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The International Board of Lactation Consultant Examiners (IBLCE) certification exam was developed in 1985 and has been accredited by the National Commission for Certifying Agencies (NCCA) since 1988.[1] The IBLCE regularly conducts role delineation studies to determine which skills, proficiencies, and domains of knowledge are central to the practice of lactation consultants. This information is used to revise the test blueprint to best match the current state of the field. The most recent study was completed in 2007,[2] and a new role delineation study was scheduled to begin in 2013.[3]

Function of the Test

IBLCE Study Guide

The IBLCE certification recognizes expertise in medical subfields related to lactation and early infant development, such as maternal and infant anatomy, nutrition, and biochemistry; growth parameters and developmental milestones; and breastfeeding equipment and techniques.[4] Earning IBLCE certification by itself does not confer any special rights or privileges to practice as a lactation consultant; rather, like many certifications in the medical field, the IBLCE is primarily designed to encourage professional development and enhance career opportunities among its certificants. To this end, certificants may use the title "International Board Certified Lactation Consultant" (IBCLC).[5]

IBLCE certification is intended for experienced practitioners. The examination is typically taken by lactation consultants who have at least 90 hours of lactation specific education and who have conducted between 300 and 1,000 hours of lactation specific clinical practice within the past five years, depending on the circumstances of the clinical practice environment. The examination eligibility requirements and pathways to eligibility are complex- for example, candidates may defer their completion of educational requirements by paying additional fees- so candidates are encouraged to review these requirements carefully.[5]

The IBLCE certification is internationally recognized. More than 26,500 lactation consultant professionals from 96 countries have received certification from the IBLCE,[6] of whom approximately 14,000 are from the United States, 2,200 are from Australia, and 1,600 are from Canada.[7] The IBLCE reports that in 2012, its certification exam was administered in 17 languages in 353 locations across 55 countries and territories.[6]

In 2012, 2,324 candidates took the examination for initial certification, of whom 78.9% passed. The mean score of all candidates was 73.3, with the passing score set at 67.[8]

Test Administration

IBLCE Flashcards

Due to the international scope of the IBLCE, examination fees vary widely among countries and are priced out in six different currencies. However, for candidates in the United States, the initial examination fee is $660.[5] The IBLCE exam is typically administered at Pearson VUE test centers.[9] Both a computer-based test and a paper-and-pencil version of the test exist, though the paper-and-pencil version is only given at specific sites where computer-based testing is not possible.

The examination is only given in one small window per year, in late July.[10] The test session is four hours in length.[10]

Score reports are not mailed to candidates until late October.[5] Unsuccessful candidates who with to retake the examination must submit a new application and pay the full exam fee again. There is no limit to the number of times a candidate may retake the examination; however, the candidate must continue to meet the exam's eligibility requirements, including the number of hours of clinical practice conducted within the previous five years.[5]

Candidates who require special accommodations for a disability should notify the IBLCE of the request at the time they apply for the examination. The exam application form provides a section in which to do this. Formal documentation of the candidate's special needs is also required.[5]

Test Format

Sections of the IBCLE Test
IBCLE Test Subject Areas # of Items
Development and Nutrition 26
Physiology and Endocrinology 24
Pathology 31
Pharmacology and Toxicology 13
Psychology, Sociology, and Antrhopology 21
Techniques 25
Clinical Skills 35
Total 100%

Test Environment

Although there are a few exceptions, the IBLCE is generally a test that is computer-based. Each candidate planning on taking the test needs to arrive at least half an hour before the exam is scheduled to start. At the computer based testing center, candidates need to take two forms of identification, one of which needs to be a photo ID. While the exam is taking place, even during breaks, cell phones and other electronic devices are prohibited. The exam is typically scheduled to last four hours.[11]

Test Structure

The IBLCE Exam deals with seven disciplines: Development and Nutrition; Physiology and Endocrinology; Pathology; Pharmacology and Toxicology; Psychology, Sociology, and Anthropology; Techniques; and Clinical Skills. Combined, there are a total of 175 multiple choice questions. The exam period lasts four hours.[12]

Test Content

  • Sample IBLCE Questions
  1. What are the two main arteries that supply blood to the breast?
    A. Lateral thoracic
    B. Internal mammary
    C. Subclavian artery
    D. A and B
    E. B and C
  2. What are the changes seen in stage 2 lactogenesis?
    A. Increased blood flow
    B. Increased oxygen and glucose absorption
    C. Abundant milk production
    D. Rising pH levels
    E. B, C, and D
    F. A, B, and C
  3. If the lactating mother becomes pregnant, what is the appropriate response to her inquiry about continuing to breastfeed?
    A. She should stop breastfeeding immediately because the pregnancy hormones will affect the nursing baby
    B. Nursing is contraindicated for pregnant women due to the discomfort
    C. Nursing during pregnancy, known as tandem nursing, does not have a negative effect on the nursing baby, but could stimulate the uterus to contract and cause premature labor
    D. Quick weaning of the baby is preferred
  4. The capability to swallow develops in week 24 of gestation; consequently, the swallowing reflex is present at birth. Which of the following statements is incorrect regarding newborn suckling?
    A. When the newborn is four days old, sucking and swallowing are perfected
    B. Swallowing occurs between inspiration and expiration
    C. Nearly half of a full feeding is consumed within two minutes
    D. Newborns are mouth breathers, so they stop sucking to take a breath
  5. The newborn has an immature immune system. What are the immunological advantages of breast milk over cow’s milk or formula?
    A. Increases the lymphocyte production of the newborn
    B. Protection against infection, shielding the GI mucous membrane against pathogens
    C. Protection against infection, shielding the GI mucous membrane against pathogens
    D. A and B
    E. B and C
  6. The American Academy of Pediatrics has guidelines for the treatment of hyperbilirubinemia. Which of the following statements regarding proper treatment is inaccurate?
    A. If the total serum bilirubin (TSB) level is ≥ 8 to 10 mg/dL on day two of life, phototherapy is considered
    B. If the TSB level is ≥ 15 mg/dL on day three, phototherapy is considered
    C. For older neonates with TSB levels of ≥ 17 to 20 mg/dL, phototherapy is considered
    D. Breastfeeding should be discontinued permanently

More free IBLCE practice test questions.


The IBLCE is scored holistically, meaning that all questions are weighted the same. Guessing is not penalized. The passing score is set every year by an Examination Committee.[8]

The 2012 version of the IBLCE exam had 175 questions, but several items were deleted from scoring based on test analysis. The average score of candidates seeking initial certification was 73.3%, compared to a passing score of 67%, and 78.9% of candidates passed the exam.[8]

2012's pass rate of 78.9% was a bit lower than the typical pass rate, which usually ranges between about 80-85%. The highest pass rate in recent years was in 2010, when 87.1% of candidates for initial certification passed the examination. In that year, the passing score was set at 65%.[13]

Recent/Future Developments

Although the IBLCE exam is still available in a pencil-and-paper format, the IBLCE reports that it is continuing to expand its use of computer-based testing (CBT) centers around the world.[5] It reports that a "vast majority" of candidates already take the examination by computer.[10]

Answers to Sample Questions

1;D 2;F 3;C 4;D 5;E 6;B


  1. ^ About IBLCE - History August 26 2014
  2. ^ IBLCE Role Delineation study - next steps August 26 2014
  3. ^ Executive Summary of the IBLCE Board of Directors Meeting (March 2012) August 26 2014
  4. ^ IBLCE Exam Blueprint August 26 2014
  5. ^ a b c d e f g IBLCE Candidate Information Guide August 26 2014
  6. ^ a b About IBLCE - IBLCE Exam Facts & Figures August 26 2014
  7. ^ About IBLCE - Current Statistics on Worldwide IBCLCs August 26 2014
  8. ^ a b c Statistical report of the 2012 IBLCE examination August 26, 2014
  9. ^ Pearson VUE - IBLCE® Certification August 26 2014
  10. ^ a b c IBLCE - Certify - FAQs August 26 2014
  11. ^ IBLCE FAQ 15 September 2014
  12. ^ IBLCE Detailed Content Outline 15 September 2014
  13. ^ Statistical report of the 2010 IBLCE examination August 26 2014