In this episode of Behind the Latch, Margaret sits down with Dr. Mandy Golman, PhD, MS, RN, IBCLC, MCHES, professor at the University of Texas at Tyler, to discuss her powerful qualitative study exploring the perceptions, barriers, and facilitators to obtaining the IBCLC certification among U.S. healthcare practitioners.
Margaret first encountered this research as a poster presentation at the ILCA Conference in Tampa — and immediately knew it was a conversation the field needed to hear.
Dr. Golman’s study, expected to be published later this year, examines who is able to enter the IBCLC pathway — and who is not — through a public health and equity lens. With 19,000 IBCLCs serving the United States and 93% identifying as white, the findings raise important questions about access, mentorship, compensation, and structural barriers within our profession.
Together, Margaret and Dr. Golman unpack what the data reveal — and what must change.
How Dr. Golman’s background in maternal-child health and public health shaped this research
Why workforce diversity in lactation care is a public health issue
The perception that the IBCLC credential “adds weight” professionally — but often without financial return
Why many hospital-based IBCLCs are required to certify without institutional financial support
The persistent bias that IBCLCs must also be RNs to be considered “legitimate”
Financial barriers beyond tuition — unpaid clinical hours, childcare, lost wages, transportation
Why indirect costs often delay certification for years
Mentorship as the central bottleneck in the IBCLC pipeline
The lack of standardized mentorship processes and consistent training experiences
Why “mass emailing IBCLCs” to find a mentor reflects a broken system
What a centralized, structured mentorship model could look like
The role of state coalitions, professional organizations, and grant funding
Medicaid reimbursement challenges and why payment structures matter for access
How passion alone cannot sustain a workforce without structural support
What meaningful reform could look like — starting with mentorship
The IBCLC credential is highly valued — but the pathway remains structurally inequitable.
Indirect costs (lost wages, unpaid hours, childcare) are often more prohibitive than exam fees.
Mentorship access is inconsistent and frequently the biggest barrier to certification.
Without structural support and compensation reform, the field risks burnout and limited diversity.
Improving mentorship infrastructure could significantly expand access and representation.
Workforce diversity is foundational to culturally responsive lactation care and trust-building.
Public health advocacy must include strengthening the IBCLC pipeline — not just improving breastfeeding rates.
Dr. Mandy Golman, PhD, MS, RN, IBCLC, MCHES
Professor, University of Texas at Tyler
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Evidence-based conversations for lactation professionals — new episodes every week.