This is a post on Pathway 1 for Peer Supporters. Not sure whether that’s the right pathway for you? Check out the overview of all the pathways to see what fits your situation best.
Are you interested in becoming a lactation consultant, but confused on where to start? Many healthcare professions have a single clear pathway: take required prerequisite courses, enroll an accredited academic program, successfully complete their requirements (including clinical rotations and classes), graduate, and pass an exam.

As a healthcare professional, that’s probably pretty close to the route you followed. However, there are relatively few formal lactation consultant training programs; in fact, lactation consultants can choose from three possible pathways – and Pathway 1, which many health professionals pursue, can be especially confusing!

Feeling overwhelmed? Know that there are tens of thousands of IBCLCs in the world, who have each figured it out – you can, too, and we’re here to help!
Because NC State offers courses that are well-suited for those pursuing Pathway 1, we get a number of questions from people confused about whether they are able to pursue this pathway. So we’re breaking it down in this post, step-by-step.
This post is for peer supporters. The other category in Pathway 1 is for members of recognized health care professions. If you fit that description or want to learn more, click here for a post all about Pathway 1 for health care professionals.
For peer supporters, Pathway 1 has the following steps:
- Obtain 1000 hours of “lactation specific clinical practice”
- Complete education in the 14 Health Science subjects OR be an approved health care professional
- Obtain 90 hours of lactation specific education
- Obtain 5 hours of communication skills education (starting April 2021)
- Take and pass the IBCLC exam
Let’s go through step-by-step! We have not numbered them as you do need to do them in any specific order, but note that your clinical practice hours and lactation specific education must be completed in the 5 years immediately prior to the date you apply to take the exam.
Obtain 1000 hours of “lactation specific clinical practice”
If you are doing Pathway 1 as a peer counselor, you must be part of an organization recognized by IBLCE. A full list of recognized organizations is here.
Examples include, but are not limited to, La Leche League Leader, Breastfeeding USA counselor, or Mom2Mom Global peer supporter.
You may also work (paid or unpaid) providing supervised lactation support in the following settings: a hospital, birth center, community clinic, lactation care clinic/practice, or primary care practitioner’s practice/office. Examples include a WIC Breastfeeding Peer Counselor who is supervised by an IBCLC, or a volunteer counselor who provides breastfeeding support in a birth center where they are supervised by midwives.
Currently, you are able to count these hours as a “flat rate”: 250 hours per year if you provide only telephone/online counseling, or 500 hours per year if you provide face-to-face support. (This will change on Jan 1st, 2022; from that point forward, you will be required to count your time on an hour-by-hour basis. More information from IBLCE here.)
All of your hours must be completed in the 5 years immediately prior to the date you apply to take the exam.
Complete education in the 14 Health Science subjects
If you are an approved health care professional (or will be by the time you become an IBCLC), you do not need to complete the requirements below (and you may also have the option to complete your training via Pathway 1 for health care professionals).
If you are not an approved health care professional, you must demonstrate that you have completed the courses below. These are courses which you may have taken as part of a degree program or individually. Many people take these online or through their local community college. (Note these cannot be non-credit courses; you must be earning academic credit for them to be accepted by IBLCE.) More details from IBLCE are available here.
Required college-level courses (8 total):
- Biology
- Human Anatomy
- Human Physiology
- Infant and Child Growth and Development
- Introduction to Clinical Research
- Nutrition
- Psychology or Counseling Skills or Communication Skills
- Sociology or Cultural Sensitivity or Cultural Anthropology
Required continuing education courses (6 total):
- Basic Life Support
- Medical Documentation
- Medical Terminology
- Occupational Safety and Security for Health Professionals
- Professional Ethics for Health Professionals
- Universal Safety Precautions and Infection Control
Obtain at least 90 hours of lactation-specific education
Either before or while you are accumulating your clinical hours, you should work on your lactation education. You may obtain these from in-person or online trainings or conferences that cover the core competencies from IBLCE. When evaluating these courses, consider whether they will give you an integrated overview of the knowledge you will need for clinical practice, and to prepare to sit the exam. NC State offers two online courses that give you all the hours you need, in a clear, sequential format, and taught by expert instructors; it’s the same course we teach in person for our lactation trainees.
Your 90 hours must be completed within the 5 years immediately prior to the date you apply to take the exam.
Obtain 5 hours of communication skills education (starting April 2021)
IBLCE is also adding a requirement for at least 5 hours of education in communication skills for those applying to sit the exam in April 2021 or later. While the exact nature of how those hours need to be documented is still unclear, NC State courses will cover those communication skills as part of our online courses.
Take and pass the IBCLC exam
The exam is offered in April and October of each year. You must apply to sit for the exam 6-8 months in advance of the exam date; the IBLCE website has upcoming deadlines. All of your education and clinical hours must be complete before you apply to sit the exam.
Once you’ve passed, congratulations! Welcome to the community of IBCLCs worldwide. There’s a lot to do, and we can’t wait for you to get started!
Have more questions? Still not sure which Pathway is right for you?
Join one of our free, live monthly webinars! Check out our Facebook events page and follow us on Facebook for announcements of upcoming dates. One of our expert instructors reviews the pathways in detail, including options for different lactation consultant training programs, and answers questions from attendees. Or watch our recorded webinar right now!