What counts as lactation specific clinical practice
Lactation specific clinical practice is time you spend actually giving care that supports breastfeeding families: helping pregnant and breastfeeding parents with lactation, and teaching families or professionals about lactation. It can be in person, by telephone or online. Watching someone else do it does not count: the Candidate Information Guide says observation or shadowing of lactation practitioners is not clinical hours. Count the time you spent on lactation care, not the length of your shift.
What counts
The guide describes clinical experience as maternal and child care that supports breastfeeding families, including lactation assistance to pregnant and breastfeeding women and lactation education to families or professionals, and it says the care must be real practice rather than observation. In this log that becomes five kinds of activity that count toward the exam totals:
- In person consultation.
- Telephone consultation.
- Online consultation.
- Lactation education for families.
- Lactation education for professionals.
For Pathway 1 the setting matters too. The guide lists a hospital, a birth centre, a community clinic, a lactation care clinic or practice and a primary care office, and it adds independent practice as a licensed or registered health professional and counselling through a recognised breastfeeding support counsellor organisation. The log offers exactly these: hospital, birth centre, community clinic, lactation care clinic or practice, primary care office, independent practice as a licensed professional, recognised breastfeeding support counsellor organisation. Anything else can be logged as another setting, and it is kept but not counted until you confirm it.
What does not count toward the exam
- Shadowing or observing another practitioner, however long.
- Time on shift that was not spent on lactation care, such as general postnatal checks with no feeding support.
- Running or supervising a service, advocacy and research. These do count later, toward the 250 practice hours for recertification.
- Hours on Pathway 2 or 3 that were not directly supervised by a certified consultant.
- Anything more than five years before your application date.
Since 1 January 2022 hours are earned hour for hour. The Pathway 1 page counts recognised counsellor hours hour for hour, and the certifying body announced in August 2019 that the old flat rate, which credited volunteer counsellors with a fixed number of hours a year, would not be accepted for hours earned from 1 January 2022.
Telephone and online care
Telephone and online lactation care count the same as in person care when the setting allows it. The Candidate Information Guide's interim guidance on technology, which the certifying body has extended, says Pathway 1 hours can be earned through telehealth where the supervised setting uses it, and that Pathway 2 students may earn their supervised hours through technology platforms.
Worked example: one week of mixed work
| Day | Logged | Result |
|---|---|---|
| 14 September | 2.5 h, in person consultation, hospital | Counts |
| 15 September | 1 h, telephone consultation, lactation care clinic or practice | Counts |
| 16 September | 3 h, shadowing or observation, hospital | Not counted |
| 17 September | 1.5 h, lactation education for families, community clinic | Counts |
| 18 September | 2 h, administration or supervision, hospital | Not counted |
| 19 September | 1 h, in person consultation, other setting | Not counted |
11 hours logged, 5 counted. The shadowing is out because it is observation, the administration is out because it is recertification practice rather than clinical care, and the session at an unlisted site waits until the setting is confirmed. You can check any week of your own the same way in the hours log.
Common mistakes
- Logging a whole twelve hour shift when two hours of it were lactation care.
- Counting shadowing or observation as clinical practice.
- Writing a patient's or a family's name in the log. Record the kind of care, never who received it.
- Counting administration or research toward the exam instead of toward recertification.
- Assuming volunteer counselling still earns a flat yearly rate. Since 2022 it is hour for hour.
Log your own hours
The log keeps each clinical session and each course with its date, and the progress page totals them by pathway inside the five year window, with the education split and the hours about to age out. Everything stays in this browser.
Frequently asked questions
Do volunteer hours count?
Yes, if they are real lactation care in an appropriate setting. Volunteer breastfeeding counsellors on Pathway 1 count their hours through a recognised support counsellor organisation, hour for hour since 2022.
Does teaching a breastfeeding class count?
Yes. The Candidate Information Guide includes lactation education to families and professionals in its description of clinical experience.
Should I put patient initials in my log?
There is no need. Hours are counted by date, time, setting and activity. Keeping patient details out of your log protects the families you work with and keeps the log free of health information.
Sources
Last reviewed 27 September 2026 against:
- Candidate Information Guide, IBCLC Commission (International Board of Lactation Consultant Examiners), updated March 2026, read 27 September 2026. Used for: The description of clinical experience, the settings list, shadowing, and the interim guidance on technology.
- Lactation Specific Clinical Experience, IBCLC Commission (International Board of Lactation Consultant Examiners), web page, no revision date shown, read 27 September 2026. Used for: In person, telephone and online care; observation does not count.
- Pathway 1: Recognised Health Professionals and Recognised Breastfeeding Support Counsellors, IBCLC Commission (International Board of Lactation Consultant Examiners), web page, no revision date shown, read 27 September 2026. Used for: Pathway 1 settings, and recognised counsellor hours counted hour for hour.
- Update to Previously Announced IBCLC Programme Change to Clinical Hours Calculation for Recognised Breastfeeding Support Counsellors, IBLCE (International Board of Lactation Consultant Examiners), announcement dated 2 August 2019, read 27 September 2026. Used for: The end of the flat rate for counsellor hours earned from 1 January 2022.
This guide is our own summary of the published documents, not legal advice and not a finding about your eligibility; the credentialing authority decides. If it disagrees with the current documents, the documents win. Lactation Ledger is not affiliated with, endorsed by, or connected to the International Board of Lactation Consultant Examiners (IBLCE), the IBCLC Commission, the Certification Board for Diabetes Care and Education (CBDCE) or any other certifying body. IBCLC and CDCES are certification marks of their owners.