The REAL difference between a lactation consultant and counselor?

Updated: Mar 31

IBCLC vs CLC. What is the difference? You may have heard Lactation Counselor or Lactation Consultant used interchangeably and though they are the same. Or you may have heard the Lactation Consultant say they are an IBCLC or your Doula is a CLC. So many credentials are they all the same or are they different? Let's start with some of the different credentials.


A Certified Lactation Counselor (CLC) has completed 52 hours of training and passed a certification exam through the Academy of Lactation Policy and Practice. A CLC may also be a dietician, doulas, nurse, childbirth educator, and woman from the community with a passion for breastfeeding. They require certification every 3 years and 18 hours of CEU to recertify. An International Board Certified Lactation Consultant (IBCLC) has completed 90 hours of breastfeeding education ( some use CLC certification for their hours), is required to have 300-1000 hours of clinical practice, basic college health education, and passed a certification exam. IBCLC previously had to recertify every 10 years. As of 2022 IBCLC recertifies every 5 years and up to 75 CERPs depending on the IBCLC self-assessment, with 200 working hours.


Lactation Counselor (CBI)


Lactation Counselor who received training and certification through Childbirth International provides 130 hours of lactation education 30 hours of lactation support and complete an exam in order to certify.


Other Certifications:

  • CBC=Certified Breastfeeding Counselor

  • BFC=Breastfeeding Counselor

  • LC=Lactation Counselor (or consultant)

  • Certified Breastfeeding Specialist



CLC and IBCLC are the most common certifications.


So what is the difference?


The main difference is the pathway to education. IBCLC have a more intensive certification process. CLC and IBCLC can both support, educate, advocate and counsel women in breastfeeding. CLC's can be found in WIC clinics, Baby Cafe's, Private Practice, La Leche League Leaders, and some hospitals. IBCLC's can also be found in these types of practices but are usually hired in for hospitals if they are also RN's. Both are considered " health professionals that provide lactation support" by the CDC.



What is their scope and how do they practice?


Both CLC and IBCLC have a similar scope of practice. Assess & Evaluate, Educate, and Counsel. Hands-on experience may vary from CLC to CLC. So its good to assess the experience of both the CLC and IBCLC. Both IBCLC's and CLC's may also be other health or birth professionals like nurses, dietitians, doulas, childbirth educators, midwives, dentists, etc. Both must assess the breastfeeding dyad for potential problems such as latching, breastfeeding position, pain in the mother and then document and counsel the breastfeeding mother and refer as needed to other health care professionals.


Which one is better for you?


It all depends on your needs. Many CLC's are in private practice, travel to homes, or work with community projects such as the Baby Cafe. Evaluate their experience. Have they worked with breastfeeding women before and for how long? While some CLCs gained breastfeeding experience prior to certification some may have received it through on-the-job training. Many IBCLC's actually took the same CLC course and added 38 hours of additional breastfeeding education through other sources. Ultimately it comes down to you. Do you like this lactation professional, is she friendly, open-minded, experienced, and knowledgeable.



Can insurance cover both?


Insurance usually covers lactation services BUT depending on the state only if it is billed under a state registered/licensed health providers such as a Nurse Practitioner or Doctor. For many Lactation Consultants and Lactation Counselors cannot bill insurance if they do not work with or under a doctor or other state registered/licensed health professional or are one themselves. Some may be able to provide a superbill but that depends on the insurance you use. IBCLC's and CLC's are not state-regulated health professionals in most states and therefore may not be able to bill insurance. Private Lactation services are therefore not usually covered by insurance for CLC's or IBCLC's. However, some do accept payment plans or HSA/FSA. CLCs and IBCLCs can be covered by Tricare if they’ve gone through the Tricare certification process.


Can they help with complicated breastfeeding issues


Both IBCLC's and CLC's can help with complicated breastfeeding issues BUT only within their scope of practice. Both IBCLC's and CLC's can identify, support and counsel breastfeeding problems like:

  • latch problems

  • milk supply issues

  • positioning

  • relactating

  • engorgement

  • plugged ducts

  • tongue ties

  • mastitis

  • SNS feeding

  • nipple shields

  • breast-pumping

  • hand expression


However both IBCLC's and CLC's must refer out for medical conditions and infections, and any problem or condition needing correction through therapy. Tongue ties cannot be clipped by either professional unless they are a doctor or dentist. Neither can prescribe medication if they are not a doctor.


Neither IBCLC'S, CLC, or any other lactation professional can:

  • Give medical advice

  • Prescribe medication

  • Give a medical diagnosis

  • Preform surgery


Unless they are a doctor.



While IBCLC's have been held as the gold standard of breastfeeding expertise the job of both professionals is the same. Support, Advocate, and Counsel.



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