We are honoured to present an ‘In Conversation’ with Joelleen Winduss Paye, an experienced International Board Certified Lactation Consultant (IBCLC), Endorsed Midwife, Naturopath & Educator, who has been supporting breastfeeding mothers and babies for 13 years.
As an IBCLC, Joelleen brings a treasure trove of knowledge and expertise to the realm of lactation and breastfeeding. Her unwavering commitment to evidence-based care and support has earned her the trust of countless mothers, healthcare providers, and professionals alike.
In this interview, Joelleen will share insights into the challenges and rewards of supporting breastfeeding mothers and babies, as well as her considered approach to working with diverse populations and incorporating cultural sensitivity into her practice.
With a compassionate understanding of the common challenges faced by new mothers on their breastfeeding journey, Joelleen will offer valuable advice that is sure to bring solace and guidance. Her profound insights will empower mothers as they navigate through the joys and struggles of breastfeeding.
Join us as we embark on a journey of discovery, where Joelleen shares her passion for expanding the boundaries of lactation expertise. Through her profound insights, you will gain a deeper appreciation for the dynamic nature of breastfeeding support and the impact of staying up-to-date with the ever-evolving lactation landscape.
This conversation promises to be an invaluable insight for anyone seeking a deeper understanding of lactation and breastfeeding, the expert way!
We are delighted to bring this article to our esteemed Mammae readers, fostering a meaningful dialogue around the significance of professional and up to-date breastfeeding support and education.
So, without further ado, let's dive in!
We are excited to learn more about your journey thus far. Can you share with us your background and what makes up your world today?
I originally began supporting breastfeeding families during my years as a midwife in New Zealand. I trained young and was very passionate about learning all I could to support pregnant, birthing and breastfeeding families. I worked at various hospitals, and during my time at a smaller birthing hospital, there was more capacity for breastfeeding support, so I spent many hours with families during these years, observing newborn feeding behaviour and learning from and about what breastfeeding mothers/families were struggling with.
I then qualified as a Naturopath as a way to channel my passion for holistic and lifestyle health. Immediately after graduating as a Naturopath, I decided to apply and prepare for the IBCLC exam, allowing me to live out my passion for breastfeeding further.
Combining my experience as a midwife with my knowledge of naturopathy and lactation consulting allows me to practice very holistically, which my clients really value.
What led you to become an IBCLC, and how long have you been practising as one?
I always had a lot of patience for breastfeeding challenges despite working in demanding hospitals and often found this would be the focus through many of my working days. It has always been important to me that parents have the best knowledge available to them and that they are guided to understand their newborn babies' needs. I gained my IBCLC qualification in 2018, worked for two private Melbourne hospitals as a Lactation Consultant, and have been practising privately since I founded JWP in 2021.
Can you explain your role as an IBCLC and how you support breastfeeding mothers and babies?
In a hospital, the consultations tend to be short and more focused on immediate concerns, whereas private practice is much more spacious. When I work with private clients, the consultation time is much more comprehensive; in this environment, I can assess their feeding furniture and set up, we discuss goals and assess what the main challenges are. We run through various feeding positions, most commonly the reclined cradle hold and side-lying either on their couch or in their bedroom. I also support clients with nutritional advice, and prescribe supplements and herbs to support their postpartum well-being, milk supply and energy/stress levels.
What are some of the most common breastfeeding challenges that you encounter, and how do you help mothers overcome them?
Nipple pain due to incorrect breastfeeding technique: supporting the mother to use baby led attachment and evidence-based breastfeeding techniques based on positioning the baby’s face and body to the mother’s uniquely shaped nipple and breast. Also applying the approriate nipple care products for that individual, as not all products acheive the same results. Education is required to use each product in the most optimal way.
Low milk supply or milk supply that is slow to establish: milk supply and demand is discussed, optimising breastfeeding (milk removal) and pumping if this is indicated. Reviewing the current diet and offering holistic nutrition strategies, protein-focused recipes and meal/snack suggestions, and supplements + health foods where indicated.
Breast refusal: this can be a conditioned response of the baby where they have repeatedly experienced stress, and now it is manifesting as refusing the breast. We try different latching positions, paying close attention to any stress/tension in the mother and baby. I find side lying can work well in this position. Assessing any underlying causes, such as forceful letdown / very fast flow) or slow flow of milk, or bottle preference.
Bottle refusal: I support clients with strategies to introduce their baby to a bottle depending on their age and stage of development. This one can be stressful, and it is good to leave more time than not before the bottle is required regularly.
Introducing pumping to replace some or all breastfeeds: parents are unsure of how to incorporate this, and I advise on what type of pump will best suit their needs for the stage they are at, keeping in mind their purpose for pumping. This includes education on bottle feeding, cleaning, storing breast milk etc.
Poor nutrition, low postpartum energy: I see this a lot, where skipping breakfast or having a piece of toast is a typical breakfast. I am a big proponent of protein-rich savoury breakfasts to set your blood sugars up for the day. If you aren't eating a balanced breakfast, this can wreak havoc on your blood sugar levels, causing crashes, cravings, mood swings and low energy. This negatively affects how you feel and also your hormonal balance, and even milk supply.
How do you work with healthcare providers and other professionals to provide comprehensive care to breastfeeding mothers and babies?
Throughout my time working in and out of the hospital, I have developed a referral network of highly expert colleagues that I can refer my clients to. Our practice styles are complementary, which helps make a smooth experience for the client.
I refer to a trusted GP IBCLC expert if there are challenges beyond my scope, such diagnosis and treatment for suspected tongue tie, or medications for bacterial mastitis, nipple dermatitis and/or thrush.
I refer clients who are experiencing breast inflammation (previously known as blocked ducts) for therapeutic ultrasound by an experienced physiotherapist which can help reduce the inflammation.
I may refer a mother or baby to osteopaths when bodywork is needed. This may be from a complicated birth (forceps or vacuum), or when there is tension and tightness in the baby’s neck, jaw, face etc, that may be affecting their ability to drink at the breast. If a mother has been breastfeeding with poor posture or needs some support with lymphatic drainage, an osteopath can be really helpful here too.
How do you stay up-to-date with the latest research and developments in lactation and breastfeeding?
To maintain the IBCLC credential, I must complete a certain amount of professional development every five years, this includes workshops, conferences, webinars and courses. I also maintain my midwifery and naturopathy qualifications annually too. I am always discussing the latest research with colleagues and am continuing research for the content I create. I also listen to podcasts and stay updated with the Australian Breastfeeding Association and the Academy of Breastfeeding Medicine (US).
Can you describe a particularly challenging case you worked on and how you helped the mother and baby overcome their breastfeeding difficulties?
Many come to mind, however, this one sticks out as I am so proud to say that this mother is still breastfeeding her now 15-month-old! Initially, she saw me quite soon after her complicated hospital birth as her baby was refusing the breast due to early unpaced bottle introduction during the hospital stay. We worked on the latch, staying calm at the breast and increasing her milk supply through pumping and nutrition. I also supported the correct bottle feeding technique to reduce the contrast her baby was experiencing from a fast-flowing bottle to a ‘slower’ flowing breast. Ultimately we used a supply line (a thin tube inserted into the baby’s mouth whilst connected to a bottle of milk) to build associations of the abundance of milk at the breast, which we persisted with for several weeks. Ultimately mother and baby were happily breastfeeding, which was so important to the mother that she could breastfeed and feel good about it.
What advice would you give to a new mother who is struggling with breastfeeding, and what resources are available to support her?
I would say call in the help of a trusted IBCLC, now is the time. If breastfeeding is important to you, you need to invest in getting the right support, it will make the world of difference. Getting expert advice and opinion about what is really going on in your unique situation (not just information from a Google rabbit hole) will help keep you on track. If stopping breastfeeding (directly from the breast) and continuing to express breast milk is the right option for you, IBCLC can also support you with that. I have a post on my Instagram which provides journal prompts to consider when things are feeling hard to help give clarity, find it here.
How do you incorporate cultural sensitivity and diversity into your practice when working with mothers from different backgrounds?
When it comes to working with mothers from diverse backgrounds, I prioritise the integration of cultural sensitivity into my practice. Recognising that each client and family is unique, I approach my interactions with a mindset of mindfulness and curiosity. I understand the importance of being open and receptive to different cultural practices, beliefs, and values.
To ensure that I provide the best possible care for families from diverse backgrounds, I actively seek out and engage with professional development content that embraces cultural diversity and sensitivity. This includes staying informed about cultural practices related to breastfeeding, understanding the cultural significance and nuances associated with infant feeding, and being aware of any specific challenges or preferences that may arise.
By incorporating cultural sensitivity into my practice, I strive to create a safe and inclusive space for all mothers, regardless of their cultural background. I recognise the importance of actively listening to their experiences, perspectives, and needs, and I aim to adapt my approach accordingly.
Moreover, I am committed to continuously learning and growing in my understanding of cultural diversity in lactation and breastfeeding. This involves ongoing education on cultural competence, and collaborating with other professionals who specialise in supporting diverse populations.
Ultimately, my goal is to ensure that every mother feels seen, heard, and respected throughout their breastfeeding journey. By embracing cultural sensitivity and diversity in my practice, I aim to provide personalised care that acknowledges and celebrates the unique cultural identities and experiences of each and every family I work with.
Can you walk me through the steps you take during a typical consultation with a breastfeeding mother and baby?
Before a consultation, I get my clients to fill out a comprehensive form which allows me to go in with some strategies. We discuss their main concerns and goals, and I observe a breastfeed, assisting and offering strategies where needed. I will observe a complete feed and settling time post feed, often a pumping session too. The whole time I am observing and listening to what the parents are saying and also observing the baby's cues. I then give a personalised plan with plenty of extra resources, which covers the breastfeeding process, pumping and bottle feeding if applicable, nutritional advice and other holistic resources as needed.
What are some of the most rewarding aspects of your work as an IBCLC, and what motivates you to continue to support breastfeeding mothers and babies?
One of the things I enjoy most about my work is seeing clients who have attended my breastfeeding workshop during their pregnancy and have been following me on Instagram. It's great to have a foundation of shared knowledge to work with, and we can dive even deeper into the nuances of breastfeeding during a face to face or virtual consultation.
I also love when clients who I've seen in the early days of their breastfeeding journey reach out to me later on. It's gratifying to be a trusted resource for their ongoing breastfeeding challenges, like teething, introducing solids, returning to work, or weaning.
As I build relationships with these clients over time, I have the privilege of witnessing their babies grow and their mothers accomplish their breastfeeding goals. It's incredibly rewarding to see the positive impact I can have on their lives and the health of their families.
Having the space to approach womens health holistically is something that I truly value. Throughout my years of working in hospital systems, I've seen firsthand how many of these organisations lack the capacity to incorporate complementary health practices.
Many of my clients also share this appreciation, particularly when it comes to nutrition. My clients feel seen when I take into account not only their physical symptoms, but also their emotional and mental well-being, when creating a breastfeeding and postpartum wellness guide. This holistic perspective allows the deeper root causes of their health concerns to be addressed, rather than simply treating the symptoms.
Having the freedom to practice holistic healthcare is truly a privilege, and it allows me to provide the highest level of care possible to my clients.
If you're interested in learning more about Joelleen's work and staying updated with her latest insights, I highly recommend following her on Instagram at @jwp.ibclc. You can also visit her website at www.jwp.care, where you'll find a wealth of valuable information and resources related to lactation and infant feeding.
Author + Contributors \ Erin Deger + Joelleen Winduss Paye.