What do CDL and IBCLC after a lactation consultant's name mean?
CDL stands for Certyfikowany Doradca Laktacyjny, a Certified Lactation Adviser. The title is awarded by the Centrum Nauki o Laktacji (CNoL, Lactation Science Centre) and is reserved for people in a medical profession: doctors, midwives and nurses who have completed postgraduate training, supervised practice and a theory and practical exam.
IBCLC stands for International Board Certified Lactation Consultant, an international lactation consultant certificate. It is awarded by IBLCE, an organisation whose website now operates under the name IBCLC Commission. The exam is open to people with a background in health sciences, and the certificate itself is not reserved exclusively for medical professions.
Both titles confirm in-depth knowledge of lactation, but they do not change the person's core profession. What a consultant can do during a visit, for example examine you or your baby, depends on whether she is a midwife, a doctor or a nurse. So when choosing, look at both the certificate and the profession.
How does someone become a CDL lactation adviser or an IBCLC?
A midwife or nurse who wants to become a CDL must complete the CNoL course series (at least 63 hours of theory) and at least 20 hours of practice supervised by a CNoL trainer on a hospital ward or in a lactation clinic. A doctor needs at least 75 hours of theory and 30 hours of practice. The candidate then documents independent work with patients and takes an exam: a 100-question test and a breastfeeding consultation in front of an examiner.
The CDL title is awarded for 7 years. Before it expires, the holder has to go through recertification, which only rarely involves retaking the exam.
An IBCLC candidate needs a health sciences education, at least 90 hours of lactation education and 5 hours of communication training, plus clinical lactation practice, the amount of which depends on the chosen pathway. Finally, she takes an international exam. The IBCLC certificate is valid for 5 years and then has to be renewed.
Who should I see for breastfeeding problems: a midwife or a lactation consultant?
Breastfeeding help is part of every midwife's job. The government portal pacjent.gov.pl explicitly lists lactation consultations and support with feeding problems among the tasks of a POZ (primary care) midwife. A midwife's competence comes from her licence to practise (PWZ, prawo wykonywania zawodu), not from a lactation certificate, although some midwives also hold the CDL title, the IBCLC or both.
For typical difficulties in the first weeks, such as a painful latch, engorgement or questions about how often to feed, an experienced midwife is usually enough. If the problem drags on or keeps coming back, it is worth finding someone with a lactation certificate. The comparison below will help you decide:
| CDL | IBCLC | Midwife | |
|---|---|---|---|
| Awarded by | Centrum Nauki o Laktacji (Poland) | IBLCE, now IBCLC Commission (international) | The licence to practise is granted by the regional council of nurses and midwives |
| Requirements | Profession of doctor, midwife or nurse, CNoL courses, supervised practice, theory and practical exam | Health sciences education, min. 90 hours of lactation education and 5 hours of communication, clinical practice, international exam | Midwifery degree and licence to practise |
| Validity | 7 years, then recertification | 5 years, then recertification | No expiry date like a certificate, the register shows the current status (e.g. suspension) |
| Where to check | List of Certified Lactation Advisers on the CNoL website | Public Registry on the IBCLC Commission website | PWZ search on the website of the Naczelna Izba Pielęgniarek i Położnych (Polish Chamber of Nurses and Midwives) |
| When to choose | Prolonged or recurring problems, poor weight gain, feeding a premature baby | As for CDL, also when you want someone with an international certificate | The first weeks, typical difficulties, care for you and your baby in the postpartum period |
If you are not sure where to start, book a midwife. If the problem goes beyond her experience, she will refer you to a lactation consultant or a doctor.
How can I check that a lactation consultant has a valid certificate?
You can check each of these titles yourself in a few minutes, without making a phone call:
- CDL: the Centrum Nauki o Laktacji website has a list of advisers with their certificate number, expiry date and city. CNoL describes it as the only complete database of CDLs.
- IBCLC: in the Public Registry on the IBCLC Commission website you can search for a person by first name and surname or by certificate number. The registry shows current expiry dates.
- Midwife: on the website of the Naczelna Izba Pielęgniarek i Położnych (Polish Chamber of Nurses and Midwives) you can check the licence to practise by entering the surname and PWZ number. The result shows whether the midwife is on the register and whether her licence to practise has been suspended.
If someone is not in the register, ask for her certificate number and its expiry date. The reason may be a change of surname or a certificate that has expired and not been renewed.
What happens at a lactation consultant visit?
The visit starts with a conversation about the birth, how feeding has gone, your health and any medicines you take. Then the consultant or midwife examines your breasts and nipples, looks at the baby and how they suck, and above all watches a whole feed. She often weighs the baby and checks weight gain.
At the end you get a concrete plan: how often to feed, whether and how to express milk, whether to give top-ups and with what, and how to care for your nipples. It is also good to agree when you will check how it is working. If the specialist notices something that needs a doctor's assessment, for example a suspected tongue tie, she will tell you where to go.
With pain, damaged nipples or poor weight gain, a home visit helps most, because the specialist sees the feed live. An online consultation works well for questions about expressing, going back to work or weaning, and as a follow-up after a visit. On MyMidwife you can check midwives' lactation qualifications and available visit types on their profiles.
Is a lactation consultation free on the NFZ?
Under the NFZ (Poland's public health fund), basic feeding support is provided by the POZ midwife. After the birth she makes at least 4 home visits (wizyty patronażowe) in the first weeks of the baby's life, the first within 48 hours of receiving notice of the birth, not counting weekends and public holidays. During these visits the midwife assesses feeding, teaches latching and helps with breastfeeding problems.
When the home visits end, the baby's care passes to the POZ nurse, but the midwife can still support you with feeding. Some hospitals and clinics run lactation clinics, but availability depends on the place, so ask about them at your hospital or clinic.
A private consultation lets you choose a specific person, for example a midwife with the CDL or IBCLC title, as well as the date and a longer visit.
When should I see a doctor about a feeding problem?
Neither a lactation consultant nor a midwife can replace a doctor when there are signs of illness. Contact a doctor urgently, and if the situation is serious go to the SOR (hospital emergency department) or call 112, if:
- you have a high fever, chills and feel as if you have flu, especially with a red, painful breast
- there is a hard, very painful lump in the breast that does not go away, or pus is coming out of the breast
- the baby is listless, hard to wake for feeds or stops eating
- the baby has noticeably fewer wet nappies than usual, a dry mouth or a sunken fontanelle
- the baby's jaundice is getting worse or the baby becomes sleepy and sucks weakly
- the newborn has a fever, difficulty breathing or vomits frequently
Once the acute problem is under control, a midwife or lactation consultant will help you get back to calm feeding.
