Joan Ellen Armstrong asks some really good questions about how to get the experience needed to take the exam, and gives me a chance to elaborate a little on my earlier post regarding the IBLCE hours requirement. First I want to note that while a person could "fudge" hours of practice to meet IBLCE exam requirements I certainly would not suggest it. A deliberate misrepresentation on one's exam application would certainly disqualify that candidate from sitting the exam, possibly for a very long time. Since I believe that most folks in our field are not just nice but honest :-) I would say that an equally important reason to assess one's contact hours honestly is that the exam is clinically-based and the time spent working with breastfeeding mothers and babies is *what you need* to do well on the exam. Each individual's learning curve and learning style is somewhat different. There are probably people who can do well on the exam with fewer clinical hours. There are also undoubtedly people who will need more clinical experience than is required before they can expect to do well on the exam. But the number of clinical hours as set by IBLCE is based on the actual qualifications and performance of previous candidates - it's not arbitrary. IBLCE wants people to know that hands-on experience is vitally important to pass the exam. Okay, on to the question about how to get those contact hours. An active La Leche League Leader can expect to spend several hours a week with phone counseling and Group Leading. The IBLCE Candidate Information Guide notes that a typical number of hours may be as many as 500 per year, but each candidate must assess her own experience. A Leader who does additional work (that is, stuff that most Leaders don't do, like working with WIC peer counselors, teaching additional classes, seeing moms in the hospital, doing a lot of home visits, running an active pump rental depot) should carefully document this experience so that she can get "full credit" for the hours she puts in when tallying up all that experience. I hope LactNetters will write in with their suggestions. As far as supervision of clinical experience: Jeannette Panchula in her post makes a good point - that those of us who started out in the field several years ago did a lot of stuff "by the seat of our pants." She describes someone who never worked under a trained LC but got her experience hours nonetheless. A person's place of employment for getting those hours makes a difference; having supervision for some aspect of your work, even if it's not specifically of the breastfeeding aspect, is certainly important. So, for example, a postpartum nurse who gradually became the "breastfeeding expert" and decided to set up a pump rental business, teach classes, etc. would make me pretty comfortable - if I were the one reading her application. I have talked to people who call the IBLCE office and want to know, can they count the hours they've spent helping their friends and relatives breastfeed? Or, someone with no HCP background and no accredited volunteer experience ("but I was a member") manages to start a pump rental business - well, no, you can't just go off helping people breastfeed, with absolutely no accountability to anyone for your work, and expect those hours to count. Sorry to go on for so long. I sort of automatically launch into the spiel that I use on the phone at work at least a few times a week. Kathy A. has suggested that we consider it for a future IBLCE column in JHL so you haven't heard the last of it! Mary Renard