As an International Board Certified Lactation Consultant (IBCLC), understanding and respecting the boundaries of our professional role is crucial for providing safe and effective care. The IBCLC scope of practice clearly defines what is within our professional responsibilities and what is not. Let’s dive into the specifics of what’s within the IBCLC scope, what falls outside of it, and how to navigate those gray areas. Please note, in this post, I’m only referring to your role as an IBCLC. If you have other credentials, you may have scope to perform some of the things I describe below as being out of scope for an IBCLC. 

• Assessment and Evaluation: We are trained to assess and evaluate breastfeeding and lactation, identifying potential issues and providing guidance to help families overcome challenges.
• Care Planning: Based on our assessments, we develop and implement individualized care plans that support and promote breastfeeding.
• Education and Counseling: Providing education and counseling to parents is a core part of our role. We help families understand breastfeeding techniques, address common concerns, and build confidence in their breastfeeding journey.
• Collaboration with Healthcare Professionals: We work alongside other healthcare providers to ensure that our clients receive comprehensive care. This collaboration is vital, especially when a situation requires expertise beyond our scope.
• Documentation: Accurate documentation of the care provided is essential. It ensures continuity of care and accountability in our practice.

These responsibilities define the core of what we do as IBCLCs. Staying within these boundaries ensures that we are working within our expertise and providing safe, evidence-based care.

What Falls Outside the IBCLC Scope of Practice? 

Just as important as knowing what is within our scope is understanding what falls outside of it. As IBCLCs, there are certain activities that we are not qualified to perform, including:

• Medical Diagnosis and Treatment: While we can assess breastfeeding issues, diagnosing medical conditions or prescribing treatments is outside our scope. This includes diagnosing conditions like tongue-tie, mastitis, or any other medical condition that requires a clinical diagnosis.
• Performing Medical Procedures: Medical procedures, such as frenotomies (tongue-tie releases), are not within the IBCLC scope. These procedures should be performed by qualified healthcare providers, such as doctors or dentists.
• Recommending or Administering Medications: We are not authorized to recommend, prescribe or administer medications. If a breastfeeding parent requires medication, they should be referred to their healthcare provider for appropriate treatment. We are trained to provide parents with information about how medications affect breastfeeding and provide information about good options while breastfeeding, but the ultimate decision about whether to use a medication what medication to use falls on the parent and her care provider. 

Understanding these limitations is essential for maintaining the integrity of our profession and ensuring the safety of the families we serve.

• Tongue-Tie Assessments: While we can observe signs that might suggest a tongue-tie, diagnosing it and recommending a frenotomy is outside our scope. Our job is to recognize what is normal in an infant’s anatomy, what is abnormal, and when function seems to be impaired. In these cases, it’s crucial to refer the family to a healthcare provider who can make the diagnosis and determine the appropriate intervention.
• Use of Alternative Therapies: Some IBCLCs may encounter requests for alternative therapies or practices that fall outside of our scope, such as suck training, tongue exercises, or other therapies. It’s important to recognize when these requests exceed our scope and to refer clients to professionals who specialize in those areas.

When faced with gray areas, collaboration with other healthcare professionals is key. By working together, we can ensure that families receive the most appropriate care without overstepping our professional boundaries.

Continuing Education and the IBCLC Scope

Continuing education is a vital part of our professional development as IBCLCs. Advanced courses, such as the IBCLC Master Class, offer valuable opportunities to deepen our knowledge and refine our skills. However, it’s crucial to understand that these courses do not expand our scope of practice.

Taking an IBCLC Master Class or similar advanced courses does not confer any additional scope or credential. These classes are not recognized by any accrediting body as conferring new qualifications or expanding your professional role. They are simply continuing education, designed to enhance your existing knowledge and expertise within the established IBCLC scope of practice.

Staying Within Your Scope

As IBCLCs, it’s our responsibility to understand and respect the boundaries of our professional role. Here are a few tips to help you stay within your scope:

• Regularly Review the Scope of Practice: Familiarize yourself with the IBCLC scope of practice and regularly review it to ensure you’re working within your professional limits.
• Refer When Necessary: When a situation falls outside your scope, make appropriate referrals to other healthcare providers who can provide the necessary care.
• Communicate with Clients: Be transparent with your clients about what you can and cannot do within your role as an IBCLC. This helps manage expectations and ensures that clients receive the right care.
• Invest in Continuing Education: Engage in continuing education to enhance your knowledge and skills, but remember that it does not alter your scope of practice.

Conclusion

Understanding the IBCLC scope of practice is fundamental to our work as lactation consultants. While advanced courses like the IBCLC Master Class can enrich your professional development, they do not expand your scope or confer additional credentials. These courses are valuable tools for continuing education, but the boundaries of your practice remain defined by the IBLCE.

By staying within your scope and using continuing education to enhance—not expand—your professional abilities, you’ll ensure that you provide safe, effective, and ethical care to the families you serve.

References

International Board of Lactation Consultant Examiners (IBLCE). (2023). IBCLC Scope of Practice. Retrieved from IBLCE Website

International Board of Lactation Consultant Examiners (IBLCE). (2022). Continuing Education Recognition Points (CERPs). Retrieved from IBLCE Website

Academy of Breastfeeding Medicine. (2021). Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants, Revised 2020. Breastfeeding Medicine, 16(1), 1-4. doi:10.1089/bfm.2020.29149.jmj

American Academy of Pediatrics. (2020). Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics, 129(3), e827-e841. doi:10.1542/peds.2011-3552

Walker, M. (2021). Breastfeeding Management for the Clinician: Using the Evidence. (5th ed.). Jones & Bartlett Learning.

Wambach, K., & Riordan, J. (2020). Breastfeeding and Human Lactation. (6th ed.). Jones & Bartlett Learning.

Lawrence, R. A., & Lawrence, R. M. (2021). Breastfeeding: A Guide for the Medical Profession. (9th ed.). Elsevier.

Smith, L. J. (2019). Comprehensive Lactation Consultant Exam Review. (5th ed.). Jones & Bartlett Learning.