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Celebrating Breastfeeding: Expert Insights and Support Strategies for New Mothers

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What if we told you that breastfeeding support could drastically transform the health of both mothers and babies globally? Join us for a special episode of Parenting Genie as we celebrate World Breastfeeding Week with the incredible Constance Banks, a midwife and lactation consultant with over 30 years of expertise. Constance dives into the concept of Baby Friendly Hospitals and the critical differences in breastfeeding rates between England and Australia. She also sheds light on the grueling process of becoming a certified lactation consultant and shares the origins and aspirations of World Breastfeeding Week, emphasizing this year's theme, "Closing the Gap," which strives to make breastfeeding support universally accessible.

Throughout this episode, we explore the evolving landscape of breastfeeding advocacy and support over the last three decades. From exclusive breastfeeding being the gold standard to adopting a more personalized approach, we discuss how lactation consultants like Constance play a pivotal role. Constance provides practical insights into common breastfeeding challenges, such as societal pressures and milk supply concerns, and highlights the significance of antenatal breastfeeding education. Additionally, she offers a glimpse into the current breastfeeding rates in Australia and why continued support and education are essential. Don't miss this invaluable conversation packed with wisdom and actionable advice for anyone interested in breastfeeding advocacy and support.

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We value your feedback, so please feel free to reach out to us via email at admin@parentinggenie.com.au.

Carey Donohoe:

Hello and welcome. This is Carey from Parenting Genie, your go-to source for all things parenting From the joys of pregnancy to the challenges of raising a vibrant five-year-old. Every Tuesday, we dive deep into pregnancy and then on Thursday, we switch gears to cover everything about parenting. Rest assured, we're committed to providing you with loads of insights and expert advice every week. Hi everyone, it's Carey from Parenting Genie. I hope you're all doing really well. I have a lactation consultant on our podcast today, which I'm really excited about, especially because it's World Breastfeeding Week. So why don't we all give a really warm welcome to Constance Banks? Hi, Constance, how are you going?

Constance Banks:

Thank you, hello everybody, nice to be here. World Breastfeeding Week, thank you.

Carey Donohoe:

Before we go any further, I really want to say a big thank you to you, constance, for taking time out of your busy schedule I know how busy you are and coming on and having a chat with us today on our podcast. Thank you so much. My pleasure, okay. Well, constance, why don't you please tell us a little bit about yourself and your professional background?

Constance Banks:

So I'm originally from Germany. I came to Australia 30 years ago and I was a registered nurse and then became a midwife in England and I worked in the Middle East. Wow and yeah. And then I came to Australia. Uh, when I started work in melbourne I happened to be employed um by a hospital which was a baby friendly hospital so baby friendly accredited by in those days it was unicef who did the accreditation right and what.

Carey Donohoe:

What's baby friendly? What do you mean by that?

Constance Banks:

yeah, so that means that the hospital is following and implementing the who 10 steps of successful breastfeeding right and few of those. And yeah, enable mothers to breastfeed their babies on cues and help where necessary. So there's 10 steps and yeah. So all of a sudden I became really passionate because, having trained in England, england has a very, very low breastfeeding rate and so in Australia it was so different when I arrived here in 1994.

Constance Banks:

So Australia had a higher breastfeeding rate compared to Australia, much higher breastfeeding, and it's still the way, even though it's not as good anymore as it used to be 30 years ago. So, yeah, so did you happen to sorry? Sorry, but yeah, I happen to be living in a suburb in melbourne who had the lactation resource center, which is a huge big library, and I spent lots of time there studying, and there was only two lactation resource centres in the world and one actually was in Melbourne.

Carey Donohoe:

Wow, that's amazing. So a little bit more about your professional background. So what training have you had?

Constance Banks:

So obviously I've got a diploma in midwifery and did that in England, and then I'm a board certified, international board certified lactation consultant and I did that first time in 1996. So I set that exam. In those days it actually took a whole day. Nowadays it's a bit shorter, even though it's still saying hundreds of questions. And in order to actually qualify to, to sit that exam, you will have to have at least just thinking it's about, I think 95 hours of breastfeeding education and 300 hours of supervised support of breastfeeding education and 300 hours of supervised support of breastfeeding women. Wow, and you have to cover 14 science subjects in that exam. So as a health professional, you have an advantage. Yes, because you would have had some of that experience. And yeah, and that exam takes place in many, many countries of this world in many, many languages. And then every five years we have to recertify with points for 75 hours, and every 10 years we had to reset the exam. But that has changed now so we can actually recertify in a different way after 10 years?

Carey Donohoe:

Oh, fantastic. So how long have you been a midwife and a lactation consultant?

Constance Banks:

So I've been a midwife for 32 years and a lactation consultant for 28 years.

Carey Donohoe:

Wow, so lots and lots of experience that you have there. Wow, that's amazing. Can you tell us a little bit about what World Breastfeeding Week is or means? What is it about?

Constance Banks:

Yeah, so World Breastfeeding Week is celebrated in more than 120 countries in this world. It started in 1992, and it's always celebrated in the first week of August, and there is a network group that is called WABA W-A-B-A World Alliance for Breastfeeding Action. They are sort of affiliated also with the WHO and UNICEF and the goal is to support breastfeeding, protect breastfeeding and to give public awareness and education. And so most times what happens in a lot of countries not in all those 120 plus countries is that organizations like, for instance, here in australia we've got, of course, the australian breastfeeding association right they have big sort of yes, gatherings and promotions to celebrate World Breastfeeding Week and also to educate the public.

Constance Banks:

And there's always a different theme that Waba will find for every year, and this year it's called Closing the Gap, making breastfeeding support available for everybody, because unfortunately, as we know, healthcare, there's a lack of equity for many, many women in this world, and so, yeah, so that's a slogan for this year, and so there's organizations and even individuals who can pledge that they're supporting this cause. And, um, yeah, well, I used to work in a big tertiary hospital as a lactation consultant. We always had, um, kind of big things happening, especially through the australian breastfeeding association. They usually had a stall, they had showbacks, they went to talk to the mothers and the families. Yeah, yeah, so, um, quite, quite an exciting week.

Carey Donohoe:

Really it is. That sounds amazing and I mean breastfeeding is just so important really and in your experience, do you, do you think that, um, australia has a good successful breastfeeding rate? Like what would you say? You know, women are generally breastfeeding, mostly, compared with formula. What do you think?

Constance Banks:

yeah. So most women will start breastfeeding and they will also say I will breastfeed if I can. So there's often that anxiety and that also that doubt is it possible? But unfortunately it drops off very quickly, so by about three months or so it's. I think it's only exclusive breastfeeding only happens then for 15 of babies. As far as I'm aware of the latest steps, that might have changed that's quite a big drop off, 50, isn't it again?

Constance Banks:

so, um, yeah, it drops off very quickly, yeah, yeah, and in australia we were very lucky because when we talk about the baby friendly hospital initiative or the baby friendly health initiative or you know, baby friendly accredited hospitals, yeah, we had so many more and of course, we had had the pandemic, and so it was really difficult to assess hospitals, because I used to be an assessor for hospitals for baby friendly and yeah, so they have to go through quite a big process to make sure that they actually, yeah, adhere to the guidelines.

Constance Banks:

That's right, yeah.

Carey Donohoe:

It's amazing, wow. Well, constance, what does a lactation consultant mean and what led you to become a lactation consultant? Yeah, um.

Constance Banks:

So even in my midwifery training I? Um was focusing.

Carey Donohoe:

Quite a few of my coursework was um breastfeeding related and that's something you've been really drawn to breastfeeding, you think right I have.

Constance Banks:

Yeah, yes, I have. I. I um suppose, um, it's something that is also a healing effect. We've got a lot of mothers who have been traumatized through their birth experience, unfortunately, these days, and we know that there's also, you know, sort of legal things happening at the moment in New South Wales to actually on trauma and childbirth. So I mean, breastfeeding could also be traumatic, but I really feel that we could actually use it as a way to heal any trauma and if it's supported well, and also over the years, as a lactation consultant, I have changed a lot of my views.

Constance Banks:

So when we started, or when I started 30 years ago, the gold standard was exclusive breastfeeding. So, you know, exclusive breastfeeding, with nothing else for the first six months, yeah, and it is achievable, no doubt, but it is for many women very difficult, and so for me, my slogan these days is it's, you know, it's not all or nothing. There is so much much in between, you know. So, even if a woman can only, you know, provide 20% of her breast milk, that is 20% of breast milk and that is, you know, so much more than not doing it at all, oh, exactly.

Carey Donohoe:

And I mean, you know any breast milk is good, isn't it? You know what is a benefit to to the mom and the baby, really isn't it?

Constance Banks:

Yeah, yeah, so that's you know, it's been a passion. And what else is probably the passion is that as a lactation consultant I felt I had more autonomy than as a midwife in the health system. Yes, and I quite like that as well. So we do have um a kind of professional conduct as an ibclc or international board certified location consultant. So and obviously you know, we have to refer if we feel that there is a need to refer. Like a mother who has mastitis, we in fact we're not even supposed to diagnose it, we're supposed to say well, actually that looks as if you could have an inflammation or an infection and you need to see your gp. So it's quite clearly defined yeah, exactly right.

Constance Banks:

Yeah, there's clear. You know definitions. Yeah, yeah, and yeah, and I mean the, the international board Certified Lactation Consultants. That whole board started in 1985. And I set my exam, well, 10, 11 years later, so it was pretty established already. But now I actually just looked up because I thought you would probably ask me a few questions. So in 2024, like this year, we have 37,000 IBCLCs in 134 countries and the exam is held in 17 languages. Isn't that amazing?

Carey Donohoe:

That is just amazing. Wow, yeah so. I can see that you're just so passionate about breastfeeding and lactation, and that was right from the word go you know, when you were studying to be a midwife. So that's you've got so many years of experience and and that's really great. So what is a lactation consultant? For the people out there that don't know what a lactation consultant is, what, what is it?

Constance Banks:

yeah, so that's a person who has obviously set an exam, so the the word lactation consultant is actually not a protected word, right? Everybody could actually call themselves a lactation consultant. You have to, actually, in order to actually be an IBCLC, you have to obviously adhere to and have set the exam, yeah, so?

Carey Donohoe:

so, um, you could call yourself a lactation consultant, um, but you may not actually have set any exams, so it's not a protected so how would women know, like if they're wanting to make an appointment with a lactation consultant, that that person really is a lactation consultant?

Constance Banks:

yeah, so they want to look up that that woman is actually, or that person is actually registered as an IBCLC, as an international board certified lactation and you can look that up very easily, can you? You can, yeah, there is actually a register as well, um which you can just google it these days and you can actually look it up and um, yeah, so, um, it's basically you have to, um adhere to international standards in terms of supporting breastfeeding um or the breastfeeding journey of mothers, families, babies, and that's what it is.

Constance Banks:

So you educate you support, yes I was about to say.

Carey Donohoe:

In a practical sense, what would you if a mum come to you with breastfeeding difficulties? Practically, what are you doing to help her?

Constance Banks:

Yes, so first of all I would actually find out what her difficulties are. The majority of mothers have got painful breastfeeding or they have damaged nipples, and latching a baby to the breast seems to be a huge big thing. And do you want to know what my kind of little tools are? So that's one of my tools, Can you?

Carey Donohoe:

see it. I can't see Constance.

Constance Banks:

What is it, oh my god, it's a breast, it's a knitted breast, and so we actually taught we actually wow we're teaching attachment how the baby has to have a big mouth to actually, that's right, you know the breast. So that's a big tool for a lactation consultant. And then, of course, the other thing that is a big, big tool is a doll. So, yes, so if we have those two, we actually have pretty much most of our toolbox already oh, that's amazing.

Carey Donohoe:

So you, you would take that to see.

Constance Banks:

Absolutely yeah, yeah so, um, and then, um, what I would do is I would find out what the mother actually expects me to do for her, what she thinks her problem is, and then I would watch her feed. So it's so important to actually watch a breastfeed and find out what's happening there, and then from there, you know, if it's the latch, we work on the latch. If, um, it's one, one of the biggest um reasons also why women actually stop breastfeeding is milk supply. They worry about the milk supply and so we have to, you know, sometimes address that, because it can often be a perceived low supply, yeah, and then it can also be a real issue with the supply, and then, yeah, so, because I know, as you start to, as your baby's getting older, and you're well establishing into your breastfeeding journey, that the breasts do become a lot more soft, don't they?

Carey Donohoe:

really feel that you know you don't have any milk in your breasts, but exactly yeah and when does that usually happen? Constance, when do the breasts usually get so?

Constance Banks:

so. So what happens after the birth due to the hormone levels and the whole um endocrine you know, everything to do with hormones really um is that the, the mother's body, actually calibrates milk making by often even having more milk than needed, and it's supply and demand. So, um, quite often the mother has more milk than needed, yeah and um, then basically the baby is the one who usually down regulates that supply and the mother will only start producing as much as she needs, and that's really sort of at around between 6 and 12 weeks.

Constance Banks:

That's often when supply actually starts, sort of um, you know, just being what she needs and then, when the baby has a growth spurt, the baby will feed more frequently again, and then, of course, the message goes to the brain we need to make more milk again, and then that will be adjusted. Wow, so it's just fascinating really, isn't it?

Carey Donohoe:

What do you think is the biggest problem that you encounter with women, with breastfeeding? Like what is the major issue for most women? Would you say it might be attachment, or like what.

Constance Banks:

Attachment, but it's also the expectations that we have these days. So we expect mothers to actually not just, you know, get used to that. I mean, with the birth of a baby, we have a birth of a mother, yes, and a birth of a father, or birth of, you know, yes, it's a whole new journey, basically, and it's a whole new journey and, and there is so much conflicting advice, um, and it's never actually changed, really, and so, and then there's, of course, the fact of sleeping, you know. I mean, I remember I used to be an antenatal educator and I had parents asking you know, when can I start sleep school? After the birth, you know. So it's this, you know this yeah, seriously.

Constance Banks:

And it's that issue with, you know, having to adjust to the rhythm of the baby. So babies need to feed, you know know, 8 to 12 times in 24 hours. There's nothing that we can do about it, that's. That's normal, innate, that's been happening for thousands of years. And you know, as a mother, we often try to change that because we've got so many other pressures. That's right and we think of you know. And if we don't feed frequently enough, then of course there's not enough milk for the baby. And then we start supplementing, yes, which decreases the milk With formula and that decreases the mother's own milk supply.

Carey Donohoe:

So it's like with catch-22, you know, it's like a snowball effect really, isn't it? Absolutely, once you start doing that.

Constance Banks:

So antenatal breastfeeding education I think is really sort of the core of a good outcome for breastfeeding education. I think is really sort of the core of a good outcome for breastfeeding.

Carey Donohoe:

And to talk about the realities and you know the normal sort of aspect of breastfeed. I mean, it's really important to have that knowledge, isn't it? Yeah, and is that something you do? Constance, do you run consultations with pregnant women?

Constance Banks:

Yeah, so at this point in time it's really antenatal education. So I mean, when I was still working, also in a hospital, I would actually run some breastfeeding classes, but they were actually not even that well attended. But I suggest to mothers if they want to do group education, definitely go for the australian breastfeeding association. I mean they do run really, you know I think, very good classes and otherwise I have actually um the. Even on my website there's antenatal um consultations and I've had quite a few women, especially in the last few years, who actually already contacted me antenatally. And they contacted me antenatally because they wanted to have a better experience this time around, because they had a fairly difficult experience the first time around and so this time they felt they needed to have a lactation consultant involved even prior to the baby being born.

Carey Donohoe:

Wow, yeah, that's amazing. Well, what qualifications Constance do you need to become a lactation consultant? Well, like you know, a registered one, not just calling yourself a lactation consultant.

Constance Banks:

yeah, yeah, yeah well, I mean, obviously you could be any kind of health care professional, so you can be a nurse, you can be a midwife, an osteopath and nutritionist, there's dieticians, there's so many health professionals who have actually set this exam and have done that journey, wow. There's also the opportunity for peer counselors, like there's peer counselors, peer breastfeeding counselors, for instance, here in australia through the australian breastfeeding association, but in other countries it's lalasha league, you know peer group association, and those counsellors they can actually get through a lot of training, also to the point where they can sit this exam and then be certified lactation consultants. So it's interesting though here in Australia, if a lactation consultant is privately working, you have to actually be APRA registered as a midwife or a nurse in order to actually get provider status with some of the private health funds. Yes, so if it's now a peer counsellor who's become an IBCLC, that person cannot actually get the provider status with private health funds because she can't be an APRA registered health professional, and APRA is the you know regulator that we have as midwives and nurses and allied health professionals as well. So just to give that a little bit of thought yeah, that's very interesting.

Constance Banks:

Yeah, so, and there is also some mid, midwives, some privately practicing midwives, some independent midwives who are, um, they're called endorsed midwives and they could also be ibclc. So okay, set that exam and these midwives have the benefit of being able to actually use Medicare for their services. So that's good to know for some of the women who may actually go through a private midwife who is an endorsed midwife, because maybe they have had private midwifery care or they had a home birth or so, so they can actually get that through Medicare. But people like myself, who is not an endorsed midwife it's um if they do have private health insurance, they can make a claim if they have extras but, other than that, unfortunately, they have to pay yeah, wow, okay, well, and what is one of your biggest success stories with?

Carey Donohoe:

with breastfeeding, like what would be the most positive experience you've had? Um, I'm sure you've had many I have met.

Constance Banks:

I tell you a little bit about um, a lady that I looked after last year, um, and it's not that we got to the point of exclusively breastfeeding for her, so that. So success needs to be defined in different ways. So, um, this woman had this most beautiful normal birth, a water birth and um term baby. No, no intervention. So we're talking about no trauma at birth. And yet this baby was basically jaundiced and did not put on weight and the midwives kind of could not understand what was going on and they had to introduce formula because the baby was losing too much weight and was sleepy.

Constance Banks:

And then she actually contacted me after, you know, probably a week or so, and and this is interesting because this is why it's so important to take a history and I went through my checklist, my history taking, and I said, um, have you had any breast surgery? And she said, well, I had a breast reduction seven years ago. And I said, do you realize that your, your body is not able to, you know, to produce the amount of milk for this baby because so much of the glandular tissue that has the milk-making cells has actually been taken away. So of course, that was a big bummer, because nobody had actually asked her in her pregnancy whether she had breast surgery, so it was not actually in her discharge.

Carey Donohoe:

Summary from the hospital where she birthed. I find that hard to believe, yeah.

Constance Banks:

However, with her GP, with medications, with a lot of support, this baby was actually starting to feed at the breast. With what is called a supply line, yes, and she managed to provide 50% of her own breast milk to that baby and the rest was um formula which she gave most times through a supply line which means that the baby had a little tubing in the mouth whilst it was sucking at the breast and was getting the extra milk.

Constance Banks:

That way, yeah, and she was very, very happy with that outcome because she, you know, kind of thought, oh well, when I told her, that you know it's going, she's. She thought she would not be able to breastfeed at all, so that was, I felt, a real success story from the last four months.

Carey Donohoe:

Yeah, that's right, and any breast milk is good, like we said earlier yeah, she would have been thrilled, you know.

Constance Banks:

Absolutely. Yeah, that's amazing Constance Well.

Carey Donohoe:

I think we're starting to run out of a little bit of time. That's okay, but we really appreciate you. I really appreciate having you on the podcast today. It's been amazing.

Constance Banks:

Thank you Well, thanks for having me.

Carey Donohoe:

Yes, and we'd love to have you back again another time, okay.

Constance Banks:

Yeah, have you back again another time. So, okay, yeah, I mean, I just want to give you a tiny little bit of something that I always love to talk in my classes about. I've got these lovely cards. You can't see them very much. Can you see them? Actually hold that a little bit higher? No, no, I can't. Oh, that's weird, you can only see. So, anyway, I'll tell you what it is. So it's actually, um, these are educational cards and I used to give them to medical students as well when I taught them. And, for instance, there is an albumin in breast milk. It's called alpha lucked albumin and the abbreviation is hamlet, and I used to say it's not about shakespeare. It's basically the human albumin made lethal to tumor cells. So this is why women have a reduced risk of breast cancer and even babies have a reduced risk, because there is actually cells in breast milk that actually destroy cancer cells. Isn't that amazing? That's just amazing. But it's just one of those little things you know?

Carey Donohoe:

yeah, I know there's so many benefits, but that is a really good one. I love the hamlet one well guys.

Carey Donohoe:

if you would like to have a consultation with Constance, you can contact Parenting Genie via the website and send us an email, and we can set up an appointment with Constance and you guys. So that would be really good if you'd like to do that. And finally, don't forget to visit the Parenting Genie podcast. You can find the link on the website in the library section. And remember, every Tuesday podcast is about pregnancy and Thursdays is about parenting, so I'm sure you'll get some great information on that as well. So, constance, thank you again. We really appreciate your time and it's been amazing listening to you today.

Constance Banks:

Yeah and thank you for having me Bye Constance Very much. Likewise Bye Bye.

Carey Donohoe:

Bye, Carey, here signing off. Thanks for tuning in to today's episode. We're looking forward to hearing from you, so please don't hesitate to send us your questions and the topics you're eager for us to explore. Join us next time for more tips and stories that make parenting a joy. Until then, happy parenting and see you in the next episode.