IBCLCs sit up! We have another drive-by comment period (it closes in a week, on 3 August 2018) on important changes proposed by the International Board of Lactation Consultant Examiners (IBLCE) to its rules for certification, re-certification, and new status designations for International Board Certified Lactation Consultants (IBCLCs). The link for SHORT comments (sigh) is at the very bottom of this IBLCE announcement, which many certificants also received in their e-mail inboxes. The matters I intend to comment upon are in bold italics, below.
**Initial** certification rules-and-requirements have had one new addition: 5 hours of education about communication skills on top of the 90 lactation-specific hours.
So – whether you are doing Pathway 1, 2, or 3, you will make sure you have:
(a) health sciences education requirements met;
(b) **95** hours of lactation-specific education (5 of those about communication skills);
(c) clinical hours as required by each Pathway (1000 for 1; 300 for 2; 500 for 3)
I hope this new requirement allows for education about “counseling” skills. One cannot presume “communication” (which could go more to documentation and privacy elements) and “counseling” (going to the way clinical care is discussed/provided) are the same. I think IBLCE could fold those 5 hours INTO the pre-existing 90, cuz proving 85 hours of lactation-specific education + 5 hours on communication/counseling skills ought surely to be enough to weed out the slackers.
**Recertification** will be done differently.
For lovers of tests … you can continue to take the exam, every five years, to maintain your certification. For haters of tests … you will NOT have to recertify by exam every tenth year. Hooray! Note that there is no announced plan to change the fee structure. Under the current scheme, recertification-by-CERPs (continuing education recognition points) fees are the exact same as the test-taking fees, and do not include the cost to acquire those 75 hours of CERPs via conference or webinar or independent study.
Also new is the option to earn 2 CERPs a year if you serve in leadership for a breastfeeding organization. But they do not include local organizations, which is a real mistake. Much of the advocacy for breastfeeding/human milk use happens in the community (Step 10 of BFHI!) and we should encourage practitioners to build leadership experience with their local peers.
New to this revised recertification system are two elements that I sure-as-heck would like to see in their final administrative incarnation before I drop my two arched eyebrows.
When recertifying by CERPs, one must now use? submit? maintain? (it’s not clear) “a required self-assessment to guide a continuing education course or plan of study.” Well, what in the heck is that? For those of us in private practice as solo practitioners, is my word alone (I am the boss of me …) enough to substantiate that my self-assessment as to what I need CERPs in was worthy?
But the one I am really scratching my head about is this one, quoted in full:
“C) Practice Requirement. For recertification (by either examination or CERPs), require 500 hours of practice (full or part-time) in lactation consulting in the area(s) of clinical practice, education, administration, research or advocacy.” There is no guidance as to what this “practice requirement” means, or how it is to be tracked and verified, and IBCLCs need to know.
Do I count the easily 100 hours of prep I do each year in addition to my 30 hours of classroom teaching as a Pathway 2 instructor at Drexel? Even if I am not in leadership and earning my 2 CERPs (see above) as part of a breastfeeding organization, do I count the scores of hours I engage in, in very beneficial networking, about clinical issues, both on social media and in-person? Are the dozens of hours I spent in “research” (on legal and ethical issues) to write a textbook chapter count, or are we only talking about “research” that is of the white-lab-coat-beaker-safety-glasses variety?
**New Certification Statuses and Clarification** is all new, and all good, as far as I can tell.
At long last, an option for “IBCLC Retired” will be offered. Hooray! I’ll need that one sooner than later!
A little wiggle room is offered in the new “Inactive Status,” recognizing that life sometimes gets in the way, and folks may need a sixth year to meet their five year re-cert deadline. While they can’t advertise themselves as IBCLC during that sixth year, and must regain their credential by taking the test, they will not have to meet test requirements required of brand-new test-takers.
“Extension Due to Extraordinary Circumstances” also permits folks a sixth year to meet their five-year re-cert deadline … and also permits re-cert by either CERPs or the exam. IBLCE plans to provide better definitions of just what an “extraordinary circumstance” might be, versus those who want Inactive Status because, perhaps, they just didn’t scramble in time to get 75 CERPs before the deadline passed.
IBLCE offers some good, common-sense examples (“the certificant or an immediate family member is seriously ill, suffers from severe personal injury, experiences unavoidable natural disaster, or has changes related to active military duty”) but I’d like to see them add demonstrated financial hardship.
The cost to take the test or re-certify is several hundred dollars. These are very real economic barriers, preventing many folks from becoming IBCLCs. Imagine the IBCLC who scraped and scrabbled to meet the requirements, took the test, passed (yippee!) and found a fabulous job … and then in year 5 was laid-off. Or had a job dependent on grant funding that falls through. We hear these stories ALL THE TIME. Practitioners who are stretching pennies for living expenses while they search for another IBCLC job should be given a break, as their circumstances are every bit as harrowing as those enduring natural disasters or family illness.
Hey Liz,
So would “IBCLC Retired” require a fee?
Karen Querna
IBLCE does not suggest, in this call for comments, whether or not the “IBCLC (Retired)” designation would require a fee.
Is IBCLE non-profit? What do they do with all the money we pay. I understand cost to develop and administrator tests, but it seem excessive.
IBLCE is organized as a non-profit organization. The IRS Form 990 is the reporting form that federally tax-exempt organizations must file with the IRS each year. This form allows the IRS and the general public to evaluate a nonprofit’s operations; it includes information on the nonprofit’s mission, programs, and finances. It is up to the Board at IBLCE to approve the strategic programming and financial strategies for the organization.
Great reply and thoughts, Liz, as always! I am deciding what to do in 2020 when I need to recently by exam. I am now 67 but still working as an IBCLC in a per diem retirement position and some private practice.
Thank you for sharing your insight! I haven’t read the proposed changes before this but there certainly seems to be a lot of foggy gray here! Now to contemplate my own responses!
IRS 990 Forms are meant to disclose much of how money is spent by federally-recognized non-profits (like IBLCE). One can learn a lot; perhaps not how every penny is spent nor are *future* budget plans disclosed. One easy resource to look up 990s is https://www.guidestar.org/Home.aspx
And yes, as I wrote in the piece: I agree that the cost to re-cert by CERPs, when added to the cost of acquiring all those CERPs, is substantial. And for many: so substantial it is a door slammed shut to enter or remain in the profession.
What is their time frame for implementation?
Thank you Liz!
IBLCE doesn’t say … I suspect that would be announced when they roll out the FINAL version of these draft changes, which are being offered for public comment prior to IBLCE issuing a final version.
Does anyone question the 500 hours of practice for those IBCLC parents who are taking time off to raise/breastfeed young children but doing continuing education to stay up to date? This is my situation and feeling rushed back to work in a more remote location without lots of family friendly opportunities stresses me out to no end. I still work actively as a LLL leader but obviously I don’t use my IBCLC credentials doing this. I did leave a comment during this open period and I hope maybe I’m misunderstanding things!
At age 72 with 31 years actively working as a lactation consultant, in a hospital setting, I had to pay the $660.00 to recertify after letting my certification lapse for just a year. I retired at age 71 but still do some casual work at the hospital. I plan to do a little private practice eventually. I felt pressured to retest as the hospital would no longer let me see outpatients without the certification. Too bad they did not see the value of experience and a great reputation in the community among both the patients and doctors. This will be the 4th time I am testing! I am happy to see IBLCE finally making changes to be more reasonable for those of us with so many years of eduction, actively working in the field and keeping current with practice.
Jane Helgesen RN, former IBCLC for 30 years
Hi Liz, thankyou for your input and feedback concerning this important topic. Details in some areas are needed. For example I am certified also with NCC as an RNC in Neonatal ICU. I won’t ever need to take that exam again. We take an assessment through NCC which dictates our area of continuing education to take. I think there is a minimum required and credit is given for taking the assessment. One cycle I did not have to take the full amount if credits. Also the recertification is greatly less than my IBCLC? Not sure what the new guidleline details will be. Hoping for decreased burden economically to maintain.
Suggesting, as per Liz Brooks (ABOVE) that work in administration at the local level and advocacy work might count towards CERPS.
Thanks for making your thoughts available to us and for encouraging us to get involved and have our voices heard.
I agree that the cost of maintaining an IBCLC certification is too much. Re-testing is ridiculous!! I have retired as an LC due to these enormous requirements. As badly as we need LCs, one would think that they would make it easier to retain certification!! I loved my job, and felt like I helped a lot of Moms!! Sad that all the fees are so high.
I’m excited about not having to sit for the costly exam for a third time. I agree with the importance of not watering-down the IBCLC certification; “yes”, we worked too hard for it! I’ve always questioned the logic behind repetitively sitting for this exam when physicians, nurses, and other professionals who worked hard for their license only sit once for their exams. We all as professionals providing patient/client clinical services must remain clinically competent while providing current evidence-based practice. Yeah, I’m so happy changes are being reviewed/made because I love being an IBCLC and as the retirement years are beginning to approach, I definitely was factoring in how I was going to maintain my IBCLC certification (thinking about exams and cost).
Well — the short answer is: IBLCE decides what they will/will not tolerate with regard to the use of their service-mark-protected mark, IBCLC.”
And they have not told us WHEN they plan to review comments to this call for public input, and finalize their new rules.
I will suggest, however, that the *proposed* changes:
would lead one to believe that your intended honoree may elect to apply for this designation herself … that your award certification should NOT use the phrase ‘IBCLC Retired’ on it … but surely it would be correct for your award to indicate something like “Jane Doe, who practiced as an IBCLC from 19xx-20xx”. That turns it into a factual statement, not a label.
You could, in an abundance of caution, just e-mail IBLCE with your proposed award certificate wording, and get them to bless it.
HI Liz!
Has the policy for not taking the IBCLE again at 10 years a done deal? I asked a well known LC who has been around for nearly 40 yrs and she said no.
I am up for testing in 2020.
If I don’t have to take the retest,I would need to have 75 CERPS. Is that right? And when would I apply for the recertification form?
Thanks so much for all your help, and your dedication to the profession!
IBLCE has not, as of Dec 2018, announced what changes if any they will make to the recert/retest requirement. And no announcement of when they expect to make the changes final and public. You gotta watch their website, or this space — that’s the best. One thing I think you can safely anticipate is that whatever changes IBLCE finalizes, they will be slowly rolled out. I don’t know if 2020 will be the first year they operate under proposed changes, or not. I’ll keep my fingers crossed for you, though!
As of 13 Feb 2019 … still no final decision announced by IBLCE as to what changes they plan to implement, and when. I think most IBCLCs agree with you!
This is one of the frustrating realities of IBCLC work in USA hospitals in the 2010s! One does not need to be an RN (or any other licensed healthcare provider) in order to be an IBCLC. One needs to be an IBCLC to be an IBCLC. Yet many hospitals require that “two-fer,” to provide the Suits the administrative flexibility to pull you OFF IBCLC work to do RN-only work. I work as an IBCLC (only) in a Baby-Friendly hospital in Pennsylvania … and did so long before they got BFHI designation. It can be done, but it is a very real challenge to find hospital administrators with the forward-thinking strategic goal to provide dedicated skilled professional lactation care.