iblce regional office in europe candidate information guide

IBLCE Regional Office in Europe

Candidate Information Guide

IBCLC: The International Standard in Lactation Consultant Certification

IBLCE Exam IBLCE Exam IBLCE Exam IBLCE Exam ---- Candidate Information Guide, version 2.9EU Candidate Information Guide, version 2.9EU Candidate Information Guide, version 2.9EU Candidate Information Guide, version 2.9EU

INTRODUCTORY INFORMATIONINTRODUCTORY INFORMATIONINTRODUCTORY INFORMATIONINTRODUCTORY INFORMATION IBLCE Contact Details and Key Dates 2 About the IBLCE and IBCLCs 3

THE EXPERIENCE, KNOWLEDGE & SKILLS REQUIREDTHE EXPERIENCE, KNOWLEDGE & SKILLS REQUIREDTHE EXPERIENCE, KNOWLEDGE & SKILLS REQUIREDTHE EXPERIENCE, KNOWLEDGE & SKILLS REQUIRED Eligibility Requirements 4-5 Breastfeeding Counselling Experience 6 Lactation Education 6 IBLCE Exam Blueprint 7

Code of Ethics for IBCLCs 8 Clinical Competencies Checklist 9-11 ILCA Standards of Practice (reprint) 12-13 IBLCE Competency Statements 13 Suggested Reading List 14-15 Attending Mother Support Group Meetings 15-16 APPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATE Sending your Application 16

MILCC Financial Assistance 16 1. Identification Details 17 2. Address and Contact Details 17 3. Exam Site City 17 4. Exam Fees 17

5. Eligibility Pathways 17 6. Accompanying Materials 18 7. Breastfeeding Counselling Hours 18-19 8. Professional Lactation Education Hours 19

9. Principal Experience Setting 20 10. Workplace 20 11. Biographical Details 20 12. Individual Considerations: Disabilities; 20 Pregnancy; Translations; Bilingual Dictionary 20 13. Signed Statement 20 Fees and Deadlines 21 Incomplete Applications 21 Withdrawal Deadlines 22 Is your employer paying? 22 Exam Fees and Professional Ethics 22

EXAM INFORMATION & PREPARATIONEXAM INFORMATION & PREPARATIONEXAM INFORMATION & PREPARATIONEXAM INFORMATION & PREPARATION Study Strategies 23 Lactation and Exam Preparation Courses 23 Checklist of Suggested Activities 24 Exam Content 25 Exam Question Referencing 25 IBLCE Exam Committee 25 Exam Confidentiality 25 Exam Questions 26 How the Exam is Scored 26 Exam Critique Form 26 Sample Exam Questions 27-29 Exam Strategies 29

AFTER THE EXAMAFTER THE EXAMAFTER THE EXAMAFTER THE EXAM Notification of Results; Appeals Policy 30 Maintenance of Certification 30 Joining Professional Associations 30 SUMMARY OF IBLCE EXAM ADMINISTRATION PROCEDURES 31 IBLCE Discipline Procedures (Preamble) 32

www.iblce-europe.org

Please note: as well as this Candidate Information Guide and Application Form, you also need the Application Supplement Please note: as well as this Candidate Information Guide and Application Form, you also need the Application Supplement Please note: as well as this Candidate Information Guide and Application Form, you also need the Application Supplement Please note: as well as this Candidate Information Guide and Application Form, you also need the Application Supplement specific to the exam year and your country, which will tell you:specific to the exam year and your country, which will tell you:specific to the exam year and your country, which will tell you:specific to the exam year and your country, which will tell you:

• specific current information about exam sites, fees, and the address to which your application should be sentspecific current information about exam sites, fees, and the address to which your application should be sentspecific current information about exam sites, fees, and the address to which your application should be sentspecific current information about exam sites, fees, and the address to which your application should be sent

• any other upany other upany other upany other up----totototo----date information you need to knowdate information you need to knowdate information you need to knowdate information you need to know

IBLCE OFFICE IN EUROPEIBLCE OFFICE IN EUROPEIBLCE OFFICE IN EUROPEIBLCE OFFICE IN EUROPE

Steinfeldgasse 11Steinfeldgasse 11Steinfeldgasse 11Steinfeldgasse 11 2511 Pfaffstaetten2511 Pfaffstaetten2511 Pfaffstaetten2511 Pfaffstaetten AUSTRIAAUSTRIAAUSTRIAAUSTRIA

PHONE +43 2252 20 65 95 FAX +43 2252 20 64 87

officeofficeofficeoffice@iblce@iblce@[email protected] www.iblcewww.iblcewww.iblcewww.iblce----europe.orgeurope.orgeurope.orgeurope.org

ILSE BICHLER, IBCLCILSE BICHLER, IBCLCILSE BICHLER, IBCLCILSE BICHLER, IBCLC REGIONAL DIRECTOR

FOR FURTHER COPIES OF THIS GUIDE, FOR THE APPLICATION SUPPLEMENT SPECIFIC TO THE EXAM YEAR AND YOUR FOR FURTHER COPIES OF THIS GUIDE, FOR THE APPLICATION SUPPLEMENT SPECIFIC TO THE EXAM YEAR AND YOUR FOR FURTHER COPIES OF THIS GUIDE, FOR THE APPLICATION SUPPLEMENT SPECIFIC TO THE EXAM YEAR AND YOUR FOR FURTHER COPIES OF THIS GUIDE, FOR THE APPLICATION SUPPLEMENT SPECIFIC TO THE EXAM YEAR AND YOUR COUNTRY, OR FOR FURTHER INFORMATION ABOUT ELIGIBILITY, PLEASE CONTACT IBLCE OFFICE IN AUSTRIA OR YOUR COUNTRY, OR FOR FURTHER INFORMATION ABOUT ELIGIBILITY, PLEASE CONTACT IBLCE OFFICE IN AUSTRIA OR YOUR COUNTRY, OR FOR FURTHER INFORMATION ABOUT ELIGIBILITY, PLEASE CONTACT IBLCE OFFICE IN AUSTRIA OR YOUR COUNTRY, OR FOR FURTHER INFORMATION ABOUT ELIGIBILITY, PLEASE CONTACT IBLCE OFFICE IN AUSTRIA OR YOUR LOCAL IBLCE COORDINATOR. APPLICATIONS MUST BE SENT TO THE IBLCE OFFICE OR TO THE ADDRESS STATED ON LOCAL IBLCE COORDINATOR. APPLICATIONS MUST BE SENT TO THE IBLCE OFFICE OR TO THE ADDRESS STATED ON LOCAL IBLCE COORDINATOR. APPLICATIONS MUST BE SENT TO THE IBLCE OFFICE OR TO THE ADDRESS STATED ON LOCAL IBLCE COORDINATOR. APPLICATIONS MUST BE SENT TO THE IBLCE OFFICE OR TO THE ADDRESS STATED ON

YOUR APPLICATION SUPPLEMENT.YOUR APPLICATION SUPPLEMENT.YOUR APPLICATION SUPPLEMENT.YOUR APPLICATION SUPPLEMENT.

KEY DATESKEY DATESKEY DATESKEY DATES

31 January Deadline for mailing MILCC Scholarship applications

28 February Early deadline for mailing complete exam applications with fees

31 March Standard deadline for mailing complete exam applications with fees

30 April Late deadline: final day for mailing complete exam applications with fees

by end May All exam applications will have been reviewed

20 June Initial deadline for mailing exam withdrawal refund requests

early July Candidates receive exam admission tickets and site information

15 July Final deadline for mailing exam withdrawal refund requests

last Monday in July EXAM DATE (27 July 2009; 26 July 2010 etc)

mid October Exam results, score reports, etc., are mailed (in June we will advise you of the exact date); coded pass/fail lists placed on the website on the same day

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ELSEWHERE AROUND THE WORLDELSEWHERE AROUND THE WORLDELSEWHERE AROUND THE WORLDELSEWHERE AROUND THE WORLD

If you are a resident of another region of the world, please ask us how to contact the relevant IBLCE Office or Coordinator. If, because of your travel plans, you might need to do the exam in a country other than your country of residence, please contact us to discuss possible arrangements. Each year, there are exam sites in many countries in the Americas, the Pacific, Asia, Africa, the Middle East and Europe.

IBLCE in EuropeIBLCE in EuropeIBLCE in EuropeIBLCE in Europe SERVING EUROPE, THE MIDDLE EAST AND NORTH AFRICA

The IBLCE office in Austria manages all IBLCE operations in Europe, the Middle East and North Africa, working in close consultation with the IBLCE International Headquarters in the USA and the IBLCE Office in Australia.

International Board of Lactation Consultant Examiners, incorporated in Virginia USA, members’ liability limited

www.iblce-europe.org IBLCE Exam - Candidate Information Guide, version 2.9EU

IBLCE CONTACT DETAILS and KEY DATESIBLCE CONTACT DETAILS and KEY DATESIBLCE CONTACT DETAILS and KEY DATESIBLCE CONTACT DETAILS and KEY DATES

ABOUT THE IBLCE and IBCLCsABOUT THE IBLCE and IBCLCsABOUT THE IBLCE and IBCLCsABOUT THE IBLCE and IBCLCs

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WHAT IS THE IBLCE?WHAT IS THE IBLCE?WHAT IS THE IBLCE?WHAT IS THE IBLCE?

IBLCE stands for International Board of Lactation Consultant Examiners, the organisation that administers the world’s first truly international certification program.

The annual exam to credential IBCLCs has been offered in eighteen languages and at numerous sites all over the world, building bridges across language and geographical borders.

The IBLCE is a non-profit organisation with a policy-making Board of Directors with broad professional, organisational and geographic representation. IBLCE has its headquarters in the USA, regional offices in Australia and Austria, and honorary local coordinators in countries where there are groups of IBCLCs and regular exam sites.

IBLCE’s primary purpose is to certify individuals who provide quality care to babies and mothers worldwide. There are around 20.000 currently certified IBCLCs worldwide, in 68 countries; IBLCE provides verification of certified individuals.

IBLCE’s certification program is accredited by the US National Commission for Certifying Agencies (NCCA), which sets stringent guidelines for health certifying organisations.

IBLCE Exam - Candidate Information Guide, version 2.9EU www.iblce-europe.org

Certification as an International Board Certified Lactation Consultant (IBCLC) is the credential that brings together those who share a common knowledge base in human lactation.

The IBCLC credential is the gold standard in lactation consultant certification. It is the only professional credential for lactation consultants recognised by the International Lactation Consultant Association (ILCA), and throughout the world by national professional associations for lactation consultants. The designation IBCLC identifies members of the health care team who can provide substantive breastfeeding assistance and skilled technical management of breastfeeding problems.

Experience has shown that lactation consultants contribute to improved breastfeeding practices and success rates and that that they have the ideal qualifications to help their hospitals become Baby Friendly. By supporting and educating their colleagues, the overall standard of breastfeeding care is improved amongst all staff.

Whether you are a health professional or an administrator, you will appreciate that optimal practice and quality of care are as important in lactation management as they are in other health care fields. The IBLCE examination is an objective and independent measure of knowledge, skill, and experience. Board certification is quality assurance.

WHAT IS AN IBCLC?WHAT IS AN IBCLC?WHAT IS AN IBCLC?WHAT IS AN IBCLC?

IBCLCs—I nternational Board Certified Lactation Consultants are health care providers who, by meeting eligibility requirements and by passing an independent examination, are certified to possess the necessary skills, knowledge and attitudes to provide quality breastfeeding assistance to babies and mothers.

IBCLCs are valuable members of the health care team who find recognition and career opportunities that may not be available to others who have studied lactation, but are not board certified. There are now many designated positions for IBCLCs. They work in hospitals, maternal and child health, the community and private practice.

As more health care facilities make a commitment to improving their breastfeeding practices and success rates, education of staff has been identified as a crucial step in this procedure.

Health facilities that encourage and support their staff to become board certified find that the exam provides them with a strong incentive to extend their study and skills. Some hospitals now require all clinical staff who help mothers with breastfeeding to work towards IBCLC certification.

INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERSINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERSINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERSINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS

The IBLCE mission is to develop the internationally recognized certification standard and

award credentials to individuals who demonstrate competence in providing breastfeeding

assistance to mothers and children worldwide.

ELIGIBILITY REQUIREMENTSELIGIBILITY REQUIREMENTSELIGIBILITY REQUIREMENTSELIGIBILITY REQUIREMENTS

To be eligible to be a candidate for the exam, you must: • be an appropriately qualified health professional (see below) OR have completed background education in certain disciplines (see below); • have completed professional continuing education in lactation (see below); and

• have had extensive practical experience providing breastfeeding counselling (see below).

To apply to be a candidate, you must: lodge a complete application, accompanied by all required supporting documentation including professional references, and pay the appropriate fee, by one of the specified deadlines (see page 5).

How much experience providing breastfeeding counselling must I have?

The amount of post-secondary education you have com-pleted, in any field, determines how many hours of experi-ence providing breastfeeding counselling (BC hours) you are required to have completed before you are eligible to be a candidate for the IBLCE exam. IBLCE has collected data over many years showing that candidates with more education, and in some cases candidates with specific backgrounds, require less experience (fewer BC hours) to pass the exam and be ready to practise competently as an IBCLC. This information has enabled IBLCE to group applicants with certain backgrounds together in pathways, and determine how much prior experience (BC hours) is required for each pathway. Your pathway is just one com-ponent of exam eligibility, and relates only to BC hours.

You should determine which of the six standard path-ways A, B, C, D , E or F is applicable to you. You mu st also read the information about BC hours on p. 6. See also p. 18 about how to calculate your hou rs. Pathway A – 2500 BC hours required. This pathway is available if you have a bachelor or higher degree (in any field), OR you are a registered nurse, a registered mater-nal and child health nurse or a registered midwife. Pathway B – 4000 BC hours required. This pathway is available if your education is lower as described in Path-way A. Pathway C – 900 precepted clinical hours in human lactation required. This pathway is available only if you have a bachelor or higher degree with a concentration in human lactation from an accredited institution. Pathway D – 900 BC hours required. This pathway is available only if you are a registered medical practitioner (doctor). Pathway E – Exceptions — 6000 BC hours required. Please contact the IBLCE Office in Europe. Pathway F – a pre-approved program covering all the Clinical Competencies (pages 9-11) over at least 500 directly supervised clinical hours. Stringent condi-tions apply. You must contact IBLCE for further information.

What qualification or background in health disciplines must I have?

You must either provide evidence that you have a degree or registration to practise clinically in one of the health pro-fessions or you must document completion of “background” education in each of the following:

• anatomy and physiology • Sociology and cultural diversity • counselling and communication skills • child development • nutrition • medical terminology

“Background” is defined as a minimum of four hours of edu-cation in each of the six disciplines above, and is further defined as basic or introductory in content and not as ap-plied to lactation. It should be taught by someone who is qualified to teach that subject at the lowest post-secondary level, at least.

This requirement must be completed before you send in your exam application. For maximum benefit, you are strongly encouraged to complete it before starting your lac-tation education; there is no time limit for the period be-tween when you do these courses and when you do the exam. Please contact the IBLCE Office in Europe for further information specific to your country.

What professional education in lactation must I undertake?

You must have completed a minimum of 45 hours of professional education in lactation reflecting the exam blueprint, within the three years immediately prior to sitting for the exam. However, if you will be doing the exam in a language other than English, you must have completed a minimum of 80 hours of professional education in lactation. (This is be-cause most textbooks and journals are in English; candidates who are not able to study these materials have been shown to need significantly more pre-exam education hours to achieve a similar standard of exam performance.) IBLCE further recommends that all candidates select and participate in a comprehensive education program which addresses all areas of the IBLCE Blueprint of knowledge and skills for IBCLCs.

Further, detailed information about the education requirement is on page 6. See also pages 19 and 23. Private study – many hours over a one to three year period – is also a major component of exam preparation for all candidates.

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ELIGIBILITY REQUIREMENTS (continued)ELIGIBILITY REQUIREMENTS (continued)ELIGIBILITY REQUIREMENTS (continued)ELIGIBILITY REQUIREMENTS (continued)

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I’d like to be a lactation consultant . . . IBLCE frequently receives enquiries from people who have met an inspiring lactation consultant, often in relation to their own breastfeeding experience, and now they are interested in becoming an IBCLC themselves. If this describes your situation, you should read the following information carefully and you should appreciate that your dream will be challenging to achieve.

Passing IBLCE’s international certification exam is the only recognised pathway to becoming a lactation consultant. To be accepted as a candidate, an applicant must first meet eligibility pre-requisites. These include participation in lactation education as well as achieving the required clinical competencies through extensive prior experience providing breastfeeding counselling in a setting which has supervision appropriate for their training in this field.

Most candidates acquire this experience working as health professionals in a hospital or community setting. Others have served for many years as accredited mother support counsellors, working within a supervised structure such as LLL or ABA. Personal breastfeeding experience, as wonderful as it is, does not meet this requirement; nor does unsupervised practice counselling mothers outside the healthcare system, such as a doula or in a similar private capacity.

IBCLCs are the specialists that mothers (and other health professionals) turn to, usually when standard measures have not solved the problem. The skills and knowledge required to pass the exam cannot be solely learnt from books, which is why clinical experience is necessary.

For pre-exam BC hours, the IBLCE cannot recognise unsupervised practice by someone who is not otherwise registered or licensed to practise independently in this field without supervision. If IBLCE were to do so, it could encourage practice that is not necessarily in the best interests of mothers and babies. The IBLCE is also not in a position to link would-be candidates with supervisors, mentors or settings where they could get supervised practice.

The candidate eligibility requirements are based on data, collected and progressively updated over the past 20 years, that indicate the minimum requirements for a candidate to have a reasonable likelihood of passing the exam and being competent to enter the profession.

Recertification by exam If you are an IBCLC whose certification is still current and who is recertifying by exam, you are not required to provide references, information on BC hours or CERPS, or documentation of qualifications. The fee is the same whether you are recertifying by exam or by CERPs. Please read the Recertification Application Supplement. As a recertifying IBCLC, you must use the buff coloured Application to Recertify form, rather than the standard exam application form.

Pathway L for lapsed IBCLCs If you were previously an IBCLC and your certification lapsed more than one year ago, you must meet all requirements and pay the normal fees. If your certification lapsed less than one year ago, you are eligible for the “Repeat” fee discount rate and you are exempt from having to provide information on BC hours, a qualification certificate, references or lactation education hours. It is your choice how you prepare for the exam and whether you participate in education programs. Please note that your certification period will not be continuous, as you are not eligible to “recertify”.

Breastfeeding counselling experience (continued from page 4)

Supplementary Pathways If your standard pathway requires 2500 BC hours or more (pathways A, B or E), you may reduce the required number of BC hours by meeting the requirements of one or both of the following supplementary pathways G and H. The maximum reduction is a total of 1000 BC hours if both pathways are used. Pathways G and H should be used only if you would not otherwise have enough BC hours for the standard pathway applicable to you. Pathway G. You may reduce by 500 the number of BC hours required for your standard pathway if you have completed 150 hours of comprehensive education in lactation, i.e. 105 more than the 45 hours otherwise required (or 110 more if 80 hours is required). The education must address the breadth of the exam blueprint; it must be within the three-year period immediately prior to sitting for the exam. An ILEAC accredited program is encouraged (see p.23). Pathway H. You may reduce by up to 500 the number of BC hours required for your standard pathway if you have completed at least 10 and up to 100 hours of planned, directly supervised clinical practice in a setting other than your usual experience setting and with an IBCLC who has been certified for at least five full years and has been recertified at least once. The reduction is at a ratio of 1:5, to a maximum reduction of 500 BC hours: e.g. 10 supervised hours equals a reduction of 50 BC hours. This pathway does not include generalised supervised experience and the plan must be approved in advance by IBLCE. Further information is available from IBLCE.


What about documentation, references, fees and deadlines?

Please read the detailed instructions on pages 17-20 about how to complete the application form, and what documents to enclose, including professional references. Full information about fees and deadlines is on pages 21-22. For the fees payable, you must also refer to the Application Supplement specific to the exam year and your country. Applications must be postmarked by:

Early exam fee deadline 28 February

Standard exam fee deadline 31 March

Late exam fee deadline 30 April

EXPERIENCE AND EDUCATIONEXPERIENCE AND EDUCATIONEXPERIENCE AND EDUCATIONEXPERIENCE AND EDUCATION

BC EXPERIENCE BC EXPERIENCE BC EXPERIENCE BC EXPERIENCE Breastfeeding counselling (BC) hours are defined as the time you spend helping mothers and babies with breast-feeding, usually in one-to-one consultations in person or on the phone. Group consultations may also be included. Your BC hours can be accumulated over any period of years, but it is important that you also have recent experience.

You are to provide self-documentation of your BC hours of experience, as follows: • at least 50%, and up to 100%, of your total required BC

hours must be in person through one-to-one consultations and follow-up, usually in a hospital, clinic, community setting; or through accredited volunteer counselling.

• you may also include telephone/email consultations, but only up to 25% of your total required BC hours

• you may also include consumer education or group consultations such as breastfeeding classes or the breastfeeding component of antenatal groups, childbirth education classes, new parent groups, etc, but only up to 25% of your total required BC hours.

BC hours may only be included for periods when you were working in an accredited capacity and/or under appropriate supervision, as IBLCE will recognise only experience hours that protect the best interests of mothers and babies. Accredited means you were appropriately trained and qualified for the type of work you were doing and the setting in which you were practising. Supervised means that you were practising within an appropriately monitored structure or setting where, if your advice or practice had been inappropriate or outside your scope of practice, it would easily have come to the attention of your “supervisor” and/or the client’s primary health care provider. The level of supervision should be appropriate for your training to practise in this field.

You may include BC hours from counselling mothers in a volunteer support group only while you were formally accredited as a counsellor/leader and practising under appropriate supervision. If you can show that you have been an active, accredited mother support counsellor, you can claim 10 BC hours per week or 500 BC hours per year without further documentation. If you believe you have done more hours than this, you must provide documentation for those periods.

Not BC hours. When calculating your BC hours, do not include: administrative or planning time; supervision time; commuting time; personal breastfeeding experience; lay counselling to friends or family; caring for babies in a normal newborn nursery; or time spent on general support or promotional activities which help more mothers to breastfeed.

You may go back as many years as necessary to retrieve your BC hours. However, do not include any of your student practice hours, e.g. your midwifery training, as these have already been allowed for when determining the eligibility pathways related to education. Exception: if you already had some BC hours as a midwife, and you then did additional training such as in maternal and child health, you can include the BC hours during that further training.

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LACTATION EDUCATIONLACTATION EDUCATIONLACTATION EDUCATIONLACTATION EDUCATION Professional education in lactation is an important part of your preparation and eligibility for the exam. It needs to be recent (with the three year period immediately prior to sitting for the exam), relevant (to the exam blueprint), and reliable (based on current information and relevant research).

Certification boards are required to be independent of pre-exam education. IBLCE does not itself conduct education, nor does it endorse or recommend any particular program. IBLCE CERPs allocation does not indicate the quality or suitability of a pre-exam program.

Your total education should reflect all disciplines and chronological periods on the exam blueprint (page 7). Ideally, candidates participate in a comprehensive lactation education program, especially one accredited by ILEAC (see page 23), covering all or most of the blueprint. Typically such a program will be much longer than the minimum of

45 hours because it is impossible to cover the entire exam blueprint, at the depth required, in the minimum time.

If your education program has not covered the blueprint, you will need to make up the deficits by specifically focussing your private study. The Suggested Reading List (pages 14-15) will help you identify relevant publications. You should be able to explain, if required, how your exam preparation has addressed all the areas on the exam blueprint.

Please note that clinical work and classes for mothers are not professional education for you, and do not count towards your lactation education hours.

Definition of lactation education Lactation education hours can be earned from professional education that is Lactation-specific, meaning that the topic:

• provides information about breastfeeding and/or human lactation; or

• addresses skills used by lactation consultants in their work with breastfeeding mothers and babies; and

• is based on scientific principles, and on current information and relevant research in the field of lactation

CERPs Certificates CERPs are Continuing Education Recognition Points allocated by IBLCE to programs that meet the learning requirements of IBCLCs after they have passed the exam. They are not an endorsement of a program by IBLCE.

Education hours for exam applicants do not have to be approved for CERPs. However, some of your attendance certificates may show that “x L (or E or R) CERPs were allocated by IBLCE: Approval No. Cxxxxx”. One CERP is equivalent to one hour of education time.

L CERPs are for Lactation topics; E CERPs are for Ethics topics; R CERPs are for Related topics.

Please note that some areas on the blueprint are not lactation specific; even though sessions on these areas are relevant to exam preparation, they would be classified as R CERPs or E CERPs.

For the purposes of pre-exam education, you may count only lactation topics (L CERPs) towards your required hours of pre-exam education. Please note that clinical work and classes for mothers are not professional education for you, and do not count towards your lactation education hours.


IBLCE EXAM BLUEPRINTIBLCE EXAM BLUEPRINTIBLCE EXAM BLUEPRINTIBLCE EXAM BLUEPRINT

All exam questions have both discipline and chronological parameters. This blueprint gives you an indication of the breadth of information you need to know for the International Board Certified Lactation Consultant (IBCLC) certification exam.

The possible number of questions on the exam that will be related to each topic appears in parentheses as a range. The examples given under each discipline are for guidance only; they are not inclusive of all aspects covered under each learning discipline. The Disciplines are expanded into chapters in ILCA’s Core Curriculum for Lactation Consultant Practice, www.ilca.org

DISCIPLINESDISCIPLINESDISCIPLINESDISCIPLINES

A. Maternal and infant ANATOMY (19-33 questions) e.g. breast and nipple structure and development; blood, lymph, innervation, mammary tissue; infant oral anatomy and reflexes; assessment; anatomical variations

B. Maternal and infant normal PHYSIOLOGY and ENDOCRINOLOGY (19-33 questions) e.g. hormones; lactogenesis; endocrine/autocrine control of milk supply; induced lactation; fertility; infant hepatic, pancreatic and renal function; metabolism; effect of complementary feeds; digestion and GI tract; voiding and stooling patterns

C. Maternal and infant normal NUTRITION and BIOCHEMISTRY (10-16 questions) e.g. breast milk synthesis and composition; milk components, function and effect on baby; comparison with other products/milks; feeding patterns and intake over time; variations of maternal diet; ritual and traditional foods; introduction of solids

D. Maternal and infant IMMUNOLOGY and INFECTIOUS DISEASE (10-16 questions) e.g. antibodies and other immune factors; cross-infection; bacteria and viruses in milk; allergies and food sensitivity; long term protective factors

E. Maternal and infant PATHOLOGY (19-33 questions) e.g. acute/chronic abnormalities and diseases, both local and systemic; breast and nipple problems and pathology; endocrine pathology; mother/child physical and neurological disabilities; congenital abnormalities; oral pathology; neurological immaturity; failure to thrive; hyperbilirubinemia and hypoglycaemia

F. Maternal and infant PHARMACOLOGY and TOXICOLOGY (10-16 questions) e.g. environmental contaminants; maternal use of medication, OTC preparations, social or recreational drugs and their effect on the infant, on milk composition, and on lactation; galactagogues/suppressants; effects of medications used in labour; contraceptives; complementary therapies

G. PSYCHOLOGY, SOCIOLOGY, and ANTHROPOLOGY (14-20 questions) e.g. counselling and adult education skills; grief, postnatal depression and psychosis; effect of socio-economic, lifestyle, and employment issues on breastfeeding; maternal-infant relationship; maternal role adaptation; parenting skills; sleep patterns; cultural beliefs and practices; family; support systems; domestic violence; mothers with special needs, e.g. adolescents, migrants

H. GROWTH PARAMETERS and DEVELOPMENTAL MILESTONES (10-16 questions.) e.g. foetal and preterm growth; breastfed and artificially fed growth patterns; recognition of normal and delayed physical, psychological and cognitive developmental markers; breastfeeding behaviours to 12 months and beyond; weaning

I. INTERPRETATION OF RESEARCH (4-8 questions) skills required to critically appraise and interpret research literature, lactation consultant educational material, and consumer literature; understanding terminology used in research and basic statistics; reading tables and graphs; surveys and data collection

J. ETHICAL and LEGAL ISSUES (4-8 questions) e.g. IBLCE Code of Ethics; ILCA Standards of Practice; practising within scope of practice; referrals and interdisciplinary relationships; confidentiality; medical-legal responsibilities; charting and report writing skills; record keeping; informed consent; battery; maternal/infant neglect and abuse; conflict of interest; ethics of equipment rental and sales

K. BREASTFEEDING EQUIPMENT and TECHNOLOGY (6-12 questions) e.g. identification of breastfeeding devices and equipment, their appropriate use, and technical expertise to use them properly; handling and storing human milk, including human milk banking protocols

L. TECHNIQUES (19-33 questions) e.g. breastfeeding techniques, including positioning, attachment and assessing milk transfer; breastfeeding management; normal feeding patterns; milk expression

M. PUBLIC HEALTH (4-8 questions) e.g. breastfeeding promotion and community education; working with groups with low breast-feeding rates; creating and implementing clinical protocols; international tools and documents; WHO Code; BFHI implementation; prevalence, surveys and data collection for research purposes

CHRONOLOGICAL PERIODSCHRONOLOGICAL PERIODSCHRONOLOGICAL PERIODSCHRONOLOGICAL PERIODS

1. Preconception (2-7 questions) 2. Prenatal (9-17 questions) 3. Labour/birth (perinatal) (9-17 questions) 4. Prematurity (9-17 questions) 5. 0 - 2 days (19-31 questions) 6. 3 - 14 days (19-31 questions) 7. 15 - 28 days (19-31 questions) 8. 1 - 3 months (9-17 questions) 9. 4 - 6 months (9-17 questions) 10. 7 - 12 months (2-7 questions) 11. Beyond 12 months (2-7 questions) 12. General principles (40-53 questions)

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CODE OF ETHICS FOR IBCLCsCODE OF ETHICS FOR IBCLCsCODE OF ETHICS FOR IBCLCsCODE OF ETHICS FOR IBCLCs

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BACKGROUND INFORMATION

The International Board of Lactation Consultant Examiners (IBLCE) is a non-profit corporation established to develop and administer a voluntary certification program for lactation consultants. Founded in 1985, it has administered annual examinations, in several languages, at numerous sites around the world.

Over the past twenty years many scientific studies have validated the benefits of breastfeeding. At the same time, mother support organisations were developing a significant body of breastfeeding management skills. From this knowledge, in the 1980s a new allied health care provider began to emerge. However, there were no competency standards for this new role.

As an international leader in providing guidelines for breastfeeding and mother-to-mother support, La Leche League International (LLLI) made a commitment to facilitate the development of standards for this new field. A panel of sixty experts representing a variety of health professions, backgrounds, and geographic locations were involved in developing the standards out of which the competencies and scope of practice for lactation consultants was developed.

The constitutional meeting of the International Board of Lactation Consultant Examiners (IBLCE) was held in March 1985. Canada, El Salvador and the Nursing Mothers' Association of Australia (NMAA) had sent representatives from the early planning stages and attention was given to the international need for mothers and babies to be protected by competency standards.

The US National Commission for Certifying Agencies (NCCA) is responsible for developing stringent guidelines for health certifying organisations, and to accredit those which meet the criteria. The International Board of Lactation Consultant Examiners (IBLCE) has utilised the NCCA's guidelines since its inception. At its initial accreditation it was one of only two organisations accredited by the Commission on first application.

NCCA guidelines require that certification organisations be administratively, financially, and corporately independent, and thus not subject to outside control. IBLCE is a completely independent organisation, quite separate from ILCA, LLLI, NMAA, etc.

The IBLCE was initially accredited by the NCCA in 1988, after having conducted the three examination administrations required as one criterion for eligibility. In 1993, the IBLCE was reaccredited for an additional five year period. As part of this process, the IBLCE periodically conducts a Role Delineation Study. All IBCLCs worldwide are surveyed for details of their practice and the knowledge base they require.

�The exam blueprint is based on this Study.

Preamble It is in the best interests of the lactation consultant profession and of the public it serves that there be a Code of Ethics to provide guidance to lactation consultants in their professional practice and conduct. These ethical principles guide the profession and outline commitments and obligations of the lactation consultant to self, client, colleagues, society, and the profession. The purpose of the International Board of Lactation Consultant Examiners (IBLCE) is to assist in the protection of the health, safety and welfare of the public by establishing and enforcing qualifications of certification and for issuing voluntary credentials to individuals who have attained those qualifications. The IBLCE has adopted this Code to apply to all individuals who hold the credential of International Board Certified Lactation Consultant (IBCLC). Principles of Ethical Practice The International Board Certified Lactation Consultant shall act in a manner that safeguards the interests of individual clients, justifies public trust in her/his competence, and enhances the reputation of the profession. The International Board Certified Lactation Consultant is personally accountable for her/his practice and, in the exercise of professional accountability, must:

1. Provide professional services with objectivity and with respect for the unique needs and values of individuals.

2. Avoid discrimination against other individuals on the basis of race, creed, religion, gender, sexual orientation, age, and national origin.

3. Fulfil professional commitments in good faith.

4. Conduct herself/himself with honesty, integrity and fairness.

5. Remain free of conflict of interest while fulfilling the objectives and maintaining the integrity of the lactation consultant profession.

6. Maintain confidentiality.

7. Base her/his practice on scientific principles, and on current research and information.

8. Take responsibility and accept accountability for personal competence in practice.

9. Recognise, and exercise professional judgment within, the limits of her/his qualifications. This principle includes seeking counsel and making referrals to appropriate providers.

10. Inform the public and colleagues of his/her services by using factual information. An International Board Certified Lactation Consultant shall not advertise in a false or misleading manner.

11. Provide sufficient information to enable clients to make informed decisions.

12. Provide information about appropriate products in a manner that is neither false nor misleading.

13. Permit use of her/his name for the purpose of certifying that lactation consultant services have been rendered only if she/he provided those services.

14. Present professional qualifications and credentials accurately, using “IBCLC” only when certification is current and authorised by the IBLCE, and complying with all requirements when seeking initial or continued certification from the IBLCE. The lactation consultant is also subject to disciplinary action for aiding another person in violating any IBLCE requirements or aiding another person in representing herself/himself as an IBCLC when she/he is not.

15. Report to an appropriate person or authority when it appears that the health or safety of colleagues is at risk, as such circumstances may compromise standards of practice and care.

16. Refuse any gift, favour or hospitality from patients or clients currently in her/his care which might be interpreted as seeking to exert influence to obtain preferential consideration.

17. Disclose any financial or other conflicts of interest in relevant organisations providing goods or services. Ensure that professional judgment is not influenced by any commercial considerations.

18. Present substantiated information and interpret controversial information without personal bias, recognising that legitimate differences of opinion exist.

19. Withdraw voluntarily from professional practice if she/he has engaged in any substance abuse that could affect her/his practice; has been adjudged by a court to be mentally incompetent; or has an emotional or mental disability that affects her/his practice in a manner that could harm the client.

20. Obtain maternal consent to photograph, audio-tape or videotape a mother and/or her infant(s) for educational or professional purposes.

21. Submit to disciplinary action under the following circumstances: if convicted of a crime under the laws of the practitioner’s country which is a felony or a misdemeanour, an essential element of which is dishonesty, and which is related to the practice of lactation consulting; if disciplined by a national, state, province or local government or authority, and at least one of the grounds for the discipline is the same or substantially equivalent to these principles; if committed an act of misfeasance or malfeasance which is directly related to the practice of the profession as determined by a court of competent jurisdiction, a licensing board, or an agency of a governmental body; or if violated a Principle set forth in the Code of Ethics for International Board Certified Lactation Consultants which was in force at the time of the violation.

22. Accept the obligation to protect society and the profession by upholding the Code of Ethics for International Board Certified Lactation Consultants and by reporting alleged violations of the Code through the defined review process of the IBLCE.

23. Require and obtain consent to share clinical concerns and information with the medical practitioner or other primary health care provider before initiating a consultation.

24. Adhere to those provisions of the International Code of Marketing of Breast-milk Substitutes, and subsequent WHA resolutions, which pertain to health workers.

25. Understand, recognise, respect, and acknowledge intellectual property rights, including but not limited to copyrights (which apply to written material, photographs, slides, illustrations, etc.), trademarks, service marks, and patents. Implementation date: 1 December 2004

To lodge a complaint IBCLCs shall act in a manner that justifies public trust in their competence, enhances the reputation of the profession, and safeguards the interests of individual clients. To protect the credential and to assure responsible practice by its certificants, the IBLCE depends on IBCLCs, members of the coordinating and supervising health professions, employers, and the public to report incidents that may require action by the IBLCE Discipline Committee. Only signed, written complaints will be considered. Anonymous correspondence will be discarded. The IBLCE will become involved only in matters that can be factually determined, and will provide the accused party with every opportunity to respond in a professional and legally defensible manner. Complaints that appear to fit the scope of the Discipline Committee’s responsibilities should be sent to:

IBLCE, Chair of the Discipline Committee 7245 Arlington Boulevard, Suite 200 Falls Church VA 22042-3217 USA


CLINICAL COMPETENCIECLINICAL COMPETENCIECLINICAL COMPETENCIECLINICAL COMPETENCIES CHECKLISS CHECKLISS CHECKLISS CHECKLISTTTT

Much of the clinical practice of the International Board Certified Lactation Consultant (IBCLC) consists of systematic problem solving in collaboration with breastfeeding mothers and other members of the health care team. This checklist includes most of the clinical/practical skills that an entry level IBCLC needs in order to be satisfactorily proficient to provide safe and effective care for breastfeeding mothers and babies. The list is designed to encompass common breastfeeding situations and the challenges that are encountered most frequently by lactation consultants. This checklist can help you identify areas where you have less experience or knowledge, and you are encouraged to try to focus your professional education on these aspects. Clinical instructors can use this checklist as an appropriate guide in providing individualised education. The checklist is also the basis of eligibility pathway F, a pre-approved program covering all the Clinical Competencies over at least 500 directly supervised clinical hours by an IBCLC with at least 5 years experience. Stringent conditions apply. You must contact IBLCE for further information.

IBLCE thanks ILCA and the IBCLCs from all over the world who worked on developing these Clinical Competencies.

COMMUNICATION AND COUNSELLING SKILLSCOMMUNICATION AND COUNSELLING SKILLSCOMMUNICATION AND COUNSELLING SKILLSCOMMUNICATION AND COUNSELLING SKILLS

In all interactions with mothers, families, health care professionals and peers, the student will demonstrate effective communication skills to maintain collaborative and supportive relationships.

The student will:

� Identify factors that might affect communication (i.e., age, cultural/language differences, hearing or visual impairment, mental ability, etc.)

� Demonstrate appropriate body language (i.e., position in relation to the other person, comfortable eye contact, appropriate tone of voice for the setting, etc.)

� Demonstrate knowledge of and sensitivity to cultural differences

� Elicit information using effective counselling techniques (i.e., asking open-ended questions, summarising the discussion, and providing emotional support)

� Make appropriate referrals to other health care professionals and community resources

The student will provide individualised breastfeeding care with an emphasis on the mother’s ability to make informed decisions.

The student will:

� Assess mother’s psychological state and provide information appropriate to her situation

� Include those family members or friends the mother identifies as significant to her

� Obtain the mother’s permission for providing care to her or her baby

� Ascertain mother’s knowledge about and goals for breastfeeding

� Use adult education principles to provide instruction to the mother that will meet her needs

� Select appropriate written information and other teaching aids

HISTORY TAKING AND ASSESSMENT SKILLSHISTORY TAKING AND ASSESSMENT SKILLSHISTORY TAKING AND ASSESSMENT SKILLSHISTORY TAKING AND ASSESSMENT SKILLS

The student will be able to:

� Obtain a pertinent history

� Perform a breast evaluation related to lactation

� Develop a breastfeeding risk assessment

� Assess and evaluate the infant’s ability to breastfeed

� Assess effective milk transfer

DOCUMENTATION AND COMMUNICATION SKILLS DOCUMENTATION AND COMMUNICATION SKILLS DOCUMENTATION AND COMMUNICATION SKILLS DOCUMENTATION AND COMMUNICATION SKILLS WITH HEALTH PROFESSIONALSWITH HEALTH PROFESSIONALSWITH HEALTH PROFESSIONALSWITH HEALTH PROFESSIONALS

The student will:

� Communicate effectively with other members of the health care team, using written documents appropriate to the location, facility and culture in which the student is being trained, such as: consent forms, care plans, charting forms/clinical notes, pathways/care maps, and feeding assessment forms

� Use appropriate resources for research to provide information to the health care team on conditions and medications that affect breastfeeding and lactation

� Write referrals and follow-up documentation/ letters to referring and/or primary health care providers that illustrate the student’s ability to identify:

� The mother’s concerns or problems, planned interventions, evaluation of outcomes and follow-up

� Situations in which immediate verbal communication with the health care provider is necessary, such as serious illness in the infant, child, or mother

� Report instances of child abuse or neglect to specific agencies as appropriate or legally required

SSSSKILLS KILLS KILLS KILLS FOR FOR FOR FOR THE FIRST TWO HOURS AFTER BIRTHTHE FIRST TWO HOURS AFTER BIRTHTHE FIRST TWO HOURS AFTER BIRTHTHE FIRST TWO HOURS AFTER BIRTH

The student will: � Identify events that occurred during the labour and

birth process that may adversely affect breastfeeding � Identify and discourage practices that may interfere

with breastfeeding � Promote continuous skin-to-skin contact of the term

newborn and mother until the first breastfeed � Assist the mother and family to identify newborn

feeding cues � Help the mother and infant to find a comfortable

position for latching-on/attachment during the first breastfeed after birth

� Identify correct attachment � Reinforce to mother and family the importance of:

� Keeping the mother and baby together � Feeding the baby on cue - but at least 8 times

in each 24 hour period

(continued)(continued)(continued)(continued)


CLINICAL COMPETENCIECLINICAL COMPETENCIECLINICAL COMPETENCIECLINICAL COMPETENCIES CHECKLISS CHECKLISS CHECKLISS CHECKLIST T T T (continued)(continued)(continued)(continued)

POSTPARTUM SKILLSPOSTPARTUM SKILLSPOSTPARTUM SKILLSPOSTPARTUM SKILLS

Prior to discharge from care, the student will observe a breastfeed and effectively instruct the mother about:

� Assessment of adequate milk intake by the baby � Normal infant sucking patterns � How milk is produced and supply maintained,

including discussion of growth/appetite spurts � Normal newborn behaviour, including why,

when and how to wake a sleepy newborn � Avoidance of early use of a dummy/pacifier

and bottle teat � Importance of exclusive breast milk feeds and

possible consequences of mixed feedings with cow milk or soy

� Prevention and treatment of sore nipples � Prevention and treatment of engorgement � SIDS prevention behaviours � Family planning methods and their relationship to

breastfeeding � Education regarding drugs (such as nicotine,

alcohol, caffeine and illicit drugs) and complementary remedies (such as herbal teas)

� Plans for follow-up care for breastfeeding questions, infant’s medical and mother’s postpartum examinations

� Community resources for breastfeeding assistance PROBLEMPROBLEMPROBLEMPROBLEM----SOLVING SKILLSSOLVING SKILLSSOLVING SKILLSSOLVING SKILLS

The student will be able to: � Identify problems � Assess contributing factors and cause � Develop an appropriate breastfeeding plan in

consultation with the mother � Assist the mother to implement the plan � Evaluate effectiveness of the plan

SKILLS FOR MATERNAL BREASTFEEDING CHALLENGESSKILLS FOR MATERNAL BREASTFEEDING CHALLENGESSKILLS FOR MATERNAL BREASTFEEDING CHALLENGESSKILLS FOR MATERNAL BREASTFEEDING CHALLENGES

The student will be able to assist mothers with the following challenges:

� Caesarean birth � Flat/inverted nipples � Thrush infections of breast, nipple, areola, and milk

ducts � Continuation of breastfeeding when mother is

separated from her baby � Milk expression techniques � Maintaining milk production � Collection, storage and transportation of milk

� Cultural beliefs that are not evidence-based and may interfere with breastfeeding, (i.e., discarding colostrum, rigidly scheduled feedings, necessity of formula after every breastfeeding, etc.)

� Medical conditions that may impact on breastfeeding

� Adolescent mother � Strategies for returning to school � Maintaining milk production

� Nipple pain and damage � Engorgement � Blocked duct and/or nipple pore � Mastitis � Breast surgery/trauma � Overproduction of milk � Postpartum psychological issues including transient

sadness (“baby blues”) and postpartum depression � Appropriate referrals � Medications compatible with breastfeeding

� Insufficient milk supply, differentiating between perceived and real

� Weaning issues � Safe formula preparation and feeding techniques � Care of breasts

SKILLS FOR INFANT BREASTFEEDING CHALLENGESSKILLS FOR INFANT BREASTFEEDING CHALLENGESSKILLS FOR INFANT BREASTFEEDING CHALLENGESSKILLS FOR INFANT BREASTFEEDING CHALLENGES

The student will be able to assist mothers who have infants with the following challenges:

� Traumatic birth � 35-38 weeks gestation � Small for gestational age (SGA)

or large for gestational age (LGA) � Multiple births � Preterm birth, including the benefits of

kangaroo care � High risk for hypoglycaemia � Sleepy infant � Excessive weight loss, slow/poor weight gain � Hyperbilirubinemia (jaundice) � Ankyloglossia (short frenulum) � Thrush infection � Colic/fussiness � Gastric reflux � Lactose overload � Food intolerances � Neuro developmental problems � Teething and biting � Breast refusal/early baby led weaning � Breastfeeding a toddler � Breastfeeding through pregnancy � Tandem feeding

MANAGEMENT SKILLSMANAGEMENT SKILLSMANAGEMENT SKILLSMANAGEMENT SKILLS

The student will demonstrate the ability to: � Perform a comprehensive breastfeeding assessment � Assess milk transfer � Calculate an infant’s kilojoule and volume

requirements � Increase milk production

(continued)(continued)(continued)(continued)

10101010 www.iblce-europe.org IBLCE Exam - Candidate Information Guide, version 2.9 EU

CLINICAL COMPETENCIECLINICAL COMPETENCIECLINICAL COMPETENCIECLINICAL COMPETENCIES CHECKLISS CHECKLISS CHECKLISS CHECKLIST T T T (continued)(continued)(continued)(continued)

SKILLS FOR USE OF TECHNOLOGY AND DEVICESSKILLS FOR USE OF TECHNOLOGY AND DEVICESSKILLS FOR USE OF TECHNOLOGY AND DEVICESSKILLS FOR USE OF TECHNOLOGY AND DEVICES

The student will have up-to-date knowledge about breastfeeding-related equipment and demonstrate appropriate use and understanding of potential disadvantages or risks of the following:

� A device to evert nipples � Nipple creams/ointments � Breast shells � Breast pumps � Alternative feeding techniques

� Tube feeding at the breast � Cup feeding � Spoon feeding � Eyedropper feeding � Finger feeding � Bottles and artificial teats

� Nipple shields � Dummies/pacifiers � Infant scales � Use of herbal supplements for mother and/or infant

SKILLS FOR BREASTFEEDING CHALLENGES SKILLS FOR BREASTFEEDING CHALLENGES SKILLS FOR BREASTFEEDING CHALLENGES SKILLS FOR BREASTFEEDING CHALLENGES WHICH ARE ENCOUNTERED INFREQUENTLYWHICH ARE ENCOUNTERED INFREQUENTLYWHICH ARE ENCOUNTERED INFREQUENTLYWHICH ARE ENCOUNTERED INFREQUENTLY

The following issues are encountered relatively infrequently, and may not be seen during the student’s training. The entry-level lactation consultant would not be expected to be proficient in these situations, but should have the basic skills to assist the mother and infant while seeking guidance from a more experienced IBCLC.

Infant: � Infant with tonic bite/ineffective/dysfunctional suck � Cranial-facial abnormalities, such as micronathia

(receding lower jaw) and cleft lip and/or palate � Down Syndrome � Cardiac problems � Chronic medical conditions, such as cystic fibrosis,

PKU, etc.

Mother: � Induced lactation and relactation � Coping with the death of an infant � Chronic medical conditions, such as Multiple

Sclerosis, lupus, seizures, etc. � Disabilities which may limit mother’s ability to handle

the baby easily, such as, rheumatoid arthritis, carpal tunnel syndrome, cerebral palsy, etc.

� HIV/AIDS: understanding of current recommendations

SKILLS FOR MEETING PROFESSIONAL RESPONSIBILITIESSKILLS FOR MEETING PROFESSIONAL RESPONSIBILITIESSKILLS FOR MEETING PROFESSIONAL RESPONSIBILITIESSKILLS FOR MEETING PROFESSIONAL RESPONSIBILITIES

The student will demonstrate the following professional responsibilities:

� Conduct herself or himself in a professional manner, by complying with the IBLCE Code of Ethics for International Board Certified Lactation Consultants and the ILCA Standards of Practice; and by adhering to the International Code of Marketing of Breast-milk Substitutes and its subsequent World Health Assembly resolutions.

� Practice within the laws of the setting in which s/he works, showing respect for confidentiality and privacy.

� Use current research findings to provide a strong evidence base for clinical practice, and obtain continuing education to enhance skills and obtain/maintain IBCLC certification.

� Advocate for breastfeeding families, mothers, infants and children in the workplace, community and within the health care system.

� Use breastfeeding equipment appropriately and provide information about risks as well as benefits of products, maintaining an awareness of conflict of interest if profiting from the rental or sale of breastfeeding equipment.

SITES FOR ACQUISTION OF SKILLSSITES FOR ACQUISTION OF SKILLSSITES FOR ACQUISTION OF SKILLSSITES FOR ACQUISTION OF SKILLS

The student may acquire clinical/practical skills in the following settings:

� Private practice IBCLC office � Private practice, obstetric, paediatric, family or

midwifery practice � Child health clinics and domiciliary services � Hospital

� Lactation services � Birthing centre � Postpartum unit � Mother-Baby unit � Level II and Level III nurseries: Special Care

Nursery, Neonatal Intensive Care Nursery � Paediatric unit

� Community nursing services � Out-patient follow-up breastfeeding clinics � Breastfeeding telephone counselling services � Antenatal and postnatal breastfeeding classes � Home births (if legally permitted) � Volunteer community support group meetings


ILCA STANDARDS OF PRACTICEILCA STANDARDS OF PRACTICEILCA STANDARDS OF PRACTICEILCA STANDARDS OF PRACTICE

International Lactation Consultant Association Standards of Practice for International Board Certified Lactation Consultants

Preface This is the third edition of Standards of Practice for IBCLC Lactation Consultants published by the International Lactation Consultant Association (ILCA).

All individuals practising as a currently certified IBCLC should adhere to ILCA’s Standards of Practice and the International Board of Lactation Consultant Examiner’s (IBLCE) Code of Ethics for International Board Certified Lactation Consultants in all interactions with clients, families and other health care professionals. ILCA recognises the certification conferred by the IBLCE as the worldwide professional credential for lactation consultants.

Quality practice and service constitute the core responsibilities of a profession to the public. Standards of practice are stated measures or levels of quality that are models for the conduct and evaluation of practice. Standards of practice:

• promote consistency by encouraging a common systematic approach

• are sufficiently specific in content to guide daily practice

• Provide a recommended framework for the development of policies and protocols, educational programs, and quality improvement efforts

• are intended for use in diverse practice settings and cultural contexts

Standard 1. Professional Responsibilities The IBCLC has a responsibility to maintain professional conduct and to practice in an ethical manner, accountable for professional actions and legal responsibilities. 1.1 Adhere to these ILCA Standards of Practice and the IBLCE

Code of Ethics 1.2 Practice within the scope of the International Code of

Marketing of Breast-milk Substitutes and all subsequent World Health Assembly resolutions

1.3 Maintain an awareness of conflict of interest in all aspects of work, especially when profiting from the rental or sale of breastfeeding equipment and services

1.4 Act as an advocate for breastfeeding women, infants, and children

1.5 Assist the mother in maintaining a breastfeeding relationship with her child

• assuring cleanliness and good operating condition 1.6 Maintain and expand knowledge and skills for lactation

consultant practice by participating in continuing education 1.7 Undertake periodic and systematic evaluation of one’s clinical

practice 1.8 Support and promote well-designed research in human

lactation and breastfeeding, and base clinical practice, whenever possible, on such research

Standard 2. Legal Considerations The IBCLC is obligated to practise within the laws of the geopolitical region and setting in which she/he works. The IBCLC must practise with consideration for rights of privacy and with respect for matters of a confidential nature. 2.1 Work within the policies and procedures of the institution

where employed, or if self-employed, have identifiable policies and procedures to follow

2.2 Clearly state applicable fees prior to providing care 2.3 Obtain informed consent from all clients prior to:

• assessing or intervening • reporting relevant information to other health care

professional(s) • taking photographs for any purpose • seeking publication of information associated with the

consultation 2.4 Protect client confidentiality at all times 2.5 Maintain records according to legal and ethical practices

within the work setting

Standard 3. Clinical Practice

The clinical practice of the IBCLC focuses on providing lactation care and management. This is best accomplished by promoting optimal health, through collaboration and problem-solving with the client and other members of the health care team. The role of the IBCLC includes:

• assessment, planning, intervention, and evaluation of care in a variety of situations

• anticipatory guidance and prevention of problems • complete, accurate, and timely documentation of care • communication and collaboration with other health care

professionals

3.1 Assessment 3.1.1 Obtain and document an appropriate history of the

breastfeeding mother and child. 3.1.2 Systematically collect objective and subjective information 3.1.3 Discuss with the mother and document as appropriate all

assessment information

3.2 Plan 3.2.1 Analyse assessment information to identify issues and/or

problems 3.2.2 Develop a plan of care based on identified issues 3.2.3 Arrange for follow-up evaluation where indicated

3.3 Implementation 3.3.1 Implement the plan of care in a manner appropriate to the

situation and acceptable to the mother 3.3.2 Utilize translators as needed 3.3.3 Exercise principles of optimal health, safety and universal

precautions 3.3.4 Provide appropriate oral and written instructions and/or

demonstration of interventions, procedures and techniques 3.3.5 Facilitate referral to other health professionals, community

services, and support groups as needed 3.3.6 use equipment appropriately:

• refrain from unnecessary or excessive use • assure cleanliness and good operating condition • discuss the risks and benefits of recommended

equipment including financial considerations • demonstrate the correct use and care of equipment • evaluate safety and effectiveness of use

3.3.7 Document and communicate to health care providers as appropriate:

• assessment information • suggested interventions • instructions provided • evaluations of outcomes • modifications of the plan of care • follow-up strategies

3.4 Evaluation 3.4.1 Evaluate outcomes of planned interventions 3.4.2 Modify the plan based on the evaluation of outcomes

. . . continued next page


IBLCE COMPETENCY STATEMENTSIBLCE COMPETENCY STATEMENTSIBLCE COMPETENCY STATEMENTSIBLCE COMPETENCY STATEMENTS

The following competency statements identify and summarise the special knowledge and skills included in the role of an International Board Certified Lactation Consultant (IBCLC).

The International Board Certified Lactation Consultant will:

1. Possess the skills, knowledge, and attitudes to provide competent comprehensive consultation and education in routine and special circumstance lactation, from preconception to beyond twelve months.

2. Integrate additional knowledge from the following disciplines in providing care for breastfeeding families: Maternal and Infant Anatomy; Physiology and Endocrinology; Nutrition and Biochemistry; Immunology and Infectious Disease; Pathology; Pharmacology and Toxicology; Psychology, Sociology, and Anthropology; Growth Parameters and Developmental Milestones; Interpretation of Research; Ethical and Legal Issues; Breastfeeding Equipment and Technology; Techniques; and Public Health.

3. Utilise knowledge of personality, counselling skills, and family and group theory when providing breastfeeding support.

4. Integrate cultural, psychosocial, nutritional, and pharmacological aspects of breastfeeding into lactation consultant practice.

5. Utilise appropriate communication skills in interactions with clients and health care providers.

6. Maintain a collaborative, supportive relationship with clients, emphasising individualised family care, client autonomy, informed decision making, and optimal health care.

7. Act as an advocate for breastfeeding in the community, workplace, and within the health care professions.

8. Utilise adult learning principles when providing educational experiences for clients, health care providers, and the community.

9. Interpret current research findings to determine appropriateness for application to practice.

10. Function and contribute as a member of the health care team, provide follow-up plans, and make appropriate referrals to other health care providers and community support resources.

11. Maintain comprehensive client records.

12. Follow a professional Code of Ethics, local laws and codes, and maintain appropriate standards of hygiene.

13. Observe the guidelines for health workers outlined in the WHO International Code of Marketing of Breast-milk Substitutes.

14. Maintain and enhance knowledge and skills with appropriate and regular continuing education.

ILCA STANDARDS OF PRACTICE (continued)ILCA STANDARDS OF PRACTICE (continued)ILCA STANDARDS OF PRACTICE (continued)ILCA STANDARDS OF PRACTICE (continued)

continued from previous page

Standard 4. Breastfeeding Education and Counselling Breastfeeding education and counselling are integral parts of the care provided by the IBCLC. 4.1 Educate parents and families to encourage informed decision-

making about infant and child feeding 4.2 Utilise a pragmatic problem-solving approach, sensitive to the

learner’s culture, questions and concerns 4.3 Provide anticipatory guidance (teaching) to:

• promote optimal breastfeeding practices • minimise the potential for breastfeeding problems or

complications 4.4 Provide positive feedback and emotional support for

continued breastfeeding, especially in difficult or complicated circumstances

4.5 Share current evidence-based information and clinical skills in collaboration with other health care providers

Approved by the ILCA Board of Directors, October 2005. Copyright © 2005 International Lactation Consultant Association. Copies of this document may be freely made, so long as the content remains unchanged, and they are distributed free-of-charge.

IBLCE Statement on International CodeIBLCE Statement on International CodeIBLCE Statement on International CodeIBLCE Statement on International Code

Health workers have a responsibility to be familiar with the International Code of Marketing of Breast-Milk Substitutes and to understand their responsibilities in relation to it (Ref: Article 7.1).

The IBLCE Code of Ethics requires IBCLCs to abide by the provisions of the Code and subsequent World Health Assembly (WHA) resolutions that apply to health workers.

If a health worker receives a contribution from a company that markets or distributes products within the scope of the International Code, e.g. exam fees, textbooks, or pre-exam education, the Code requires that both the company and recipient must disclose this to any institution with which the recipient is affiliated. This also applies to contributions made to a third party on the health worker’s behalf (Ref: Article 7.5).

Financial contributions can create a conflict of interest, especially in regard to the Baby Friendly Hospital Initiative. (Ref: WHA 49.15)


SUGGESTED READING LISTSUGGESTED READING LISTSUGGESTED READING LISTSUGGESTED READING LIST

Since individual study is a major component of exam preparation, this reading list is included to aid you in your preparation. This Suggested Reading List is not all-inclusive, nor does it cover all exam items. The IBLCE recommends that candidates become familiar with a wide range of literature, scientific studies and journals, including material published outside their own countries. In addition to the listed books, it is useful to review good basic texts on child development, neonatology, prematurity, research methodology and statistics. Candidates should also be familiar with books written for mothers, particularly the mother-support literature which covers normal behaviour, older babies and breastfeeding management in a range of situations. Inclusion on this list does not constitute an endorsement by IBLCE.

NOTE: The letters in brackets after a title in the alphabetical listing refer to those Disciplines in the Exam Blueprint which are well covered in that book or series. General lactation texts and practical breastfeeding management texts do not have Discipline references after them, since they cover a broad spectrum of topics.

GENERAL LACTATION TEGENERAL LACTATION TEGENERAL LACTATION TEGENERAL LACTATION TEXTSXTSXTSXTS

Lawrence, Ruth and Lawrence, Robert. Breastfeeding: A Guide for the Medical Profession: Elsevier Mosby, 2005.

Riordan, J. Breastfeeding and Human Lactation. Jones & Bartlett, 2004.

PRACTICAL BREASTFEEDPRACTICAL BREASTFEEDPRACTICAL BREASTFEEDPRACTICAL BREASTFEEDINGINGINGING MANAGEMENT TEXTSMANAGEMENT TEXTSMANAGEMENT TEXTSMANAGEMENT TEXTS

Biancuzzo, M. Breastfeeding the Newborn: Clinical Strategies for Nurses. Mosby, 2003.

Brodribb, W. (ed) Breastfeeding Management. Australian Breastfeeding Association, 2004.

Lauwers, J, and Swisher A. Counseling the Nursing Mother. Jones & Bartlett, 4th Edition 2003.

Mohrbacher, N, and Stock J. The Breastfeeding Answer Book. La Leche League International, 2003.

The Royal College of Midwives, UK. Successful Breastfeeding. Churchill Livingstone, 2003.

Walker. Breastfeeding Management for the Clinician. Harcourt Brace, Canada

PROFESSIONAL PROFESSIONAL PROFESSIONAL PROFESSIONAL TEXTSTEXTSTEXTSTEXTS

ILCA Core Curriculum for Lactation Consultant Practice. Walker, M (ed), Jones & Bartlett, 2001.

BOOKS OF CLINICAL PHOTOGRAPHSBOOKS OF CLINICAL PHOTOGRAPHSBOOKS OF CLINICAL PHOTOGRAPHSBOOKS OF CLINICAL PHOTOGRAPHS

Auerbach K., and J. Riordan. Clinical Lactation: a visual guide. Jones & Bartlett, 2000.

Wilson-Clay, B., and Hoover K. The Breastfeeding Atlas 3rd edition. Lactnews Press, Austin Texas, 2005.

14141414

ADDITIONAL READINGADDITIONAL READINGADDITIONAL READINGADDITIONAL READING

AAP & ACOG. Breastfeeding Handbook for Physicians. 2006 (primarily for candidates who are physicians)

Allain A and Chetley A. Protecting Infant Health: A Healthworker’s Guide to the International Code of Marketing of Breast-milk Substitutes. IBFAN, 2003. [J,M ]

Bornmann, P. A Legal Primer for Lactation Consultants. Chapter in ILCA Core Curriculum for Lactation Consultant Practice. Walker (ed), Jones & Bartlett, 2001. [J]

Greenhalgh, Tricia How to read a paper: the basics of evidence based medicine. BMJ Publishing Group. Relevant full text extracts available as articles at: http://www.bmj.com/ [I ] Hale, Thomas. Medications and Mothers’ Milk Pharmasoft Publishing, 2006 or biennial new edition. [F]

Hale, T and Berens P. Clinical Therapy in Breastfeeding Patients. Pharmasoft Publishing. [F]

Hale, T and Ilett K. Drug Therapy and Breastfeeding. Pharmasoft Publishing, 2002. [F]

Hanson, Lars. Immunobiology of Human Milk: How Breast-feeding Protects Infants. Pharmasoft Publishing, 2004. [D] Ivey AE and Ivey MB. Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society. 5th edition. Wadsworth: 2003. [G]

Lang, S. Breastfeeding Special Care Babies. Bailliére Tindall, 2002. [most disciplines; chronological period: 2]

Merewood A and Phillip B. Breastfeeding Conditions and Diseases. Pharmasoft Publishing, 2001. [E]

Morris, SE and Klein, MD. Pre-Feeding Skills — A Comprehensive Resource for Mealtime Development. Therapy Skill Builders, 2nd edition, 2000. [A,C,E,G,H,L] NHMRC. Dietary Guidelines for Children and Adolescents in Australia incorporating the Infant Feeding Guidelines for Health Workers. Australian Government Printer, 2003. [M ]

Polit, D and Beck, C. Essentials of Nursing Research: Methods, Appraisal, and Utilization. 6th edition. [I ] Roberts, K and Taylor B. Nursing Research Processes: An Australian Perspective. Nelson, 2002. [I ] Scott, J. The Code of Ethics for International Board Certified Lactation Consultants: Ethical Practice. Chapter in ILCA’s Core Curriculum for Lactation Consultant Practice. Walker (ed), Jones & Bartlett, 2001. [J]

Schaefer, CH., Spielmann, H. Drugs during Pregnancy and Lactation, Elsevier, Amsterdam, The Netherlands

Shealy K, Li R, Benton-Davis s, Grummer-Strawn LM. The CDC Guide to Breastfeeding Interventions. US Dept of Health and Human Services, CDC, 2005. [M ]

Shelov, S. Caring for Your Baby and Young Child: Birth to Five Years. AAP. Bantam Books, 2004. [H]

Stuart-Macadam P and Dettwyler K, Breastfeeding: Biocultural Perspectives. Hawthorne, NY: 1995. [G]

Tappero, EP and Honeyfield ME. Physical Assessment of the Newborn. NICU Ink, 2003. [chron. periods: 5&6]

WHO. The International Code of Marketing of Breast-Milk Substitutes: frequently asked questions. 2006 http://www.who.int/child-adolescent-health/ [M ]

Wolf, LS and Glass RP. Feeding and Swallowing Disorders in Infancy: Assessment and Management. Psych Corp, 1992. [A,E,H,L]


READING LIST (continued)READING LIST (continued)READING LIST (continued)READING LIST (continued)

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JOURNALS AND OTHERJOURNALS AND OTHERJOURNALS AND OTHERJOURNALS AND OTHER PROFESSIONAL PUBLICATIONS PROFESSIONAL PUBLICATIONS PROFESSIONAL PUBLICATIONS PROFESSIONAL PUBLICATIONS

Academy of Breastfeeding Medicine www.bfmed.org Clinical Protocols open access on website Breastfeeding Medicine (quarterly professional journal) ABM News and Views. Quarterly newsletter by subscription.

Australian Breastfeeding Association (ABA) www.breastfeeding.asn.au

Breastfeeding Review. Professional journal published twice each year, available by subscription from ABA.

Lactation Resource Centre. An annual subscription to ABA’s LRC provides quarterly listings of the latest published research and journal articles, vouchers for database searches and photocopying of articles; phone enquiry and referral service; Topics in Breastfeeding papers; plus a subscription to Breastfeeding Review.

Topics in Breastfeeding. A set has been published by ABA’s LRC each year since 1991. Back copies of sets still available and useful. Check titles with ABA.

ILCA www.ilca.org Journal of Human Lactation. Quarterly professional journal available by joining the International Lactation Consultant Association.

Evidence-Based Guidelines for Breastfeeding Management during the First Fourteen Days.

International Breastfeeding Journal IBJ is an open-access peer-reviewed online journal: http://www.internationalbreastfeedingjournal.com/

La Leche League International www.lalecheleague.org Breastfeeding Abstracts Quarterly annotated summary of important new research - by subscription from LLLI.

World Health Organisation, Geneva www.who.int and http://www.who.int/nutrition/publications/en/

Complementary Feeding: family foods for breastfed children. WHO 2000 [H] Evidence for the Ten Steps to Successful Breastfeeding. Geneva, WHO 1998 [M ] Global Strategy for Infant and Young Child Feeding. Geneva, WHO 2003 [M ] HIV and Infant Feeding. A guide for health care managers and supervisors and Guidelines for decision makers. Geneva, WHO 1998 [D, M] Hypoglycaemia of the Newborn: Review of the Literature. Geneva, WHO 1998 [B] International Code of Marketing of Breast-milk Substitutes. Geneva, WHO 1981 [M ] Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant During The First Six Months of Life. 2002 [C, H] Protecting, Promoting and Supporting Breastfeeding: The Special Role of Maternity Services. WHO/UNICEF Statement, 1989. [M ] Relactation: Review of experience and recommendations for practice. Geneva, WHO 1998 [B]

Psych Corp, 1992.

Earning education hours by attending mother-to-mother support group meetings The International Board of Lactation Consultant Examiners feels strongly that candidates for the IBLCE exam should understand the importance of mother-to-mother support and community resources, and learn more about “normal” breastfeeding.

Applicants for the IBLCE examination who are not counsellors/leaders of such an organisation can therefore earn 1 education hour per meeting session (to a maximum of 4 hours; i.e. 4 meetings) towards their required minimum 45 (or 80) hours of education by attending a discussion meeting of a breastfeeding mother-to-mother support group. Examples include, but are not limited to La Leche League or the Australian Breastfeeding Association.

Candidates are asked to phone before attending a meeting to check that it is appropriate for them to attend that particular meeting (there may already be other observers attending or it may be a social meeting without a discussion topic) and to confirm the time and place.

Before the meeting commences the counsellor leading the discussion may wish to talk with the candidate about how s/he is to be introduced, how s/he can participate in the discussion, the support group’s Code of Ethics and any other concerns or questions either party may have. The candidate is there in an observer capacity, not as a health professional, and should not be giving advice to mothers or asked to consult in a professional capacity.

The counsellor or group leader is required to sign a form to confirm that the candidate attended. If there are concerns about the candidate (e.g. unethical behaviour), please contact the IBLCE Regional Director at [email protected], or the local IBLCE Coordinator.

Cut this half page off along the dashed line and use the form on the other side

as your record of attendance at mother-to-mother support group

discussion meetings.

MOTHER SUPPORT MOTHER SUPPORT MOTHER SUPPORT MOTHER SUPPORT GROUPSGROUPSGROUPSGROUPS

Dear Mother Support Group Counsellor

As an accredited counsellor or leader of your organisation, please read the information below and complete the information relevant to your meeting on the other side of this sheet. Return it to the bearer so that s/he may submit it with her/his application for the IBLCE exam.

Thank you for your cooperation.


SENDING YOUR APPLICATIONSENDING YOUR APPLICATIONSENDING YOUR APPLICATIONSENDING YOUR APPLICATION

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__________________________________________________ Name of Observer (IBLCE Exam Candidate)

MEETING 1:

______________________________ __________________ Name of Counsellor or Group Leader Phone ____________________________ ____________________ Date of Meeting Name of Organisation __________________________________________________ Topic of Discussion Meeting I certify that the above-named observer attended this discussion meeting of my breastfeeding support group. ___________________________________________ Signature of Counsellor/Leader _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ MEETING 2:



______________________________ __________________ Name of Counsellor or Group Leader Phone ____________________________ ____________________ Date of Meeting Name of Organisation __________________________________________________ Topic of Discussion Meeting I certify that the above-named observer attended this discussion meeting of my breastfeeding support group. ___________________________________________ Signature of Counsellor/Leader

MILCC FINANCIAL ASSISTANCE Monetary Investment for Lactation Consultant

Certification (MILCC) is an international body which provides financial assistance to IBLCE exam or

recertification applicants who demonstrate financial need, with priority given to applicants who work with

under-served or disadvantaged families.

A MILCC application form is available from IBLCE on request or can be downloaded from the

website. It must be submitted with a completed exam application, and mailed

to IBLCE by the end of January.

Please note that all eligibility requirements, including all education hours, must have been

completed by the time of application.

The JoAnne W. Scott scholarship is also available through MILCC for applicants from a

mother-to-mother support background.

IBCLCs recertifying by exam or by CERPs may also apply for MILCC financial assistance. If recertifyi ng by CERPs, the completed recertification application and

MILCC application must be mailed to IBLCE by the end of January.

Please follow carefully the instructions on pages 17-20 for completing your application form, and the fees and deadlines information on pages 21-22. Check that every section of your application is complete and that you have signed and dated it. Also check that you have enclosed all required accompanying materials with the form. Please do not fold or staple your application or the documentation enclosed in it.

Keep a photocopy of your application for your records, along with your Candidate Information Guide and Application Supplement.

Mail your application to the address shown on your Application Supplement. If you are mailing close to a fee deadline, you are advised to ensure the envelope is clearly postmarked.

Applications are processed in the order in which they are received. In busy periods, it may take three to four weeks before your application is processed. We will contact you if there is any problem with your application and we will notify ineligible applicants. End of June candidates with complete files who meet eligibility requirements will receive the admission package, confirming eligibility, acceptance, exam site allocation and a receipt for exam fees received. However please feel free to contact us any time before end of June if you have questions.

Avoid additional fees by including all Avoid additional fees by including all Avoid additional fees by including all Avoid additional fees by including all required information and documents required information and documents required information and documents required information and documents

with your application form. Keep a copy with your application form. Keep a copy with your application form. Keep a copy with your application form. Keep a copy of your application, and keep this Guide of your application, and keep this Guide of your application, and keep this Guide of your application, and keep this Guide and your Application Supplement for and your Application Supplement for and your Application Supplement for and your Application Supplement for

reference.reference.reference.reference.


APPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATE

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This section provides important information This section provides important information This section provides important information This section provides important information about applying to be an IBLCE exam about applying to be an IBLCE exam about applying to be an IBLCE exam about applying to be an IBLCE exam candidate and tells you how to fill in the candidate and tells you how to fill in the candidate and tells you how to fill in the candidate and tells you how to fill in the Application Form (version 2.9EU). The Application Form (version 2.9EU). The Application Form (version 2.9EU). The Application Form (version 2.9EU). The numbers refer to the items on the form.numbers refer to the items on the form.numbers refer to the items on the form.numbers refer to the items on the form.

1. IDENTIFICATION DETAILS:1. IDENTIFICATION DETAILS:1. IDENTIFICATION DETAILS:1. IDENTIFICATION DETAILS:

Enter your given names and family or surname. Print clearly and enter one letter in each square.

Please tell us your preferred title and also state any other surname that you use or are known by.

Enter the exam year, your date of birth (dd/mm/yy) and your country of citizenship. 2. ADDRESS AND CONTACT DETAILS:2. ADDRESS AND CONTACT DETAILS:2. ADDRESS AND CONTACT DETAILS:2. ADDRESS AND CONTACT DETAILS:

Print your home postal address clearly. Use the customary format for your country, and the appropriate number of lines. We want to be sure that your admission packet and exam results reach you quickly, without having to be redirected. (We prefer that you do not use a work address, as we have had too many problems with mail not getting through to candidates at their work addresses.)

We may need to contact you for further information. Therefore, please provide your phone numbers, including the area code, and your email address (please print very clearly). We usually prefer to communicate with you by email when appropriate and convenient.

If you change your address or any of your other contact details, you must advise us immediately. We will send you your exam admission packet about four weeks before the exam. Also, during the last few weeks before the exam, we may need to contact you with important information. Therefore, please make sure we have your contact details, especially if you will be away from your usual address. 3. EXAM SITE CITY:3. EXAM SITE CITY:3. EXAM SITE CITY:3. EXAM SITE CITY:

See your Application Supplement for the anticipated exam site cities in your country, normally a capital or main city. The actual location of the exam venue may be in the city or in the surrounding metropolitan area.

Write the name of a city referred to in your Application Supplement. You may also write the name of a city, not mentioned in the Application Supplement, where you would prefer to sit for the exam. Such a request for an additional site will be considered after applications close and you will be advised if your request is successful. We try to make the location of exam sites as convenient as possible for as many candidates as possible. However, when we make decisions about exam sites, we must take into account our overall costs and administrative requirements, the numbers of candidates in the areas served by each site, the reasonableness of the travel that candidates need to

undertake, and whether evidence of any exceptional circumstances is provided. Our security requirements also affect the decision.

Additional sites cannot always be justified but, if a small additional site is arranged, the extra local costs are the responsibility of the candidates who take advantage of it.

Please note that sites for one or a few candidates are considered only in exceptional circumstances.

You will be notified of your allocated exam site with your application package. If your allocated site must be cancelled, you will be contacted earlier and given the option to move to another site or to accept a full refund of fees.

If an additional site is added closer to your home, you will be notified. You will have the option of changing to the new location or remaining at your original site.

A site change may be requested at any time, but may not be possible after the end of June. Contact IBLCE with your request as early as possible. 4. EXAM FEES:4. EXAM FEES:4. EXAM FEES:4. EXAM FEES:

Your full exam fee (credit card details, copy of bank transfer receipt or cheque) must be included with your application. The details of how you can pay your exam fees are described on page 21 of this Guide. Be sure to enclose your correct exam fee. Fees are based on

• the deadline by which your complete application is postmarked

• your country of residence, and

• the fee schedule for which you are eligible.

Please make cheques payable to IBLCE and send to IBLCE as registered mail.

Application fees and deadlines are shown in the Application Supplement specific to the exam year and your country. Deadlines are strictly adhered to and postmarks are checked. 5. ELIGIBILITY PATHWAYS:5. ELIGIBILITY PATHWAYS:5. ELIGIBILITY PATHWAYS:5. ELIGIBILITY PATHWAYS:

The requirements for all the eligibility pathways are described on pages 4 and 5 of this Candidate Information Guide. Please circle one letter only for the Standard pathway for which you believe you are eligible. You may also circle one or both Supplementary pathways, but only if you meet the requirements and need one or both of these pathways to be eligible to sit for the exam. If you have been a candidate before, please indicate the year/s. If you have ever been an IBCLC, but your certification has lapsed, please circle only L as your pathway.


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6. ACCOMPANYING MATERIALS:6. ACCOMPANYING MATERIALS:6. ACCOMPANYING MATERIALS:6. ACCOMPANYING MATERIALS:

All the required accompanying materials must be submitted with your application form. Tick the boxes on the form to confirm that you have included these materials.

Your application is not complete and will not meet fee deadlines unless all accompanying materials are sent by the due date. Please include:

Payment: Your full exam fee – complete credit card details given on the Application Form or copy of bank transfer receipt, cheque or money order.

Qualification: A photocopy of the relevant degree, diploma, practising certificate, etc that verifies your eligibility pathway. Please do not send more documents than necessary; one is often enough. For instance, if you are a midwife, a copy of your registration card or a copy of your degree is sufficient.

Lactation education certificates: Photocopies of certificates of attendance or similar verification for education hours already completed, as listed by you in item 8 of the form. Where these are not available, provide full details or a copy of the program.

If you have not yet completed all the education hours required, you may lodge your application now, but in section 8 of the form you must provide a list of completed education, and/or education for which you are signed up to undertake, that totals at least 45 hours (80 hours if you are doing the exam in a language other than English) and that covers the exam blueprint. All this education must be completed before the exam. The photocopies of these further education hours must be sent to us when completed, preferably before the exam, but in any case within two weeks after the exam.

References: TWO recent original professional references from supervisors or colleagues. For convenience, these may be on the reference forms provided with the application form but, if the referee prefers to write a letter, it must cover all the areas addressed on the form. References may not be from fellow exam applicants (unless they are recertifying IBCLCs), nor can one letter signed by two people count as two references. Do not send unsigned references or photocopies.

Name change document: If any of the above materials are in a name that you use or used, but different from the name in which you have applied, enclose a photocopy of the documentation of your name change.

Please remember that, if you overlook any of the required documents, you are liable for substantial additional fees.

7. CALCULATING YOUR BC HOURS7. CALCULATING YOUR BC HOURS7. CALCULATING YOUR BC HOURS7. CALCULATING YOUR BC HOURS

To determine your eligibility, we need you to tell us your total number of breastfeeding counselling hours (BC hours) and how you have made this calculation.

BC Hours are explained on page 6 of this Guide.

Using the table provided in the application form (attach an additional sheet, if necessary), fill in a new line for each position in which you have worked or had experience providing breastfeeding counselling. Also use a new line for the same position if a change in your responsibilities affected your BC hours. For concurrent work experience, list each separately; for example, if you are employed in the daytime, but teach breastfeeding/parenting classes for another organisation in the evening, use a separate line for each. Please list your experience chronologically.

Column 1: Place of Work/Experience Write the name of your employer/organisation and the location of your work/experience.

Column 2: Title / Position Fill in your job title or the name of your position.

Column 3: Area / Nature of Work / Experience Briefly describe the nature of your work/experience.

Column 4: Month/Year Started and Ended Fill in the month and year you started and the month and year you finished in this position.

Column 5: Total Weeks, Excluding Leave Looking at the dates in Column 4, translate this period of time into the total number of weeks for this position, excluding recreational leave periods (usually at least 6 weeks per year, including public holidays) and sick leave.

Column 6: Average Hours Per Week Fill in the usual number of hours per week you worked in this position. Part-time, relief or shift work employees may average the number of hours per week.

Column 7: Total Hours Worked Figure out your total number of work hours by multiplying the total number of hours per week by the number of weeks in the position. Your employer may be able to provide this figure for you. A full-time job is generally about 38 hours per week times 46 weeks per year or approximately 1700 hours per year worked.

It is accepted that an active, accredited volunteer mother support counsellor averages 10 BC hours per week or 500 BC hours per year. You can claim this, and no further documentation is required. However, If you believe you have done more hours than this, please provide documentation for those periods.

Column 8: Percentage of time providing Breastfeeding Counselling Figure out the number of hours per week you spend on breastfeeding counselling. If your BC hours in any one position varied widely from week to week, it may be necessary to average the different totals. In your current position you may find it helpful to keep a record of your hours for a few weeks.

APPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATEAPPLYING TO BE AN IBLCE EXAM CANDIDATE (continued)(continued)(continued)(continued)


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Divide the number of hours per week that you spend on breastfeeding counselling by the total number of hours you work per week. If you figured 16 hours a week for BC hours within a 38-hour work week, your percentage is 16 divided by 38, multiplied by 100, which equals 42%.

As a general guide, midwives on postnatal wards (where 75% or more of mothers are breastfeeding) commonly average 40% or more of their time providing breastfeeding counselling, depending on the size of the hospital, staffing levels and other duties. Some midwives with particular responsibilities for breastfeeding may do significantly more. Where breastfeeding rates are lower, percentages tend to be lower.

Columns 9 to 12: Total Hours providing Breastfeeding Counselling Multiply your BC percentage in Column 8 by the total number of hours you worked (Column 7). This is your total BC hours for a single job/work experience. For each line, write the total BC hours in Column 9, then give the breakdown of one-to-one in person, telephone/email and consumer education (groups/classes) hours, in Columns 10, 11 and 12 respectively.

Total BC Hours: Then add up the BC hours in Column 9 to give you your total BC hours. For you to be eligible, this overall total figure must be equal to or greater than the minimum number of BC hours required for your Eligibility Pathway. Ensure that the total of each of Columns 11 and 12 is less than 25% of the total of Column 9; if not, you must reduce the number of hours you have included in Columns 11 and 12.

Too few BC hours? If necessary, you may include hours you are certain you will complete between the date of your application and the exam date. Show these hours on a separate line on your application. Before the exam, you will be required to send verification that you have completed the outstanding hours. Please be aware you will not be eligible to receive your exam results if you do not complete these hours before the exam date. If you find yourself in this situation, you should withdraw before the exam (see the Application Supplement for withdrawal deadlines).

Too many BC hours? If you are very experienced, you may find you have many hours in excess of your eligibility requirement. You should provide full details of your most recent hours, up to your eligibility requirement, and then you can summarise your earlier experience. However, please estimate your total hours, for data purposes. 8. PROFESSIONAL LACTATION 8. PROFESSIONAL LACTATION 8. PROFESSIONAL LACTATION 8. PROFESSIONAL LACTATION EDUCATION HOURS: EDUCATION HOURS: EDUCATION HOURS: EDUCATION HOURS:

Using the table in the application form (attach an additional sheet, if necessary), provide details of the professional education specific to lactation or breastfeeding management that you have attended, or are signed up to attend, during the three-year period prior to the date of the exam. You can include relevant education from:

• courses, conferences, seminars, and workshops • in-service study days for health professionals

• distance education (check with the organisers for the contact hour equivalent)

• formal coursework specific to breastfeeding.

You cannot count practice exams as part of your education.

For further information about lactation education and pre-exam training courses, see pages 6 and 23 of this Guide.

To be eligible for the exam, you must document at least 45 hours of professional education specific to lactation and reflecting the exam blueprint. (The minimum is 80 hours if you are doing the exam in a language other than English.)

If you are doing, or have completed, a comprehensive lactation education course, you do not need to list each session, just list the total number of hours awarded.

Sessions with essentially the same content can be counted only once. Private study is not included, nor are audio or video tapes except as part of a structured learning program. Attending or conducting education sessions for parents are not professional education for you.

Sessions or programs do not have to have been formally approved for CERPs (see page 6). If CERPs have been allocated, 1 CERP equals 1 hour. You can only count L (lactation) CERPs towards pre-exam education. If a program has R (related) CERPs or E (ethics) CERPs allocated, these sessions may be useful exam preparation but they can not be included in the required 45 (or 80) hours.

Attach photocopies of any attendance certificates or CERPs certificates you have received. Where you do not attach certificates for proof of program attendance, you must provide detailed self-documentation for each session, or attach a copy of the program. To calculate the hours, count only the actual session time programmed, including questions. Panel sessions relevant to lactation may be included, but do not include breaks or opening/administrative sessions. Generally, a one day lactation seminar will be no more than 5 to 6 education hours.

If necessary, you may include sessions you are signed up to attend between the date of your application and the exam date. Show these uncompleted hours on separate lines on the form. You can be accepted as a candidate while completion of your education hours is still pending, but you must send documentation of at least the required minimum hours to IBLCE as soon as they have been completed. This should preferably be before the exam, but in any case no later than 2 weeks after the exam (or your results may be delayed). Please be aware you will not be eligible to receive your exam results at all if you do not complete these hours before the exam date. If you find you will be unable to complete these outstanding hours you should withdraw before the exam. See the Fees section of this Guide for withdrawal deadlines, and your Application Supplement for refund information.

If you are an applicant who is not an appropriately qualified health professional, you must not include your “background” education in this section of the form. Please enclose a separate sheet showing how you have met this requirement and attach attendance certificates.



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9. PRINCIPAL CURRENT EMPLOYMENT9. PRINCIPAL CURRENT EMPLOYMENT9. PRINCIPAL CURRENT EMPLOYMENT9. PRINCIPAL CURRENT EMPLOYMENT SETTING: SETTING: SETTING: SETTING:

This information is sought for IBLCE’s statistical purposes. Please tick one box which best indicates your principal current employment setting, or describe your situation beside the box marked “Other”. If you regularly work in more than one setting, you may tick a second setting if it involves a significant proportion of your time.

10. WORKPLACE:10. WORKPLACE:10. WORKPLACE:10. WORKPLACE:

Please complete the information requested about your workplace name and address.

11. BIOGRAPHICAL DETAILS:11. BIOGRAPHICAL DETAILS:11. BIOGRAPHICAL DETAILS:11. BIOGRAPHICAL DETAILS:

Tick all the boxes that correspond to your qualification/s or registration/s. If you have relevant qualification/s or registration/s in the health care field that are not included on the list, please fill in the “Other” line.

Tick one box to indicate the highest level of post-secondary education that you have successfully completed. Do not tick a qualification not yet completed.

Tick the box for your gender. We need to know this information for selection of exam supervisors.

12. INDIVIDUAL CONSIDERATIONS:12. INDIVIDUAL CONSIDERATIONS:12. INDIVIDUAL CONSIDERATIONS:12. INDIVIDUAL CONSIDERATIONS:

It is IBLCE policy that no individual shall be excluded from certification on the basis of race, national origin, religion, gender, age, or physical disability.

If you have reason to require individual consideration when you sit for the exam, mark the appropriate box/es in this section of the application form, and provide accompanying documentation where requested. These requests should be made at the time of your application as they may require special arrangements. If a problem requiring individual consideration arises closer to the exam date, please advise IBLCE as soon as possible.

The time that is allowed for the exam in generous, and allows for candidates who are slow test takers or doing the exam in a language other than their primary language.

Candidates with disabilitiesCandidates with disabilitiesCandidates with disabilitiesCandidates with disabilities

A candidate with a disability may request individual consideration by providing written notice, with an original signature and appropriate documentation, including: • an official letter which clearly states the nature and extent

of the disability; and • details of any appropriate modifications to the exam

procedure which are requested; and • details of any appropriate auxiliary aids that the candidate

may need to sit for the exam.

Where possible, individual arrangements at the exam site for candidates with disabilities will be provided by IBLCE. There will be no additional charge to the candidate. It may not be possible to meet requests received after the final application deadline. For more information contact IBLCE.

Pregnant candidatesPregnant candidatesPregnant candidatesPregnant candidates

A candidate who will be in the last trimester of pregnancy or recently delivered at the time of the exam, should provide her due date. Special consideration can be given to seating for pregnant candidates. Parents of young babies will need to make their own arrangements for care of the baby during the two exam sessions. Babies are not allowed in the exam room.

Exam translationsExam translationsExam translationsExam translations

Each year the exam is translated into several languages according to demand and availability of suitable translators. For a translation where there is typically only a small number of candidates, or for a translation language new to IBLCE, at least 15 eligible candidates must have applied and paid their exam fees before 31 December for the translation to be considered.

At the time of application a candidate should indicate in which language other than English s/he wishes to do the exam, if it were to be made available. If there are not enough applicants wishing to do the exam in this language, there will not be a translation offered, and applicants will be entitled to a full refund or may elect to do the exam in English.

Translations in previous years have included Arabic, Dutch, French, German, Icelandic, Italian, Japanese, Korean, Polish, Portuguese, Spanish, Hungarian, Slovenian and Swedish. A candidate may have access to exam materials in only one language version. It is not permitted to have two exam booklets in different languages.

Use of a bilingual dictionaryUse of a bilingual dictionaryUse of a bilingual dictionaryUse of a bilingual dictionary

A candidate may be given permission to use her/his own unmarked non-electronic bilingual dictionary during the exam. An unmarked non-electronic bilingual medical dictionary is also permissible, as long as it contains only translations of words and has no definitions.

The use of dictionaries can be requested on the application form and IBLCE will communicate the local arrangements to you. At sites where many candidates are using them, you may be required to submit your dictionary to the Chief Proctor or a designated assistant prior to the exam date. Please include your name, address, and telephone number inside the front cover. You will not be permitted to use any dictionary that has not been submitted for checking.

Electronic dictionaries, computers, calculators, etc. are not permitted in the exam room. 13. SIGNED STATEMENT:13. SIGNED STATEMENT:13. SIGNED STATEMENT:13. SIGNED STATEMENT: Please read the Statement carefully. Be sure to circle the appropriate response to each of the five questions. If you answer “Yes” to any of the questions, you should provide information with your application. If necessary, IBLCE will confidentially seek further information from you. A “Yes” response will not necessarily mean you will not be permitted to sit for the exam, especially if you are otherwise able to be employed in the health care system without restriction.

You must sign and date your application, or it will be classed as incomplete and additional fees will be charged.



FEES AND DEADLINESFEES AND DEADLINESFEES AND DEADLINESFEES AND DEADLINES

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EXAM FEESEXAM FEESEXAM FEESEXAM FEES

Fees are set according to country of residence and take into account central and local administrative costs. The fees are set out in the table in the Application Supplement specific to the exam year and your country.

All fees must be paid in EURO and may be paid by:

Credit card authorisation: by completing the section on the Application Form, using only Visa or MasterCard.

Bank transfer from a bank account to IBLCE’s bank account in Austria: For a European Standard Transfer:

IBAN: AT55 2020 5012 0000 3067

BIC: SPBDAT21XXX

For bank transfers from the Middle East and North Africa:

Account in the name of: IBLCE in Europe, Steinfeldgasse 11 2511 Pfaffstaetten, Austria

Account no: 1200-003067

Name and address of bank: Sparkasse Baden, Stiftgasse 1 2511 Pfaffstaetten, Austria

SWIFT/BIC: SPBDAT21XXX

Please make this bank transfer before you post your application, and enclose a photocopy of the bank transfer receipt with your application form so that we can match your payment to our bank statement.

We cannot accept payment of fees by cheque or money order!

Please note that banking of your payment does not constitute an acknowledgment of eligibility.

Your fee depends on when your complete application (with all accompanying materials) is postmarked. Please check the three levels of fees listed in the table in your Application Supplement, and ensure that the fee you are paying is correct for the date of posting. Deadlines are strictly adhered to.

APPLICATION DEADLINESAPPLICATION DEADLINESAPPLICATION DEADLINESAPPLICATION DEADLINES

Applications must be postmarked by the following dates to qualify for the respective fee level:

Early exam fee deadlineEarly exam fee deadlineEarly exam fee deadlineEarly exam fee deadline 28 February28 February28 February28 February Standard exam fee deadlineStandard exam fee deadlineStandard exam fee deadlineStandard exam fee deadline 31 March31 March31 March31 March Late exam fee deadlineLate exam fee deadlineLate exam fee deadlineLate exam fee deadline 30 April30 April30 April30 April

INELIGIBLE APPLICANT FEEINELIGIBLE APPLICANT FEEINELIGIBLE APPLICANT FEEINELIGIBLE APPLICANT FEE

An applicant whose application does not meet the requirements to sit for the exam will receive a refund of her/his exam fee minus the processing fee listed in table in your Application Supplement. INCOMPLETE APPLICATIONSINCOMPLETE APPLICATIONSINCOMPLETE APPLICATIONSINCOMPLETE APPLICATIONS

If any item of required information or documentation is not included with your application, your application will be classed as incomplete and therefore it will not have met the fee deadline. We will contact you about what is missing.

Incomplete applications will be treated as meeting the next deadline. There will therefore be an additional charge, being the difference between the fee you have paid and the fee for the next deadline.

This policy has been instituted because of the extra administrative time and costs involved, and so as to be fair to other applicants who have delayed their applications till a later deadline to ensure that their applications included all the required information and documents.

Do not send your application unless all sections are completed, full payment and all accompanying materials are enclosed, and it is signed. To avoid further fees, check it very carefully before sending.

Examples that would make your application incomplete:

• not enclosing two references* [section 6] • not enclosing your qualification certificate/s [section 6] • not enclosing a name change document if required

[section 6] • not listing the required BC hours [section 7] • not listing at least 45 (80 if applicable) completed

education hours (or not naming the comprehensive course ) [section 8]

• not providing your biographical details [section 11] • not completing the signed statement or not answering all

4 questions or not signing the statement [section 13]

*If a referee is sending a reference directly to us, please include a note with your application stating the name and contact details of that referee. Such a reference must reach us before, or within 10 days after, your application is received, otherwise your application will be classed as incomplete.

HANDHANDHANDHAND----SCORING FEESCORING FEESCORING FEESCORING FEE

A request for hand-scoring of exam answer sheets (see page 30) must be accompanied by the fee listed in the table in your Application Supplement.


FEES AND DEADLINES FEES AND DEADLINES FEES AND DEADLINES FEES AND DEADLINES (continued)(continued)(continued)(continued)

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RERERERE----ISSUE OF CERTIFICATE FEEISSUE OF CERTIFICATE FEEISSUE OF CERTIFICATE FEEISSUE OF CERTIFICATE FEE

Requests may be made in writing for a certificate to be re-issued, due to name change, damage to your certificate, etc. Please enclose your old certificate with your request. The fee listed in the table in the Application Supplement is required for processing and mailing. Certificates damaged when they are mailed out will be replaced at no cost if IBLCE is notified immediately.

WITHDRAWAL DEADLINESWITHDRAWAL DEADLINESWITHDRAWAL DEADLINESWITHDRAWAL DEADLINES

Examination fees are partially refundable. A candidate who decides to withdraw from sitting for the exam, for any reason, must send a written request for a partial refund by mail, fax or email by 20 June (for the higher level of refund) or 15 July (for the lower level of refund). The levels of these refunds are shown in the table in your Application Supplement. If you have already received your exam admission ticket, return it with your request.

You do not need to provide a reason or supporting documentation to request a withdrawal refund. Only the candidate can request the withdrawal. If the exam fees were paid by a third party, the partial refund will be made to that party. An alternative candidate is not permitted to sit for the exam by using your exam fee.

A candidate whose application is accepted subject to the eligibility requirements being completed, and who later finds that s/he will not be able to complete all the requirements prior to the exam date, cannot be certified and should withdraw, sending the written request for a partial refund by the dates specified.

Except in the following limited circumstances, no applications or exam fees may be held over or transferred from one year to the next. In extreme circumstances IBLCE will consider allowing a candidate to defer to the following year, but only if a case is presented outlining the unusual and exceptional circumstances that would justify deferral, accompanied by appropriate medical certificates and other documentation, and then only if an additional administrative fee is paid the following year. Such a deferred candidate must lodge the next year’s application by the early closing date, and all eligibility requirements (including education hours) must already have been met by that date. A candidate wishing to request consideration of a deferral must contact IBLCE as soon as possible.

Please understand that IBLCE needs to set strict rules about deadlines, and limitations on refunds, because it incurs costs and financial obligations at certain stages of the period leading up to the exam date. For instance, as well as administrative and printing costs incurred per candidate, exam room bookings and engagement of proctors have to be organised in advance; these costs are related to the numbers of candidates at each site.

Avoid additional fees by including all required Avoid additional fees by including all required Avoid additional fees by including all required Avoid additional fees by including all required information and documents with your application information and documents with your application information and documents with your application information and documents with your application

form. Keep a copy of your application, and keep this form. Keep a copy of your application, and keep this form. Keep a copy of your application, and keep this form. Keep a copy of your application, and keep this Guide and your Application Supplement for reference.Guide and your Application Supplement for reference.Guide and your Application Supplement for reference.Guide and your Application Supplement for reference.

IS YOUR EMPLOYER PAYING?IS YOUR EMPLOYER PAYING?IS YOUR EMPLOYER PAYING?IS YOUR EMPLOYER PAYING?

We welcome the fact that many employing institutions show their support for their staff by paying fees on behalf of candidates. We appreciate the need of those institutions to be supplied with a complying tax invoice. As a not–for-profit-organisation we will issue a “Confirmation of Exam Fees” for this purpose on request.

We very much prefer that payment accompany the same time as sending the candidate’s application form, as we cannot process an application unless and until the appropriate fee has been paid. A “Confirmation of Exam Fees” is available on request. Exam fees and associated administration charges, are VAT-free. A receipt will be provided with the admission package or earlier on request.

We kindly ask you to understand that in terms of fairness to all candidates, deadlines will be monitored strictly. In order to be valid for a certain deadline we will need your complete documentation and proof of payment of exam fees sent within the specified deadline. If the transfer of fees falls into the next deadline or if an application is not complete, we will have to ask you to pay the difference to the next level of fees.

Alternatively to an employer paying for exam fees, the staff member may pay the fee and be reimbursed by the employer. We strongly recommend the latter method, as that way the staff member keeps control over the date of payment and avoids the liability for the additional cost of a higher fee level if the employer’s finance department is slow in generating payment and the intended deadline is missed.

EXAM FEES AND PROFESSIONAL ETHICSEXAM FEES AND PROFESSIONAL ETHICSEXAM FEES AND PROFESSIONAL ETHICSEXAM FEES AND PROFESSIONAL ETHICS Health workers have a responsibility to be familiar with the International Code of Marketing of Breast-milk Substitutes and to understand their responsibilities in relation to it (Article 7.1). The IBLCE Code of Ethics requires IBCLCs to abide by the provisions of the Code, and subsequent World Health Assembly (WHA) resolutions, which apply to health workers. If a health worker receives a contribution from a company which markets or distributes products within the scope of the International Code, for example-exam fees, textbooks, or pre-exam education, the Code requires that both the company and recipient must disclose this to any institution with which the recipient is affiliated. This also applies to contributions made to a third party on the health worker’s behalf (Article 7.5). Financial contributions should not create a conflict of interest, especially in regard to the Baby Friendly Hospital Initiative. (WHA 49.15)

“Repeat” DISCOUNT“Repeat” DISCOUNT“Repeat” DISCOUNT“Repeat” DISCOUNT

This special rate is available to an exam candidate who was unsuccessful and is applying again in the immediately following year. Eligibility must still be current; the IBLCE Office will provide further information. The fees payable are shown in the “Repeat” column in the table in your Application Supplement. This special rate is also allowed to a former IBCLC whose certification lapsed in the immediately preceding year.


STUDY STRATEGIESSTUDY STRATEGIESSTUDY STRATEGIESSTUDY STRATEGIES

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Because each candidate’s background and experience is different, you are expected to determine your own strengths and weaknesses in the relevant Disciplines and Chronological Periods, and to organise your own program of study. The following information may help you organise your study, and may be used in conjunction with other sections of this booklet: Exam Blueprint, Clinical Competencies, the Suggested Reading List, and ILCA’s Standards of Practice.

Plan your study program ahead and determine how you study best. Do you learn better on your own or when you can discuss material with colleagues? You may want to organise a study group or find a study partner, then take turns in preparing and presenting topics. Some people learn well from working through a textbook cover-to-cover; others prefer to choose a topic and study different sources of information.

Identify areas where your background has given you little experience and ensure you cover these areas in your preparation. For example, if you have worked only in a hospital postnatal area, you may have little experience with breastfeeding beyond the early period. Use the Suggested Activities in this booklet as a checklist to see how well prepared you are.

The IBLCE exam is a certification exam, which means that it is a standardised independent assessment of knowledge and competency. This is recognised as a higher standard than courses with internal exams, which may teach to their assessment or assess to their teaching.

As well as meeting the pre-exam eligibility requirements, you must take responsibility for preparing yourself for the exam. Most candidates find that the simplest way to ensure their education reflects the exam blueprint, and is at the appropriate level, is to participate in a comprehensive lactation course which is designed for this purpose. It is very difficult to prepare adequately for the exam and cover the exam blueprint by putting together only sessions from conferences, in-service education and chat nights.

Evaluate available courses to determine whether there is one that will best meet your needs as a candidate. The IBLCE in Europe website has got a list of available pre-exam-education programs in Europe and the Middle East. See section “Pre-Exam-Edu”.

On the website of the International Lactation Consultant Association (ILCA) http://www.ilca.org/accredi.html you will find information about pre-exam-education programs which have been accredited by ARCC, an international body established to provide a reliable indicator of the educational quality of courses.

It is important that you assess the degree and depth to which a course addresses all the Disciplines and Chronological Periods which the exam blueprint covers. This assessment will enable you to identify aspects that will need to be

We strongly suggest that you check off the Exam Blueprint and the Clinical Competencies and be sure you have addressed all areas. Typically, candidates’ exam scores are lower in the disciplines that are less clinical (G, H, I, J & M), and yet practising lactation consultants consider that these are important aspects of their work. To gain a better understanding of the roles and skills required, try to spend time with experienced IBCLCs working in various settings.

Allow time to integrate your new knowledge and skills into your practice. Two-thirds of the exam questions will test application of knowledge.

In determining how deeply to study a subject area, you need to asking yourself what a lactation consultant might need to know. As you study each topic, ask yourself how the information might fit into the broad scope of an IBCLC’s practice. Application of your knowledge is the ultimate purpose of your study.

LACTATION AND EXAM PREPARATION COURSESLACTATION AND EXAM PREPARATION COURSESLACTATION AND EXAM PREPARATION COURSESLACTATION AND EXAM PREPARATION COURSES

covered in other ways. Courses may also be basic or advanced. Some are conducted over several weeks or months; some are short and intensive; and some are on-line or by distance education. Some simply require attendance; some encourage pre-reading on specified topics; and some have written work to be submitted for assessment. Some may also include clinical hours. Some include a practice exam, but please note that, while practice exams and the associated discussion may help you to better understand exam questions, they are not an optimal way to learn about lactation and breastfeeding management, and you cannot count them as part of your lactation education hours.

No course can possibly teach you everything you need to know for the exam; that’s why you need both private study and clinical experience in a setting where your practice is based on the application of scientific principles and on current research and information.

Please note that the IBLCE does not provide any Please note that the IBLCE does not provide any Please note that the IBLCE does not provide any Please note that the IBLCE does not provide any educational materials or conduct any courses, and is educational materials or conduct any courses, and is educational materials or conduct any courses, and is educational materials or conduct any courses, and is completely independent of the many private lactation completely independent of the many private lactation completely independent of the many private lactation completely independent of the many private lactation and exam preparation courses, practice exams and other and exam preparation courses, practice exams and other and exam preparation courses, practice exams and other and exam preparation courses, practice exams and other materials that candidates use to prepare for the exam. materials that candidates use to prepare for the exam. materials that candidates use to prepare for the exam. materials that candidates use to prepare for the exam. The content of the courses and their practice exams may The content of the courses and their practice exams may The content of the courses and their practice exams may The content of the courses and their practice exams may be quite different from the IBLCE exam. “CERPs” be quite different from the IBLCE exam. “CERPs” be quite different from the IBLCE exam. “CERPs” be quite different from the IBLCE exam. “CERPs” approval by IBLCE is not an endorsement of a approval by IBLCE is not an endorsement of a approval by IBLCE is not an endorsement of a approval by IBLCE is not an endorsement of a presenter’s content or opinions, nor does it necessarily presenter’s content or opinions, nor does it necessarily presenter’s content or opinions, nor does it necessarily presenter’s content or opinions, nor does it necessarily indicate whether a program is of suitable standard or indicate whether a program is of suitable standard or indicate whether a program is of suitable standard or indicate whether a program is of suitable standard or content for exam preparation.content for exam preparation.content for exam preparation.content for exam preparation.

PREPARING FOR THE EXAMPREPARING FOR THE EXAMPREPARING FOR THE EXAMPREPARING FOR THE EXAM


CHECKLIST OF SUGGESTED ACTIVITIESCHECKLIST OF SUGGESTED ACTIVITIESCHECKLIST OF SUGGESTED ACTIVITIESCHECKLIST OF SUGGESTED ACTIVITIES

The IBLCE Exam Blueprint covers many Disciplines and Chronological Periods. The experiences in each candidate’s background may not address all areas listed. For example, someone who works on a postpartum ward may have little experience with older breastfeeding babies. An accredited mother support counsellor may have little experience with premature or special care babies. A candidate with children of her or his own may have a better knowledge of child development.

It is vital that lactation consultants are thoroughly familiar with normal breastfeeding. This puts abnormal situations and experiences into perspective.

The following suggested activities may help broaden the scope of your professional development. You should seek to observe areas that are not part of your everyday work experience. Although most of these activities will not be applicable toward your clinical practice hours, they will help to make you aware of deficiencies in your background and increase the efficiency of your preparation. This list is in no particular order and is a starting point only; you may think of other activities that will augment your general breastfeeding consultant experience.

As you prepare for the exam, tick the boxes on this checklist to measure the breadth of your experiences.

� Work with or observe a lactation consultant to study her or his experiences and client interactions.

� Expand your professional education to a broad spectrum of programs. Consider attending a childbirth conference, a seminar conducted by a professional association, or sessions presented by a lawyer, a dietician, or a human relations counsellor. Although only lactation topics meet the exam eligibility requirement, other professional education opportunities are also valuable.

� Study the anatomy and physiology of the breast in detail, including how milk is synthesised. A course may help. Learn about infant oral anatomy and development.

� Offer to present a session to your colleagues on the biochemistry of human milk, or a similar challenging topic. Presenting a topic usually requires you to develop a real understanding of the subject matter you are talking about.

� Observe the interaction of a mother and baby continuously for the first two hours after birth. Compare the baby of a mother who used no medication during labour with the baby of a mother who used pain relief medication.

� Study the interactions of newborns with their mothers.

� Attend a variety of mother-support meetings to observe mothers and babies and to learn breast-feeding techniques. Note how counsellors listen, ask questions, practise ethics, etc.

� Observe the developmental milestones of babies and young children in a casual setting. You might spend time at a playground, a playgroup or a mother support gathering watching the inter-actions of mothers and babies/toddlers. Try to guess the ages of babies/toddlers by observing their developmental activity level. Ask the mother her child’s age to see if you have determined correctly.

� Study the normal growth, development and breastfeeding behaviour of a single baby over a six month period. Describe the first few days, weeks. How do these differ from breastfeeding at six months?

� Have an IBCLC observe your consultations or interactions with mothers. Ask her or him to critique different things at different times - your counselling skills, your problem solving skills, your practical skills, or your breastfeeding knowledge in the clinical situation.

� Become a mother-support group newsletter subscriber. These publications are generally full of mothers’ personal experiences.

� Sit with a lactation consultant who is staffing a breastfeeding phone counselling line. Listen to her/his counselling techniques.

� Attend a Baby Friendly Hospital Initiative course. Review hospital practices to see how breastfeeding-friendly they are. What types of breastfeeding problems might poor hospital practices generate? How might these be prevented?

� Seek out a professional lactation consultant organisation for support, information and educational opportunities.

While these suggestions are not mandatory, they will help you to broaden your perspective, enhance your skills, and focus your studies in this multi-disciplinary field. You may think you are going to use the credential only in your current practice setting, but IBCLCs are qualified and accountable for competence in all practice settings.


EXAM INFORMATIONEXAM INFORMATIONEXAM INFORMATIONEXAM INFORMATION

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EXAM CONTENTEXAM CONTENTEXAM CONTENTEXAM CONTENT

The exam is composed of 200 multiple choice questions. The degree of difficulty is set at postgraduate university level. Since effective lactation consultation requires assessment and decision-making skills, the questions are primarily designed to test the application of knowledge, rather than the pure recall of facts. Application questions are more realistic and enhance the validity of the exam.

The exam is administered in two sessions of 100 questions each. Of the 200 questions, 125 are cognitive, based on word scenarios, and 75 are based on photos. They are all combined for classification into Disciplines and Chronological Periods.

The Exam Blueprint in this Guide gives more information about the Disciplines and Chronological Periods, with the number of anticipated exam questions for each shown in brackets. This outline helps you determine the relative emphasis of the exam and reflects average lactation consultant practice, based on an extensive role delineation survey. For example, Pathology (19-33) means that there will be a minimum of 19 questions and a maximum of 33 questions which address infant and maternal pathological conditions relevant to lactation consultant practice.

Checking your knowledge and skills off against the Exam Blueprint will help you to identify areas you need to address, and help you focus your study.

The sample test questions in this booklet were selected as examples of the type of multiple choice questions that may be expected on the cognitive portion of the exam. Since they are limited in scope, they should not be regarded as representative of the full range of material that will be tested, or the degree of difficulty.

The photo section has 75 questions based on colour photographs which illustrate various situations and clinical conditions relevant to lactation consultant practice. Typically, candidates are asked to evaluate whether or not a problem is present, the nature of the problem, or how it should be managed. Each candidate will be provided with a booklet of colour pictures to use for this part of the exam.

Although the exam is administered in two sessions, the scores for the both sessions are added together to determine each candidate’s overall score and pass/fail designation. Candidates pass or fail the examination as a whole. A higher score in one area can compensate for a lower score in another area, so the candidate passes the overall exam.

EXAM QUESTION REFERENCINGEXAM QUESTION REFERENCINGEXAM QUESTION REFERENCINGEXAM QUESTION REFERENCING

All examination questions are referenced to the technical/medical literature, usually to literature published within the last five years. Older scientific studies may be used if they are still quoted as reputable references in current texts. Each exam question is referenced to printed materials, not to statements made at conferences. Anecdotal material, controversial information, authors’ opinions and areas where the major texts give conflicting information are all avoided. References are current to the end of the calendar year prior to the exam.

IBLCE EXAM COMMITTEIBLCE EXAM COMMITTEIBLCE EXAM COMMITTEIBLCE EXAM COMMITTEEEEE

The Exam Committee, chaired by a Director of the IBLCE Board, works under the direction of a PhD in Psychometrics, who is a Health Professions Certification Examination Consultant. The following groups will typically be represented on the Exam Committee to give a range of professional expertise: IBCLCs in hospital and in community practice, lactation educators, IBCLCs trained primarily through the mother support system, IBCLCs who trained through traditional health professions, medical practitioners experienced in supporting mothers and babies, a PhD level researcher in lactation, and the highest scorer from the previous year’s exam. As far as possible, the Committee reflects the geographic distribution of IBCLCs, including Europe and the Asia/Pacific region.

The Exam Committee meets over several days to prepare, review, edit, and select test items which are then compiled into a draft exam based on the blueprint. The Committee draws from previously-used questions and from new questions submitted by IBCLCs and other experts worldwide. All questions are written in a sophisticated multiple choice format. The final exam goes through several editing and approval stages before being translated into other languages, according to demand.

EXAM CONFIDENTIALITYEXAM CONFIDENTIALITYEXAM CONFIDENTIALITYEXAM CONFIDENTIALITY

Each year, the IBLCE uses a percentage of previously used questions on the current exam, for validity testing. It is therefore considered unethical to divulge any questions on the IBLCE exam or to request information from previous candidates. If a candidate who had received inside information were to pass the exam unfairly, it would be to the detriment of breastfeeding babies and mothers and to the profession itself.


EXAM INFORMATION (continued)EXAM INFORMATION (continued)EXAM INFORMATION (continued)EXAM INFORMATION (continued)

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EXAMEXAMEXAMEXAM QUESTIONS QUESTIONS QUESTIONS QUESTIONS Each question in the exam has an introductory sentence or paragraph (stem). All the information necessary to answer the question is given in the stem or the accompanying picture. Candidates can be assured there are no additional complicating circumstances if they are not mentioned.

Many items refer to a clinical situation involving the mother and/or baby and ask what “you” should do. In these items, “you” means you in your role as a lactation consultant. If you have another professional role which authorises you to perform additional functions (such as a doctor with prescribing rights), do not include these functions in the role of the lactation consultant for the purposes of this exam. See ILCA’s Standards of Practice for Lactation Consultants to better understand the LC role.

Each item contains a specific question which you should read carefully to know what is being asked. The key word is capitalised. Some questions may ask for “the MOST appropriate intervention” or “which of the following would NOT be appropriate to recommend”. The purpose of these questions is not to mislead or “trick” you, but to represent the types of decisions that lactation consultants often face.

For example, a mother may benefit from any of several interventions, but the lactation consultant should know the intervention that is MOST likely to be effective in her situation and why other interventions might not be as effective. At other times, there are several interventions which may be effective, but there is one that should NOT be recommended.

There may also be questions which ask for “the MOST (or LEAST) likely cause or explanation”. These questions test knowledge of the general principles which apply to clinical practice, which candidates acquire through their experience.

Each item has three to five responses, most commonly four. There is only ONE correct answer, and knowledgeable candidates will be able to identify why the other answers are not correct. IBLCE does not use true/false questions or such options as “all of the above”, “none of the above”, “a and c” , etc. because these types of questions are not psychometrically valid.

Common misconceptions and outdated ideas are often included among the incorrect responses. Candidates should not worry that these responses are intended to be correct. The exam has been checked by experts.

HOW THE EXAM IS SCOREHOW THE EXAM IS SCOREHOW THE EXAM IS SCOREHOW THE EXAM IS SCOREDDDD

The pass/fail cut-off score is determined according to the Nedelsky-Gross technique which measures the degree of difficulty of each question, based on the number of sophisticated responses which might distract candidates from the correct response. The level of difficulty of the overall exam is, therefore, based on averaging a myriad of individual analyses of each question. The more difficult the exam, the lower the pass/fail cut-off score, and vice-versa.

The Nedelsky-Gross technique ensures that there is no arbitrary number or percentage of candidates who pass the exam each year, and that candidates are not competing against each other. It also ensures that variations in the degree of difficulty of the exam from one year to another will not affect an individual candidate’s likelihood of passing or failing the exam. Over the years, the pass/fail cut-off has ranged between 61% and 68%.

All answer sheets are computer-scanned and scored by a consultant psychometrician. Each sheet is checked for stray marks and possible double counting where a response has been erased and replaced. Every year, a number of answer sheets are hand scored to check accuracy.

There is only one correct answer to each question. Each item receives one point if correct, zero if incorrect. Points are not deducted for incorrect answers, so candidates should attempt all questions.

After all answer sheets have been initially scored, each question is individually analysed in the post-exam review process, using performance data from all (approx. 2500) candidates. This identifies any questions which did not perform as expected or were ambiguous. If there were to be a faulty question, this post-exam review is most likely to identify it. Questions are also reviewed on the basis of comments that candidates have made on their critique forms. Questions determined to have been flawed, e.g. two correct answers, are deleted from scoring for all candidates so no-one is disadvantaged. All candidates’ scores are then recomputed. This quality control procedure enhances reliability, validity, and fairness.

Each year, a number of previously used questions are included in the current exam, and the performance of the current candidates on those questions is compared with how the question performed when it was previously used. This procedure enhances validity by providing a check on whether the competence level of the candidate body has changed.

The IBLCE exam has a low failure rate, yet the highest scores are typically in the mid-80% range and the mean scores in the low to mid-70% range. This result demonstrates a well prepared, well screened candidate body and a challenging exam.

The Critique Form IBLCE is unusual in that we give you a Critique Form to use during the exam. Comments on individual questions should be restricted to those which you have good reason to believe may be faulty and must include an explanation or they will not be collated and considered by the Post-Exam Review Committee. You should also state which answer you chose - many comments merely tell us why an incorrect answer is incorrect.

Your comments are entirely optional and will not affect your individual score in any way.


SAMPLE EXAM QUESTIONSSAMPLE EXAM QUESTIONSSAMPLE EXAM QUESTIONSSAMPLE EXAM QUESTIONS

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1. A woman interrupts your breastfeeding class to ask you about breastfeeding an anticipated adopted baby. She has been using an electric pump and has generated a 30 ml (1-oz) per day supply. What should you do FIRST?

a. Praise her for her interest and offer to meet with her later to discuss it further.

b. Ask how she plans to provide nutrition for the baby beyond her own 30 ml (1-oz) per day production.

c. Thank her for attending and ease her out the door as quickly as possible.

d. Inform her that it is unlikely she will bring in more milk. [1-G]

2. A pregnant woman contacts you after attending a prenatal

class on infant feeding. The instructor has been very positive about breastfeeding, but emphasised that lactation hormones may affect sexual functioning. You should tell her that lactation hormones usually:

a. reduce libido. b. increase libido. c. reduce vaginal lubrication. d. increase vaginal lubrication. e. do not affect libido or vaginal lubrication. [2-B] 3. Which of the following techniques minimises the risk of

causing nipple trauma?

a. Position the infant on his back in his mother’s arms and elicit the rooting reflex; when the infant turns his head, place the nipple in his mouth.

b. Support the breast using the first and second fingers on either side of the areola.

c. Prevent the nipple from coming in contact with the infant’s soft palate to decrease the incidence of tongue thrusting.

d. Position the infant so that his entire body faces the mother, and much of the areolar tissue is in the infant's mouth. [5-L]

4. The MOST advantageous moment for the first breastfeed

of a premature infant is when the baby is:

a. awake and in an alert state.

b. crying from a recently performed procedure and needing comfort.

c. relaxed, peaceful, and drowsy.

d. in a deep sleep and unable to resist an attempt to put the breast into his mouth. [4-L]

5. The definitive symptom of incorrect positioning of a baby at the breast is:

a. nipple pain. b. irritated, inflamed nipple epithelium. c. stabbing pain when the baby latches on. d. a compression stripe across the nipple. e. blanching of the whole nipple after feeding. [6-L]

6. You are a lactation consultant in private practice. A mother reports that she feels rejected by her 2-week old infant's refusal to breastfeed, and she wants to hit him. How should this conversation be handled for documentation purposes?

a. Do not write any notes, since they can be subpoenaed. b. Write her statement as a quote and urgently phone her

doctor or an appropriate social service agency. c. Contact a lawyer. d. Take written notes and require that the mother initial

them. [12-J]

7. A mother had been expressing to maintain her milk supply for her very sick baby. You have been seeing her weekly and her son is now 4 months old and has been hospitalised since birth . When told three days ago that her son would be in hospital for a year, she stopped expressing. You should:

a. begin intensive counselling to convince her to relactate.

b. discontinue meeting with her. c. meet with her a final time to explain how to dry up her

milk. d. send her a leaflet on breastfeeding, bringing her

attention to drying up one's milk. e. continue to meet with her until both of you feel

comfortable with ending the appointments. [9-G]

8. A mother contacts you complaining of overall aching and fatigue and has a fever of 39.4oC (103oF). Her breast is sore and has red streaks. Her baby refuses to breastfeed. The MOST important thing you should advise her to do is:

a. go to bed and get plenty of rest, arranging for the father to give the baby a bottle of formula at night.

b. breastfeed frequently, offering the affected side first. c. see her doctor to discuss antibiotic treatment. d. offer the unaffected breast only. [12-E]

9. For babies, objects and people do not exist when out of sight. In which of the following age ranges is this perception most likely to change?

a. 3-5 months b. 6-9 months c. 10-13 months d. 14-17 months [10-H]

These sample questions are indicative of the types of questions you can expect in the exam. They are not representative of the overall degree of difficulty, so “passing” this exam is not an indication that you are ready to pass the IBLCE exam. These questions are from old exams and more likely to be easier because they are testing more basic knowledge. The number and letter in brackets after each question indicates the Chronological Period and the Discipline on the Exam Blueprint. The answers are shown in a box at the end.


SAMPLE EXAM QUESTIONS (continued)SAMPLE EXAM QUESTIONS (continued)SAMPLE EXAM QUESTIONS (continued)SAMPLE EXAM QUESTIONS (continued)

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10. A mother is found to be HIV positive as a result of artificial insemination. She breastfed her baby, who is now 6 months old, for the first 6 weeks. The child will MOST likely have:

a. no symptoms of AIDS and no HIV antibodies. b. no symptoms of AIDS but may have HIV antibodies. c. symptoms of AIDS and no HIV antibodies. d. symptoms of AIDS and HIV antibodies. [9-D]

11. The mother of a 19-month-old baby is concerned because he wants to breastfeed at naptime and bedtime, and he appears to have little appetite for other foods. The doctor considered him to be very healthy at his 18-month check-up, but the mother still worries that his continued breastfeeding is preventing him from eating enough solid foods. Your BEST response is that:

a. toddlers who drink too much milk and do not eat enough solid foods can develop “milk anaemia.”

b. many toddlers have small appetites, whether they are weaned or not.

c. human milk is all he needs. d. human milk has very little nutritional value for a

19-month-old child. [11-H]

12. You are working with an obstetrician in conducting a study of pregnant women who have inverted nipples. The study requires photo documentation of the women's breasts. What is the MOST appropriate legal and ethical procedure in taking these photographs?

a. Obtain written release from the women before photographing them.

b. Obtain written release from the women after photographing them.

c. Obtain written release from the women only if the photographs are to be submitted for publication.

d. Offer written assurance to share any royalties from the use of the photographs. [2-J]

NEGATIVE STEM NEGATIVE STEM NEGATIVE STEM NEGATIVE STEM QUESTION CONSTRUCTIONQUESTION CONSTRUCTIONQUESTION CONSTRUCTIONQUESTION CONSTRUCTION

The following questions are samples of certain kinds of construction forms with which some candidates may be unfamiliar. Because this type of question requires a “mental shift” to think in negative terms after answering a series of positive questions, candidates sometimes interpret them as ambiguous or tricky. However, in spite of these concerns, the construction forms below are psychometrically valid and they represent skills that lactation consultants use. As familiarity and practice may help allay candidate concerns, these questions are grouped according to three common construction types. Work through them carefully and the interpretation shift will become evident. You will be alerted to the groups of negative stem questions on the exam and you should take special care to make the mental shift.

The “NOT” Construction

13. A 9-day-old infant with cleft palate defects should NOT be positioned for feedings with its body:

a. in the cradle or across the front position b. semi-upright or upright c. in the clutch/underarm position d. prone [6-E]

14. Which of the following is NOT a developmental indicator for introducing solid foods?

a. baby shows interest in table foods b. baby has the fine motor skills to grasp food with the

thumb and fingers c. baby swallows without tongue protrusion d. baby can hold and drink from a cup with few

spills [9-H]

15. Which of the following is NOT a part of normal sucking technique?

a. tongue darting in and out b. tongue covering the gum line c. tongue curved around the breast d jaws rhythmically compressing the areola e. lips flanged [5-L]

16. Which of the following foods is NOT a good source of calcium?

a. natural cheese b. red meat c. almonds d. dark green, leafy vegetables [12-C]

A Statistical Report on the most recent exam is published each year by IBLCE’s psychometrician,

Dr. Leon Gross.

The report can be read on the IBLCE web site and is updated each year,

usually in early December.

www.iblce-europe.org


SAMPLE EXAM QUESTIONS (continued)SAMPLE EXAM QUESTIONS (continued)SAMPLE EXAM QUESTIONS (continued)SAMPLE EXAM QUESTIONS (continued)

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The “LEAST likely” Construction

17. A mother contacts you because she is concerned that her 3-month-old baby is suddenly waking up more frequently at night, in spite of being breastfed at least every 3 hours during the day. Which of the following would be the LEAST appropriate response?

a. “The baby may be experiencing a growth spurt.”

b. “The baby may be experiencing the discomforts of early teething.”

c. “The baby may have a chronic or low-grade infection and should be examined by the doctor.”

d. “The baby does not need feedings at night at this age, and is using you as a pacifier.” [8-G] 18. After several years of planning, a hospital will be

implementing a new breastfeeding protocol. Which of the following components of the protocol is LEAST likely to promote breastfeeding success?

a. early initiation of breastfeeding b. progressive lengthening of time at the breast c. night-time breastfeeding d. supplements only when medically indicated [5-M] 19. A mother, 4 months postpartum, has a large lump at the

12:00 position on the areola. She can express a yellowish, thick fluid from the corresponding nipple pore. The LEAST likely cause of this lump is:

a. a plugged milk duct b. a galactocele c. a neoplasm d. an abscess [9-E] 20. A woman is ready to be discharged from the hospital. She

will be returning to work when her baby is 8 weeks old. She wants to express milk at work and have her milk fed to her baby by her childcare provider. She asks you what she can do during those first few weeks to promote a smooth transition back to work. Which of the following suggestions is LEAST likely to help her?

a. Try to arrange a longer maternity leave.

b. Be sure that she has a childcare provider who is supportive of breastfeeding, and that she freezes some extra breast milk for the first few days when her return to work will likely cause her milk supply to diminish.

c. Breastfeed the baby exclusively for 4-6 weeks and then start bottle-feeding expressed breast milk several times per week, so that the baby will take a bottle when she leaves.

d. Introduce the bottle during the first week in order to accustom the baby to it. [5-H]

The “EXCEPT” Construction

21. Actual drug passage to breast milk is dependent upon all of the following EXCEPT:

a. milk pH b. drug teratogenicity c. drug solubility d. drug ionisation e. lipid solubility [12-F]

22. You should expect breastfeeding problems with a baby who has a cleft defect to include all of the following EXCEPT:

a. forming a seal b. maintaining a vacuum c. positioning his tongue over his gum line d. preventing aspiration [6-E]

23. All of the following can be responsible for suboptimal milk production EXCEPT:

a. short frequent feedings b. insufficient mammary glandular tissue c. lower than normal prolactin level d. retained placental fragment. [12-B]

ANSWERS TO SAMPLE QUESTIONS ANSWERS TO SAMPLE QUESTIONS ANSWERS TO SAMPLE QUESTIONS ANSWERS TO SAMPLE QUESTIONS

1. a 2. c 3. d 4. a 5. a 6. b

7. e 8. c 9. b 10. b 11. b 12. a

13. d 14. d 15. a 16. b 17. d 18. b

19. c 20. d 21. b 22. c 23. a

EXAM STRATEGIESEXAM STRATEGIESEXAM STRATEGIESEXAM STRATEGIES

Both the morning and afternoon sections are three hours each. This is sufficient for even slow test takers and candidates doing a the exam in a second language to finish. During the afternoon session there will be 75 questions that correspond to clinical photographs in the exam booklet.

There are no penalties for incorrect answers, so attempt every question, even those of which you are not sure. This strategy will increase your chance of passing and prevent mismatching subsequent questions with the wrong numbers on your answer sheet. You may mark in your test booklet the questions you wish to reconsider and return to them later. If you change an answer, be sure to erase your original answer completely.

Questions with a negative stem construction (see samples on this page) are grouped together on the exam with a note advising you when they start. These are not trick questions, but they need careful attention.

Questions are not arranged in order of difficulty or subject matter. Therefore, you can work out how many questions you should complete within a chosen time interval and pace yourself accordingly.


AFTER THE EXAMAFTER THE EXAMAFTER THE EXAMAFTER THE EXAM

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NOTIFICATIONNOTIFICATIONNOTIFICATIONNOTIFICATION OF RESULTS OF RESULTS OF RESULTS OF RESULTS

Your official exam result will be mailed to you in mid-October. When we send your Candidate Admission Ticket, we will tell you the exact date on which the results will be sent out. On this date we will also place a pass-fail list on the website, with your own result identifiable only by a personal code we issue to you.

No exam results are available before this date, nor can they be provided at any time in response to phone enquiries. All results are mailed on the same day, although they will inevitably be received over a period of days. Exam results for any candidate with an incomplete file (e.g. documentation not submitted) will not be released until the file is complete.

With your official exam results, you will receive information on your performances in each of the Disciplines and Chronological Periods. This information may help you to identify your strengths and weaknesses and to focus future study. If you pass, you will also be sent your IBCLC certificate and The IBCLC Handbook, which includes information about recertification.

IBLCE keeps lists of currently certified IBCLCs and reserves the right to provide verification of certified individuals. Scores, and the names of candidates who fail, are strictly confidential to IBLCE and will not be released to anyone else.

APPEALSAPPEALSAPPEALSAPPEALS POLICY POLICY POLICY POLICY

All appeals against the IBLCE examination must be sent to IBLCE in written form, and with supporting documentation, postmarked no later than 10 November in the same year. A signed critique form, lodged at the time of the examination, is the sole basis for appeals against exam content and will be considered during the post-exam analysis, before final scoring of the exam.

Candidates can not review their exam materials under any circumstances. The IBLCE cannot delete a question for an individual candidate without deleting it for everyone and re-scoring the exam, and individual scores cannot be adjusted because of hardship or other circumstances. However, a candidate whose exam performance was genuinely disadvantaged by circumstances outside her/his control should make the relevant IBLCE office aware of the situation, preferably soon after the exam, but no later than 10 November in the same year.

If a candidate fails the exam she/he may request that her/his answer sheets be hand scored for the fee advised in the applicable candidate materials. If an error was made in machine scoring the candidate’s exam, the candidate’s score will be corrected and the fee for hand scoring will be refunded. All requests for hand scoring must be postmarked on or before 10 November in the same year.

(Appeals against CERPs recertification decisions must be sent to IBLCE in written form, and with supporting documentation, postmarked no later than 30 days after notification was mailed to the IBCLC.)

RETESTRETESTRETESTRETEST POLICY FOR UNSUCCESSFUL POLICY FOR UNSUCCESSFUL POLICY FOR UNSUCCESSFUL POLICY FOR UNSUCCESSFUL CANDIDATESCANDIDATESCANDIDATESCANDIDATES

There is no limit to the number of times an unsuccessful candidate may apply to retake the IBLCE certification exam. To be eligible to do the exam again, a candidate needs to meet current eligibility requirements, submit another application, and pay the relevant exam fee. If the supporting documentation is still up-to-date it will not need to be resubmitted.

FUTUREFUTUREFUTUREFUTURE EXAM DATES EXAM DATES EXAM DATES EXAM DATES The IBLCE exam is held annually, always on the last Monday in July, concurrently at multiple sites worldwide.

MAINTENANCEMAINTENANCEMAINTENANCEMAINTENANCE OF CERTIFICATIO OF CERTIFICATIO OF CERTIFICATIO OF CERTIFICATIONNNN If you pass the exam, you may use the title “International Board Certified Lactation Consultant” or the letters “IBCLC” for a period of five years after you pass the examination. Make an effort to learn these letters correctly and to use them as your title and after your name. You may see reference to the designation RLC (Registered Lactation Consultant); this is applicable only in North America.

Initial certification is effective from the date of notification until the end of October in the fifth calendar year following certification.

Before the end of this five-year period, you must recertify either by passing the exam again, or through a recertification application showing 75 Continuing Education Recognition Points (CERPs).

Ten years after you last passed the exam (and five years after CERP recertification), you are required to do the exam again for recertification. The IBLCE has determined that this is the best way to ensure continued competence of IBCLCs, and hence to protect consumers.

About a year before your certification is due to expire, we will send you current information and application materials - if we have your current address. The IBLCE also publishes a newsletter The IBCLICK! to keep IBCLCs informed and posts regular updates on the www.iblce-europe.org website.

Please note: updating your address with your professional association will not update it with IBLCE. You need to advise us directly of any change of address, by phone, mail or email.

JOIN YOUR PROFESSIONAL JOIN YOUR PROFESSIONAL JOIN YOUR PROFESSIONAL JOIN YOUR PROFESSIONAL ASSOCIATIONSASSOCIATIONSASSOCIATIONSASSOCIATIONS

The IBLCE urges IBCLCs to join ILCA (The International Lactation Consultant Association), VELB (The European Association for Lactation Consultants) and the appropriate professional association/s in your country. By becoming an IBCLC, you become part of a local, a national and a global community. The IBCLC is the one credential that is recognised by all national and international professional associations. You can meet and communicate with others who share your credential and your interests. And, as part of your continuing professional education at conferences, seminars and meetings you can share your passion about this wonderful field.


SUMMARY OF IBLCE EXAM ADMINISTRATION PROCEDURESSUMMARY OF IBLCE EXAM ADMINISTRATION PROCEDURESSUMMARY OF IBLCE EXAM ADMINISTRATION PROCEDURESSUMMARY OF IBLCE EXAM ADMINISTRATION PROCEDURES

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1.1.1.1. INQUIRY: INQUIRY: INQUIRY: INQUIRY:

You make an initial inquiry about the IBLCE exam. We send you the Candidate Information Guide and the Application Supplement specific to the exam year and your country. If you decide to do the exam in another year, you will need to request the Application Supplement for that year.

2.2.2.2. APPLICATION: APPLICATION: APPLICATION: APPLICATION:

You complete all pages of the application form and enclose photocopies of the necessary documentation. You send it to us with the appropriate exam fee, postmarked by the early, standard, or late deadlines. Closing dates are strictly adhered to. You keep a photocopy of your application. We check that your application is complete, establish your file on the database, and determine your eligibility. We confirm information on request. Incomplete applications are followed up and additional fees charged. Applications are processed in the order in which they are received. In busy periods, it may take three to four weeks before your application is processed. We will contact you if there is any problem with your application and we will notify ineligible applicants. In early July candidates with complete files who meet eligibility requirements will receive the admission package, confirming eligibility, acceptance, exam site allocation and a receipt for exam fees received. However please feel free to contact us any time before early July if you have questions.

3.3.3.3. CHANGES/ERRORS: CHANGES/ERRORS: CHANGES/ERRORS: CHANGES/ERRORS:

Check the accuracy of your name and address on correspondence you receive from us. Be sure the spelling and presentation of your name are as you wish them to appear on your certificate, and that the address is correct for receiving your exam results. Please notify us in writing of any changes or corrections. We update your entry on the database, if there are changes or corrections. Candidate details in the database are used to coordinate administration and organisation of the exam. They are confidential to IBLCE and are never released to any other organisation.

4.4.4.4. SITE ALLOCATION: SITE ALLOCATION: SITE ALLOCATION: SITE ALLOCATION:

Your site allocation is noted in your admission ticket. In case a change of site becomes necessary, we will contact you as soon as your application is assessed. If you want a site change, please inform us immediately. Candidate numbers at each site determine the size of the exam room, the number of proctors contracted, and the number of exam materials dispatched. If you request a site change after the end of June, we may not be able to accommodate you. Initially, we place each candidate at the exam site stated on her/his application form, but we note any preference for a more convenient site. Once candidate numbers are finalised, decisions are made about which sites, if any, must be cancelled or moved and whether we will offer additional sites. If your choice is affected by a cancellation, or if a site closer to you is offered (even if you did not request it), we send you notification of the proposed change.

5.5.5.5. ADMISSION PACKET: ADMISSION PACKET: ADMISSION PACKET: ADMISSION PACKET:

Early in July, you should receive your exam admission packet containing your admission ticket, information about the exam site and its location, including transport and parking details, exam rules and arrangements for the day and a receipt for fees.

7.7.7.7. EXAM ADMINISTRATION AND SCORING: EXAM ADMINISTRATION AND SCORING: EXAM ADMINISTRATION AND SCORING: EXAM ADMINISTRATION AND SCORING:

You sit for the exam. We send your answer sheets to be computer scored by IBLCE’s psychometrician. This process is time consuming, since the validity of each question is checked by a number of procedures. The Exam Review Committee meets and some questions are deleted from scoring before all answer sheets are re-scored. The exam as a whole is also validated.

8.8.8.8. EXAM RESULTS: EXAM RESULTS: EXAM RESULTS: EXAM RESULTS:

We mail your exam results to you in mid October. We mail all pass and fail letters on the same day, but experience has shown that some candidates receive their letters on a different day to other candidates, even in the same city. If you did not complete your BC or education hours before the exam, or if you did not send the documentation to us, your exam results will not be issued. If you have failed the exam, we send you your score report; your details remain confidential to IBLCE. If you have passed the exam, we send you your certificate, score report, and your copy of The IBCLC Handbook. We will also send you your IBCLC ID card when produced and a copy of The IBCLCK! newsletter.

6.6.6.6. SEND OUTSTANDING DOCUMENTATION: SEND OUTSTANDING DOCUMENTATION: SEND OUTSTANDING DOCUMENTATION: SEND OUTSTANDING DOCUMENTATION:

If you had incomplete BC or education hours at the time of your application, you must complete these hours before the exam. You send us the documentation of completion, preferably before the exam, but in any case no later than 2 weeks after the exam (or your results may be delayed).


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www.iblcewww.iblcewww.iblcewww.iblce----europe.orgeurope.orgeurope.orgeurope.org This is the address for the regional IBLCE website.

... where you can find further information about the IBLCE, the exam,

recertification and CERPs, and where you can download this Guide and the Application Form.

… where you can find out about some of the programs, courses, modules

and discussion meetings where you can earn CERPs.

… where you can find out more about the IBLCE administrative team,

and see photos to help you put faces to names.

... where you can find the number of currently certified IBCLCs in each country.

... where you can find the latest information in the news section.

… where you can read the most recently published Statistical Report on the IBLCE exam.

... where you will find links to the lactation consultant professional associations.

IBLCE Recognition Statement about MotherIBLCE Recognition Statement about MotherIBLCE Recognition Statement about MotherIBLCE Recognition Statement about Mother----totototo----Mother Support OrganisationsMother Support OrganisationsMother Support OrganisationsMother Support Organisations

The International Board of Lactation Consultant Examiners recognises the critical role served by

mother-to-mother support organisations such as La Leche League and the Australian Breastfeeding

Association in support of mothers and babies in the initiation and duration of breastfeeding. These

organisations also serve a vital role in providing the experiential base for developing the breastfeeding

expertise of mother-to-mother support group leaders/counsellors and lactation consultants. In addition,

these organisations provide essential continuing education for leaders/ counsellors/lactation consultants

and others, disseminating knowledge and information based upon empirical research and clinical

experience.


IBLCE DISCIPLINE PROCEDURES

PREAMBLE Privilege to Practice. An IBLCE Certificate is a conditional privilege which is revocable for cause. It confers no vested right to the holder thereof.

Generally. The IBLCE Board has the inherent authority and duty to prescribe a Code of Ethics for its Certificants, to determine what constitutes grounds for discipline of its Certificants and those persons applying to take any IBLCE examination, to discipline its Certificants and Applicants for cause, and to limit, suspend or revoke the certification of every IBLCE Certificant or the eligibility for certification of every IBLCE Applicant whose unfitness to practice as a lactation consultant has been duly established.

These procedures apply to: (1) any and all persons currently certified by the IBLCE; (2) any and all persons who were certified by the IBLCE at the time of the acts or omissions complained of, whether or not they remain certified when the procedures are applied; (3) any and all Applicants for any IBLCE Examination (provided they were Applicants at the time of the acts complained of); and (4) any and all IBLCE Certificants and Applicants in relation to acts or omissions complained of which occurred prior to their becoming IBLCE Applicants or Certificants provided the Complaint alleges:

(a) conviction of a crime; (b) misconduct that reflects on the Respondent’s honesty or trustworthiness, such as in cases alleging conduct involving dishonesty, fraud, deceit or misrepresentation; (c) misconduct due to disability (Article XXIII); or (d) any other misconduct which would warrant suspension or revocation of certification of an IBLCE’s certification pursuant to the Guidelines for Imposing Sanctions set forth in Article VIII of the IBLCE Procedures for Discipline in effect at the time of the misconduct which is the subject of the Complaint.

(Effective: 1 January 2007)

iblce regional office in europe candidate information guide

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