My Professional Background

The first thing I can tell you about myself is that I never planned to be a lactation consultant. In fact, until I had my first baby, I didn’t even know that the profession existed. I was planning to be a business psychologist — helping businesses hire, train, and manage employees. I had just graduated with my bachelor’s degree in this field while five months pregnant with my first baby. I worked at two business psychology internships in the second half of my pregnancy. I was applying to graduate school. I just hadn’t yet figured out what I was going to do with the baby while I attended.

The one thing I did know was that I wasn’t going to breastfeed. I’d had breast reduction surgery when I was 25 years old in 1990 and my surgeon had said it wouldn’t possible, which didn’t bother me because there was no partner in sight, let alone children, so it didn’t seem important.

After meeting and marrying my husband Brad and becoming pregnant a few years later (in that order), I accepted it was a given that I wouldn’t be able to breastfeed. So I skipped all the breastfeeding chapters in all the pregnancy books and scheduled foot surgery for the week after giving birth since I wouldn’t have to worry about medications going into my milk.

Well, Nature had a different idea about all this. My son Alex was born in 1995 after a long labor and three hours of pushing under full epidural. But as soon as I saw him, I immediately wanted to put him to breast. It didn’t matter that I “couldn’t breastfeed.” I just wanted him there no matter what. He latched well and something in me shifted at that moment: I suddenly knew I wanted to breastfeed. I could see I had colostrum (the early milk), so maybe the surgeon had been wrong. Maybe I could do it after all. I was certainly determined to try. I kept bringing him to my breast any time he seemed to want to do it. I’ll never forget my father-in-law saying “You’re doing it, Mom!”

At the end of that first long day, the hospital nurse insisted on taking Alex away to the nursery so I could sleep. She seemed certain it was the best thing to do, so I meekly agreed to let her. But as soon he left my arms they seemed to ache from his absence. I lain awake, unable to sleep, while my husband Brad slept deeply on the other bed in the room. Finally, after an hour of aching for my baby that felt like weeks, I put on my slippers and shuffled down the hall to the nursery. As soon as I got there, the staff said, “Oh thank goodness! He’s been crying since he got here!” Horrified they hadn’t let me know, I scooped him up, sat in the nearby rocking chair, and nursed him until he was happy again. Then I took him back to my room and snuggled back into bed where I could watch his sweet face in awe. When I got sleepy, I woke my husband up to hold him so I could get a little sleep. We switched off like that until we were discharged from the hospital the next day. He hardly ever cried again in those first few days.

Alex seemed to be breastfeeding well — I didn’t have any pain — but after a few days, we realized he wasn’t getting enough milk and needed supplementation. His pediatrician recommended that I see a “lactation consultant,” so I made an appointment with her. What an amazing experience! I went to her home where she had a very efficient area set up in her well-lit and lovely basement. She introduced me to a new way of supplementing using an at-breast supplementer so he could get formula while he nursed. I adored the idea of it because it made me feel like a fully breastfeeding mother.

In day-to-day use of it, though, I discovered that it wasn’t always convenient, so there were lots of times we simply gave a bottle. By about the time he was three months old, Alex started to adamantly refuse to nurse at all, preferring the faster flow of the bottles. He screamed any time I brought him to my bare breast. I didn’t know enough to work through his “nursing strike” but by this time I was so dedicated to breastfeeding and giving him my milk that I started pumping several times a day and giving all his feedings by bottle. This allowed me to calculate that I was contributing about 60% of his daily needs.

But there were so many times that my breasts were full of milk and I ached to feed my baby at breast, yet knew he would just scream if I tried. It was heartbreaking. He also developed such severe food allergies that we had to switch to the super expensive less allergenic formula for supplementation. I avoided all the foods he was allergic to and noticed that he did so much better when he got more of my milk than formula. This made me so determined to give him my milk that I continued to pump until he was fourteen months old when I became pregnant with my second baby and pumping started to hurt too much.

While I was pumping all those months, I began exploring “Usenet Newsgroups” (the early internet places to find other people) about breastfeeding. I spent a lot of time reading posts and connecting with other breastfeeding mothers. I and four other women who had had breast reduction surgery decided to start an email list just for women who were trying to breastfeed after reduction surgery. We called it “BFAR”: BreastFeeding After Reduction. I eventually started a website of information to share information we had learned and the email list grew and grew. (Now it’s a Facebook group.)

During this time, I also started attending local La Leche League meetings. I was nervous that the moms there would judge me badly for feeding my baby with a bottle, but they were incredibly supportive that I was still pumping even though my baby wouldn’t nurse. They were very understanding about my reality that I couldn’t make enough milk because I’d had breast reduction surgery. In fact, after the first meeting, a group of moms came over to me and told me they thought I was a “heroine” for working so hard to give my baby my milk. I felt so accepted at that La Leche League group that I became very involved and even applied to be a Leader. My first application was rejected because I hadn’t nursed a baby at the breast long enough to have first-hand experience. I completely understood that very valid reason and was determined to reapply when I had nursed my next baby the required minimum of nine months.

When Alex was six months old, I finally realized that I was never going to be able to leave him with a stranger in daycare to go back to graduate school. We didn’t have any family nearby who could take care of him, so I decided that I would become a “stay-at-home mom” and we would live frugally just on my husband’s income. It was pretty tough at times, but we managed and I really enjoyed being home all day to take care of baby Alex.

When I became pregnant with my second baby in 1997, I was passionately determined to do everything possible to make breastfeeding more successful this time around. I ordered every kind of herbal galactagogue known at that time, two kinds of at-breast supplementers, two kinds of hospital-grade breast pumps, and then I made a decision that probably made the biggest difference at all: to give birth with midwives at a free-standing birth center (not connected to a hospital, but near enough to get there quickly if there is a problem) so that I could have a fully unmedicated, non-intervention birth.

I went into labor about a week after my due date and labor progressed so quickly without any medications that I delivered my second son, whom we named Ben, about twenty minutes after we arrived at the birthing center. He latched immediately and never left my side. In fact, to my complete astonishment, he never lost an ounce of weight.

My milk came in by the end of the second day and he gained and gained and gained and gained. I kept waiting for that moment when we would need to start supplementing but it never came. He gained so fast that he was in the 90th percentile for weight by the end of his first month. That isn’t to say there weren’t times he cried so hard and so long that I wondered if he was starving and needed formula. But then I’d look at all his rolls of chubby fat on his cute little thighs and see the proof that he wasn’t starving. I never needed to give him any formula and he never needed a bottle.

I did have very, very sore nipples for about 12 weeks, but eventually the sores healed and it stopped hurting. No one could ever figure out why it hurt and his latch looked fine. Much later, I learned he had a posterior tongue-tie, but thankfully it never reduced how much milk he was able to get. Ben nursed until he was about three years old, just after I became pregnant for the third time.

At the end of Ben’s first year, after I passed that magic nine month mark, I reapplied to be a La Leche League Leader and was quickly accepted, trained, and accredited. I became a very active Leader in my local Gaithersburg Maryland group in the US and was also very active with the BFAR email list and website.

At the 1998 Maryland, Delaware, and DC La Leche League conference, I happened to mention to one of the speakers who represented La Leche League International that I had been thinking about writing a book about breastfeeding after breast reduction surgery. She loved the idea and passed it along to Judy Torgus, the head editor at La Leche League International at that time. She contacted me excited about the idea (she actually lost my contact info and I got word about it through a funny series of notes passed around to Maryland Leaders looking for me). She thought there surely couldn’t be enough information for a book, though, thinking it would more likely be a brochure. By this time, though, I had collected so much information that I knew it would definitely be better as a book. She asked to see an outline, which I quickly put together. She was so impressed that she sent me a contract right away and I got started writing the book, which I called Defining Your Own Success: Breastfeeding After Breast Reduction Surgery. It took me about two years to write and we were still editing the final type-set pages on my due date with my third baby. So I asked my new unborn baby to hold off on being born until we could finish the edits and he happily agreed, not initiating labor until three weeks after my due date, just as we finished the book. Sweet guy!

Quinn was born in the same free-standing birthing center — in fact, the very same room — as Ben. Unlike Ben, though, he didn’t latch easily after the first day, probably as a result of the half-dose shot of nubain I’d been given when his birth was moving too fast. I had to finger-feed him for several days until the drugs passed out of his system and he figured it out. It took some persistence, absolute belief that this child was biologically designed to breastfeed to get to that point, and lots of skin-to-skin time, but it finally happened and then he nursed wonderfully thereafter. Happily, it never hurt and he gained just as well as his brother Ben, never needing formula or a bottle.

My book about breastfeeding after reduction came out a month after Quinn born in 2001, and I began to be asked to speak at breastfeeding conferences. At first, I was very nervous. But then I quickly realized that I was only nervous because I thought I should be nervous. I actually enjoying being on stage and interacting with audiences a lot. Once I realized that I really wasn’t nervous at all, I started having a lot of fun with lectures and it’s been like that for me ever since. I love speaking to audiences and meeting people all over the world and I think my enthusiasm is part of why I began to be asked to speak in so many places. At first it was locations throughout the US. Then I was asked to speak at cities in Canada. Then conferences beyond North America began inviting me. Now I’ve lectured in over 20 countries and hopefully more to come.

After Quinn was born, I began thinking about turning my developing expertise into a career as a professional lactation consultant. Because I had been an active La Leche League Leader for four years by that point and because I had written the BFAR book that was grounded in academic extensive research, I was granted permission by the late Joanne Scott, founding director of the International Board of Lactation Consultant Examiners, to sit for the IBCLC exam a year earlier than normal. Her personal support meant the world to me and I was determined to make the most of it.

I began studying very hard and took the exam in the summer of 2002, with my husband taking care of one-year-old Quinn and bringing him to me to nurse at breaks. Four months later, I learned that I’d passed the exam with flying colors. Soon after, I opened my private practice as an independent IBCLC in my community.

The birthing center where I had delivered Ben and Quinn began referring clients to me, which was wonderful because their low-intervention births made breastfeeding so much easier and the mothers were usually very dedicated to breastfeeding. I visited mothers in their homes to help them breastfeed, which meant driving many hours every day to see clients all around the Washington DC area. During this time, my husband Brad began working from home so that he help with our young boys, including Quinn who was now an active toddler.

My lactation consultation practice rapidly grew and grew and I became incredibly busy. It was exhausting! I was working all alone and figuring out how to run the business and help mothers all on my own. I was also still an active La Leche League Leader and speaking at conferences, and I had been elected to the Monetary Investment for Lactation Consultation Board (a sub-Board of IBLCE who provides IBCLC certification), which met quarterly in Washington, DC. And I had three young, very active boys, one of whom was still nursing, which meant I was a very busy woman! But mothering was always, always my first priority.

About three years after I started my practice in the uncomfortable years following 9/11, my husband’s company decided to relocate his department to rural New Jersey, outside of New York City. He was offered a nice promotion to move to this new location. It was a great opportunity, so we moved the family from the crowded suburbs of Maryland, just outside of Washington, DC, to the lovely rural mountains of New Jersey, about an hour west of New York City. The small town with excellent schools and a slow pace of life was a wonderful change for our three growing boys, and it was still within easy driving distance for my husband’s work. Since my husband couldn’t work from home as much anymore and also because I was really, really tired from all my long hours of working, I decided not to start my lactation practice up in the new location, but rather to take a break from it and focus on my taking care of my boys and new home. The timing was good — they needed lots of mommy time now and there was so much to do to make this new, much larger house feel like home.

I still kept in touch with my professional life, though, and about a year or so after we moved, I started thinking about another book that I thought was needed — one just about breastfeeding with low milk supply in general. A lot of people were buying my BFAR book for the general information about how to increase their milk supplies. So I thought a book just on that topic alone might be what moms are looking for. After hearing her lecture at a local conference, and being very impressed with the depth of her knowledge, I asked Lisa Marasco to co-author this new book with me. She happily agreed and we called it The Breastfeeding Mother’s Guide to Making More Milk. At first, we were under contract to publish with La Leche League International, but eventually they decided not to publish it due to budgetary constraints. Lisa reached out to Martha Sears, wife of the La Leche League favorite doctor Dr. Bill Sears, who was also one of Lisa’s co-Leaders in California. Martha was very supportive of our book and recommended us to her literary agent who was able to secure a contract with McGraw-Hill, one of the largest book publishers in the world.

When we heard the news that McGraw-Hill was going to publish our book, it was like winning the lottery. I can’t express how happy we were. I remember going out to dinner with my husband and three boys for Thai food and wanting to tell everyone at the restaurant about the exciting big news. Working on that book was a dream come true. Lisa was a rich source of knowledge and we greatly expanded the scope of the book to cover all aspects of not having enough milk, from understanding if it was really a problem, to troubleshooting the underlying issues, to improving milk production. The final result exceeded our expectations and has been a huge seller throughout the world. In November 2019, we released our second edition with a slightly tweaked title, Making More Milk: The Breastfeeding Guide to Increasing Your Milk Production, upgraded with new and exciting ways to increase milk production and a more gender-neutral approach to better recognize the wide gender continuum of breastfeeding parents.

While working with Lisa on first edition in 2006, I also began working on an idea for a laminated card for doctors and nurses with succinct information about how to treat the most common breastfeeding problems. I pictured that it could sit in clinic rooms or be put in the pocket of their lab coats. I called it the Clinicians’ Breastfeeding Triage Tool and it was first published in 2007 by the International Lactation Consultant Association (ILCA). I worked with an international team of clinicians on the second and third revision (June, 2014), which have been translated into many languages. 

Around the same time, I also began working on a clinical monograph with Dr. Elliot Hirsch. It was called “Breastfeeding after Breast and Nipple Procedures,” and published by Hale Publishing in 2008 (now owned by Praeclarus Press). It contains technical information to help clinicians advise mothers about breastfeeding after cosmetic, diagnostic, and therapeutic breast and nipple surgeries and procedures.https://stores.praeclaruspress.com/clinics-in-human-lactation-breastfeeding-after-breast-and-nipple-procedures/

Once the “Making More Milk” and clinical monograph books came out in 2008, requests for me to speak at lectures increased dramatically both in the US and internationally. Soon after, I was approached by La Leche League International to work on the eighth revision of their seminal book, The Womanly Art of Breastfeeding. This was to be a complete rewrite of the book from scratch, co-authored with Teresa Pitman and Diane Wiessinger, published by Ballantine Books, a division of Random House, who is THE biggest book publisher in the world. Wow! I felt incredibly honored to be working on such an important book with such wonderful co-authors. Working on the book was a dream come true, as we envisioned and dreamed about what we would have wanted in a breastfeeding book as new mothers. We wanted to write a book that had a real girlfriend-to-girlfriend tone, but was also backed by the latest lactation information and science.

We kicked off the book with a week-long retreat at Diane’s rustic family cabin (camp) in the Adirondacks, inviting Marian Tompson, La Leche League International’s co-founder and first president, to join us so we could learn about how the first edition was developed and the thinking behind the core philosophies that made La Leche League’s approach to breastfeeding so successful. We were very proud of our end result and the book was so well-received that it became a national (US) bestseller. We continually hear compliments about how much mothers and lactation professionals like the friendly, non-judgmental tone and depth of information.

During this time, I also was elected to the Board of the International Lactation Consultant Association as their Director of Professional Development, which was a new type of organizational work that I thoroughly enjoyed.

Working on these projects and speaking at conferences kept me very busy until 2010 when I met Beth Myler, a highly skilled nurse, Peace Corp volunteer, La Leche League Leader, and newly certified IBCLC. She lived in my area and we met for lunch to talk about our obvious commonalities. We really liked each other and had such similar practice philosophies that we began talking about opening a lactation consultation practice together. We called our company “Mahala Lactation and Perinatal Services, LLC.” “Mahala” is a word Beth liked, which seems to have various meanings about women and community in several languages, but we decided it meant “MA-ternal, “HA-rmony,” “LA-ctation.” Once we decided to begin it, the company was organized quickly and we started seeing mothers. We only offered home visits, which kept our overhead expenses low. We packed our cars with all the tools and equipment we needed. Working with Beth was a dream come true because she taught me so much about clinical skills while I shared my experience about the practical aspects of conduction lactation consultations and running a lactation consultation business.

About a year after Beth and I started Mahala, we began accepting and training newly certified IBCLCs as subcontractors. They allowed us to offer services in a wider geographic area, reaching from Manhattan, across all of northern New Jersey, into eastern Pennsylvania. We eventually offered one of our first subcontractors, Jennifer Lisimachio, ownership in the business. We had three Partners (including me), three subcontractors, and two interns who were training to take the IBCLC exam and hoping to become subcontractors. We opened a fully-equipped brick-and-mortar clinic, which we decorated warmly with beautiful art of breastfeeding mothers, and began seeing clients both in the clinic and in their homes. About a year later, though, I sadly had to leave Mahala because I was stretched too thin with my publishing and lecture demands and something had to give.

About three years after starting Mahala, La Leche League International approached Diane and Teresa and me about writing another book for them, also to be published by Random House. They let us choose the topic and we decided the world needed a book about bedsharing just for breastfeeding families, which was eventually titled, Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family. For this book, we also invited Linda Smith to join us for her vast knowledge about the history and politics of bedsharing. Diane and I did most of the writing and development, while Linda worked on research and shared her extensive experience and insights. Teresa wrote selected sections and provided skilled and sublime copyediting. We also worked closely with Dr. Helen Ball, one of the top infant sleep researchers in the world. Together, our amazing team produced a comprehensive book about sleep and the breastfeeding family that we are exceptionally proud of. We studied the research very closely and identified seven criteria that affect SIDS and suffocation risks, which we called “The Safe Sleep Seven.” When mothers and babies meet all seven criteria, the baby’s risk of death from SIDS or suffocation is the same for bedsharing as sleeping in a crib. These clear research-based criteria help reassure low-risk mothers that bedsharing is safe for them and makes breastfeeding work so much easily.

In 2016, my first research paper, Transmasculine individuals’ experiences with lactation, chestfeeding, and gender identity: a qualitative study, was published with a fabulous team led by Trevor MacDonald and the late Dr. Joy Noel-Weiss, with a wonderful group of researchers and clinicians.  Just after publication, it was in the top 1% of the most-viewed academic research papers of all time!  When time permits, we hope to publish additional papers about other aspects of our study results.

In the last few years since 2016, my life has changed substantially. My husband found another partner and ended our 25 year marriage so I’m now entirely on my own. My three sons are all grown men now and I’ve carved out a new life for myself. Unfortunately, none of my work that you’ve been reading about above ever earned much income and I’m not a nurse, so when the marriage ended, I knew that it would be nearly impossible to earn enough steady income as a lactation consultant to support myself. I thought about my skills and passions and decided my best option was to go back to university to become an ordained Unitarian Universalist minister. I applied to and was accepted by two seminaries, and enrolled at the historic and esteemed Meadville Lombard Theological School in Chicago. I finished all the coursework in the program, including two internships with non-profit social service agencies (a domestic abuse shelter and Habitat for Humanity) and a summer serving full-time as a hospital chaplain. But when it was time to begin the ministerial internship, I realized that my physical health wasn’t up to what’s needed and I had to make the difficult decision to change my degree to a Masters in Religion, forgoing my dream of becoming a minister.

To make ends meet, returned to my first love — being a lactation consultant — and accepted a position working fulltime remotely (from home) as the Inhouse Lactation Consultant for PumpinPal, a breast pump flange manufacturer (WHO Code compliant). I worked for them for two years, eventually offering virtual support by Zoom and seeing hundreds of moms each week to help them resolve pumping and nipple pain issues (becoming quite experienced at treating infected nipples!). My personal pumping experience from all those years ago with Alex became relevant again as I worked with pumping mothers who weren’t finding enough help from lactation consultants who didn’t know much about pumping. This opened my eyes to the reality that there is a vast unmet need for help with pumping and treating nipple pain.

Sadly, my work for PumpinPal ended abruptly and unexpectedly at the end of 2021. Thankfully, my colleague and friend Barbara Glare, who owns the Breastfeeding Conferences company in Australia and who had hired me to speak in Australia for two conferences in years past, jumped at my availability and hired me part-time to help her with administration. I’ve really enjoyed working with educational conferences again and began offering private virtual consultations through this website.

As for many of us, times are so much harder now with COVID and inflation. But I have many ideas for future projects, lectures, and books to help parents breastfeeding more successfully, and I’m open to any opportunities that might come my way. If you need breastfeeding help, I’m here for you. If you need professional lactation clinical forms, look no further. If you need professional mentoring, I’d love to help. If you need a speaker for your virtual or live conference, definitely reach out.

Thanks for reading all this background about me. If you’ve reached this point, my hat’s off to you! That’s pretty impressive!  🙂  Truly, though, I wish you only the best in all that matters to you. I believe the more we help each other, the better the world becomes. So if there’s anything I can do to support your personal or professional goals, just let me know! It will be my most sincere pleasure to help you in any way I can.