Breastfeeding as relationship

The place of breastfeeding in the practice of Australian midwives has not always been a straightforward one. Over the last 50 years broader social patterns of change have seen Australia arrive at a point where almost all Australian women initiate breastfeeding. Exclusive breastfeeding rates, however, decline rapidly from the first few days after birth until reaching a nadir of just 15% at around six months. International Board Certified Lactation Consultants have been in Australia since certification began in 1985 and in 2019 there are just over 2000, most of whom have midwifery backgrounds. In conducting an ethnographic study of Lactation Consultant practice I found many connections between their culture of practice and that of woman-centred midwifery philosophy. Relationships were found to be central to their approach to breastfeeding support and were valued highly as a part of their work. Lactation Consultants place the mother-baby dyad at the centre of their care and this relationship was seen to direct their care generally. Lactation Consultants and midwives in Australian often work in parallel with each other. The care models that LC's practice in tend to frame their work as reactive: they are often called on to “fix” problems that have arisen for breastfeeding mothers in their earlier experiences of care. Can the insights gained from this observation of Lactation Consultant care for breastfeeding women offer something helpful to midwifery care for the breastfeeding dyad? This paper will suggest some ways that this might occur.