option for those interested in becoming an IBCLC.
Pathway One is designed specifically for current healthcare providers who are already working with breastfeeding dyads, such as nurses, pediatricians, and dietitians. It requires the same base of lactation-specific course work, but since the applicant is already working in healthcare, they most likely have already completed the other health science prerequisite courses. This path does require 1000 documented hours working directly with breastfeeding clients, which is the most of the three paths, but it allows the candidate to use their previous and ongoing dyad experience towards those clinical hours.
Pathway Two is tailored for individuals without a healthcare background. Candidates for this pathway need to ensure they’ve fulfilled the health science prerequisite courses before beginning the program. Course topics include biology, human anatomy, psychology, human development, or other similar courses from accredited colleges or universities that are approved by the International Board of Lactation Consultant Examiners (IBCLE). Some of these courses may have already been completed during the candidate's undergraduate education.
Pathway Two candidates will also have to ensure completion of six required continuing education healthcare courses such as basic life support (CPR), occupational safety and security for health professionals, and others; as well as the completion of a 45-hour lactation education training program, offered as the Lactation Education Counselor (LEC) course at UC San Diego Division of Extended Studies. These are both prerequisites for the UC San Diego Division of Extended Studies Lactation Program but that won’t necessarily be the case for all programs.
The pathway will include the same lactation-specific coursework as other pathways, and will also require 300 hours of supervised clinical experience. These hours are typically included in the program, with the educational institution pairing candidates with a preceptor for their 300 clinical hours.
Like many programs, the UC San Diego Division of Extended Studies Lactation Program has relationships with hospitals, clinics, and private practices all over the country through which to pair students with preceptors.
All Pathway Two programs are offered by a university or college and are accredited by the Lactation Education Accreditation and Approval Review Committee (LEAARC) in cooperation with the Commission on Accreditation of Allied Health Education Programs (CAAHEP).
The final pathway, Pathway Three, is similar to Pathway Two, But with the primary difference that Pathway 3 candidates will identify their own IBCLC mentor to develop a proposal on how the candidate will complete didactic and clinical requirements for the IBCLC exam on their own. The International Board of Lactation Consultant Examiners (IBCLE) must approve the proposal before the candidate can begin. The candidate is then required to complete 500 clinical hours with their mentor before taking the IBCLC exam.
A common candidate for this route would be someone who already works in healthcare and wants to switch careers. They have much of the required medical training but still need breastfeeding-specific education, clinical hours, and mentorship. Yet a candidate does not necessarily have to have a healthcare background to be a Pathway 3 candidate.
Currently UC San Diego Division of Extended Studies Lactation Program offers Pathways One and Two but does not offer a specific Pathway Three option. Those candidates would alternatively take Pathway 2 through the UC San Diego DES program.
How long does it take to become a lactation consultant?
Typically coursework towards the IBCLC will take between 6-9 months on a part-time schedule. Clinical hours can happen concurrently, although they may take more time depending on the pathway and the amount of time the intern is available to work. Obtaining the prerequisites for Pathway 2 can also take six months to a year or more depending on the level of relevant education the candidate already has.
"[The whole process] can take 6 months to 2 years, depending on how many prerequisites and clinical hours a person needs to complete," said Chamberlain.
“It's part-time but it's pretty rigorous,” Chamberlain continued. “Our program does a great job of preparing somebody for the IBCLC exam, and it also gives them a great foundation to start their career as a competent and research-savvy lactation consultant. You might graduate not knowing everything but you will know where to find the answers.”
What is a typical lactation consultant salary?
Salaries can vary quite a bit for lactation consultants depending on the hours and context in which they work. In most cases, lactation consultants are paid an hourly rate comparable to an RN in the area. This can be $20-$45 per hour or more.
While some lactation consultants do work full-time in clinics, hospitals, or private practice, many also work independently or part-time. This can create a lot of variation in expected income too.
Currently, UC San Diego Division of Extended Studies does not offer job placement assistance, however, most graduates from the program who have sought employment as lactation consultants have been able to secure positions.
The Future of Lactation Consulting
Over the years, the field of lactation consulting has witnessed significant growth and interest. More people are recognizing the importance of lactation consultants, leading to increased interest in the profession.
"It's definitely grown, and families now expect this level of support," said Chamberlain.
The demand for lactation consultants from diverse backgrounds is also rising. Families increasingly seek consultants who understand their unique cultural and personal experiences, driving the profession to become more inclusive.
For those considering a career in lactation consulting, Chamberlain offers some advice: "I would recommend getting out there and observing, volunteering, or finding a mentor if you can. Get a sense of the actual work, see what it entails, and see if it's a good fit for you."
Chamberlain describes one of the most rewarding aspects of being a lactation consultant as being part of families' most vulnerable moments.
"It's an honor for most of us," Chamberlain says about the role. “Lactation consultants help create a positive experience for families during a potentially challenging postpartum period.
“You might not necessarily fix everything but you're supporting them in a vulnerable moment. You’re able to help create a more positive feeling and better outcomes. And then hopefully you are able to help fix things to make breastfeeding work for the family again.”
If you’d like to know more about becoming a lactation consultant and the Lactation & Perinatal Education program at UC San Diego Division of Extended Studies, click here.