Perception, Barriers, and Facilitators to Obtaining the International Board-Certified Lactation Consultant (IBCLC) Certification Among Current and Aspiring IBCLCs in the United States

BACKGROUND: The benefits of exclusive breastfeeding (EBF) and the need to support lactating individuals to achieve EBF are well documented. The International Board-Certified Lactation Consultant (IBCLC) certification is the gold standard for lactation care. However, only 19,930 IBCLCs serve the entire United States, and there is a notable lack of diversity among them. While considerable effort has focused on measuring the role of IBCLCs on breastfeeding outcomes, studies examining the experience of becoming a lactation consultant and obtaining IBCLC certification are scarce. RESEARCH AIMS: This study aimed to explore perceptions of the IBCLC certification and identify the barriers and facilitators to obtaining the IBCLC certification among current and aspiring IBCLCs in the United States. METHODS: Participants were selected using a purposive sampling method. The sample included 20 individuals who had successfully obtained the IBCLC certification or were in the process of obtaining one. Thematic analysis was conducted following Clarke and Braun (2013) six-phase framework. Themes were interpreted using Bourdieu's forms of capital. RESULTS: Facilitators in obtaining the IBCLC certificate included personal motivation and passion, supportive mentorship, scholarships and financial aid, strong networking, and flexible learning options. The identified barriers included high monetary costs, difficulty finding mentorship, balancing multiple responsibilities, gatekeeping, a lack of standardization in training, insurance and compensation issues, and exam preparation and anxiety. CONCLUSION: The identified facilitators and barriers to obtaining the IBCLC certification are multifaceted. To address the significant barriers identified in this study, recommendations include developing interventions that focus on reducing costs while increasing mentorship opportunities.