The Speech-Language Pathologist's Role in Lactation Consultancy

As a speech-language pathologist you may find that additional certifications empower you to better serve your patients. And if you’re working in the NICU or with infants, the International Board Certified Lactation Consultant (IBCLC) certification is your best bet.

Why You Should Care About Breastfeeding

For babies in the NICU, breast feeding has been proven to result in improved health almost immediately and better outcomes overall. In her presentation on SLP’s and breastfeeding, Nina Isaac, MS, CCC-SLP, IBCLC, explains that infants who were fed breast milk experienced:

  • Improved blood oxygenation and respiratory rate
  • Stable heart rate
  • Improved ability to moderate body temperature
  • Decreased effort when breathing while feeding (versus bottle feeding)
  • Improved suck-swallow-breathe coordination
  • More consistent weight gain

By helping your infant patients transition to breastfeeding as early as medically possible, you actually offer them a chance for improved and expedited recovery.

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In addition, breastfeeding has been shown to decrease postpartum depression (PPD). For those mothers with little ones in the NICU or facing other health challenges, the risk for PPD is even greater. Anything we can do to decrease that risk will improve mother-baby bonding and serve to improve baby’s sense of well-being.

The evidence speaks for itself, and is so strong that it prompted the American Association of Pediatrics (AAP) to release an official position statement on the matter: “Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue, and not a lifestyle choice.”

In fact, it is estimated that the US would see a $13 billion reduction in healthcare costs if we could see 90% of women exclusively breastfeeding for the first six months of life, with continued breastfeeding throughout the first year. Researchers also estimate that this would prevent over 900 infant deaths each year.

How an IBCLC Certification Will Benefit Your Career… And Your Patients

It is not unusual for your training as an SLP to focus more on bottle-feeding, writes Adara Blake, MS, CCC-SLP, IBCLC, than on the physiology and mechanics of lactation and breastfeeding.

All too often, babies become proficient at the bottle but continue to struggle with breastfeeding, losing out on many of the benefits.

One reason for this is that while SLP’s and IBCLC’s do have some overlap in their skill set, there is enough that is unique to each profession that SLP’s are not always able to address long-term feeding problems when a mother wants to breastfeed.

In an anonymous survey published by the University of North Carolina – Chapel Hill, one SLP said, “As an SLP, I thought I myself was knowledgeable enough to nurse my infant daughter, but had to seek the help of a lactation consultant.”

With the wider-angle view that additional training brings, you will catch and personally address a wider range of feeding difficulties, providing baby and mother with a more holistic approach to therapy.

In addition to better serving infants, acquiring an IBCLC certification makes you more marketable as a practitioner, since many hospitals now hire IBCLC’s in addition to SLP’s in order to address the issue of breastfeeding problems. Having staff members qualified to fill both roles can be extremely attractive to many hospitals, clinics, and private practices.

Ultimately, anything you can do to improve your ability to assist infants with feeding will benefit you and the patients you serve.

As SLP and IBCLC Nina Isaac says, “If an infant has a breastfeeding problem, it IS a FEEDING problem. As SLPs, it is our professional obligation to help these infants feed optimally.”

How To Become Certified in Lactation Consultancy

The International Board of Lactation Consultant Examiners provides three pathways to certification, but if you already have your SLP certification you will want to choose Pathway 1, the pathway for recognized health professionals.

  1. Education. You need 90 hours of lactation specific education. This must be completed within the 5 years immediately prior to applying for the IBCLC exam.
  2. Practicum. During the 5 years prior to the exam you need to accumulate 1000 hours of lactation specific clinical practice. These hours can be obtained in any of the following supervised settings:
    • Hospital
    • Birth Center
    • Community Clinic
    • Private Lactation Clinic
    • An IBLCE Recognized Breastfeeding Support Counselor Organization
    • Licensed health care professionals approved to work independently within your scope of practice can also be approved to get credit for hours outside of the above mentioned settings.

If you are unable to obtain the required hours as stated above, you can also consider these additional pathways:

    • Pathway 2: Attend and graduate from and IBLCE verified academic program. This program must include a minimum of 300 hours of supervised experience. Your chosen program must include a minimum of one course in each of the following areas:
      • 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
      • 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
    • Pathway 3: Complete 500 hours of lactation specific clinical experience under the direct supervision of an IBCLC. The Board of Examiners must verify these plans before you begin in order for the hours to count. This pathway includes three phases:
      1. Observing the mentor IBCLC at work
      2. Clinical practice experience with the IBCLC mentor in the room, providing assistance as necessary.
      3. Independent practice with the IBCLC physically nearby (phone supervision unacceptable) and available to assist if needed.
  1. Exam. You can choose to take the exam in April or October. This is a computer-based test, but it must be taken at an approved testing site. It’s important to apply early, or you may not find seats available at the testing sites closest to you.

Because this exam is offered by an international board, the exam fees are adjusted based on the purchasing power parity of each country. To see the fee schedule for the current year, as well as upcoming exam dates, you can check out the IBLCE’s Certification & Key Dates page.

In order to apply for the exam, you will need to create an account on the iblce.org page and login. From there, the site will guide you to the application.