Are you experiencing a dip in milk supply – or another lactation or pumping challenge?
Wish you could run your question by someone who knows more about breastfeeding?
Chances are, you already turned to Google, ChatGPT, or maybe a kind breastfeeding friend for lactation advice. But doing so likely took you down a dizzying rabbit hole of theoretical solutions, when what you really needed is personalized, one-on-one lactation support specific to you and your baby’s needs. And ideally, from a human with actual breastfeeding training.
Which “lactation expert” should you turn to for support? The options for lactation support people, along with their acronyms, may feel similarly dizzying – there’s an IBCLC, CLC, BC, and the list goes on and on…
To help you decide, here’s a rundown on what the most common types and their acronyms mean. Plus, a summary of the training involved to initially obtain each of these lactation designations.
(Note: This may also be a helpful resource if you are considering a career or volunteer work in lactation support!)
International Board Certified Lactation Consultant (IBCLC)
An IBCLC is often thought of as the go-to source for lactation-specific care that may also be clinical in nature. But many people don’t realize that IBCLCs can practice in a wide range of environments, not just in hospitals. For example:
- clinical practice (such as in a hospital, a pediatrician’s office, or a lactation consulting private practice)
- education (such as teaching breastfeeding classes, writing about lactation, or educating breast milk donors at a human milk bank)
- administration (for example, overseeing a breastfeeding-related department at WIC or a hospital)
- research (to further breastfeeding science, such as at university settings)
- advocacy (promoting breastfeeding initiatives to the public, such as through state breastfeeding coalitions)
To obtain initial certification as an IBCLC, individuals must complete:
- 14 health science classes
- 95 hours of lactation specific education (including five hours focused on communication skills), and
- enough clinical hours to fulfill one of three pathways:
Pathway 1 involves 1000 clinical hours obtained through work as a health professional or as a breastfeeding support counselor (this also includes “breastfeeding peer counselors” who volunteer for select organizations),
Pathway 2 involves 300 directly supervised clinical hours through an accredited lactation academic program, and
Pathway 3 involves 500 directly supervised clinical hours through a mentorship with an established IBCLC.
Then, regardless of pathway, the individual must pass a 4-hour exam to earn their IBCLC for five years. (Every five years, to maintain certification as an IBCLC, individuals must recertify through at least 250 hours of continued lactation consulting practice, coupled with either completion of a large number of continuing education hours or by passing the IBCLC exam again.)
Keep in mind: The term “lactation consultant” is a loose term and not heavily governed, while the term IBCLC is more protected. Only those lactation consultants with “IBCLC” after their name are board-certified as such through the International Board of Lactation Consultant Examiners (IBLCE). There are more IBCLCs in the U.S. than any other country (21,185 as of this blog writing, per the IBLCE website), so one is likely near you.
For which scenarios is this best?
Really, for any lactation question, an IBCLC is a great resource, but particularly for ones involving knowledge beyond basic breastfeeding care, and requiring clinical evaluation and management of a lactation plan. For example, if you’d like pre- and post-breastfeeding weight checks of your baby to help assure you of good milk transfer, an IBCLC in a clinic setting is the way to go.
One caveat: IBCLC’s are not prescribers unless they are dually trained and licensed as prescribing medical providers (MD, DO, NP, etc.), so if you have an inflammatory condition or a breast rash, for example, opt for a physician, instead.
Where can you find one?
IBCLCs who specifically offer one-on-one consultations are most often found in these settings:
- in hospitals taking care of postpartum parents immediately after delivery (ask to see one while an inpatient)
- in hospital lactation clinics, seeing patients by appointment after discharge from the hospital
- at their own private practice (either home-based or at their own clinic). To find one in private practice in the U.S., use the U.S. Lactation Consultant Association’s private practice directory here. Some private practice lactation consultants even travel to patients’ homes to do all or some of their lactation consultations!
- at a select number of pediatric clinics across the U.S. (Check your pediatric clinic’s website to see if they have one on staff.)
- In the Women, Infants and Children (WIC) program in the U.S., oftentimes a WIC area has at least one lactation supervisor who is an IBCLC (or sometimes a CLC, or equivalent) overseeing the area’s breastfeeding peer counselors. If you are WIC-eligible, and have a lactation challenge that requires clinical judgment beyond the knowledge of a WIC breastfeeding peer counselor who you are seeing, they will often refer you to their IBCLC supervisor.
Breastfeeding Medicine Specialist
(sometimes: FABM or NABBLM-C)
According to the website for the American College of Obstetricians & Gynecologists (ACOG), a “breastfeeding medicine specialist” is still a somewhat generic term for a physician with a high level of training or experience managing breastfeeding and diagnosing lactation disorders, and who has often also met the criteria to become an IBCLC, breastfeeding counselor (CLC, for instance), or lactation educator (CLE, for example). However, the Academy of Breastfeeding Medicine says that training programs specific to breastfeeding and lactation medicine as a medical subspecialty are starting to emerge in several countries. The field is largely supported by resources from the Academy of Breastfeeding Medicine (ABM).
One avenue for becoming recognized as a breastfeeding medicine specialist is to obtain status as a “Fellow” of the Academy of Breastfeeding Medicine, also referred to as becoming an “FABM”. To apply for initial FABM status, applicants must first hold an MD, DO, MBBS (or equivalent) and an active medical license, have maintained at least five consecutive years of membership with the Academy of Breastfeeding Medicine, show ongoing breastfeeding medicine professional experience and proof of breastfeeding medicine continuing education, be active in the ABM community, and provide letters of support on their behalf – written by peers in the ABM community. For more details, see the ABM webpage here.
Another respected avenue for a U.S.-based physician to become a breastfeeding medicine specialist is through obtaining a special credential from the North American Board of Breastfeeding and Lactation Medicine (NABBLM), which grants the physician the right to use the special initials “NABBLM-C” after their name. Receiving this credential is no easy feat. Physician applicants must complete either an NABBLM-accredited fellowship program, or NABBLM’s “comprehensive educational program”, both of which require over 100 hours of direct or indirect educational time – as well as clinical competency in breastfeeding and lactation medication that typically adds up to 1000 hours spanning at least two or more years.
For which scenarios is this best?
Consulting with a breastfeeding medicine specialist is terrific for complex medical situations that may or may not also require some coordination with additional specialists. For example, a mother who keeps getting mastitis that just won’t go away, despite multiple rounds of treatment, and whose baby has a cleft palate. Although technically any ob/gyn or possibly even a primary care physician should be able to help the parent at least initially, for complicated medical scenarios a breastfeeding medicine specialist is often best.
Where can you find one?
To find a breastfeeding medicine specialist in your area, check out this Academy of Breastfeeding Medicine directory: Find a Physician. (If you want the physician to be an IBCLC, too, select “IBCLC” as one of the criteria.)
And if you wish to find out if the “breastfeeding medicine specialist” is credentialed by the North American Board of Breastfeeding & Lactation Medicine, check out their directory here.
Lactation counselors and educators (CLC, CLE, etc.)
Many doulas, WIC staff, nurses and other healthcare professionals seek to expand their knowledge of lactation by pursuing one of the many types of lactation counselor or educator certifications. They do this in order to better care for their perinatal clients, and/or to prepare to teach breastfeeding classes.
Keep in mind, these are not peer-to-peer breastfeeding supporters, so the lactation educator or counselor may or may not have personally breastfed before. And depending on the requirements of the specific designation sought, the training involved may or may not entail more hours than what is required to become a “breastfeeding peer counselor” for a specific organization. (See the section below this one if you’d like to find out what breastfeeding peer counselors are.)
Here are some common lactation counselor and educator designations, along with examples of the training required to initially obtain each designation. (Check with the training organization if you would like to learn about any requirements for recertification after initial certification status.)
Acronym… |
What it stands for… |
Training requirement examples… |
|
CBS |
Certified Breastfeeding Specialist |
|
|
CLC |
Certified Lactation Counselor |
|
|
CLE |
Certified Lactation Educator |
|
|
CLEC |
Certification as a Lactation Educator Counselor |
(This is an older term for a U.C. San Diego Extension certificate program. Their program and requirements have since changed to become a Lactation Education Counselor (LEC) Certificate Program.) |
|
CLS |
Certified Lactation Specialist |
|
|
LEC |
Lactation Education Counselor |
For which scenarios is this best & where can you find one?
While pregnant: You may find a lactation educator (or other designation in the table above) teaching your hospital’s in-person or online breastfeeding basics class. (Note: IBCLCs also often teach these classes.) These classes are often interactive, so you can ask simple questions during class time, or sometimes during class breaks if you want more one-on-one discussion with the instructor.
While an in-patient in the hospital immediate postpartum: If you can’t see an IBCLC for a while to answer a simple breastfeeding question because they are tied up with taking care of other patients, in the interim consider asking if staff with one of the above designations is available to help.
Once home after the delivery: Check with your pediatrician’s office to see if they have either an IBCLC or a staff member with one of the above designations for lactation counselor or educator. For more complex clinical management of lactation, though, ask for a referral to an IBCLC. And if you feel you may need a prescription for a breast-related concern such as vasospasm of the nipple or an inflammatory breast condition, opt instead for a physician or breastfeeding medicine specialist, as lactation educators/counselors and IBCLCs cannot independently prescribe, unless dually trained as licensed healthcare providers with prescriptive authority. For example, unless the person is also a MD, DO, NP – or a PA under the supervision of a physician (and to the extent of the prescribing laws in the state the physician assistant practices).
In addition: You may want to visit ZipMilk, a growing directory for locating breastfeeding counselors and educators (as well as other lactation support options) in the United States. But please note: the site currently only includes listings for some U.S. states.
Breastfeeding peer counselors (PC, LLL Leader, BC)
Breastfeeding peer counselors are parents who have had experience breastfeeding their own children. They have completed training with the organization that they volunteer or work for in order to meet that organization’s established criteria to provide basic breastfeeding peer-to-peer support and information. They are not trained by their organization to act as medical providers. Their services are free to access, although for some organizations such as Breastfeeding USA, with the option to become a member for a fee.
For which scenarios is this best?
Breastfeeding peer counselors may be a good option if you need basic breastfeeding support for common situations, such as how to get started breastfeeding or how to recognize your baby’s cues to nurse. And, if you are looking to connect with other parents who are nursing and pumping, some breastfeeding peer counselors facilitate breastfeeding support groups.
However, for tricky situations requiring more lactation training and clinical judgement, opt instead for an IBCLC. However, if you can’t get in to see an IBCLC for an in-person or telehealth visit for a few days, a breastfeeding peer counselor may be quicker to reach for some interim support and peace of mind. Many are quite skilled.
The criteria to initially become a breastfeeding peer counselor varies from one organization to another. In the U.S., here are some common types of breastfeeding peer counselors. Note: This list is certainly not exhaustive of all types available!
WIC Peer Counselor (PC)
Referred to as either “WIC breastfeeding peer counselors” or simply “WIC peer counselors,” these are parents who have breastfed at least one baby, and who likely received WIC support for their own families in the past or currently. They are typically paid for their work. According to the USDA’s WIC website, the WIC peer counselor role is not clinical in nature, but rather involves information-sharing and support of basic breastfeeding.
WIC breastfeeding peer counselors must complete the breastfeeding curriculum provided by their state (in the state of Washington, for example, that would involve about 20 hours worth of initial training modules, among other activities). They must also shadow experienced staff before serving as breastfeeding peer counselors, and keep up with continuing education opportunities while on the job. When presented with breastfeeding challenges beyond their scope or more clinical in nature, WIC peer counselors refer clients to their supervisor or a WIC Designated Breastfeeding Expert, who is often, but not always, an IBCLC.
Where can you find one?
WIC peer counselor services are free to WIC participants in the U.S. If you are WIC-eligible, contact your local WIC clinic to ask to be connected with a WIC breastfeeding peer counselor. Besides providing some in-office support, many also work remotely and may communicate with parents by phone, email or text – often even outside of clinic hours, which is helpful for working parents!
La Leche League Leader (LLL Leader)
La Leche Leaders are trained volunteers of the nonprofit organization La Leche League International, who provide basic breastfeeding support and encouragement, both one-on-one and in group settings with other parents present (called “La Leche League meetings”). The organization has been around for ages – since 1956!
The steps to become accredited as a La Leche League Leader involve a considerable time investment. Many applicants complete the necessary reading, study, discussion, observation and practice in answering breastfeeding questions within six months to a year – depending on the applicant’s pace.
Applicants must have “breastfed, nursed, chestfed or suckled a child for 12 months or more” with attentive breastfeeding, according to the organization’s website, and be supportive of La Leche League’s philosophy and policies. However, there may be some exceptions to that breastfed 12+ month rule requirement for leadership, according to their website. In addition, those interested in leadership must have attended at least four La Leche League meetings in-person or online, among other leadership requirements.
Where can you find one?
If you’d like to see if a LLL Leader is located near you, check out the U.S.-based locator or international locator. Depending on the volunteer LLL Leader’s availability, they may be willing to help by phone, email, text, or in-person. In addition, many LLL Leaders facilitate La Leche League group meetings where parents in the community gather to discuss breastfeeding. Such meetings are held either online or in-person in a community setting.
Breastfeeding USA - Breastfeeding Counselor (BC)
The nonprofit Breastfeeding USA is a newer organization than La Leche League International, but it has been around for over two decades and is growing in recognition. Their Breastfeeding Counselors are trained volunteers who provide breastfeeding support both one-on-one and/or in group settings, such as these Facebook support groups.
Their Breastfeeding Counselors have personal experience breastfeeding or pumping milk for a baby for at least 6 months and have personal experience initiating solids with a baby, among other personal requirements. The average time to become a Breastfeeding Counselor is about 13 months to complete an orientation, and a basic breastfeeding management and counseling skills education course, but individuals may take up to two years to complete it. The course uses the lactation textbook, Counseling the Nursing Mother: A Lactation Consultant’s Guide.
Note: Once accredited as a Breastfeeding USA Breastfeeding Counselor, within three years there are also continuing education requirements that must be completed.
Where can you find one?
Breastfeeding USA peer counselors are available in some, but not all states. If you’d like to see if one is near you, check out this map search tool. And regardless of where you live in the U.S., their breastfeeding support warmline is available 24/7 to leave a message – with a return call within 24 hours – for “parents needing support and information on infant feeding and related subjects,” says their website.
We hope you find the support you need to aid your lactation journey and are rooting for you every step of the way!
This blog is for informational purposes only based on our basic understanding of lactation support categories and their training requirements as of August 17, 2026. It is not intended to diagnose, treat, or be a substitute for medical advice. Please consult with your healthcare provider for any questions you may have related to your own health, or your baby’s health.
