45 hours of lactation specific education are required to sit the exam. 45 clock hours of education, and not even at the college level, are required to prepare for a career. There are no requirements as to the content of these 45 hours. Theoretically, it could be 45 hours of basic positioning and latch, and the applicant would have met the requirement. How many clock hours do other people spend in classrooms preparing for other allied health care careers? At the present time, these hours are not even required to be CERPs (although it is strongly recommended), which would guarantee at least a certain level of quality and relatively valid subject matter. What happens is that most people accumulate their hours, rush off to take the “lactation consultant course” which through clever marketing and hospital administration pressure seems to have become a “requirement” to sit the exam –it is NOT--, which gives you 45 CERPs, and voila you are eligible to sit the exam. Taking any 45 hour course or review type course in the time immediately before sitting the exam if anything, should serve as a review of what you have learned over the past years you have accumulated your practice hours and read the books (at least some of them) on the recommended reading list. It isn’t currently a question on the exam application, but I would love to see a poll of how many of the candidates read any of the books on the list beyond Lawrence and Riordan before the exam. They don’t even read the entire Candidate Information Guide, based on questions I was accustomed to answering. Ideally, individuals preparing to become IBCLCs should be thinking of it as at least a 2-3 preparation experience. I always advised “newly in love with breastfeeding” IBCLC wannabe’s to take a week-long course, do some reading from the recommended reading list, go to some conferences, and THEN begin accumulating hours. If they were nurses, and had already begun (or indeed finished) their hours, they still need to do these activities. All of this, and more, is in the Candidate Information Guide. 45 Hour Requirement, Continuing education and the CERP system: The CERP system is another area that, I believe, needs major review and revamping. Currently, CERPs are granted after an evaluation of the program, the speakers CV, the program bibliography, and payment of a miniscule fee. Other than this, there is no verification of the speaker’s actual knowledge on the subject, or skill at presenting the information. Even more disturbing, there is no sure way to verify actual attendance and LEARNING of the attendees at the sessions. Course providers often cannot even verify attendance, let alone that participants learned anything. I personally have attended more than one conference and registered only to find the completed CERP certificate for 15 or more CERPS already in the folder! Why not just see the sites of Chicago or New York in this case? Do you attend every session at every conference? If the certificate is preprinted, do you correct it? Which brings us to another point. Recertification is currently required every 5 years by exam or CERPs, and at 10 years by exam only. The recertification by CERPs is, essentially, a gift. Continuing education has not been linked to continuing competency. The only means of guaranteeing continuing competency is through examination. Our young field is continually changing. So are others. Other allied health care professions and international professional certifications require recertification by exam every 2 or 3 years. Practicing with out of date information is a Code of Ethics violation. Think about that one. CERPs are also not currently rated or ranked by level or difficulty, although this is under consideration. Entry level, mid-level and advanced experienced level program designation not only would help individuals discern what would be appropriate for them, it would also help to ensure that at least an effort is being made for continuing competency and continuing learning. I must respectfully disagree with Kathleen B. that there is no real standard of information, or standard of care for breastfeeding. We do have the beginnings of standard of information ad care, based on ILCA’s evidence based practice guidelines. They need to be updated regularly of course, but more importantly, they need to be used! There are IBCLCs in practice who do not know they exist. There are others who do not observe them. Is it any wonder that MDs and others greet our profession with mixed reviews, if we cannot even ensure that IBCLCs practice quality, basic care across the board? 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