Lactation Certifications: What Are They and What Do They Mean?

There are at least 17 different certifications within the lactation field. So, even we can get confused sometimes on what’s what. That is why we put together our own guide / analysis to help set the record straight.

Before we dive deeper, there are 2 things we want to point out first.

Historically, Lactation Consultants were rarely considered “healthcare professionals” in the eyes of the law

  • In order to be considered a healthcare professional, such as a Medical Doctor or Registered Nurse, you must obtain a license at the state-level. Until very recently, there were no state licensure laws for Lactation Consultants. Now,  four states have licensure laws for Lactation Consultants: Rhode Island, New Mexico, Oregon, and Georgia (which is currently being challenged in the Georgia court system). Within those 4 states only, Lactation Consultants with licenses are now considered healthcare professionals.

  • Therefore, unlicensed Lactation Consultants haven’t usually qualified for healthcare reimbursement because most health insurers have rules that they only allow licensed healthcare providers to contract with them as an “in-network” provider.

  • With passage of the Affordable Care Act (ACA), lactation support services are now 100% fully-covered by most commercial health insurance plans with no-cost at all to families (no co-pays, no co-insurance and no deductibles). Since health insurance must cover lactation support services, lactation support is now being considered a healthcare service. So, health insurers must come up with their own care standards and decide which types of lactation professionals they will work with to deliver lactation support.

That brings us to point #2…

Most health insurers only recognize the IBCLC certification for health insurance coverage

  • The International Board Certified Lactation Consultant (IBCLC) is considered the “gold standard” for lactation training and education. The four states that license Lactation Consultants only do so for Lactation Consultants that hold the IBCLC certification. If obtaining health insurance coverage for your lactation consultations is of the utmost importance to you, then you usually want to ensure that the Lactation Consultant that you want to work with holds the IBCLC credential.

Now that we got those two points out of the way, let’s continue…

There is no official ranking (or classification) system when it comes to lactation certifications. In our opinion however, we believe there are four general “tiers” when it comes to lactation certifications. These tiers are not even remotely equivalent to each other though, with Tier 1 being far and away the most qualified type of Lactation Consultant from both a training / education perspective and also from the health insurance benefits you can get from working with them.

We won’t get into the specific training or requirements of each lactation certification program as that would be too time-consuming. We have included links to each certification program if you wish to learn more about it.

Without further ado, here are the four tiers of lactation certifications:

Tier 1

As we mentioned before, the IBCLC is the “gold standard” of lactation training and education. These are considered healthcare professionals and often qualify as an “in-network” healthcare provider within health insurance plans because of this certification.
Here are some highlights related to the training & education requirements for IBCLCs.

  • All IBCLCs must have the following:

      A health sciences background in 14 different subject areas within an institute of higher learning (or be listed as a “recognized health profession” such as a Dietitian, Midwife, Nurse, Occupational Therapist, Physical Therapist, Medical Doctor, or Speech Pathologist, to name a few profession types),
      A minimum of 95 hours lactation specific education (including 5 hours of communications skills), 
      As well as have relevant clinical experience (of at least 300, 500, or 1,000 hours of clinical experience depending on which of 3 potential pathways are being taken)

When should you reach out to an IBCLC specifically (compared to the other 3 Tiers of Lactation Consultants)?

  • If you think you might be experiencing a medical issue that is prohibiting you from achieving your breastfeeding goals (e.g. a possible tongue tie / oral tie), then you want to seek out an IBCLC to help you determine if you likely need to seek out proper medical attention.
  • If getting health insurance coverage is of the utmost importance, then you should likely reach out to an IBCLC

Tier 2

These three lactation certifications are accredited through the Academy of Lactation Policy and Practice.

  • This is “a non-profit organization that provides a national certification program in breastfeeding and human lactation for nurses, physicians, dietitians, WIC personnel, peer counselors, independent lactation counselors and others.” The organization’s “mission is to promote evidence-based knowledge and clinical competencies of lactation professionals.”

When should you reach out to any of the Tier 2 Lactation Consultants (compared to the other Tiers of Lactation Consultants)?

  • If you don’t believe you are experiencing a medical issue and having health insurance coverage is not very important to you, but you want to find a Lactation Consultant with more advanced training from an accredited program, then any of the Tier 2 Lactation Consultant certifications could be a good choice for you.
  • It’s likely that Tier 2 Lactation Consultants can provide “good value” for the money.

      They tend to have more training / education than other Tiers (except for IBCLCs) and in the instance of ANLCs (Advanced Nurse Lactation Consultants), they are also Registered Nurses too. ALCs (Advanced Lactation Consultants) are required to be CLCs (Certified Lactation Counselors) first in order to qualify for the ALC training.
      If your needs are not very complicated, Tier 2 Lactation Consultants can be a great choice for lactation support.

Tier 3


When should you reach out to any of the Tier 3 Lactation Consultants (compared to the other Tiers of Lactation Consultants)?

  • Tier 3 Lactation Consultants have received some level of professional lactation training, but since these programs are not accredited, that level of training can vary wildly between these different programs.

      For example, the Lactation Education Counselor (LEC) certification is conducted by the UC-San Diego, an accredited university that is part of the highly acclaimed University of California collegiate system. The WIC Designated Breastfeeding Expert has earned this certification through the US Department of Agriculture. Whereas the Certified Lactation Specialist (CLS) program is conducted through a private company.
      Some certification programs are thorough enough in training / coursework that many Lactation Consultants can qualify to take the IBCLC exam after finishing the program.
      Some certification programs also have stricter entry requirements, such as already holding at least a Bachelor’s Degree or a medical license or some level of collegiate coursework.

Tier 4

When should you reach out to any of the Tier 4 Lactation Consultants (compared to the other Tiers of Lactation Consultants)?

Tier 4 Lactation Consultants have not undertaken any “professional” lactation training. Often the only requirement is that the person has breastfed themselves at some point, such as the La Leche League Peer Counselor. We are hesitant to include this “4th Tier” in this guide, but having peer support can still be helpful. If you are primarily struggling with motivation and want someone to help “hold you accountable” as a peer supporter or give you that extra emotional support when times are challenging, then a Tier 4 Lactation Consultant could be all that you need. Outside of providing emotional support and having “been there before themselves,” we recommend caution when asking for lactation advice from a Tier 4 Lactation Consultant because that advice might not be “evidence-based.”

Final Thoughts

One thing we want to point out is that just because a Lactation Consultant is not in Tier 1 or Tier 2 doesn’t necessarily mean they are not a good choice for getting lactation support.

Less than 5% of women have medical issues that prohibit them from being able to properly breastfeed. Most of the time, families don’t achieve their intended lactation goals because of the lack of a supportive environment. ALL Tiers of Lactation Consultants can help create a supportive environment for you.

If you don’t believe a medical issue is likely interfering with your ability to hit your lactation goals, then any Tier of Lactation Consultant can be a good choice for you. Often IBCLCs are only located in large, metropolitan areas. If having “in-person” consultations is important to you and no IBCLC is available locally, a different Tier of Lactation Consultant could be a better fit for you than getting virtual assistance via telehealth calls with an IBCLC.

In the end, these certifications are meant to help guide you in picking the best lactation professional FOR YOU. But, having a certain qualification is not always the most importance choice in the decision-making process. Sometimes advice from any lactation professional, at the right time, is a lot more important than the qualifications that this person holds. Sometimes having “in-person” support from any lactation professional is a lot more important to some parents than having the most qualified lactation professional only being available via a telehealth call. We recommend weighing what factors are most important to you and then make your decision based on how well someone lives up to those criteria. Some potential criterion include:

  • Urgency
  • Appointment Setting
  • Qualifications
  • Insurance Coverage
  • Preferring Communication Method
  • Working Style, and
  • Overall Comfort Level