This article was published by the Centre Daily Times on May 4, 2013.  

Karen Foard regularly seats her houseguests on “the throne.”

It looks like an ordinary wingback chair in her Ferguson Township living room, but it’s where she works her magic. For 25 years as a board-certified lactation consultant, Foard, 56, has helped thousands of mothers and babies plopped in the chair nurse properly, in the process becoming a local guru for new families.

The work energizes Foard, a mother of four grown children and an elementary school instructional support teacher, so much, she collects breastfeeding stamps from around the world. But her main passion is still the real thing.

What have 25 years of helping mothers meant to you?

I don’t know who I would be if I hadn’t been doing this these last 25 years, because it’s so much a part of me ... To me, it’s a ministry. To become a part of a brand-new family’s starting-off-into-a-whole-new-life phase, for that mom and that dad, let alone the baby, to be a part of that is incredibly special. It’s quite an honor to be invited to be a part of that.

The other thing that’s way cool is that I am now, having done this long enough, just in the last couple of years in particular, I am doing babies of my babies. A new mom is one of my babies. So the grandma is my peer. She was of my child-rearing age, doing all that 25 years ago ... Now I get to see those women in the role of grandma, and help her little one, and know that grandmother has as much of a value about it as I do, because she now brought her grandbaby to me.

How does coming full circle like that make you feel?

Knowing that somebody trusts you that much, or that they have such a positive memory of what I was able to do with them when they had their little ones, there’s no dollar amount associated with that. There’s nothing you can say that takes the place of that. It’s connections. And I would extrapolate from that, it’s a connection to my community then. I’m a part of a lot of households over the years in this community. And I feel like, wow, what a nice sense of belonging.

Did that sense keep you consulting?

When we moved here, a lot of the La Leche League [a nonprofit organiation that promotes breastfeeding] leaders were outgrowing it. That was a part of their life. There have been peers of mine, who have been lactation consultants, over these last five, 10 years, they have decided to not renew their certifications. They have moved into other fields.

I probably could have done that, as I started to look at: What do I want to be when I grow up? When my kids were all in middle school and above, and all that. But I didn’t, even for one minute, think I needed to stop, that I wanted to stop. This is a lifer for me. I wasn’t done. ... I consider myself a lifelong learner. I’m getting my master’s now in education. I’m always interested in learning new things. Well, the field of lactation is just prime for learning new things. Science over and over again is developing, or finding out, what is in breast milk, how does breast milk interact with a human body. ... Breast milk is an amazing substance for healing, even in adults. Breastfeeding, and the action of getting breast milk into a baby, is not just to help them grow from birth to age 1. It’s doing things to a little body, and even to adult bodies, that are potentially preventing or reducing the risk for breast cancer, ovarian cancer, diabetes. ... It’s a huge auto-immune system maturer. [There’s] interesting research on breast milk in a petri dish with cancer cells, and it kills the cells. We’re on the cutting-edge cusp of wondering what else breast milk can do. ... It’s an ongoing scientific field, so for me, it’s great to be able to keep learning, and that keeps my brain going, too. There’s some selfishness in that. I like learning about it. It’s really cool.

What kind of help do you give?

Basically, I am on a referral basis, and it can be self-referral, it can be a doctor referral, it can be a hospital referral, it can a [Women, Infants and Children] referral or a home nursing agency referral, all of the people out there in that mother-baby, maternal-child field. I’d say the majority of them know who I am, and if there are any breastfeeding issues, they know that they can call.

More often than not, it’ll start off with a phone call. Somebody will call and they’ll have a specific question. Sometimes I just answer it on the phone. It’s a quick, little, bitty question that I can just answer, and that’s all they need.

Other times that I’m listening to a mom talking about poor weight gain in the baby, excessively sore nipples, unrelieved engorgement of her breasts, all of those things together, meaning there’s no milk transfer, then we would do a feed together so that I can watch and see. Positioning solves probably 85 percent of the issues. It’s amazing. It’s just like playing pool: If you’re not on on the angle, you’re not going to go into the pocket. ... It’s amazing how many times all I do is say, ‘Lift here, or rotate the baby, or try this,’ and all of a sudden, she’s pain-free. Sometimes that’s all it takes.

... I do get a lot of trainwrecks. I get a lot of babies who get to their 2-week check-up and haven’t gained weight. So that means those breasts have had two weeks of not making enough milk, and that’s how we wean. We tell the breasts we don’t need what they’re making. So we’ve got an artificial weaning. The baby is compromised; the milk supply has been compromised. Those are the ones I may be in contact with a mom two or three times a week, either by e-mail or phone calls. She may come back for another visit to see if we can figure out what’s going on, what’s causing it.

Is it something from inside of her, meaning something didn’t develop properly during the pregnancy to get ready for the baby? Or were there procedures done to her, with her, for her, whatever, that interfered with the transfer of milk? Or, is it a baby issue, and the baby can’t suck, or the baby won’t suck? There are physical reasons for that. There are birth reasons for that. And sometimes, it’s a matter of buying the baby a little time to figure things out, and in the meantime, preserving the milk supply. There’s a lactation consultant in Ohio, and she has two rules, and it boils down to this: Feed the baby. Preserve the milk supply. So if a baby is having difficulties, we need to get this baby fed, and, yes, sometimes that means using the other stuff. Sometimes that means using some formula.

Once we know that the baby is not at risk any more, then at that same time we’re also preserving the milk supply, getting the mom pumping, getting her doing things either frequently enough or well enough. If the baby didn’t do the job, the pump has to. The pump is her best friend at that point. So those are the moms I might have an ongoing relationship with for a couple of months until things really settle down.

Honestly, a lot of those don’t turn intoeverything is exclusively, 100 percent breastfeeding at the end of that time. If I was queen of the forest, I would say that it should be an automatic that everybody who has contact with that mother and baby in the first week or two should be able to do exactly what I do. I’ve always said my goal is to work myself out of a job, that everybody knows what to do. And then it doesn’t take a specialist to do it. Because it’s normal. It’s natural. It’s human.

Have you seen attitudes toward breastfeeding change?

Oh yeah. When I started doing this, when I first had mine in the early ’80s, it was the natural childbirth movement, the late ’70s into the early ’80s. We had babies being born to unmedicated moms. A lot more pushing on the breastfeeding. At first, it was, ‘Oh, those women who’ll just nurse their babies till they go to college. No white sugar passes their lips.’ It was like that hippie movement kind of thing.

Then it became more mainstream, and the development of the lactation consultant profession was basically a response to: Women want to [breastfeed] but they have some difficulties with it, more and above what perhaps a mom who was La Leche League leader signed up to help with. Because those usually were mostly just meetings, sitting around chatting, and some phone work. So a lot of lactation consultants in the ’80s came from that mother-to-mother support groups, the La Leche League groups. Others were maternal child nurses. And so we had the meshing of the medical world and the mother-to-mother support group world. So my motto for my practice is: Combining the art and science of breastfeeding. Because it’s an art. Mothering is an art. Breastfeeding is an art. But there is science involved, that we can really make a difference if we pay attention to the science, too.

How have you changed?

I would personally have to say I haven’t. ... I’m a board-certified lactation consultant in private practice. My practice is my ministry. And to this day, much to the chagrin of many, many other lactation consultants, I don’t charge. People want, and I applaud it, they want to make this their living. They want to say, ‘My job is being a lactation consultant. And when I see a mom and a baby, it’s going to cost a couple hundred dollars.” ... Interestingly, the Affordable Care Act is supposed to start covering lactation services. But they’re doing it in different ways, depending on each insurance company.

... Because I have been doing this for 25 years, I have no interest in trying to play the insurance game. And I also have felt very strongly over the years, and this is probably because of my background in the mother-to-mother part, I shouldn’t say to a mom, ‘It’s going to cost you this much, and for you to walk in the door, you will have to pay me that.’ Because I also know my area. That could preclude many women from saying, ‘I want to use my disposable income.’ ... It hasn’t been important to me because I have been fortunate enough to have a spouse with a full-time job. Now I have a job. But even 10 years ago, I didn’t want to charge. I didn’t want to quantify my services.

But I will say that, more often than not, most people will say, they now will ask, ‘What do I owe you?’ And my response is generally: ‘Well, I don’t charge for you to do this, but many people do. Pay something.’ ... More often than not, they’ll slip a twenty, a forty, whatever. It feels more like a gift or a donation.

There’s still enough couples, though, they don’t [pay], and I’m glad they’re there getting information, rather than thinking they had to decide whether or not they wanted to pay me. ... It’s more important for [babies] to get breastfed than for me to get paid. That’s probably the bottom line.