Podcast: What is a breastfeeding counsellor?

Find out more about what a breastfeeding counsellor does

Leila talks to Jess about the role a breastfeeding counsellor plays in providing mum-to-mum support. We also hear from Kristy about her experience calling the National Breastfeeding Helpline and receiving that support. Leila also tells us about the training breastfeeding counsellors receive and how people can become involved with volunteering with ABA.

Information discussed in this episode:

• Training with ABA
• Volunteering with ABA
• National Breastfeeding Helpline

Credits:

This episode is presented by Jessica Leonard. Featuring Leila Forde. Special thanks to Kristy.

Audio editing by Jessica Leonard. Show notes by Belinda Chambers. Transcription by Madina Hajher. Produced by Belinda Chambers, Jessica Leonard and Eleanor Kippen.

LEILA: The thing in our society, we tell mothers about the value of breastfeeding. But without giving the skills to breastfeed we’re really setting mothers up for failure.

JESS: Welcome to Breastfeeding… With ABA. A podcast brought to you by volunteers from the Australian Breastfeeding Association. Breastfeeding…With ABA is a podcast about breastfeeding made by parents, for parents. In this episode we’ll be explaining what actually is a breastfeeding counsellor. We’re recording this podcast in different parts of Australia. We acknowledge the traditional custodians of the lands on which we’re recording and you’re listening to this podcast. We pay our respects to Elders past, present and emerging and to any indigenous people who are listening today. We’d also like to acknowledge the long history of oral storytelling on this country and of women supporting each other to learn to feed their babies.

My name’s Jess and I’m a breastfeeding counsellor with the Australian Breastfeeding Association. I’m speaking to you from my home in the North-eastern suburbs of Melbourne on Naarm, and that’s the land of the Wurundjeri people of the Kulin nation.

LEILA: And my name’s Leila and I’m also a breastfeeding counsellor with the Australian Breastfeeding Association and I have some other roles in the Association as well. I’m a trainer and assessor with the Association; we’re a registered training organisation. We have trainers who are all able to deliver our courses in breastfeeding education to our volunteers. I’m also a community educator as well.

JESS: So, I think because of that, Leila, you’re the perfect person to speak about what a breastfeeding counsellor is. So, maybe you can start by just telling us what is a breastfeeding counsellor?

LEILA: Well, there’s a long answer and there’s a short answer. And so, I’ll start with the short answer, briefly a breastfeeding counsellor is a mother-to-mother peer support counsellor, and what that means is that we give support on a mother-to-mother basis as one mother to another mother. The reason for this is that having the ability to talk to someone who’s had the experience of breastfeeding, who’s met some of the challenges of breastfeeding, and has worked through those ups and downs as well as the joys of breastfeeding makes a big difference to mothers being able to start their breastfeeding journey and continue their breastfeeding journey. So, we’re not there as health professionals even though we have an extensive knowledge about breastfeeding, we’re there as another mother talking with, and on the journey with, a mother who is breastfeeding, starting out on breastfeeding. And as such in the Association we’re volunteers, so we’re not paid for that role even though we’ve done quite extensive training in that role.

JESS: So, a breastfeeding counsellor isn’t speaking to a mum as a health professional. What are some examples of when a mum might find speaking to a breastfeeding counsellor helpful and when might she need to see a health professional?

LEILA: Because there’s actually some overlap and so people might think well what’s the difference between a breastfeeding counsellor as against a lactation consultant or a psychologist or the child and family health nurse for example? And one of the differences that I mentioned is that we’re volunteers, but I guess people in those other roles can volunteer for things as well. Um, we don’t give medical advice for example. Our role is not to advise somebody, it’s to provide some suggestions that we know have worked in the past, and we know now from lots of research that’s happened over the last couple of decades that our suggestions are also backed by evidence. But we’re giving suggestions to mothers in their situation so that they can choose what’s going to work for them when they’re with their baby in their own family context. Generally speaking, there’s a range of suggestions that we give, whereas a health professional can give medical advice, and give more information about actual medical procedures or medications. A lactation consultant as a health professional will do somethings that we don’t do, we, for example, don’t examine inside a baby’s mouth and do medical examinations. So, we don’t do that as breastfeeding counsellors, or things that might be appropriate for a lactation consultant to check a mother’s breasts, physically check them. So, we don’t do some of those things which would be considered in the realm of the medical practitioner. We’re not taking over that medical role of a lactation consultant, or later on, a child and family health nurse who’s weighing and checking the progress and the milestones of the baby.

JESS: And it’s really our role to work together with those health professionals to provide everything that a mum needs to help her to continue breastfeeding her baby as long as she wants to, and we provide that mum-to-mum support, and the health professionals provide something different that has some overlap, but we work together.

LEILA: Picture it as a jigsaw with the pieces fitting together and we’re one part of that, and we do really value being able to work able in a positive way with health professionals so that we’re all working together as a team to assist the mother and help her gain her confidence and achieve her own breastfeeding goals.

JESS: And what’s the difference between a breastfeeding counsellor and a community educator?

LEILA: A community educator with the Australian Breastfeeding Association has also done a Certificate IV in Breastfeeding Education just like breastfeeding counsellors have done but they’ve done some different elective units that prepare them specifically for roles in presenting sessions and talk., Their role is to perhaps run Breastfeeding Education Classes or our online Breastfeeding Education Live sessions. Breastfeeding counsellors work more individually with a mother and her situation and try to find out a lot more specifically what’s happening with her and her individual suggestions that we think are going to be helpful for her, whereas a community educator would be helping more in general.

JESS: One mum who found it helpful to speak to a breastfeeding counsellor is Kristy.

KRISTY: My name is Kristy; I live in Perth with my husband and our daughter Nora who is 16 months old.

JESS: So, Kristy what was the reason for you calling the National Breastfeeding Helpline?

KRISTY: So, I actually called them multiple times (laughs). In the very beginning it was because I had a lot of issues feeding in the early days starting off with really severe nipple damage, and by day five of Nora’s life she was spitting up blood because the nipple trauma was that bad. So, I was in quite a lot of pain, and I think that was probably the very first time I called, so around 1 to 2 weeks old and I was just sort of at that point of ‘this can’t be normal, this is excruciatingly painful every feed’. I was seeing a lactation consultant through hospital, but she was not particularly helpful, so I did find a private one later, but in the interim I was just sort of desperate for help. That was when I decided I would call the Helpline for the first time.

The call that always sticks in my mind was a little bit later down the track which was the day of my 6 week check. So, I’d been through sort of a horrific 6 weeks in terms of breastfeeding. I was determined to exclusively feed but in that time I had severe nipple damage, I had had two separate infections, and rounds of antibiotics. I was having laser therapy almost every day, seeing a private lactation consultant, exclusively expressing by about 2 weeks old, so pumping every 2 hours around the clock, in a lot of pain, very unwell. It was just hard work but I was determined to stick it out. And then eventually at the 6 week check with the GP, and she wasn’t happy with Nora’s weight and just said, ’You need to go home and put this baby on formula’. So obviously I was devastated because I was working so hard. She didn’t give me any other suggestions, but I’ve learnt so much since then about alternative options I had, like I could have topped up with expressed milk, I could have sought donor milk. No one ever talked to me about that. I’ve since donated to four different babies so that is a really great option that isn’t always offered. Anyway, I was just devastated that the recommendation was to go home and put her on formula. So, instead I came home and called the Helpline. And because I had had a few initial calls along the way I just knew that they would be able to help me with some kind of solution.

So, I came home in tears, and I called them, and I just spoke with this beautiful counsellor who just reassured me that there’s nothing wrong with formula feeding but I can hear that that’s not what you want to do, and so you’re going to be more unhappy, you’re going to feel like you failed. And I’m like, Yes!. She just really validated what I was feeling, which is so important. Because I think in those early days it’s really easy to think that you are failing or that you’ve got the wrong idea, or you’ve set unrealistic goals or something, and it’s all a bit of a blur in early post-partum, but she just really reassured me and validated what I was feeling, which was brilliant. And then she just went into helping me develop a plan, so a plan around feeding. She talked me through Nora’s weights and how to interpret charts and things. I was visiting my lactation consultant a couple days after that, and then she also told me about the local ABA groups in the community which I wasn’t aware of. Then she actually gave my details to, so I didn’t have to do anything, she gave my details to the lady who was running my local group. She got in contact with me and later that week I went along to my local support group and there was a breastfeeding counsellor there who was able to watch me feed and give me some tips. And also, just to talk to other mums about their challenges and meet like-minded people who are also really determined to exclusively breastfeed, because a lot of my friends and family didn’t understand why I was persevering, like, ‘If it’s hard just stop, just formula feed, that’s an option that’s available’. But this counsellor just really heard me and that that wasn’t what I wanted for my child so, it honestly just saved our breastfeeding journey cause she just got me back on track, linked me in with the supports that I needed and I went on to feed for well over a year.

JESS: So how did you feel in the lead-up to calling the National Breastfeeding Helpline?

KRISTY: So, the very first time I called the Helpline I remember having a lot of reservation like, didn’t want to be a burden. I didn’t know if I was overreacting, I was really quite hesitant to make that call. And I guess yeah, just not wanting to bother anybody if this was just a normal thing I was experiencing. The very first time I called, within a minute or two I was reassured that that was not the case, it was just so helpful, and so then that time that I was talking about after the 6 week check I had no hesitation to call, I knew that that was who I needed to speak to.

JESS: And how did you feel afterwards?

KRISTY: I just always felt so uplifted and validated and like I had a plan for what to do next in order to keep going.

JESS: And Kristy what would you say to other mums who are having difficulties with breastfeeding?

KRISTY: I tell everybody to contact the ABA, I think my friends are probably sick of hearing it, because it really did just save our breastfeeding journey. I’ve had a few friends recently that have had different challenges with supply or all sorts of different things. They will message me, and I just say, ‘Call the Helpline’. The other thing is I did a little bit of breastfeeding education when I was pregnant because I was really keen to exclusively breastfeed, but then upon going to my local group I was hearing from a lot of other mums that they had done breastfeeding education through the ABA while they were pregnant. And obviously, you know, it won’t prevent all the issues, but they seemed to have a lot smoother journeys than myself and I wish that I had known about that and done that. So that is something that I’d like to recommend to other mums as well that if it’s important to you and you really want to breastfeed, get educated about it. It doesn’t always just come easy, there can be a lot of different challenges, and it’s better to be prepared than to just, it’s like any new skill you wouldn’t just rock up having no preparation, so I wish I knew about that.

JESS: Thank you for sharing your experience, Kristy. I know for a lot of breastfeeding counsellors, hearing stories like Kristy’s is what motivates us to volunteer. I’ve talked on the podcast before about my reasons for training with ABA, that I had a really rough start with breastfeeding my first baby, and I knew how important the support was that I got to get through the rough times. Leila what about you, what’s your story?

LEILA: When I had my first two children, I really found the breastfeeding counsellors incredibly helpful. I didn’t know at that time anyone else who was having children amongst my friends so, it was quite a shock to me to find that breastfeeding takes some time to establish. It never had occurred to me that that would be the case and that there could be some challenges on the way to getting breastfeeding established. And I really found the breastfeeding counsellors that I spoke to incredibly helpful and supportive and they made a great difference to my life, to my overall ability to breastfeed, and to my abilities as a mother to gain confidence and feel that I could actually be able to look after this new, little baby that I had.

JESS: And I’ve found that some of the skills outside of the breastfeeding information sort of stuff that I’ve learned in training to be a breastfeeding counsellor have helped me in my day to day life as well. Have you had that experience?

LEILA: Yes, I think that’s one of the things that was a gift, I think, that was not expected, to find that I learnt so much that it made a big difference to me personally and also to the way that I was able to do other jobs in my workplace. And, also with my children and my family, I felt that the things that I learned as a breastfeeding counsellor, ah, really spilled over into a lot of areas and it has made me very appreciative of what the Association does and has done for so many women, and families and men, too, I might add.

JESS: Yeah, absolutely it’s really sort of far reaching, puts its tendrils out into the community and that support it really goes a long way, doesn’t it?

LEILA: Yeah.

JESS: So, why do you think breastfeeding counselling is important?

LEILA: The thing in our society, we tell mothers about the value of breastfeeding, but without giving the skills to breastfeed we’re really setting mothers up for failure. We’re not making it possible for them to breastfeed simply by telling them about the value and significance of breastfeeding, and while it’s an instinctive thing for both babies and mothers to breastfeed, it’s also a learnt skill. And in many cultures that skill is learnt through people seeing breastfeeding happening and they learn through watching and they learned it as part of the general culture, but for many of us that’s not happened. So, we need to give mothers the skills, and families the skills to support them, because it hasn’t happened through osmosis. And so breastfeeding counselling is one of the ways we can work with an individual mother and her breastfeeding journey. And that’s why I think it’s so important that a breastfeeding counsellor is walking with her and beside her and giving her that support.

JESS: Part of it is about a community as well, that we’re so insular in the way that we’re raising children in our sort of culture and times that we don’t necessarily have that village that has existed throughout history. It’s a way of creating that and creating a community of people who can support each other.

LEILA: And I guess one of the things that the COVID-19 experience has reinforced for us is the value of communities and how important it is for new families to receive support and how much new mothers really need support from other mothers as well, that we need that contact and community.

JESS: So, I want to talk a little bit about some things that will relate to your role as a trainer. So, you are qualified as a trainer and assessor with the Association, which is a registered training organisation, so you support people to go through their course that trains them in how to be a breastfeeding counsellor. So, what are some of the skills that people have to learn and practice in order to become a breastfeeding counsellor?

LEILA: Our counselling approach is based on the work of Carl Rogers, the very famous psychotherapist that was very influential in establishing a way of being able to counsel other people in a non-judgemental, humanistic, and empathetic approach. And that’s what we’re aiming to do also. So our, um, training is based on that in that role we would be teaching skills about reflecting, empathy, questioning skills, developing a rapport and trust, we also practice active listening and one of the things that we’re also developed is using mother to mother language not that language of being an expert or an authority or using medical or technical language. We give reassurance to mothers and that’s a very significant role because it’s a very confusing situation with a young baby who can’t talk to us, And it can be more confusing when we’re trying to find information from all of the various sources that are available on the internet and try to work out which one applies to me and my child, so we can give reassurance and guidance in that way. And through that empowers mothers to develop their strategies to be able to help achieve their breastfeeding goals.

JESS: So, you talked a little bit about empathy, can you maybe expand on that, and, like what is empathy and how do people learn how to be empathetic?

LEILA: Empathy is the ability to pick up the feelings of another person and reflect them back. And it’s different from sympathy, we can be sympathetic of course in our normal everyday lives. We can be sympathetic with our friends, but sympathy is more about us feeling upset, or sad, or worried about somebody else and that has a role of course in families and friendships and relationships. But empathy is slightly different in that we would be walking beside that person picking up their feelings from what they’re saying, their tone of voice, how they look, and reflecting it back to them and then they may actually agree or disagree with us. They might say, ’Well, no I don’t feel angry, I feel really disappointed’. for example. And so, it’s developing that skill to help reflect back feelings to somebody, which also then helps them clarify what’s happening for them, and that’s something that can be developed and practiced. It doesn’t mean that we don’t also feel with them, but it does mean that they’re not going to be so caught up as to be really distressed. We’ve tried to have a little bit of ability to help the person rather than end up ourselves in a situation where we’re feeling so overwhelmed by what’s happening, that we can’t help the person.

JESS: So, I know there was one thing that I learned about while I was doing my breastfeeding counsellor training which was called ‘unconditional positive regard’. Could you talk a little bit about what that is and why it’s important?

LEILA: Well, that’s something that Carl Rogers was really keen on counsellors developing was unconditional positive regard, and that is that it’s not our job to judge people. It’s something that we are accepting of that other person and aware that they’ve reached whatever point that they’ve reached for a lot of reasons that we don’t have any knowledge or understanding of, and we’re not trying to make them into different kinds of people. We certainly are giving suggestions that we would think will be useful and that are based on evidence, but it’s not our job to judge what they are doing or not doing.

JESS: One of the other things that I think it’s really important to talk about that we have to do, and this is certainly one of the things that I’ve found has been really valuable for me to take into the rest of my life, is taking stock of how we feel about things ourselves and sort of evaluating that without letting it impact the way that we are doing. So, figuring out what our values are, and what we would do for ourselves, and recognising that that’s not necessarily what someone else values and what they want, and that that’s okay and that it’s not about us telling people what to do. It’s about us walking with them, as you’ve said, and helping them to figure out what they want their goals to be and helping them to get there.

LEILA: Yeah, so it doesn’t mean we don’t have our own values, but we’re not imposing those on the other person, we’re aiming to see them in their whole family and cultural context and be accepting that there are going to be differences in values, in attitudes, in situations.

JESS: What about asking questions? Can you talk a little bit about as breastfeeding counsellors how we do that?

LEILA: Well, when we’re asking questions it’s very easy to end up asking quite closed questions or yes/no questions. If that’s all that’s happening, then a person could feel like they’re being interrogated. Also, the range of information that we would receive as a breastfeeding counsellor is very narrow, and so, one of the skills that we do learn is to ask open questions. And open questions are questions that invite a longer, more extended answer, and it puts their situation into context. Then we might just ask a few specific sort of questions to fill in some details but we’re able to get a bigger picture and therefore give more appropriate suggestions. The act of breastfeeding really impacts very widely in a mother’s life, her biology, her hormones, things that are happening in her family, or the community, or the workplace, all fit into how breastfeeding is going. So, it’s such a wide area that our questioning also helps narrow things down a bit.

JESS: Yeah that’s right, and sometimes it’s about, like as you said, finding out how the mum’s feeling about the situation and that can really help us to help her figure out what her goals are and what she wants from breastfeeding. And often you know, we’ll hear from mums that’ll feel really overwhelmed but they really want to continue breastfeeding. Or, you know, mums will call because they’re ready to wean and they’re feeling really good about it. and those are two very different conversations. So those questions about feelings and situations are important, but it’s also really important to have those really specific questions so things like ‘how many wet and dirty nappies is your baby getting?’. If a mum calls and is worried that her baby isn’t getting enough milk, those are the sorts of questions that can be really helpful to determine what exactly is going on. Because a lot of the time it is that the baby, yes, is getting enough milk, but they’re really unsettled, and then it’s a matter of looking at the details of that and figuring out, ‘Okay, is this a normal amount for a baby to be unsettled?’. It’s quite normal for babies to cry and grizzle for, you know, an hour or more every evening, but for a baby who’s very unsettled all of the time, and maybe isn’t getting enough milk, there might be something else going on that we need to support the mum through and figure out how she can get through that.

LEILA: Yeah, sometimes the information that we find out allows us to reassure the mother that her baby’s going fine and what’s happening is actually a normal situation with babies. And then sometimes we might find out that, oh, this sounds like a medical situation, so we can give some help and information to help her keep going but also suggest she seek help from you know, her medical advisor, maybe her child health nurse or doctor for example. And then other times it’s a situation that requires breastfeeding management, and it’s not actually necessary to get medical advice from a medical health professional, but the breastfeeding management is something that we can help her with so that things are working out better for her and the baby.

JESS: How important is it then that we give accurate information?

LEILA: Oh, it’s very important because there’s a lot of inaccurate information around and some information is very unhelpful for breastfeeding. One of the things that we know about breastfeeding is that the baby and the mother, getting their bodies get in tune with each other so mothers are establishing breastfeeding with a young baby and helping her to feel confident that she can feed the baby frequently for example. Because other people might be saying, ‘Oh that baby can’t be hungry now’, so we want to give the mother confidence to trust her instinct, but also information so that she is able to base her instinct on something that we know happens with babies when they’re getting breastfeeding established. A lot of information really has been known by mothers for thousands and thousands and thousands of years, otherwise we wouldn’t actually be here, and a lot of the information about breastfeeding that we are finding out due to science and research is actually reinforcing why these things that mothers have known about, and communities have known about, for such a long time, finding out why they work.

But nevertheless. there’s still sometimes developments that we find that clarify things or that show that something that we thought was happening one way actually happens a different way. So, we do need to keep our skills and our knowledge up to date and that’s one of the things that’s required of us as breastfeeding counsellors. There are various seminars that are run, we have literature that we can read, lots of resources and support to keep our breastfeeding knowledge up to date and our skills current so that we know that we’re giving information and support that’s appropriate.

JESS: Yes. so we’re required to do certain activities as part of professional development to stay active in our volunteer roles, and we also have a research team who checks every piece of information we publish as an Association, so everything from website articles to Facebook posts right down to every episode of this podcast, as well.

LEILA: And it also means that although as breastfeeding counsellors we have personally breastfed a baby, we’re not just giving out information based on something that worked for us.

JESS: The final question I have for you today, Leila, is that if there are people listening and they’ve heard our experiences about training with ABA and being a breastfeeding counsellor and what it means and involves, what would you say to them if it might be something that they’re interested in doing?

LEILA: Well, I’d say that it is a really great way of supporting mothers, and fathers, and anyone who is wanting to breastfeed and provide that wonderful start for babies. It’s a great way to be involved in your local community as well, it’s something that is extremely rewarding. We’re an RTO, Registered Training Organisation, so we provide training for our volunteers. We actually do it as a traineeship, so our Certificate IV in Breastfeeding Education is a traineeship which means that we do provide it with the understanding that people are going to contribute back as volunteers to the Australian Breastfeeding Association. There’s a link on our website that those who are interested can read some of the information about what we do and the various ways that training takes place. Being a member of the Association is part of the requirement but is also a really valuable step because that way you receive all the resources like our magazine ‘Essence’, our book ‘Breastfeeding Naturally’, there’s meetings with your local group, there’s regular news letters, there’s the premium content on the app. So, there’s a lot of resources that you already get simply by being a member of the Association, and being in touch with your local group also gives you a good picture of what happens. Because it is a traineeship so you’ll be expected to contribute to your local group and to the Association. And also then reading our module about training on our website and discussing with a trainer in your local branch about how to go ahead with that next.

JESS: Yeah, I think I would say to people if you’re interested to make those enquiries, sort of move ahead and find out more from your local group and your local trainer, because it is a really big commitment and I’ve spoken to a lot of people who thought that was something they wanted and then they found out more and they realised it was a really big commitment and maybe it wasn’t for them. But if it is something that you decide is for you then it’s really, really rewarding, I’m still really close friends with other people who are no longer ABA volunteers but did their training with me and volunteered for maybe four or five years, and then they’ve gone to other parts of their lives. But we’re really close because of that experience, it was very bonding.

LEILA: Yes, I think that is something that happens a lot. If counselling as such, doesn’t seem to be something that appeals to you, we also have a lot of community educators, you don’t need to have breastfed a baby to become a community educator, and dads can become a community educator as well. Sometimes we have people who are interested in breastfeeding. They may be working with mothers who are breastfeeding for example, but not actually have had children or breastfed a child themselves. But that is still a role in our Association that they can train for.

JESS: And there’s even other volunteer roles within local groups if you want to come along and just be the person who helps mums with new babies and make them a nice cup of tea and hold their baby while they have a warm cup of tea, because that’s often rare when you have a new baby to finish a cup of tea while it’s still nice and warm. You don’t have to be a trained breastfeeding counsellor to come along and provide support to other mums. We do direct any breastfeeding queries to our trained volunteer breastfeeding counsellors, but you can be part of that community without going through that sort of process of training; you can just come along and meet people and create a little village.

LEILA: And that also makes an incredibly valuable contribution to supporting breastfeeding in Australia.

JESS: Thanks so much for joining me Leila and for sharing your knowledge and your wisdom and a huge thanks to Kristy for telling us about her experiences.

If you need to speak to a breastfeeding counsellor, you can call the National Breastfeeding Helpline on 1800-MUM-2-MUM or 1800 686 268. The National Breastfeeding Helpline is supported by funding from the Australian Government. But if you hate talking on the phone, check out breastfeeding.asn.au for details on when our LiveChat service is running. If you want to find out more about becoming a breastfeeding counsellor or educator head to our website and look for the training section. And lastly if you enjoyed our podcast episodes, please leave us a review, and let your friends know about it. And if you want to support ABA you can become a member on our website which will help us support new parents.

Thanks for listening.

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