My Submission - Select Committee on Women’s Health
Select Committee on Women’s Health
PO Box 6100
Parliament House
Canberra ACT 2600
5 October 2026
Submission to the Select Committee on Women’s Health
Thank you for the opportunity to make a submission to the Select Committee on Women’s Health.
I am a private-practice International Board-Certified Lactation Consultant (IBCLC) working in the Newcastle, NSW area. I provide specialist lactation and infant-feeding support to mothers and babies throughout the postnatal period, most commonly from approximately four days of age through to 12 months and beyond.
The women who seek my care present with a broad range of breastfeeding and infant-feeding concerns. These include breastfeeding pain, difficulties understanding breastfeeding and infant feeding, concerns about milk supply, poor infant weight gain, tongue-tie, reflux, undersupply and oversupply, anatomical breast challenges including insufficient glandular tissue, previous breast surgery and inverted nipples.
Some of these issues can be resolved relatively quickly with appropriate education, practical support and reassurance. Others are complex and require weeks or months of individualised care, monitoring and multidisciplinary management.
In my clinical experience, there is a significant relationship between unresolved breastfeeding difficulties and maternal mental health. When women are experiencing ongoing pain, feel that they are not being heard, receive conflicting information from different health professionals or are struggling to feed a baby who is not breastfeeding effectively, the emotional burden can become overwhelming.
In the past 3 years alone, I have referred a significant number of women to their GPs and to the limited mental health services available for counselling, psychological support and medication management. I have also encountered women experiencing severe psychological distress. On two occasions, women disclosed suicidal ideation and I referred both women for urgent specialist support through the Mother and Baby Unit at Westmead Hospital. However, in one of these cases, the woman was discharged within 48 hours and advised to seek counselling within her local community.
Access to appropriate counselling and mental health services is also a significant concern. Women I have recommended for counselling, have frequently been placed on waiting lists of six weeks or longer. For a woman experiencing severe postnatal distress, this is an unacceptable period to wait for appropriate support.
IBCLCs are often among the first health professionals a woman sees following hospital discharge and before her routine six-week postnatal GP appointment. As a result, we are frequently in a position to identify emerging mental health concerns at an early stage.
The nature of IBCLC practice also places us in a unique position to understand the broader circumstances affecting a mother and baby and wider family unit. Consultations can involve several hours of discussion, assessment and observation. We have the opportunity to understand feeding difficulties, family circumstances, maternal wellbeing and the practical challenges affecting infant feeding.
This places IBCLC’s in a valuable position to identify women who may require additional mental health support and to facilitate appropriate referrals.
One of the most common comments I hear from women is: “Everyone who saw me told me something different.”
The inconsistent messages women receive about breastfeeding are deeply concerning.
Women can receive different advice from midwives, nurses, GPs, paediatricians, child and family health nurses and other health professionals. While different professionals have different areas of expertise, the absence of consistent, evidence-based breastfeeding and infant feeding information can leave women confused, anxious and lacking confidence in their ability to make decisions about feeding their babies.
There is a significant gap in specialist lactation education for many nurses and midwives, alongside an insufficient number of IBCLCs available within the hospital system.
Access to specialist lactation support should not depend upon whether a woman is a private or public patient, how long she remains in hospital or how persistently she advocates for herself.
Women who are discharged early may not receive specialist lactation support at all. Public patients can face significant barriers to accessing specialist services, while hospital lactation services may be under-resourced and unable to see every mother and baby dyad before discharge.
Every mother and baby should have access to appropriately qualified lactation support before leaving hospital.
I have also encountered situations where women have received advice from medical practitioners that has conflicted with specialist lactation assessment.
In one particularly concerning case, a mother with mastitis evolving to a breast abscess was initially unable to obtain an ultrasound after her GP questioned the need for one following my recommendation. The situation had the potential to deteriorate significantly and highlighted to me the risks that can arise when specialist lactation concerns are not appropriately recognised or when health professionals work in isolation rather than collaboratively with IBCLC’s.
I have also encountered women whose concerns regarding tongue-tie or infant reflux have been dismissed. Regardless of the individual diagnosis, dismissing a mother's concerns without appropriate assessment can create considerable distress and leave women unsure about whom they should trust.
The solution is not for one profession to replace another. Rather, women and babies require genuinely multidisciplinary care, where each profession recognises the scope and expertise of the others.
Recommendations:
I believe the following measures would significantly improve outcomes for women and babies:
Qualified IBCLCs should be available to all women, regardless of their socioeconomic status or whether they are receiving care through the public or private health system.
Every mother and baby dyad should have access to appropriately qualified lactation and infant feeding support prior to hospital discharge, particularly where feeding difficulties have been identified.
Comprehensive, evidence-based antenatal breastfeeding and infant feeding education should be routinely available to all women before birth. This education should provide realistic expectations about breastfeeding and infant feeding, normal newborn behaviour, feeding frequency, milk supply, common challenges and when and where to seek professional assistance from IBCLC’s.
Midwives, nurses, paediatricians and GPs should receive additional evidence-based lactation and infant feeding education, with clear pathways for referral to IBCLCs when specialist lactation assessment is required.
Health professionals should work collaboratively with IBCLCs, recognising the distinct expertise of specialist lactation professionals rather than attempting to manage complex lactation issues outside their scope of practice.
IBCLCs should be recognised as the specialist standard for lactation care, with urgent consideration given to Medicare rebates for all qualified IBCLCs. Subsidised access would reduce financial barriers and allow women to seek assistance earlier, rather than waiting until feeding difficulties have become entrenched.
Government-issued maternal and child health books should contain clear, consistent breastfeeding and infant feeding resources, including information about how to access appropriately qualified IBCLC’s and evidence-based breastfeeding education.
Public health campaigns should normalise breastfeeding and provide consistent, evidence-based information, helping to address misinformation and negative social attitudes surrounding breastfeeding.
The WHO International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions should be fully implemented and enforced in Australia. This would help protect women and families from inappropriate marketing practices by infant formula manufacturers, particularly during the vulnerable antenatal and postnatal periods.
Breastfeeding is not simply a matter of individual choice or determination. Successful infant feeding is influenced by education, timely access to skilled support, health-system practices, social expectations, maternal mental health and the quality and consistency of information provided to families.
Women should not have to experience significant pain, deteriorating mental health or feeding failure before they can access specialist support.
IBCLCs have a highly specialised role in supporting breastfeeding and infant feeding, identifying complications early and working alongside other health professionals to support the health and wellbeing of mothers and babies.
I strongly encourage the Committee to consider the integration of qualified IBCLCs into maternity and primary healthcare pathways, improved access to specialist lactation care, comprehensive antenatal education, greater lactation education for other health professionals and stronger protections for women and families from inappropriate infant-formula marketing.
Improving access to skilled lactation support is not simply about increasing breastfeeding rates. It is about supporting women to make informed choices, reducing preventable distress, improving maternal and infant health outcomes and ensuring that women are not left to navigate complex feeding challenges alone.
Kind regards,
Peta Arthurson
IBCLC - Beaches Baby Pty Ltd