Documenting Clinical Experience

You may report clinical experience in lactation management from a variety of employments, both paid and volunteer.  In addition, if you have college or university education beyond a Bachelor’s degree, you may count breastfeeding counseling experience you obtained during your graduate level studies.  Consult the relevant sections of the Candidate Information Guide and use the following guidelines to calculate and document your hours.

You may report work experience from any job, whether paid or volunteer, in which you were accredited and/or appropriately supervised to provide breastfeeding assistance to mothers and children.  Only the time that you spent providing breastfeeding assistance may be counted.  For example, if you are a nurse on a postpartum care unit of the hospital, that portion of your daily work that is devoted to providing breastfeeding assistance may be counted, but you may not count the time that you spend providing other types of nursing care.

While there are no time restrictions placed upon the clinical experience requirement, if your experience is not recent—within the past five years—you may find yourself at a disadvantage.  As the profession’s knowledge base continues to expand rapidly and new insights and practices develop, candidate’s without recent clinical experience are more likely to be distracted by out-dated knowledge.  Enhancing your clinical experience by completing one or both of the Supplemental Pathways is a good way to overcome this challenge.

The information which follows will help you evaluate your work experience and determine how much of that experience can be counted toward the clinical experience requirement.  If you want to count your experience as an accredited breastfeeding mother-to-mother support group leader/counselor, please consult the relevant section of the Candidate Information Guide.

Calculating Your Clinical Experience Hours

To calculate the number of hours of clinical experience in lactation, you will need to estimate how many hours each day/week/month were spent in providing breastfeeding counseling.  IBLCE refers to these hours as “BC Hours”—short for breastfeeding consultancy or counseling hours.  The majority of your BC hours must come from experience in providing one-to-one counseling.  Administrative hours or hours spent teaching other subjects cannot be counted. 

The Candidate Information Guide provides a worksheet for recording and calculating your BC Hours or you may click here to download a copy of the worksheet.  On the worksheet, you should list each position in which you provided breastfeeding assistance.  Use the following questions to evaluate each work experience and estimate the number of BC Hours achieved on each job. 

When calculating the number of BC Hours in each position, keep in mind that you are making a reasonable estimation of your clinical experience in lactation management.  Exam candidates are expected to do this self-reporting with honesty.  When applying for the exam, you will be required to provide two professional references from people who have knowledge of and can verify at least some of your clinical experience. 

Click on each question below for additional information and examples.

How long did you work in each position?

On average, how many hours per week/month did you work?

What percentage of your day/week/month was devoted to providing breastfeeding assistance?

What type of breastfeeding counseling did you provide?

How recent is your experience?

How long did you work in each position?

Record your start and end dates for each job and determine how many weeks you worked.  On average, most people take at least 2 weeks leave from their jobs every year, so it is reasonable to count 50 weeks per year. 

For example, if you worked 40 hours per week for two (2) years, the total number of hours worked would be:  40 x 50 x 2 = 4000 

On the other hand, maybe you worked for eight months, in which case you could reasonably estimate four weeks per month for a total of 32 weeks.  Then your grand total would be:  40 x 32 = 1280 hours.

On average, how many hours per week/month did you work?

Full-time work is typically 35 to 40 hours per week; part-time work may be based on a weekly or monthly work schedule.

Here’s an example of part-time work that illustrates how to calculate the number of work hours.
 
Jane worked 12 hours per day, every other weekend, for 3 years.  For simplicity sake, this means she worked about 25 weekends per year for 3 years, or 75 weeks.  Assuming that Jane worked both Saturday and Sunday, she worked 24 hours per weekend for a grand total of:  24 x 75 = 1800 hours.

What percentage of your day/week/month was devoted to providing breastfeeding assistance?

You may count only that portion of your work that involves providing assistance to breastfeeding mothers and children.  Even in a job with a principal focus on lactation, part of your time will be spent on administrative duties that do not involve clinical experience in lactation.  Evaluate each position you have held and determine a reasonable estimate of the average amount of time you devoted to breastfeeding counseling every day, week or month.

For example, as a nurse on a postpartum care unit, you work 3 days a week and part of your job includes assisting breastfeeding mothers and infants.  In addition, you work part-time at the local health department where you teach breastfeeding classes and provide individualized breastfeeding instruction during prenatal counseling sessions.

As you think about an average day or week, how do you determine the percentage of your time that can be counted toward the BC Hours requirement?  First of all, it will help to consider your three roles—postpartum care nurse, breastfeeding class instructor and prenatal breastfeeding counselor.

Postpartum Care Nurse:  Let’s say that you spend about 4 hours a day helping breastfeeding mothers and babies.  If you work a 10 hour shift every day, then 40% of your time can be counted toward the BC Hours requirement.

Breastfeeding Class Instructor:  You may count all the hours spent teaching these classes but keep in mind that no more than 25% of your BC Hours may come from teaching group breastfeeding classes.

Prenatal Breastfeeding Counselor:  Let’s say that you work 8 hour per day at the clinic and you estimate that about 25% of your time is devoted to breastfeeding counseling.  Then you could count 2 BC Hours for every day you worked in this position.

What type of breastfeeding counseling did you provide?

If you look at the worksheet, you will notice that most of your BC Hours must come from providing in-person, one-to-one breastfeeding counseling.  There are limits on receiving credit for time spent providing telephone, email or group classroom instruction in breastfeeding.  When completing your exam application, documentation of BC hours must be as follows:

» One-to-one, in-person counseling:  at least 50%, and up to 100%, of the total required BC hours

» Telephone or email counseling:  no more than 25% of the total required BC hours

» Group Breastfeeding Instruction:  no more than 25% of the total required BC hours—childbirth education or other subject matter may not be counted. 

Here’s an example that may assist you in evaluating your work experience: 

Beth is a registered dietician, with a Master’s of Science in nutrition, an accredited La Leche League Leader and a certified childbirth educator. 

She has worked full-time in her community hospital for two years.  As part of her duties, she provides one-to-one breastfeeding counseling to mothers of newborn and ill infants; teaches pre-natal and postpartum breastfeeding classes; and works closely with the staff of the neonatal intensive care unit to provide breastfeeding assistance to families of pre-term infants.  In addition to her regular duties as a registered dietician, Beth periodically staffs a telephone help line for breastfeeding mothers and teaches childbirth education classes.    

Prior to her current job, Beth served two years as a La Leche League Leader and then returned to school for her Master’s degree.  Her graduate studies included an internship in the milk bank at the university hospital. 

How can Beth reasonably estimate the number of BC Hours to report?

Let’s look at Beth’s experience by breaking it down into the various types of breastfeeding counseling she provided. It will help to record each job function as a separate position even though she worked for the same employer for two years.

One-to-one breastfeeding counseling as a registered dietician:  Beth works 40 hours per week and estimates that about 15% of her time—6 hours per week—is spent working with breastfeeding families on the postpartum and neonatal intensive care units.  Counting 50 weeks per year, her total BC Hours from this position would be:
6 x 50 x 2 = 600 one-to-one BC Hours

Breastfeeding classes:  Three times a week, Beth teaches a one-hour breastfeeding class for in-patient mothers: 3 x 50 x 2 = 300 group BC Hours

Four times a year, she teaches a 3-hour breastfeeding class for expectant parents: 4 x 3 x 2 = 24 group BC Hours

Help Line:  Beth works on the help line 6 hours every month: 6 x 12 x 2 = 144 telephone counseling hours

Childbirth Education Classes:  Beth has a separate contract with her hospital to provide childbirth education through the community education department.  For the childbirth education classes, she can count only that portion of the class time that is devoted to breastfeeding.

She has taught one series of classes every month for the past 18 months.  Her class series includes about 1.5 hours of breastfeeding instruction.  To calculate the BC Hours from her childbirth educator role: 1.5 x 18 = 27 group BC Hours

La Leche League Leader:  Beth can receive 500 one-to-one BC Hours credit for every year of service.  She should request a letter from La Leche League International verifying her two years of service to document:
1000 one-to-on BC Hours

Master’s Degree Milk Bank Internship: Beth counseled parents of sick and pre-term infants about the value of banked human milk and assisted the milk bank director in conducting the effectiveness of various methods of milk pasteurization during this six-month internship.  She can claim credit for the time she spent providing breastfeeding counseling, but cannot claim BC Hours credit for the research portion of her internship even though it was a valuable experience. 

As a rule, she worked 2 days a week with breastfeeding families, devoting the rest of her time to the research work.  She estimates that this amounts to about 10 hours per week for the 25 weeks of the internship:
10 x 25 = 250 one-to-one BC Hours

To summarize, Beth can report the following:

» One-to-one BC Hours:  600 + 1000 + 250 = 1850 BC Hours

» Group BC Hours:  300 + 24 + 27 = 351 BC Hours

» Telephone BC Hours:  144 BC Hours

Grand Total BC Hours:  1850 + 351 + 144 = 2345 BC Hours

Congratulations!  Beth is very close to meeting the clinical experience requirement of 2500 BC Hours for her pathway—Pathway A.  With another 6 months employment in her current job, she will have achieved the clinical experience in lactation necessary to be eligible for exam application. 

How recent is your experience?

Recent clinical experience in lactation is important.  The IBCLC certification exam is based on current evidence-based knowledge and clinical practice.  If you are not currently providing breastfeeding counseling or if it has been a number of years since your last clinical experience, it would be to your advantage to seek out clinical experience opportunities and/or complete one or both of the Supplemental Pathways which provide ways to update your clinical knowledge.

For more information, consult the Candidate Information Guide.