Pathway Comparison

A side-by-side comparison of the eligibility requirements, timelines, and key differences across the three pathways to NABBLM board certification.

Next exam dates are November 3 – 11, 2026.

Application expected to open September 2026.

Fellowship Pathway

Alternate Pathway

Graduation from an accredited allopathic or osteopathic medical school in the United States or Canada, or possession of Final Certification by the Educational Commission for Foreign Medical Graduates (ECFMG) if graduated from a medical school in a different country. 

Possession of a current, valid, unrestricted license to practice allopathic or osteopathic medicine in a state or jurisdiction of the United States, or province or territory of Canada. 

Current or previous board-certification by a medical specialty board recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) for physicians practicing in the United States OR current or previous certification by the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada for physicians practicing in Canada.

Successful completion of a NABBLM accredited fellowship program.

Comprehensive Program

  • Certificate from a NABBLM accredited comprehensive educational program 

OR


Self-Directed Program 

  • Certificates from NABBLM accredited educational programs demonstrating successful mastery of content in each of the following:
    • General Knowledge of Breastfeeding and Lactation Medicine
    • Advanced Topics in Child BFLM
    • Advanced Topics in Maternal BFLM

The candidate must acknowledge and attest that they have the skills and knowledge to independently practice full scope Breastfeeding and Lactation Medicine.  This practice involves both the parent and their infant/child throughout the whole duration of human lactation (2+ yrs) to include all of the following (more comprehensive list at NABBLM knowledge categories): 

  • Taking a comprehensive BFL history of both the lactating parent and child 
  • Performing an exam of the lactating breast 
  • Performing a breast pump assessment 
  • Evaluating infant oral anatomy and function 
  • Evaluating feeding and assessing milk transfer 
  • Evaluating infant and toddler growth
  • Ordering and interpreting labs and diagnostic imaging for parent and child
  • Documenting on both parent and child 
  • Managing parent mental health concerns (screen, refer, treat) 
  • Managing treatment for BFL conditions (e.g., mastitis, hyperlactation, vasospasm) 
  • Managing milk production issues (e.g., insufficient or over-production

Application fee: $100
Examination fee: $1500

Effective 1/1/25 NABBLM will be changing from a differential cost structure to a universal fee structure. This will apply for both the application and examination fees. In an effort to fulfill a commitment we made during the grandparenting period, we will honor the discounted rate for Canadian applicants in the Grandparenting Pathway for the duration this pathway is open.

Learn more about the Fellowship Pathway.

Learn more about the Alternate Pathway.

* These pathways will be re-evaluated every two years. NABBLM reserves the right to adjust eligibility criteria to reflect changes in the field of BFLM and available training opportunities as they develop.

All Pathways:

Graduation from an accredited allopathic or osteopathic medical school in the United States or Canada, or possession of Final Certification by the Educational Commission for Foreign Medical Graduates (ECFMG) if graduated from a medical school in a different country. 

Possession of a current, valid, unrestricted license to practice allopathic or osteopathic medicine in a state or jurisdiction of the United States, or province or territory of Canada. 

Current or previous board-certification by a medical specialty board recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) for physicians practicing in the United States OR current or previous certification by the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada for physicians practicing in Canada.

Fellowship Pathway:

Successful completion of a NABBLM accredited fellowship program.

Alternate Pathway:

Comprehensive Program

  • Certificate from a NABBLM accredited comprehensive educational program 

OR


Self-Directed Program 

  • Certificates from NABBLM accredited educational programs demonstrating successful mastery of content in each of the following:
    • General Knowledge of Breastfeeding and Lactation Medicine
    • Advanced Topics in Child BFLM
    • Advanced Topics in Maternal BFLM

All Pathways:

The candidate must acknowledge and attest that they have the skills and knowledge to independently practice full scope Breastfeeding and Lactation Medicine.  This practice involves both the parent and their infant/child throughout the whole duration of human lactation (2+ yrs) to include all of the following (more comprehensive list at NABBLM knowledge categories): 

  • Taking a comprehensive BFL history of both the lactating parent and child 
  • Performing an exam of the lactating breast 
  • Performing a breast pump assessment 
  • Evaluating infant oral anatomy and function 
  • Evaluating feeding and assessing milk transfer 
  • Evaluating infant and toddler growth
  • Ordering and interpreting labs and diagnostic imaging for parent and child
  • Documenting on both parent and child 
  • Managing parent mental health concerns (screen, refer, treat) 
  • Managing treatment for BFL conditions (e.g., mastitis, hyperlactation, vasospasm) 
  • Managing milk production issues (e.g., insufficient or over-production

Application fee: $100
Examination fee: $1500

Effective 1/1/25 NABBLM will be changing from a differential cost structure to a universal fee structure. This will apply for both the application and examination fees. In an effort to fulfill a commitment we made during the grandparenting period, we will honor the discounted rate for Canadian applicants in the Grandparenting Pathway for the duration this pathway is open.

Learn more about the Fellowship Pathway.

Learn more about the Alternate Pathway.

* These pathways will be re-evaluated every two years. NABBLM reserves the right to adjust eligibility criteria to reflect changes in the field of BFLM and available training opportunities as they develop.

Not sure which Pathway is right for you? Try taking the Certification Path Guide.

List of NABBLM Accredited Programs

Fellowship Programs: LILAC | Lawrence Family Medicine Residency

Comprehensive Program: Deep Dive