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Ep. 66- Leadership in Lactation- Meet Marie Biancuzzo!

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This is Maureen Farrell and Heather O’Neal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way.

So join us for another episode. Welcome to The Milk Minute Podcast, everybody. Today, we’re going to interview breastfeeding goddess, Marie Biancuzzo, but first we have a listener question, and then if you stick around to the end, we will have an award in the alcove. That’s right. You want to stick around because you never know, it could be you.

Oh, today’s question comes from Valerie W. She says, how do you become a lactation consultant? I don’t think I want to do it as a full-time job or anything, but the further I’m getting into my breastfeeding journey, the more passionate I am becoming about it. Plus I like learning about everything science and mechanics wise in regards to breastfeeding. So all in all, it would be something that I would want to do on the side.

Okay. So I have like a couple part answer to that. First, if you kind of know where you want to go with this, it’s easier to know where to start. There are entry-level certifications like the CLC or the CLS that are sort of one contained course with an exam at the end, they’re really accessible.

They don’t have prerequisites. So this is a good place to start, especially if you’re not sure if this is going to be a career path for you, right. And those are often weekend intensives, you know, they’ll host them at resorts. You can also do them virtually. Things have definitely changed with the pandemic.

So things that used to be in person they’ve now figured out a way to make it online. And actually, if you check with your organizations in your state, like for example, we have the West Virginia perinatal partnership, which offers scholarships for those CLC certifications. And they, yeah, they usually host one in the state every year, too.

So there’s probably something like that local to you. Right. So I would look up your, your state perinatal partnership to see yeah. Yeah. Or Breastfeeding Alliance sometimes. Yeah. Yeah, there’s usually scholarships you can find because it can be a little steep sometimes, especially if it’s something that you just plan on doing on the side that you’d like to have.

We love having people in the community that know what they’re talking about with breastfeeding. That’s very helpful because there’s not one lactation consultant for every 10 people in this world, not even close. Yeah. But then, you know, if you think like, actually I want to take this to another level or maybe this should be my career path, the IB CLC is sort of your top-level lactation certification.

It requires some college level courses, some clinical hours, a lot of studying and an extensive exam, but it is a really useful certification to have, especially if you’re already an RN or something like that. Right. I, so I have my IB CLC and because I’m a nurse midwife, I was able to use my college courses for my midwifery program towards the IB CLC certification, as well as the clinical hour requirements.

And then also I was able to use for clinical requirements, my experience as a labor and delivery nurse, working with breastfeeding families, which I did for years. So that was the most logical step for me because it technically is the highest certification you can get where you are, you’re now in a position where physicians are referring people to you, and that is going to open up a lot of doors for you.

If you want to work at your local WIC office, I think CLCs can still work at WIC offices. Absolutely. And, and, you know, a lot of people have CLCs in the hospital, but usually they’re not hired just for that. It’s something that they ‘ll ask an RN to get, right. Exactly. Yeah. I’m in a unique position as an IB CLC because I also have an advanced practice nursing degree where I can prescribe.

So that’s kind of why I have my own practice and I’m doing that kind of thing. So if that’s something that interests you, maybe you’re already a nurse practitioner and you want to learn more. It’s really not that much of a jump. And I definitely want to encourage anybody that already holds an advanced practice nursing degree to just go ahead and get it.

If you’re working with breastfeeding families, we need you on the team. We need you to help change the minds of pediatricians and other clinical people that work with breastfeeding families. Yeah, for sure. But any of these will give you the start that you need to start working with families. I’m a CLC.

Heather’s an IBCLC. Honestly, when we work with clients, we both bring the same thing to the table because we’re self-motivated and we do our own education too. Yep. That’s right. I really haven’t seen anybody be limited in any way, depending on what certification they have, but wherever you’re starting, kind of determines what the smartest quickest way for you to get a certification would be.

Yeah. So I hope that answers your question, Valerie. And anyone else out there who’s been thinking, huh? Maybe I want to help lactating parents too. Right. And if you actually go to, they have three different pathways to the IB CLC that you can choose. So if that’s something that interests you, you can go see which pathway is going to work the best for you.

Thanks, Valerie. We wanted to also give a quick shout out to our friend, Martha May. Yeah. She sent us a private message the other day that I like immediately screenshotted and texted to Heather. I was like, if you’re having a tough day, read this. It’s amazing feedback. Yeah. We’ve been getting more and more of these, which definitely keeps our fire burning and makes us want to continue this project.

So if you are loving the podcast, we love to hear from you. Martha says that she wanted to take a second to reach out and thank us both for creating her favorite podcast, that she never could have guessed she needed in her life. She was introduced to us several weeks after giving birth and she could not be more grateful for every episode.

And she says she genuinely felt a sense of loss when she finished our most recent episode after marathon listening sessions. We promise we’re going to keep making them. And seriously, if you just are sitting there thinking like, I love this podcast. Message that to us guys, we don’t hear from you often enough. Yeah. Please. And then share with a friend who might be missing out.

Let’s take a minute to thank our sponsor Lume. Lume didn’t invent deodorant, but they changed everything about it. It’s clinically proven to control odor for 72 hours, but it’s all natural. And it’s six times more effective than the other leading natural deodorants. Plus it’s fun to say, they have hilarious commercials,. And it’s a female founded business and they don’t just have deodorant for your armpits, but for your other private parts. So exciting. So say goodbye to your breastfeeding stank and click the link in our show notes to get your Lume today. Yeah.

Heather: We have a very special VIP guest here today. Marie Biancuzzo thank you so much for being here. I have always thought of you as the czar of breastfeeding, the czaress, the goddess. I’ve heard you referred to as the Ina May Gaskin of breastfeeding. I don’t know if you know any of that about yourself, but you’re kind of a big deal.

Marie Biancuzzo: I’m flattered. I did have somebody a while ago to my face call me the goddess of breast breastfeeding.

Heather: Well, you are. I mean, and I have to tell you. This is a big deal, because if you knew me in college, you’d know that I didn’t actually read any of the textbooks. I was one of those people that kind of figured it out other ways. Your textbook that you wrote, Breastfeeding The Newborn, is the only textbook I have ever read cover to cover. And that’s all that’s serious. I read it cover to cover and enjoyed it. So I don’t know how you manage to write a textbook that was enjoyable to read, but I appreciate that so much.

And I, everything I know I really attribute to you. And I mean, just imagine that first textbook that I read for lactation, if it had been boring and it didn’t spark any passion in me, we might not be here today. So thank you so much for writing that book and all the other amazing work that you do with your podcast, Born to Breastfeed and your multiple multiple CBLs that you do for everybody. You teach the teachers now. So thanks for adding to our profession.

Marie Biancuzzo: Well, thank you, Heather. Thank you for having me here and for all of your nice comments. Let me just say that I have a piece of trivia about that book, which is I typed every word in there. I did. All 464 pages and I can type wicked fast. That was one of the best, side-effects of doing that book.

Heather: Wow. I didn’t think I could be more impressed, but here we are. Well, that’s awesome. So you’ve been in the game for a long time now, it’s been about over 25 years now? How many years has it been?

Marie Biancuzzo: Oh more than that. I got into the game really about the late seventies and certainly was well into it by the early eighties. Yeah.

Maureen: Wow. Yeah. That’s, that’s a whole different universe of breastfeeding back then.

Marie Biancuzzo: Oh yes. Oh yes.

Heather: We love to talk about the history of things on our show to just give people context, because I mean, people are barely able to keep up with what we are currently doing today, you know, and they don’t have time to figure out how we got here, but how we got here is just as fascinating sometimes.

And you used to help parents directly. And you still do in many ways, but now you’re teaching the teachers. So talk to us about that transition that you went through, where you went working from one-to-one with patients to teaching the teachers.

Marie Biancuzzo: Well, that transition was not as abrupt as it might seem. Let me say, first of all, I really wanted to be a hot shot, labor and delivery nurse. And so I did not in any way, start out wanting to do breastfeeding. I just, that just wasn’t part of my world. Actually, my first ding, ding, ding, ding, ding of how I needed to help with breastfeeding was as a labor and delivery nurse.

That is a story for another podcast. But anyway, I kind of realized my own ignorance. And I remember one day just saying, I don’t know anything about this breastfeeding and stuff, but it’s gotta be like anything else. It’s gotta be something I can just learn. And I can help people to do this. And so I was at the staff nurse level at that time and somewhere in all of that later on, I became a clinical nurse specialist. And I know that clinical nurse specialists are not very well understood, but it’s really, the clin spec really works at the system level.

So for me, it was about doing that one-to-one, helping, counseling, teaching mothers. And then all of a sudden I realized in a facility where we did 4,200 deliveries a year, there was no way I was going to be able to help all of them, myself. So it really came by necessity. The one-to-one thing, I realized that I was not going to be able to touch as many. Oh, dear. This is probably not a good pun.

I was not going to be able to help as many breastfeeding mothers as I needed to. So I kind of really had to clone myself. And then eventually that just got bigger and bigger and bigger until I realized that I had to teach the people that were teaching the mothers on a broader level.

Interestingly enough, I have now taught 25% of the currently certified IBCLCs in the United States. And that does not count the ones who have lapsed or retired or sadly those who have died. So, you know, that’s a lot of people that I don’t really have to do things myself. I’m all about getting the job done.

And sometimes that means letting somebody else do it and enabling them to do that.

Heather: So what year was this that you transitioned into a clinical nurse specialist and were the people that you were initially teaching receptive to it?

Marie Biancuzzo:  No.

Heather: Okay. I want to hear about it.

Marie Biancuzzo: I wish I had a nickel for every time that I heard one of the staff say, oh, it’s Marie and one of her crazy ideas again. And now often I get a new lactation consultant who says they treat me like they even tell me, well, I’m just a lactation consultant or I’m just a nurse, or I’m just a fill in the blank. I said, well, I guess you’re in good company because to this day I hear, “you are just a nurse.”

I used to kind of take personal offense to that. Now I kind of don’t. I just, just goes over my head. I know that I can do my job better than all the people out there who have a more important credential than mine. So too bad.

Heather: Yeah, I had to I didn’t have to, but I volunteered to teach the labor and delivery nurses for the baby friendly initiative cause they were re-upping. And oh, my, we had to call in some reinforcements at some point because they were like, I don’t know why I even have to be here. And on one hand I have to say, I do understand that over the years they’ve just been throwing more and more and more stuff at nurses, more charting, more responsibility, more patients for just the nurses.

Yeah. For just the nurses. And so, you know, and then just one more thing, they have to be breastfeeding experts, which they don’t have to be breastfeeding experts, but you do need to know how to not do any harm as a provider. Yeah, I I’m with you on that one. And, and I, I definitely understand, and I appreciate you telling me that because I’m not quite at the point where it goes right over me, like washes over my back, working on it every day, though.

Marie Biancuzzo: Here’s the thing. At some point or another in my career, I have held multiple certifications, multiple licenses, advanced degrees, blah, blah, blah. So, you know, I kind of do know what I’m doing. Thank you very much. In terms of having some official recognition, but at the end of the day, people have no hesitation to tell me that I’m just a nurse. So you just got to get over it, Heather.

Heather: Okay. Okay. Marie, I’ll do whatever you say.

Marie Biancuzzo: Otherwise, you can set yourself nuts, right? You just reassure yourself that you do know what you’re doing, and I will go toe to toe with any physician, any day of the week over any issue, any research article, any, any, anything that you can name. I will go toe to toe won’t bother me a bit.

Heather: Oh, gosh, I want to be a fly on the wall. I’m almost there, like I’m at the point now where, when I do make an appearance at the hospital, people sorta know me. They’re like, I think that’s the breastfeeding girl. I’m not quite sure. And so I teach nursing students also. So I’m really big into getting the nursing students breastfeeding education at the beginning.

And I’m like, this might be it for you guys, by the way. Like this might be the only breastfeeding education you get. So listen up. The next time you care about this might be when you’ve got bleeding nipples and you’re trying to breastfeed your own baby. So this is important.

Marie Biancuzzo: Funny story then. Well, I was a clinical instructor at Georgetown University and I had my own group of students of course, on the clinical floor. Okay. Got it. And I’m, I’m all good with that. And I can do way more than breastfeeding. Thank you very much, but here’s the deal. Is that the students went to the course director and said, Hey, you know, Marie Biancuzzo’s students, her group, helped breastfeeding mothers and we don’t really know how to do that.

But breastfeeding is the biggest question that we always get. So could we have Marie come and talk to the, Heather I dunno what you called it in your day, but in my day we called it the theory part of the course. All right. And she said, oh no, no. Oh no, we don’t no. We don’t have time for that. No, no. So, interestingly enough, these students who were not in my group eventually came to me and said, is there something that you can do to persuade her?

And I said, well, I’ll talk to her. So I talked to her and I got exactly nowhere. But the students still kind of bugged me and I said, okay, look. You need to go to her and make a different case because I’m totally willing to do this, but maybe, you know, sometimes you just got to hound people. Okay. So they did.

And eventually the course director comes to me and she says, now, Marie, it does seem that the students are interested in this breastfeeding stuff, so I carved out a little time if you’d be willing, she says, do you think you could fill a 45-minute slot?

Maureen: Yes. You’re like, well, the question is, can I cut it down to 45 minutes?

Marie Biancuzzo: I remember I just stood there with my jaw, dropping to the floor, and thinking, what on earth am I going to do in 45 minutes to teach these kids everything they need to know for the rest of their career? Okay. That’s really what I was thinking. As nonchalant as I could, I managed to say. Yeah. Yeah. I’m sure, I’m sure I could do 45 minutes.

Went back to my desk and started jotting down what I thought would be like the don’t miss this ever kind of point. So Heather, this did not start today or tomorrow. All right. Or yesterday we’re talking a long time ago. It’s just, she, the woman truly could not understand that it was going to 45 minutes. Yeah. Yeah. I can. 45, 45 minutes. Yeah.

Maureen: So you, you have been an IBCLC for more than 25 years. And like we all in this room know that that means you faced a lot of challenges. So, you know, what was your biggest challenge when you first started versus like what what’s really challenging for you today?

Marie Biancuzzo: I think Heather probably hit it. Even when I wasn’t certified. Even when I didn’t have a lot of information, I always was able to help the individual mother, family, whatever. I, I can figure things out. I just have like this clinical sixth sense about me. I, I can do my job one-to-one. Unquestionably the biggest challenge was getting through to the doctors and the system and know it’s all about, well, no, we can’t do that.

Oh, why can’t we do that? Well, because this is the way we do it. Okay. I get that. Why, why well, because that’s the way we’ve always done it. And I’m thinking there’s no stupider reason that I can think of, but okay. We didn’t have in my young day such a thing as evidence-based practice, they didn’t call it that, but I can tell you that’s what I was doing.

I always had on my duty shoes, one foot in the clinical arena and one foot in the library. Oh, that was quite a little burper there.

Maureen: Well, yeah. That was more than a burp.

Heather: Welcome Lyra. Quick pause.

Maureen: Okay. I’m back.

Heather: Okay. The system.

Marie Biancuzzo: The system is the tough thing. It was at first for me, it was the hospital or the hospital in the area or whatever. And eventually in 1999, I became a founding member of the United States Breastfeeding Committee. And that was a, that was a whole that gave the whole idea of system level.

That was a whole new ball game. I realized though that this is not news to you, probably not to your listeners, but here’s the thing. We have a culture of bottle feeding here in the United States. And until that culture changes, we’re going to be swimming upstream with this breastfeeding stuff. I will tell you also that I have been in this game for more than 40 years, and I am seeing some stuff now and hearing some, some stories now that have not changed one iota in more than 40 years.

Like I can hear the story coming before the family tells me. I know where it’s going. In fact, I think I just did an interview with somebody just a few weeks ago. I don’t think it’s aired yet where I knew exactly what she was going to say because nothing has really, I mean, things have changed.

It has definitely gotten better. Okay. But the system is slowing us down. It is.

Maureen: Absolutely. I think Heather and I feel the same way. You know, we sit in on a consult and we’re like, oh, here’s the birth trauma. Oh, there’s the provider that said to supplement too soon. Oops. There’s the breast shield. Well, here we are.

Marie Biancuzzo: Yup. Yup. And I really don’t think that we are going to solve. This problem did not come overnight and it’s not going to go away overnight, but there are now many more loud voices. I’ve certainly been a loud voice, but I got a lot of work to do. Somebody asked me a while ago, Marie, are you going to retire?

I said, retire? Are you kidding me? I’ve got a lot of work to do here. I’m not done.

Heather: Oh my gosh. I feel that on every level. I, I hope though that in 40 years we’re not sitting here saying not much has changed, you know? And I just, you, you mentioned that you, you think our listeners might already know this, but I think they don’t because there’s a lot of people that are interested in becoming a lactation consultant.

Our breastfeeding support group on Facebook called Breastfeeding for Busy Moms is full of people. There’s like over 14,000 people in there now. And several of them are very interested in being lactation consultants. And they’re like, pie in the sky. They’re like unicorns and breastfeeding. And it’s the best thing in the world.

And I’m going to, I’m going to make a good money. I’m going to, you know, support my family. I’m going to do something I love and everyone will appreciate me. And I’m like, I love that. Let’s have a real conversation about this, because same thing with midwifery, nobody warned me before becoming a midwife what I was walking into.

 Nobody, nobody said, get ready for politics. Nobody said, get ready for pushback. Nobody said everyone will hate you, but the patients. And it’s very similar. And I think that it often feels, and I’m not trying to discourage anybody from being a lactation consultant, please do, but go in and keep that fire lit and know that you have a small rudder on a giant ship and you’re trying to turn it around and it’s going to take working together and it’s going to take a lot of people and a lot of passion.

I just don’t want anyone to be surprised by this crazy system we’re in. You know, it wasn’t that long ago we were feeding baby with Carnation instant milk and vitamin drops. You know, it was just a minute ago really in time.

Marie Biancuzzo: Well, I will tell you that about a year and a half ago. Well, maybe a little bit more. More like two years ago, maybe two and a half. I was doing a live course and I had a woman in the live course preparing to be an IBCLC, mind you. And she told me in front of the whole group that her hospital was still giving glucose water to babies. And I had to kind of pick myself up off the floor because I thought to myself, holy cow, I it’s so hard for me to under I was, I was fighting this, how many decades ago?

How can this still be happening? And of course, I really wanted to say, where on earth is your hospital? Let me go clunk them in the head.

Heather: Yeah, probably West Virginia.

Maureen: Maybe, maybe one of those neighboring states too.

Marie Biancuzzo: I just, it was just in comprehensible to me that somebody could be that far behind. And then I reminded myself that while I have seen slow progress, I have seen progress. There are some that still need a lot of some, everybody’s got more catching up to do, but some have to do more catching up than others. So, so when answer to your question, the system is the biggest issue. And quite honestly, I don’t feel that IBCLCs are in any way prepared to deal with the system. Even when you work in a small rural hospital.

And by the way, I’ve done that too. You’ve only got a small handful of people that you have to get it through their heads. It’s still really hard. And then by the time that you make it up to the United States Breastfeeding Committee, You’ve got people who are like-minded, that’s really great, but going home and actually making that happen, that’s another whole story.

Heather: Yeah. I, how do we fix that? Do we just, do we include that in the IBCLC education? You know, is it, it’s gotta be more than a continuing education?

Maureen: I mean, I feel like, you know what, when I talk to people who are interested in doing something in lactation, you know, often I’m like, so do you, do you feel like you’re an activist? Do you feel like that kind of work drives you and energizes you? Because if that sounds tiring to you, maybe let’s find a different way for you to help people?

Marie Biancuzzo: Yeah. Well, let me say this. I have been doing continuing education for a lot of years. And one of the things that I’ve noticed is that there are some people, and I don’t mean just IBCLCs. I mean, nurses, midwives, whoever else, there is some people who want to do what I call, check the box. They just want to get their credits and they want to be done. And that’s okay. I can offer that and they can pay me and we can both shake hands and walk away. That’s fine. However, that is not any incentive. There, there is no incentive that I can see for either the IB CLC or the nurses who are arguably the largest majority of the people that I serve.

There’s really no incentive for anything along the lines of leadership. If you look on the IBCLC’s detailed content, outline nowhere there will, you see leadership, but really that’s what you and I are talking about, ladies. That’s really what we’re talking about. We’re talking about changes at the system level and you can call that activist or whatever you want to call it.

That’s fine. I’m good with that. But the question is, how do we develop the skills and abilities to do that? So somebody says to me, well, we’re in hospital X and I don’t have a job description. So my boss wants to know what should be in the job description. What do you say? I said, well, the first thing that I would do is I would try to write my own job description, which by the way I have done.

So I would not let my boss do that. If she would let me do that. And secondly, the real question is what is needed in your hospital? And what I find is that people want to write a job description for themselves along the lines of, well hospital so-and-so, you know, across town has a lactation consultant and she’s my friend so I’ll just, just copy.

No, no, unless you are going to have the same doctors, the same patients, the same bosses, the same blah, blah, blah. It’s not going to your job description is not going to be the same. It’s really about what does your system need? And while I have always been primarily hospital-based, so I talk hospital, the truth of the matter is you could substitute the word clinic or private office or whatever.

You’ve got to be able to move the system forward. And that takes leadership skills. That takes skills in conflict management. That takes skills in group dynamics on and on, and on the list gets, and IBCLCs just don’t get that. So would I like to offer that as a course? Absolutely. As a matter of fact, spoiler alert, I’m really looking to do that.

Heather:  Can we help you?

Marie Biancuzzo: I got to tell you; I don’t know if anybody’s to want to pay me for it. All right.

Heather: I will. Oh my gosh. But it’s so stressful because a lot of us want to go to the pediatricians in the hospital, the newborn team, and be like, Hey, let me show you this new research, this analysis, this thing, and these results are so good. And we are not enjoying the pushback we’re getting, but then we don’t know what to do with it. And I think lactation draws in people that are naturally sweet, wonderful, kind, giving and forgiving and forgiving. And totally non-confrontational I would say is probably in there. And so it’s basically asking the impossible and I think over enough years, if you are a person like that, who’s been beat down and pushed back and your best practices have been stomped on repeatedly, you’re going to be like, give me, give me, it gave me the continuing education where you show me how to stand up for myself in a professional manner. I would totally take that class.

Marie Biancuzzo: Well you’ve just given me some courage then, Heather, because I, I really feel like, you know, we all have some set of skills that is like what we really do well. I was able to make some massive, massive changes and it’s not because I’m the best nurse on the planet or the best IBCLC on the planet. Not at all. I think it’s because I’ve innately had innately, intuitively had some, some persuasive skills. And that’s a big piece of it. I, I just bumped into it this morning where I wrote a blog post on power.

We all have it, but here’s the thing about power is that people will think you’ve got to be a manager or something in order to have power. And that’s just not true. If you go back to the old French and Raven model, which by the way, I think French and Raven were probably in the seventies or something, but that model always guides me.

I always have power and you’ll be happy to know that only once in my life for a very small amount of time, did I have what French and Raven would call legitimate power. That is, I was in an administrative position where I said do this because I’m the boss and I said so, but most of the time I’ve had informational power.

As a matter of fact, since you have invited me on this show, it’s because I have informational power, right?

Maureen: Yep. Exactly.

Marie Biancuzzo: As soon as you feel like you don’t have any power and by the way, I know that everybody uses this term empowerment these days. I kind of don’t use that. I think it’s a little overused, but I think we need to understand the kind of power that we carry and use that, not abuse it.

And oh, by the way, we’ve got to have phenomenal communication skills and we have got to have phenomenal passion and oh, by the way, I, at least once in my career almost got fired from the hospital, because guess what? I was a breastfeeding advocate and the real trouble was that I was so stinking far ahead of my time.

You’ve got to really be willing to like, go all out there and you got to do it all. You got to take it all. You got to put on your flap jacket and you got to go because it’s the truth. And because you really believe, I mean, you got to really believe that mothers have been doing this for thousands of years and we’re the ones screwing it up in the hospital and then have the WIC people say to me, well, yeah. And then we get those patients afterwards. Yeah.

Heather: Yeah. And they’re booked, they are chockablock full.

Maureen: Oh yeah. When I tried to use the WIC office for breastfeeding support five years ago, and you know, we’re in a really rural area, they were like, okay, well our IBCLC services four different WIC offices and she’s here Thursday.

I’m sorry, what? Okay. You know, like, yeah, they’re booked full. They don’t have as much staff as they need.

Heather: And that’s where we need leadership on the legislative level where it’s like, we need more money. We need a levy; we need something passed that’s going to give us more money to support our local people. I mean, I would say the resources are there, but sometimes they’re not beefed up enough.

And I think that they get ignored. And I am, can I, this is so inappropriate, but I am really glad that you almost got fired. It makes me feel so connected to you. There’s a reason I am not in charge of things at the hospital and that the educational sphere invited me in with open arms because in education they say, oh, you’re a weirdo and you want to do weird different things? Yeah. Go explore that. Tell us about it. Do some studies, bring your knowledge back here and disseminate it to the rest of us. The hospital is like, Ooh, new and different?

Maureen: They’re like, here’s, here’s the rules. Could you just follow them?

Heather: Yeah, here’s the policy. Also be quiet, but that’s just not me. So thank you for saying that.

Marie Biancuzzo:  You know, honestly, I don’t, I don’t really think that that’s changed much, but I think that when you get to the stage of the game where you are such a threat, that the higher ups, actually, it was the director of nurses that tells you how bad I was, threatened me pretty much.

I mean, she didn’t say you’re done today, but she gave me the real clear message that I was way out of line. But that’s, that’s when you really made an impact. And by the way, it was shortly thereafter that I went to see a former professor of mine. And I can remember this day as if it was yesterday. It was a beautiful autumn day and I knocked on her door and she said, oh, it’s so nice.

Let’s go sit on the porch. I said, okay. So we did. And I told all my whole story just came all tumbling out of my mouth. And she said, I said they call me a troublemaker. And I can see her yet. She smiled a big smile and she said, change agent Marie, change agent. And I think that was probably the day that I knew I wanted to become a clinical nurse specialist because that’s what clin specs do. They evoke change.

But as soon as she told me that I took my whole troublemaker persona and realized that that’s actually a pretty good thing, you know? So I would like to believe that I have been a respectful troublemaker. I’m not sure about that, but probably. I would like to believe that I’ve made some inroads, like to give you an idea.

I was trying to get skin to skin contact about 1985 or 1996 post, post-delivery, within the first hour of life. Okay. I would like to believe that I was all about the patients, not all about Marie or Marie’s agenda. Cause you know what? Marie’s agenda is like not really important. I’m, I’m pretty talented.

I could do a lot of things in this world, but I do this because it’s the right thing to do. And so I think that when we can go forth with that kind of momentum and that kind of passion and that kind of, by the way, you got to get some smarts along the way. I really didn’t know much about it, but I determined that I was going to learn.

And that’s why I lived in the library. It amazes me when somebody calls me the lactation goddess, and people think that I came to lactation fully grown.

Maureen: Well, and I imagine you’re still growing, you know, you, yeah.

Marie Biancuzzo: Yes. It’s one of the reasons why I write a blog because it forces me to learn something new. Okay. I mean, sometimes I write evergreen stuff. I do. I absolutely do. But I try to write about stuff that I have to think about, that other people ought to be thinking about.

And the fact of the matter is, you know, if all we’re, if all we’re going to do is positioning and latch, that doesn’t really say much for us. Right? We’ve really gotta be able to meet mothers where they’re at. And we’ve got to look at, first of all looking at other mammals, when you look at other mammals, it, it, the stuff that we do in the hospital is just so goofy.

It just makes no sense. And actually, when you asked me, I don’t know if you really asked me this or not, but I’ll address it. You know, what got me into this? It was when I realized that none of this junk we’re doing makes any sense, it just doesn’t make any sense to me. Right?

Maureen: Absolutely. I mean, I, I talk about other mammals all the time in practice and in the podcast. And sometimes the looks people give me the, you know, they’re like, there’s that crazy lady who has a farm and she’s talking about her sheep again, but it really like. I mean, you know, that’s that, that just, it, it’s such an, it’s such a resource that we have to learn from all around us all the time, while we can go watch it,

Marie Biancuzzo: What makes us thing that we’re different than other mammals? What makes us think that we are different than other large primates? And by the way, I did just do a post on this a bit ago about because people’s comeback is, well, a little puppies just get up there and they just nurse and they just do fine. Yeah. Well, let me tell ya. It’s because they didn’t have to get born at the hospital where we’ve got all this stuff, which is so unphysiological.

And has that changed? Yes. Has it changed enough? No. Will it change before I die? I certainly hope so.

Maureen: I mean, it, in, in even like, you know, if we do have to help, that doesn’t mean that we have to keep intervening. You know, like I raise animals, usually I just leave them alone. They do their thing. I had to pull a sheep out of its mom when it was being born a couple of weeks ago, but that’s what I did. I pulled it out and I stepped back and I was like, okay, let me watch. If they need help, I’ll step in.

Marie Biancuzzo: And let me tell you why. Because the word obstetrics comes from the Latin ob stet, which means to stand by. It does not mean to stand in the way.

Heather: To stand at the foot of the bed, ready to catch it or remove it operatively. Well, I’m, I’m guessing that you’re pro midwifery then.

Marie Biancuzzo: Yeah, actually I seriously considered becoming a midwife. Except at the time I was working straight nights and I thought, you know, it’s hard enough to work every night when you’re planning on it. I don’t think that I would like getting up in the middle of the night when I wasn’t planning on it. Somehow it just does not appeal to me.

Maureen: No, that’s really the, I think the biggest challenge for most people who have to work on call with midwifery is just the unpredictability of it for sure.

Heather: Yeah. But you know, to, to touch back on what you said just a minute ago, about all the different blogs that you write and continuing your growth and your lactation education, there are new crazy products every single day that are hitting the market and people will send me a picture of this wild nipple contraction. And are like, do you recommend this? And I, I don’t know. I don’t know what it is. There’s no research on it. I can tell you I’m very concerned about that little thing on the tip there. I don’t know what that is, you know? Well, yeah, does your nipple feel anything with that at all?

Maureen: And you know, it seems like the game hasn’t changed much for lactation professionals, right? We’re all still doing the same thing, fighting the same fights, but parents in the last. 20 30, 40 years. I mean, the resources available, good and bad, has both increased exponentially.

You know how, how and where we birth is changing, all of that. Like, this is a whole different game for parents. What, you know, what do you see now, as opposed to back when you started, that’s hurting parents the most with their internet and the social media and the apps they have in all the products being marketed?

Marie Biancuzzo:  First of all, it’s information overload. And secondly, even when I was a young nurse, even when I was not in the, the middle of the breastfeeding swirl, I always heard so-and-so told me this and so-and-so told me that. And so-and-so else told me the other thing that I don’t know what to believe. Well, guess what? That has now increased exponentially.

No, but the parents don’t know what to believe. And I’m in the same boat as I was a gazillion years ago, only worse off now. Because now they’ve got all of the online voices talking at them as well. So I guess what I would say is the information is everybody wants a quick fix. So we’ve got way too much information, and everybody is looking for that quick fix.

So any information that seems as though it’s going to give the quick fix, that’s what people glom on to. And here’s another thing. I think the real question is how do you help parents and how do you help professionals to get the right information? And I believe this one true. Whether we’re talking breastfeeding or whether we’re talking labor and delivery, or whether we’re talking, what stock to buy or what phone to buy or anything else.

I think the real question is how do you discern the real deal from the people who are just trying to make money? Hello, that’s why they’re sending you all these gizmos, right. Or they just want a quick fix. Right? So when people ask me, I say, okay, well, first of all, you really need to have a few go-to sources.

So for me, a big one would be the Academy of Breastfeed Medicine. If it’s on the Academy of Breastfeeding Medicine site, I’m in. I know right off the bat, that that is a believable place. Another one would be buy Dr. Lawrence’s book. Dr. Ruth Lawrence is now in her, I think it’s her eighth edition. She is a board-certified pediatrician, board certified toxicologist, board certified neonatologist.

And I don’t know if she still holds all those, but last I knew she did. She knows her stuff and she’s been in this breastfeeding thing longer than I have. As a matter of fact, I worked elbow to elbow with her for years, and I don’t know how somebody can get along without that book, because I mean, I can call her on the phone and I actually still do, but a lot of times I can just find that answer right in that book.

So that’s another piece. And I think that you’ve got to find authors that have been consistent in their ability to do high quality research that are always publishing. And another piece is somebody told me this gigs, Karen Haler, who at the time was the editor of JOGNN when I was on the editorial board. She said, you know, Marie, when you read a piece of research, no matter how well done it is, if it doesn’t square with your clinical experience, you got to ask yourself, is this really true?

Is, is, is this like just junk science? And I have no idea how long ago that Karen Haler told me that, but she was spot on. But I think that when you learn to, for instance, every single thing that Shearston Nyqvist publishes, I try to read cause she’s excellent. Anything that Jane Morton writes, I try to read because she’s excellent.

I’ve had a few guests on my podcasts that. They’re the ones that I’ve been reading their stuff for ages, you know, those are the kinds of people that you want to follow because they’re the real deal, but it takes you a long time to be able to know who the people with the real deal are. And who’s just out there to get their agenda fulfilled. Does that make sense?

Heather: Yeah. Yeah. Well, you know, this is maybe showing my hand a little bit too much here, but my husband and I talk about this all the time and if you are truly helping people in this women’s health lactation sphere, you’re probably not making big money. It is not set up for you to make big money.

And so, you know, God bless the people that have figured it out. I am still figuring it out. I in fact, pay for the privilege to help people at this point in my career and I’m happy to do it. You know, I think a big challenge for people and I refuse, you know, we had a big talk about this when we started the podcast about who we would allow to advertise.

And we have some very strict vetting rule, vetting processes, rules. We will not advertise for people that will damage breastfeeding relationships or exploit moms. Anything that has a promo code, that’s like an affiliate program where they’re exploiting moms who have abysmal parental leave, you know, where they’re breastfeeding and they don’t have, they have 60% of their paycheck.

So they’re like, I guess I’ll try to promote this crazy lactation cookie to make some extra money. I mean, that just, it makes me sad. It drives me crazy. So we try really hard to make sure that we never promote any products like that. And then on the flip side, because we’re not doing that, we don’t make any money.

Marie Biancuzzo: I get it.

Heather: And then like all my products that I offer are classes that are comprehensive and private consults that are a little bit expensive because they’re time consuming and I don’t leave you hanging. Like I will follow up with you via text for weeks if we have to. Months, if we have to. And so people that come looking for the quick fix, it ain’t here.

Like I don’t have that for you. And you know, I do this because I love it. And I hope to one day be able to, like, you know figure out how to do a podcast and a blog and read all of the interesting educational articles that my, you know, all the cool mentors have written. I’m still trying to figure that out. And it seems to me like you’re always on the cutting edge of everything to do with lactation. You started your podcast, Born to Breastfeed in 2014. That was long before podcasting became hip. Like we’re so basic. We came into the game, right when everybody else did in the pandemic. And so how are you doing that? How are you constantly staying ahead of the game? You’re constantly morphing to give people what they need in a format that they need it. How are you doing that?

Marie Biancuzzo: Heather, I hate to break it to ya, but it’s really simple. You just, I guess it’s a little bit like helping a woman to labor or helping a woman to breastfeed. You simply go where the need is. You simply watch and learn.

What is it that people need? And by the way, I’ve told this to other business owners. If you’re not solving a problem for somebody, you shouldn’t have a business. Cause that’s what you’re in business for. Okay? So I would say that by and large, the people that are half my age and want to learn about lactation, don’t want to sit down and read a book. Actually, Heather, I think you kind of just confessed to that earlier in this show.

All right. So people want to consume things in more user-friendly ways, I guess. Interestingly enough, I don’t listen to a lot of podcasts. I do listen to a few because I don’t really like to consume things just in my ear. I want to sit down and read things. I just do. But I realized that that is not the case for people that are your age, you know. When I said to you a few minutes ago, I was pushing for skin to skin contact in the first hour of life.

This was long before Baby Friendly. I’m talking the mid to late eighties for crying out loud. It’s because I could see that that’s what the baby I was just watching. Okay. I was seeing that, that baby was rooting all around and I, one time I remember thinking to myself, okay, I don’t know how to do this, but if this baby is rooting and this mother’s nipple, it actually started with a mother who was delivered totally naked, which was kind of unusual.

And yeah, I just, I asked myself what would happen if these two things like got hooked up?

I was just watching. Okay. The same thing with writing a book. That the book came out of my own need, really. I remember thinking to myself. I always feel like an idiot when I go into this patient’s room and I got to face something that I’ve never faced before, and I don’t really know what to do. I can probably figure it out.

But boy, I wish that I just had a book that I could like run out to the nurses’ station, read the page, get the answer and go back in the patient’s room and solve the problem. So that’s how the book came about. Not because I was some super-duper expert. Okay. My husband, bless his little heart. When the first edition was published, we were sitting at the stoplight one night talking about it as we were driving.

And he said, you know dear, when you started the book, I don’t think you were the expert, but in writing the book, you became the expert.

Maureen: You have a smart partner.

Marie Biancuzzo: I thought, wow, what a guy for an engineer, he really gets this, you know. But I think that that’s really the answer. Is that you go where the need is.

And I don’t really think that matters whether it’s a book or a podcast or a parent that needs some help with whatever, whatever. And quite honestly, a lot of the times you’ve got to wait into something that you don’t know how to do. I didn’t know how to do a podcast. I have no training in journalism.

Same thing with writing a book. I had no formal training in writing. I’ve always been kind of a strong writer, so that was good. I don’t know it all, but I’m a step ahead of the people that I help. You know what I mean?

Maureen: Yeah. And, and I mean, you know, we’re watching you continue to adapt to new needs and, you know, new, I mean, one of the newer things that providers are grappling with today is that the LGBTQ community is continuing to speak up and speak out about their needs, which is amazing.

And, you know, we’ve watched you adapt to that. You have a continuing education course called everyday clinical care for the LGBTQIA family. And we wanted to first thank you for that. It’s a very important to us that those resources are out there and that we promote them and provide them when possible. You know, we wanted to ask you, what’s your advice for care providers who want to work with the LGBTQIA community and support them and really be giving evidence-based informed care?

Marie Biancuzzo: I would say two things. One is stop thinking that you have to know it all or that you have to be it in order to give that care. I have never been a diabetic, but I can take care of diabetic clients. Okay. So try to understand that you don’t have to know it all. You don’t have to be it all. Again, you have to meet their needs.

And the second thing is just try to be respectful. Try to try to see what it is that they want or don’t want or need or don’t need, and then try to shut your mouth. If you don’t know what to say and be eager to say, I’m sorry, if you, and, and, and sometimes I even preface that, and I don’t know about LGBTQ so much as just any situation where I, where there is some sort of cultural difference.

Sometimes I just say, I don’t know if this would be fill in the blank, helpful, appropriate, respectful, whatever, but many parents want/ need blank. Would that be helpful for you? And tell me if I say anything or do anything that you find offensive. I think the people are very forgiving when you just say upfront, I don’t really, I don’t really know, but I’m trying to help. Right? I think there are just some basic rules of communication. It’s not all that, I guess maybe this is what I’m saying. It’s not all that mysterious.

Maureen:  I’m glad to hear you say that because I, you know, I’ve had this conversation with a lot of other midwives especially, you know, we live in West Virginia. It’s a little rural are, you know, our practices are a little bit behind sometimes. We’re working on it. And, and I think that’s the thing I hit home with people is like, Hey, actually, this shouldn’t be different from care you give other people, cause it should be individual for every client. You should ask every client, if what you’re doing makes them comfortable or uncomfortable, or if the language you’re using is appropriate.

Heather: And what their goals are. Yeah. Asking a patient what their breastfeeding goal is, is incredibly important because sometimes it’s not exclusive breastfeeding and you can really offend somebody and push them completely away from you if they feel like you’re forcing them into something. And I think that it just that, that guilty feeling that you get when you’re like, oh gosh, I didn’t serve that patient the way I needed to is amplified when you add the LGBTQIA on top of it. And because you didn’t prepare, like why didn’t I take the class? But I love that you, you are mentioning that it’s okay to invite criticism. I think, you know, like basic communication skills are starting to dwindle, I think because of the internet and social media at a time when LGBTQIA is coming out.

And I think that that pairing, it can be awkward sometimes. And I think that all of us going back to communication basics is really important and should be part of your leadership course that I’m going to encourage.

Maureen: And we’re going to also take when it’s available.

Marie Biancuzzo: So it really comes down to the same old thing, which is meet the patient where they are. Patient client. That’s another whole thing, by the way, call somebody in my day. It was always patient. I think client is useful, but I do sort of use them interchangeably. But the fact of the matter is, that most people just want your help.

It’s really that simple. And sometimes you just have to say, I don’t really know what that would be. And I think it’s always okay. None of us know it all, none of us know it all. The best that we can hope for is to try to be the best version of ourselves and then use our superpower to help somebody else.

And if we’re not helping somebody else, my question is then why are you a nurse, a lactation consultant, a midwife, a whatever you are, why are you in business? Why are you on the planet? It’s really that simple.

Heather: Marie Biancuzzo, thank you so much. This has been a true joy of my career. I feel like I’ve made it. I do. And I’m so thankful. I’ve learned much from you just today. Things that I’m going to look up, people I’m going to follow. Of course, we’ll put all of her suggestions in the show notes, but before we let you go, could you please tell our listeners where they can find you and what they should be looking for as far as your offering?

Marie Biancuzzo: A couple of things. You can find me at And even if you misspell it, you’ll probably find me, but here it is. It’s M a R I E B I a N C U Z Z I offer a comprehensive lactation course if you are thinking of becoming an IBCLC, we run that all year long online. People are asking me when the live one is going to resume and the answer is, I don’t know.

We already had to cancel one. I offer continuing education for both IBCLCs and nurses offer credit for yikes, like so many that I don’t even know how many credits we’ve got total, but a lot. We also sell those in bundles or we sell them individually. So for instance, if you wanted just the LGBTQ or you want just the essential oils or you want just the thing on how to pick out daycare for your kid or whatever, I have all of that.

Let’s see. I have a podcast. It’s called Born to Be Breastfed, but you can’t listen to that one if you means you can’t listen to this one. Okay. So.

Maureen: I think people can listen to both.

Heather: I think there’s more than enough room for everybody. Yeah.

Marie Biancuzzo: I guess the other thing is, yes, I’m going to be creating a goal planning course, and I know that sounds like so stinking boring, but it isn’t. And let me tell you why. Because for many years of my life, I just ended up reliving the last year and going nowhere. And one day I woke up and I realized that I needed to have goals. That was a life-changing event for me. So I’m going to be offering that. Also going to be doing some stuff on starting your own private practice, although that’s coming significantly later.

If you want information about this or anything else. You can go to MarieBiancuzzo. You can subscribe to my blog. You can be a Marie Biancuzzo inside. You can just send me a little love note at and tell me that you like my white hair or something. I don’t care. Okay. People say to me, how’d you get all that white hair? I say I earned every one of those white hairs at the hospital, believe me.

Heather: No doubt.

Marie Biancuzzo: Thank you so much for having me on the show today. I had a lot of fun.

Heather: Thank you so much. Everybody go check her out immediately. Thank you so much again, it’s been a pleasure.

Marie Biancuzzo: Likewise. Thank you so much.

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Maureen: All right, well, let’s hop over to our award. Yes. Who is that for today, Heather?

Heather:  We have a really good award today. Today’s a word goes to Ashley K. She private messaged me and said that she just listened to Episode 41. It highly resonated with me. I definitely shouldn’t have been listening to it in the car, but it brought old wounds for me today.

Thank you for bringing those to light and making me feel not so alone with my trauma.

Maureen: And in case you missed it, Episode 41 was our one about trauma and breastfeeding.

Heather: Right. And I kind of talk about my personal experience with my trauma and how that kind of translated into my breastfeeding experience. So if you feel like you’re ready, like Ashley was, to listen to that episode and start confronting your past trauma, we will link Episode 41 in the show notes. But we just wanted to shout out to her because her and I have similar coping mechanisms, we’re workaholics. So she says that she currently holds three jobs, one full-time, one part-time and her dog poop, scoop business.

And then she jokingly said, it’s my time to listen to The Milk Minute Podcast, when she’s scooping poop.

Maureen: We love that by the way, whether you’re scooping poop or you’re pooping while you listen. Yeah.

Heather: So what awards should we give Ashley today?

Maureen: The super scooper?

Heather: The super scooper. Ashley gets the super scooper award. She scoops poop and she scoops out that old trauma. And we couldn’t be more happy for you. Thank you so much for being brave to confront your old trauma and sharing and letting me share this with others. And I hope you inspire other people as well.

Maureen: All right, until next time everybody, we love you. You’re doing a great job and we’ll see you next week. Keep it up, keep it up.

Thanks for listening to The Milk Minute. If you haven’t already please like, subscribe, and review our podcast wherever you listen. If you’d like to support our podcast, you can find us on Patreon at to send us feedback, personal stories, or just to chat, you can send us an email at


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