The information provided below is a general overview of how to become a donor for a Human Milk Banking Association of North America Milk Bank. While we’ve tried to be as accurate as possible, some HMBANA banks might have slightly different requirements. Please contact your closest HMBANA Milk Bank directly. 

Carissa with her OWN milk donation!

Becoming a human milk donor is an incredibly valued and important role. Currently, there are 13 HMBANA milk banks serving all of North America and many of them have experienced donor shortages over the last few years as demand for donor milk has grown.  HMBANA banks provide pasteurized milk via physician prescription to some of the most vulnerable infants, where access to donor milk can sometimes literally be life-saving. HMBANA estimates they need 9 million ounces of donated breast milk to fill the needs of NICU babies in the US alone. For many women, the path to donating may seem intimidating but, in reality, by following a few simple steps, we can get you on your way quickly!

Step #1: Contact your closest HMBANA Milk Bank for pre-screening.

For most HMBANA Milk Banks, calling them by phone is the fastest way to start the pre-screening that is required for donors. We pre-screen potential donors to make sure that the donor human milk we provide is free of substances that could compromise the health of the critical babies we serve and assists us in processing milk in the most efficient manner possible. You will connect with the Donor Mother Coordinator who will ask you a number of questions such as:

• How old is your baby?
• Was he or she born before 36 weeks gestation?
• Are you donating milk collected prior to contacting the milk bank?
• Since you started storing your milk, have you taken or are you currently taking any prescribed or over-the-counter medications (used regularly or occasionally) including birth control, allergy medications, or alternative treatments?
• Are you willing to have a simple blood test, at the milk bank’s expense?
• Do you use nicotine products?
• Do you use illegal drugs?
• Can you donate at least 100 ounces or more? (Volume requirements vary by Milk Bank.)

A number of Milk Banks also have pre-screening on their website. You can fill out the questionnaire online at your convenience.

Step #2: Fill Out Appropriate Paperwork

Your conversation with the Donor Mother Coordinator helps us to determine if you meet the Donor Selection Criteria. We want to make sure that both you and your baby are healthy enough to take on the task of donation. This paperwork needs to be filled out and returned to the Milk Bank. Some banks also have the option of filling out these forms online. Included in your packet will be:

• A consent form for you to sign and return to the milk bank.
• A Donor Interview and Lifestyle Questionnaire to fill out and return.
• A Healthcare Provider Release for you to forward to your OB/GYN.
• A Healthcare Provider Release for you to forward to your Pediatrician
• Blood Testing Information
• Collecting and Storage Guidelines
• Medication and Lifestyle Guidelines

Step #3: Have a Simple Blood Test

The milk bank will provide you with the information necessary to have your blood drawn. You will receive a form to take to your local lab or a kit that can be shipped to have your blood drawn by your health care provider. All HMBANA Milk Banks will cover the cost of this blood draw and it is a similar experience as to what you had while pregnant. The results of your blood testing will be forwarded directly to the Milk Bank. HMBANA Milk Banks test for the following:

• HIV 1, 2 & O
• Hepatitis B & C
• HTLV I & II (Human T-lymphotropic virus)
• Syphillis

Step #4: Review and Approval

After all of your paperwork and blood testing results are returned to the Milk Bank, your file will be submitted to the Clinical Coordinator for review and approval. You will then be contacted by the Donor Mother Coordinator, who will give you a donor number and provide you with options for transporting your milk to the Milk Bank.

Step #5: Send Us Your Milk!

There are a number ways that donors get their milk to us. Here are some of our options. Ask at your local Milk Bank for specific methods that they use:

• Milk Pick Up – If you are local to the Milk Bank, staff are occasionally available to come to your home to pick up your milk.
• Milk Drop Off – If you are within driving distance of a HMBANA Milk Bank, you can come by our office during our business hours and deliver your milk to us yourself!
• Milk Depot – Many Milk Banks have convenient drop off locations. These locations are operated by volunteer staff who will take care of the packing and shipping of your milk to the Milk Bank.
• Shipping – If none of the other options are available to you, the Milk Bank will ship you a cooler for you to fill with your milk and 5 lbs of dry ice. It will also include an overnight return label and instructions on how to pack the box so that your milk arrives safe and sound. Dry ice can be purchased at some grocery stores or your local Praxair or Home City Ice location. Some ice cream shops and hospital laboratories sell dry ice as well. Make sure you forward your dry ice receipt to the Milk Bank for reimbursement.

Carissa with her OWN milk donation!

Step #6: Feel Fantastic About What You’ve Done!

Your hard work pumping is paying off in the lives of babies you will probably never meet. You can take pride in your donation and your commitment to health babies and their families. 

Step #7: Share Your Story!

We’d love to connect with you by Facebook and hear about your HMBANA donation experience. And, we’re suckers for cute donor baby photos, too!

About Carissa Hawkins, Communications Coordinator:  Everyone said Motherhood would change me. I knew they were right, I just didn’t anticipate a career change in addition to all the other capacities I have gained after having my first child. I chose to breastfeed and quickly found that I was making more milk then my babe would use, so I donated. My role at Indiana Mother’s Milk Bank is all things marketing and communications. I have a Bachelors Degree in Communication Studies and have worked in care coordinator since graduating. I am so thankful to be using my skills for such a worthy population. Aside from spending time with my baby girl and biking, I volunteer with the Junior League of Indianapolis. Feel free to contact me: chawkins@immb.org.

We are so pleased to have Dr. Nils Bergman as one of the speakers at our conference in Melbourne in just a few short weeks.

Dr. Bergman calls himself a Public Health Physician, and currently promotes and researches skin-to-skin contact on a fulltime basis. He is an Honorary Senior Lecturer at the University of Cape Town, South Africa, and a research affiliate of the South African Medical Research Council.

Dr. Bergman was born in Sweden and raised in Zimbabwe, where he also later worked as a mission doctor. He received his medical degree (MB ChB) at the University of Cape Town, and later a Masters in Public Health at the University of the Western Cape. During his years in Zimbabwe, he completed a doctoral dissertation (MD, equivalent to PhD) on scorpion stings. He has worked in rural South Africa, Zimbabwe and Sweden, and his last posting was Senior Medical Superintendent of Mowbray Maternity Hospital in Cape Town, overseeing 18000 births per year.

He enjoys sharing the wildlife of Africa with his wife and three youngsters.

Dr. Bergman will be presenting two plenary sessions at this year’s conference. At 9:00am on Friday, July 26, he will share with us about “The Neuroscience of Birth and Breastfeeding”. In addition, at 3:00pm on Sunday, July 28, he will help us wrap up our conference with a session entitled “The Neuroscience of the Global Public Health Imperative”.

He will also be presenting two sessions where he encourages attendees to focus on the most basic of baby’s needs. Plan now to attend the following sessions:

Clinical Best Practice Workshop on Thursday, July 25

• 8:00am: Practical Aspects of Skin-to-skin Contact and Breastfeeding

Concurrent Session on Friday, July 26

• 4:00pm: Theory on Feeding Frequency

For more information about our upcoming conference and to register, please visit the Conference Page on our website.

IBCLCs are often under-recognised for their skills within the multi-disciplinary neonatal setting.  Where this is the case, IBCLCs report that they face reduced work opportunities and lower earning potential.

The way to reverse this trend is to increase demand for the qualification through establishing a sound commercial understanding of what the profession can offer and increasing brand awareness worldwide.

When speaking to IBCLCs online, I have regularly found the conversation drifting towards discussions around the “fairness” of IBCLC pay and the perceived lack of understanding of the IBCLC qualification, both from other health care professionals and by mothers in the community.  Recently, one such thread prompted me to think about the situation in more detail.

As a 100% breastfeeding supporter, I understand at least some of the frustrations.  I want heath care systems to understand that we need experts in this field and to pay for it appropriately. In short, I want to be out of a “job”, replaced by somebody with way more expertise, who gets paid.

The only way to achieve high-quality paid support is to increase demand for the best.  It is not through breastfeeding professionals arguing that their pay is poor or that less well qualified supporters charge too much, as all too often happens on the threads.

Why does demand matter?

It is worth taking a brief look at the economic “price-supply-demand” model.  Basically, it says that, in a market economy, price can only be high if demand outstrips supply. You cannot increase demand by increasing price BUT you can increase price if you increase demand (relative to supply).

This clearly doesn’t work when mothers are paying out of pocket (nor would we want it to) however, we have the scope here to move away from “patient payment” and into a situation where support is a “covered service”. This has potential to work however your health service is funded.

How can demand be generated?

The only way to make the medical profession sit up and listen and start demanding your services is to hit them in their pockets – or, in this case, to demonstrate how NOT using you is hitting their pockets.

At the end of the day, purchasing and pricing are commercial decisions. Customers (insurance companies/governments etc) are unlikely to buy your services if they can’t see the value to them of doing so.  Perception of value is as important here as value itself.  If a product is not marketed well, then it will not be perceived as having high value irrespective of the numbers.

You, as IBCLCs, along with the organizations that surround your profession, are the only ones who can market you and your skills. This may seem uncomfortable but it is the way the world works.

What can be done?

So far, we have established that IBCLCs need to market themselves better in order to increase demand and to be able to demonstrate the financial value of their service.

If members are really serious about improving pay and respect for the profession, it is time to increase the expectation placed on the International Board of Lactation Consultant Examiners (IBLCE) etc., in terms what they do for the profession and how they market it.

IBLCE is key to this situation as they have the greatest interest in making “Brand IBCLC” a success.  They are financially invested in it and need to see service growth in order to support that investment. In addition, they have a commercial interest in maintaining the standing of the qualification – If they don’t, then you might not renew.

So, what might you ask of IBCLE?

There are some basic questions that it would be worth asking IBCLE that focus specifically on marketing and brand awareness. These may include:

What are they doing to improve perceptions of the brand?
How are they affecting purchasing decisions within your health system?
How do they plan to do this in the future?
What is their plan for expansion for the next 10-20 years?
What do they see the long term aim for the organization to be?
Are those long term aims centered around increasing appreciation and use of the specialism?
Are the aims based “on the ground” or are they wooly?
What information are IBLCE giving you so that you are able to better market yourself locally?

Looking locally

Perhaps it is also time to take a look at what you are doing locally to demand greater respect for the profession, and what you are doing to earn that respect. Are you lobbying your local hospitals? Are you actively campaigning for recognition or carrying out research? Are you demonstrating your worth at every possible occasion?

All feeling too commercial?

A lot of this is fairly basic business sense and I think this makes many IBCLCs shy away from discussing it.  There is a strong cultural feeling that kind and caring people shouldn’t like talking about commerce, however, the business aspects of this really do need discussing for everyone’s benefit.

Many people working in similar caring professions have managed to find a way to do this.  Indeed, some time ago I worked for an examination board (educational) where we routinely asked similar questions in order to try and increase the uptake of our service. Just because we spent some time thinking commercially, it didn’t mean we didn’t care.

We work within commercial health care systems. We have to play the game or we will be out competed.

Cathey Horsfall is a trainee Breastfeeding Counsellor with the Association of Breastfeeding Mothers, UK.  She has two children under four and holds an eclectic set of qualifications including a B.ed (Hons) and a post graduate business qualification from Cambridge University, UK. She has spent the last ten years working in commercial organisations where the importance of good marketing and brand awareness were felt very keenly.  Most recently, she has written for a large UK public relations company, giving her a strong understanding of just how important it is to actively lobby and constantly ensure that potential customers are exposed the skill and strengths possessed.

I grew up in Switzerland and later moved to Israel as an adult. In both countries, breastfeeding is fairly common, although one rarely sees older children nurse. But even when I moved back to the US when I was in my mid-twenties, where bottle feeding is the norm, it never occurred to me that I would not breastfeed my children. My mother had breastfed me for six months and I had a vague similar goal in mind. I was very surprised when I encountered breastfeeding issues with my first baby.

I had planned an unmedicated birth, but inexperienced and insecure as I was, I let a labor nurse of a major Boston hospital push Demerol on me and later, when my labor stalled, the Pitocin I was given soon overwhelmed me. An epidural was added to the process. I gave birth, all numb from the waist down, and it felt like a movie, unreal. It was as if I wasn’t there. My daughter was lethargic, and after have been deeply suctioned due to having ingested meconium, she was not interested in nursing. To make matters worse, my breasts were marked by edema and every attempt to breastfeed soon fell apart. I didn’t get the help I needed in the hospital; the nurses were inexperienced and the lactation consultant was not able to give one on one help.

Our breastfeeding difficulties were prolonged by inadequate lactation support both by lactation consultants and pediatricians, which made for a physically, and more so emotionally, painful and exhausting experience. It ultimately contributed to an early end of our nursing relationship. The support I was given included gadgets, which I had to either purchase or rent, but our difficulties – engorged breasts, red and raw nipples, my daughter popping off after only a few minutes – were neither diagnosed, nor taken seriously. No one asked me how I pumped, how I fed bottles, or suggested ways to make my breasts less taut. More than ten years after the fact, the memory of it still hurts.

In contrast to this, my other two nursing experiences were wonderful. I switched my care to a midwife and gave birth in a hospital that respected my wishes for no intervention unless medically needed. Both babies latched within the first hour of being born and breastfeed for several years without any problems.

It was my traumatic introduction to breastfeeding that eventually motivated me to become an International Board Certified Lactation Consultant (IBCLC) and I began my training while I was pregnant with my third child. I don’t ever want a mother to feel as inadequate and helpless as I felt. After seven years of helping mothers in various drop-in settings and completing my Masters degree in Health and Wellness, I am looking forward to sitting the exam this summer.

We are so pleased to have Liz Brooks, our current ILCA president, as one of the speakers at our conference in Melbourne in just a few short weeks. If you’ve heard Liz speak, you know that you are in for a treat.

Liz Brooks, JD, IBCLC, FILCA, is a lawyer (since 1983) and private practice lactation consultant (since 1997) who brings to life the connection between lactation consultation and the law. IBCLCs face a maze of ethical, moral and legal requirements in their day-to-day practice, no matter what the work setting. With plain language and humor, Liz explains how IBCLCs can work ethically and legally. She offers pragmatic tips that can immediately be used in daily practice. She is the President of the International Lactation Consultant Association (ILCA), and serves on the Board of Directors for the United States Breastfeeding Committee (USBC).

Liz will be giving the President’s Address on Friday, July 26, at 11:45am. In addition, she will also be presenting four sessions to inform and help attendees think critically about our ethical responsibilities, legal tensions found in our profession, and effective communication with mothers. Plan now to attend the following sessions, eligible for E-CERPs:

Professional Practice Workshop on Thursday, July 25

• 8:00am: Dazed and Confused After Discharge: Cases from a Home-Visiting IBCLC

• 10:30am: SOAP, LATCH or IDK? Law and Ethics of Lactation Documentation

Concurrent Sessions on Saturday, July 27

• 8:45am: Who’s Your Daddy…Mommy, Surrogate or Donor? Modern Families, Lactation, Ethics and the Law
• 2:45pm: Who Wants to Be A Millionaire and Is That Ethical? A Game Show Approach to IBCLC Ethics

For more information about our upcoming conference and to register, please visit the Conference Page on our website.

My name is Jodi Fan and I am a La Leche League Leader in Champaign-Urbana, Illinois. When I was working as a small animal veterinarian in 2002, I got pregnant with my first little bundle of joy. I knew right from the start that I wanted to breastfeed. Nothing seemed more natural or perfect to me — providing my baby with everything he would need to thrive and being able to form that special bond with him through nursing. I read all the breastfeeding books that were available, took breastfeeding courses at my local hospital, and felt very prepared and confident all throughout my pregnancy.

What I didn’t realize at the time was that although breastfeeding truly IS the most natural way to feed a baby, it doesn’t always come naturally to a mother/baby dyad. There can be a pretty steep learning curve and unanticipated difficulties, no matter how prepared a mother-to-be is. When I gave birth in 2003, I experienced many difficulties with breastfeeding. From latch problems to thrush, plugged ducts and mastitis, nothing seemed to be working out as easily as I had expected it would. Feeling alone and ready to throw in the towel, coupled with not being able to find the help and guidance I felt I needed, I vowed that if I could make it through this, I would do everything possible to provide caring support for women whose goal it was to breastfeed their babies.

I finished my training to become an accredited La Leche League Leader, and three breastfed baby boys later, I am registered to sit for the IBLCE boards in 2013! I believe that every mother (and her family) deserves breastfeeding support, guidance and education both prenatally and postpartum in order to successfully deal with those “bumps in the road” that might make it challenging to experience the pure joy that is breastfeeding.

Photo by jeff.snodgrass via Flickr

In this day and age, Google can be a new mother’s best friend. It can also be their worst enemy.

I’m an IBCLC in Fairbanks Alaska and I run a successful virtual breastfeeding support group (through Facebook) for our local WIC clinic. The group started about a year ago and now has over 300 mothers. It’s a great alternative to Google as it’s filled with real live mothers at various stages in lactation, all of whom have encountered their own challenges.

Mothers participate in our closed group multiple times per day and throughout what can be the lonely midnight and morning hours.  Here in the interior of Alaska, winter time temperatures can often dip to -50 below zero. Who wants to take their newborn out in that? The group provides a way for mothers to get critical breastfeeding support from their own homes. This is especially important for those who may have transportation issues. Some mothers hide behind our online Facebook group, never attending an in person breastfeeding support meeting. However for others, the group helps them feel connected and actually encourages them to venture out and meet these moms that they interact with daily. This provides for in-person peer support and often helps encourage relationships.

Subjects range widely. Is my baby getting enough to eat? My baby is biting me, what can I do? Can I use birth control? I need help with breastfeeding, who can I call? Mothers supporting mothers is what keeps the group going. They are able to link one another to online articles, to share information and even videos.

Our WIC clinic has 4 breastfeeding peer counselors that help monitor the group and ensure accurate evidence based information is being provided. One of our peer counselors took a video of her nursing in public in a baby carrier and shared it in our group for all to see. Nursing in public can be intimidating for some, and being able to share that fear with others and explore options for conquering that fear can be helpful. It’s awesome to read when a mom posts about how she nursed in public for the first time that day and just wanted to share with us.

Fairbanks is a big military town. The moms here often have no family living nearby and when they have visitors, or they go home to visit, they can experience anxiety with breastfeeding and what their family is going to think. With smart phones on the rise, the group is available at the touch of a finger. The online group provides a constant source of stable support. A core of other mothers facing similar situations. When partners deploy or spend 12-14 hours a day in the field the mothers have each other.

This group has by far exceeded my expectations. Often, we get moms in the clinic who decline our breastfeeding services but later request to join our Facebook group. While some may not want the phone calls that our breastfeeding peer counselors provide or an in office consultation with me, they are still receiving support.

Since starting this online group our breastfeeding rates have increased! More moms are reaching out, feeling comfortable and getting the support they need. We have flyers posted all over our town promoting our group. While our group is mainly composed of WIC mothers, it is not limited. I feel having a wide range of mothers truly helps the support dynamic amidst the array of challenges a nursing mother can face. It has been rewarding running this group and I look forward to seeing it and others like it grow!

The kind of support that we provide online isn’t unique to Alaska. Just a few weeks ago, Lara Audelo released a book called The Virtual Breastfeeding Culture: Seeking Mother-to-Mother Support in the Digital Age. In it, she shares stories from more than 30 mothers who have found what they needed to be successful at breastfeeding online. As more and more mothers are seeking information and support on the internet, I encourage more of you to explore whether an online support group is what the women in your community seek.

Jessica Harper currently works for WIC as an IBCLC. She is a LLL Leader & mother to 3 in Fairbanks, Alaska. After experiencing her own breastfeeding challenges, she became a strong advocate in her community. When she’s not supporting breastfeeding mothers, she enjoys gardening, sewing and running.

My name is Angie Brekken and I will be sitting for the exam to certify IBCLCs this July. Breastfeeding wasn’t something I was familiar with growing up. The first time I recall seeing a woman breastfeed was when I accidentally walk in on my cousin’s wife with her infant. I remember feeling a little uneasy and embarrassed. My mother breastfed me for 3 months, and my little sister for a brief period as well. But I remember hearing stories from my mother that her milk “dried up” because of the stress she was going through when her grandmother died.

I thought that I would be doomed for my own  breastfeeding experience. My dad asked me when I was pregnant with my first son if I would be breastfeeding. I answered “I will try”. I truly lacked the confidence in my body to succeed. Luckily, there was a fantastic lactation consultant at the hospital when I delivered. She helped guide me through learning to latch and was a true support and cheerleader for me. We made it out of the hospital without supplementing with formula despite an emergency C-section and loss of blood.

During my first week back at work at eleven weeks postpartum, my dad died of a heart attack at the age of 49. To say the least, I was devastated and crushed. I was sure my milk would “dry up”, like my mother’s. This same lactation consultant kept cheering me on and encouraging me through my grief. My first son didn’t receive formula and I nursed exclusively for 13 months. My second son went on to nurse for almost two years when he weaned himself. All through this, I was back in college to earn my Bachelor of Science (BS) degree in nutrition and became a Registered Dietician. The support that I received from this lactation consultant was so valuable to me.

I now work with WIC (Women, Infants, and Children) and my goal is to be able to help mothers the way she helped me. I feel that the IBCLC credential will help me to do that. What better first nutrition than mother’s milk? What a great fit for a Registered Dietician (RD) to also be able to support mothers in their breastfeeding experience. I had the honor, a couple of weeks ago, to talk with a mother that said “I would have quit breastfeeding in the first week if it wasn’t for seeing you.” I shut my door and cried when she left, knowing that in some small way, I had made a difference. I want to continue making a difference, however small or large, and pass on this great gift that was given to me by that hospital lactation consultant 9 years ago. Thank you, Mary!

Hopefully, at this time 6 months from now, I will be able to add the coveted IBCLC credential to my RD and continue helping mothers to reach their breastfeeding goals.

The reality of the presence of environmental chemicals has been on the world’s radar since the release of Rachel Carson’s book Silent Spring in 1962.

Today it is accepted that every human body contains many man-made chemicals that can cause harm. Human milk has a high proportion of fat and therefore fat soluble contaminants, including dioxins, can be very easily measured.

Expressed breastmilk used to be included in the Australian Basket Market Survey, now called Australian Total Diet Study (ATDS), because it was easy to collect from consenting women in postnatal wards.

Over the last few decades, scare tactics have emerged, warning women about the perceived danger of breastfeeding.  I clearly remember one front page headline in a Sydney Sunday paper in the mid 70’s screaming: “DDT’s in breastmilk: mothers poisoning their babies.”

The press coverage of Florence William’s 2012 book: “Breasts: A Natural and Unnatural History”, which covers her investigations into the issue, did little to allay these fears.

It is therefore heartening that the International Baby Food Action Network (IBFAN) has just released “IBFAN Statement on Infant and Young Child Feeding and Chemical Residues” (2013), which presents objective and independent information for parents, carers and health professionals.

The main author of the paper is well respected Dr Adriano Cattaneo, Consultant Epidemiologist and Co-ordinator of the Unit for Health Services Research and International Health, Institute of Child Health “IRCCS Burlo Garofolo”, Trieste, Italy, a WHO Collaborating Centre for Maternal and Child Health. Dr Cattaneo was an Expert Reviewer on the 2012 NHMRC Infant Feeding Guidelines.

This evidence-based, well referenced statement goes beyond the issue of possible residues in human milk to include that of contaminants in infant formula including in the unnecessary, but cleverly marketed, follow-on formulas, baby foods, feeding bottles and teats.

The paper also emphasises the potential harm of chemical exposure during pregnancy at a time when tissues and organs are growing rapidly. It reinforces the fact that there is now far greater understanding of the beneficial effects of breastfeeding and its role in developing immune protection and mitigating the harmful effects of chemical exposure in the womb.

Conversely, formula feeding does not afford any protection to babies at all. The ecological footprint and consequence of increasing rates of formula feeding is also addressed.

The document lists 10 Key Points and Key IBFAN Messages, which includes the statement that “pregnant and breastfeeding mothers have the right to receive full and unbiased information”.

IBFAN endorses international health regulations to protect, promote and support breastfeeding – because the benefits outweigh any possible harm -“except in the case of industrial disasters and of exceedingly high residues after industrial disasters”.

Contained within the paper is a Call for Action, urging decision-makers and industry across the globe to implement the Stockholm Convention on Persistent Organic Pollutants (POPs).

The Appendix is an excellent reference and carries an analysis of 13 chemical residues or families of chemical residues. IBFAN have considered only substances “for which there is ample literature and that are a target for important policies and regulations worldwide.”

This paper provides strong evidence that the continuing fight for a healthy global environment, with minimum toxins, is a challenging one considering industry redistribution and weak environmental regulations.

This post was originally published on Crikey, a news service from Australia. We thank them for allowing us to republish it here. 

Joy Heads, OAM, IBCLC, FILCA,  is a midwife and has been an International Board Certified Lactation Consultant since 1986. In 2009, she was awarded the designation of Fellow of the International Lactation Consultants Association (ILCA™). She is currently on the Board of Directors of ILCA, and co-wrote the chapter on “Breast Pathology” for the ILCA’s Core Curriculum for Lactation Consultants (Editors: Mannel B, Martens P J, Walker M. (3nd ed) Jones & Bartlett. MA. USA. 2013). In 2006 she was awarded the Order of Australian Medal for service to nursing and midwifery as a specialist lactation consultant and to health professional and parent education. Joy was the Clinical Nurse Consultant (Lactation) at the Royal Hospital for Women, Sydney for many years until she retired from paid work in late 2010.