Certified lactation counselors (CLCs) advise and support women planning or preparing to breastfeed their newborns or who struggle with breastfeeding. PayScale reports that CLCs make an average annual salary of $51,833.
While a large number of CLCs come from healthcare backgrounds, others bring a variety of educational and employment experience to the job. Many already hold credentials as dieticians, mental health counselors, midwives, nurses, and therapists. Common traits of successful CLCs include being empathetic, nonjudgmental, respectful, thoughtful, and warm.
This guide features a Q&A with Kealy Hawk, a registered nurse (RN) CLC, who talks about her experiences as a practitioner and a mother. We also provide information on what CLCs do, how to become a CLC, and related career paths.
Q&A With a Certified Lactation Counselor
Kealy Hawk, RN, BSN, CLC
Kealy Hawk is a registered nurse (RN), certified lactation counselor (CLC), and most importantly — a mommy. Her own breastfeeding struggles gave her a passion to help moms throughout their breastfeeding journey. She offers virtual one-on-one lactation consultations, breastfeeding classes, and shares her knowledge to equip and empower moms. If you’re interested in talking with her or taking one of her breastfeeding classes, visit www.littlebearcare.com.
What is a certified lactation counselor and why is this work so important? Is there a difference between a CLC and a CBC?
A lactation counselor identifies as a professional who is trained in assessing and providing support for women during lactation. Professionals must be competent in anatomy and physiology of the breast, assessment of breastfeeding dyads, troubleshooting common breastfeeding difficulties, composition of human milk, and hormone and endocrine function. Following training, an examination must be passed to confirm competency.
It’s important work because breastfeeding can be tough. Breastfeeding has so many evidence-based, positive outcomes that it should be encouraged. But often moms have trouble continuing to breastfeed without help; that’s where we come in.
A CBC (certified breastfeeding counselor) is similar to a CLC but directly recognizes the specialty role of the nurse as an educator and supporter in breastfeeding management. You must be a registered nurse in order to obtain a CBC certification.
Does one need to have a nursing or medical background to become a CLC?
Most CLCs have a nursing or medical background, but it isn’t required. There is a comprehensive five-day training course that offers in-depth information to ensure that those certified are competent. The course isn’t required to sit for the CLC examination, but it does prepare professionals to take it.
What drew you to the idea of helping new moms by becoming a CLC? When in your nursing career did you decide this was something you were interested in doing?
I was pregnant with my first baby when I graduated from nursing school. I was also a military spouse with a move coming up, and I knew I couldn’t sign a contract for a traditional job that required training and a set commitment of years working. After I had my baby, we struggled to breastfeed. Because of our difficulties, I decided to learn everything I could about breastfeeding. I became a CLC and started my own business — I wanted to help others in a way that I wish I’d had as a new mother. I’ve worked in hospitals during my previous career, and now that I’m an RN and CLC, I wouldn’t trade it. It’s my passion, and I love what I do every day.
What does a typical day look like for you? How many patients do you work with at a time, how long do you usually work with a patient, and in what ways do you help them?
A typical day really varies for me. That is probably the biggest drawback of what I do. As a start-up business, I’ve had times of feast and famine. The most clients I’ve worked one-on-one with at a time is probably four or five.
Sometimes a patient will reach out to me with a breastfeeding struggle and after one virtual visit, we’ve figured out how to overcome it. But sometimes it isn’t that easy. I’ve worked with some patients for over six months. I would say the average time I work with a patient is about 1-2 months, usually in the newborn period when mom and baby are learning how to breastfeed.
The main way I help is by offering support. Because of my knowledge as a registered nurse, I understand that there’s a whole mother and baby dyad to assess. Issues like jaundice, weight gain, and the mother’s medical history are a few examples of things I need to consider. So, I make sure to gather a thorough history and assess my patients based on their circumstances. Then I offer solutions to breastfeeding struggles and emotional support. Sometimes, it’s advice for increasing milk supply, some moms need help with latching and positioning their baby, and some have more in-depth problems that need a referral to another medical professional.
What are some of the greatest challenges and rewards of working with new moms in this way?
I love working with new moms. It’s so rewarding when a mom overcomes a breastfeeding struggle and achieves success. And sometimes moms just need to hear that they’re doing a good job. Just because breastfeeding is natural doesn’t always mean it’s easy. I didn’t know that as a new mother, so it helps to hear that they aren’t the only ones that struggle. Another great reward is being able to stay at home with my children while I work virtually.
I think the greatest challenges come more from owning my own business. Sometimes I get too busy with small tasks like running my website. And learning how to find patients that need help has been a challenge. Once I start working with a mom, I do what I’m good at. The hard part is sometimes just getting there and finding the moms that need help.
How does one become a CLC?
There are a few different options. Ultimately, you need to sit for the CLC examination. You must either have prerequisites approved, have taken an accredited lactation program, or attend the five-day training course offered by the Healthy Children Project in order to be eligible to sit for the examination. Once you pass the examination, you are a certified lactation counselor.
What advice would you give to nurses considering this pathway?
If you have a passion for supporting postpartum moms and new babies, this pathway is extremely rewarding. Starting your own business isn’t for the faint of heart, though. You can still be an RN and CLC while working in a hospital or clinic and help many moms and babies in a traditional setting. If you have an entrepreneurial spirit and want to work for yourself, then you really can’t go wrong with a private practice in lactation counseling.
What Does a Certified Lactation Counselor Do?
The Academy of Lactation Policy and Practice (ALPP) lists the knowledge and skills CLCs acquire through their training and use on the job, including:
- Working collaboratively on a healthcare team
- Providing evidence-based information on breastfeeding and medications and other drugs
- Counseling, educating, and supporting pregnant and breastfeeding mothers in a clinically competent manner
- Supporting and counseling family members
- Advocating for public health strategies and policies that promote, protect, and support breastfeeding
- Maintaining records in compliance with ALPP’s ethical code and documentation guidelines
- Coordinating care according to professional behavioral and ethical standards
- Determining the behavioral, cultural, physical, and social conditions that predispose mothers and newborns to complex or complicated breastfeeding experiences
CLCs find employment in a variety of workplaces, such as hospital maternity units and birth centers, neonatal intensive care units, outpatient lactation clinics, physician and midwife offices, public health agencies, and private practice.
How to Become a Certified Lactation Counselor
ALPP offers three ways to become a lactation counselor: a comprehensive course pathway, aggregate pathway, and alternate pathway. The comprehensive course path consists of taking a 52-hour course from an ALPP-approved training partner and passing the CLC examination. This option, including taking the exam, can be completed in as little as five days.
The aggregate pathway involves providing specific documentation prior to taking the CLC exam, including a bachelor’s degree or current health professional license, completion of 45 hours of WHO/UNICEF breastfeeding training, and proof of providing supervised lactation care. The alternate path allows graduates of a Commission on Accreditation of Allied Health Education Programs (CAAHEP)-approved, postsecondary lactation consultant program to take the CLC exam.
The CLC examination can be completed online. CLC certification must be renewed every three years, which requires logging 18 hours of evidence-based breastfeeding continuing education each renewal period. Home-study modules can be accessed online or CLCs can retake the comprehensive course, which continually incorporates up-to-date research in the field. Renewal does not require retaking the exam.
Aspiring CLCs do not need an RN license to earn lactation counselor certification, but other types of lactation certifications do require it, as described in the next section.
What is the Difference Between a Certified Lactation Counselor and Other Certified Lactation Specialities?
Additional lactation certification options include becoming an International Board Certified Lactation Consultant (IBCLC) or pursuing Breastfeeding Counselor Certification (CBC).
IBCLCs perform many of the same duties as CLCs but already hold licenses as healthcare professionals.
To become IBCLCs, nurses, midwives, or other healthcare professionals complete 90 hours of education covering human lactation or breastfeeding, gain 1,000 hours of lactation-specific clinical experience, and take the IBCLC exam.
CBC certification counts among the specialty areas in nursing. CBC nurses provide counseling and education in lactation management to their patients. Actively licensed RNs can earn lactation consultant certification by working with lactating women for at least a year or completing a two-day lactation management course and taking the Prepared Childbirth Educators’ CBC exam.