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Meet a Certified Lactation Counselor

| Maura Deering

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Becoming a new parent can offer one of the most profound experiences in a person's life — but childbirth may present unexpected difficulties and challenges, including breastfeeding or chestfeeding.

Certified lactation counselors (CLCs) guide parents who experience challenges with lactation and breastfeeding. They assess problems that parents encounter with breastfeeding to devise solutions or manage breastfeeding pain. Many CLCs find great fulfillment in helping expectant parents create a deep bond with their newborn infants.

Kealy Hawk, a registered nurse (RN) and CLC, shares her experience working as a lactation counselor. In the following interview, she chats about the challenges and benefits of working as a CLC, along with what first drew her to the job. Read on for Hawk's expert advice.

Q&A With a Certified Lactation Counselor

Kealy Hawk, RN, BSN, CLC

Kealy Hawk is an RN, certified lactation counselor (CLC), and most importantly — a mommy. Her breastfeeding struggles gave her a passion for helping parents throughout their own journey. She offers virtual one-on-one lactation consultations, teaches baby feeding classes, and shares her knowledge to equip and empower expectant parents. If you are interested in talking with her or taking one of her baby feeding classes, visit www.littlebearcare.com.

What is a certified lactation counselor, and why is this work so important?

A lactation counselor is trained in assessing and providing support for women during lactation. These professionals must be competent in anatomy and physiology of the breast, assessment of breastfeeding dyads, troubleshooting common breastfeeding difficulties, the 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.

Is there a difference between a CLC and certified breastfeeding counselor (CBC)?

A CBC 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 an RN 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?

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?

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 that I've worked one-on-one with at a time was 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 an RN, 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.

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 to be eligible to sit for the examination. Once you pass the examination, you are a CLC.

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 a CLC while working in a hospital or clinic and help many moms and babies in traditional settings. 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 receive through their training and use on the job.

Key Skills and Responsibilities:

  • Work collaboratively on a healthcare team
  • Provide evidence-based information on breastfeeding and medications
  • Provide counseling, education, and support in a clinically competent manner
  • Support and counsel family members
  • Advocate for public health strategies and policies that promote, protect, and support breastfeeding
  • Maintain records in compliance with ALPP's ethical code and documentation guidelines
  • Coordinate care according to professional behavioral and ethical standards
  • Determine the behavioral, cultural, physical, and social conditions that may contribute to complex or complicated breastfeeding experiences

CLCs can find employment in many different workplaces, including hospital maternity units and birth centers, neonatal intensive care units, outpatient lactation clinics, physician and midwife offices, and private practice.

How to Become a Certified Lactation Counselor

Aspiring lactation counselors can earn certification by meeting ALPP's standards of competence, passing the CLC examination, and agreeing to comply with the ALPP code of ethics.

Candidates can meet these requirements through three different pathways.

  1. An individual can complete a comprehensive course pathway with an approved training organization such as Healthy Children Project.
  2. A second pathway available includes providing proof of health professional licensure, completing at least 45 hours of education that follows WHO/UNICEF guidelines, and working under supervised lactation care to prove mastery of skills.
  3. A final pathway requires attending and graduating from a Commission on Accreditation of Allied Health Education Programs-approved lactation program.

Many candidates pursue the comprehensive course pathway, especially if they do not already have the education and professional background for the alternative pathways. Read the step-by-step process of the comprehensive course pathway below.

Register for a Breastfeeding Counseling Training Course
These training courses must receive ALPP approval. You can find out what qualifies as an ALPP-approved training course with this document.
Complete the 52-hour Course
These hours cover several topics, including comprehensive breastfeeding management training, practical hospital skills, and strategies for special circumstances, like premature newborns or babies with Down Syndrome. The course also teaches aspiring lactation counselors how to speak to new parents in compassionate and encouraging ways.
Take the CLC Exam
This exam includes didactic and practical components. The didactic section covers long-term breastfeeding and nutrition, along with problems relating to latching, nipples, and breasts. The practical portion of the exam assesses test-takers
Renew CLC Certification Every Three Years
To renew certification, lactation counselors need to complete at least 18 hours of continuing education every three years. ALPP also accepts up to three hours related to social justice or discrimination and bias in the healthcare field, which may relate to breastfeeding and lactation.

How Much Do Certified Lactation Counselors Make?

According to PayScale, CLCs earn an average annual salary of $58,430 as of June 2021. Salaries vary based on location, demand, educational background, and previous experience.

RNs considering becoming CLCs may also expect higher earnings, especially if they have previous RN work experience. As of 2020, RNs made a median annual salary of $75,330, according to the U.S. Bureau of Labor Statistics.



$31.61

Average Hourly Wage

Source: PayScale (June 2021)



$58,430

Average Annual Salary

Source: PayScale (June 2021)

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 an IBCLC, a healthcare professional must complete 90 hours of education covering human lactation or breastfeeding, gain 1,000 hours of lactation-specific clinical experience, and pass the IBCLC exam.

CBC certification counts among the specialty areas in nursing. CBC nurses provide counseling and education in lactation management for their patients. Actively licensed RNs can earn lactation consultant certification by working with lactating individuals for at least a year or completing a two-day lactation management course and taking the Prepared Childbirth Educators' CBC exam.

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