Interview with Robert Monteverde: Pittsburgh’s Male IBCLC

This post is part of a series featuring men who support breastfeeding in Allegheny County. Bob, our first interviewee, is an IBCLC at West Penn Hospital’s Lactation Center. He is the only male nurse lactation consultant in Pittsburgh and believes he is one of only two males in this field in the state.

KRL: So how does a man like you begin work as a lactation consultant?

RM:  In 1987, I was working as a nurse in the newborn nursery on the Air Force base in Anchorage, Alaska. The pediatricians there decided to implement a program to start all newborns on breastfeeding and put me in charge of the taskforce. I began reading articles, working with the midwives…I didn’t know much! At first I was hesitant to touch the mothers because I’m a guy. But the midwives assured me this is a very hands-on job. They taught me “this isn’t nipple feeding. It’s breastfeeding.”

Since our hospital didn’t have private rooms, we got the idea to pair new mothers in rooms with experienced mothers so they could teach each other a little bit.photo of Robert Monteverde

KRL: At what point did you actually sit the exam to become an IBCLC?

RM: As I went along, I got more and more experienced. I left the Air Force in 1989 and returned to Pittsburgh, working as a transport nurse taking care of sick babies at West Penn Hospital. Word got out that I knew a lot about breastfeeding, and moms were having issues.  I started being asked to step in and help moms more and more.  Doctors noticed this and sent me to take a course at Georgetown to obtain certification as an IBCLC.

It’s my belief that all nurses working in the NICU or with newborns should have these skills!

We should be able to get 85-90 per cent of babies to their mothers’ breast without issue.

But back in the 90s, only about half the nurses I worked with had these skills or wished to deal with the breastfeeding mothers.

I didn’t actually sit the exam until 2001. Having the title and certification didn’t change my skill set, though.

KRL: What do you think makes you a good IBCLC?

RM: One thing I do is make sure to be calm. You can’t intimidate new mothers. If they feel threatened, they aren’t going to want to do it. It’s a personality thing. I make moms laugh; I make jokes.

When I did finally sit the exam, it was because I was helping mothers so much on the floor that my director wanted me to switch over from being a nurse with lactation experience to being certified as an IBCLC.

By the time mothers leave the hospital here, they’ve met with our team at least twice, if not three times. We have three other very experienced IBCLCs and staff to support new mothers.

KRL: Are you excited about the new milk bank being developed locally?

RM: Yes indeed. New moms of preemies, extremely low birth weight babies, are under a tremendous amount of stress, which affects milk supply. Many of them can’t even get a drop of colostrum for the first few days. Moms feel like they don’t have a lot of control at this stage because the NICU team is making pretty much all the decisions about the babies’ care. I notice a lot of moms with sick, fragile babies tend to blame themselves.

I enthusiastically support mothers in the NICU because this is their connection to the baby. I tell them [pumping] is what they can do for their baby, to provide nutrition that’s unique to their baby. Genetically, biochemically, nutritionally, spiritually, breastmilk gives a better connection to their baby.

KRL: Why do you think there is so much misinformation about breastfeeding circulating among pediatricians?

RM: I have a few theories. Before the 1920s, there was very little cow’s milk available because it was rationed during the War years. So everyone breastfed. After that, we saw the development of formula, which doctors could use to measure quantitatively what babies were eating. It was very scientific.

By the 1950s, science and sexualization were the buzz words. Breastfeeding was viewed as exotic or erotic. Formula (although 60 years old) was the science of nutrition and scientists and physicians were trusted. Around this same time, Playboy magazine began publication and breasts were available at the newsstand. I think that’s when things started to change rapidly.

It became a status symbol to use formula and breastfeeding was something considered to be for low-income families. All of this contributed, I believe, to a lack of knowledge for health professionals. When I graduated from nursing school at Carlow in 1981, I was the first male graduate of the nursing program and we sure didn’t discuss breastfeeding much there.

KRL: Do you see things starting to shift back toward breastfeeding as a biological norm?

RM: Well, if you were training to be a physician in Pittsburgh in the ’90s and you went to Mercy Hospital, you had to sit the IBCLC exam to graduate. So all those pediatricians are IBCLCs and tend to give much better advice to mothers and parents.

More and more doctors are interested in breastfeeding today. The AAP, WHO, and ACOG support breastfeeding. In PA, we have something called the Breastfeeding Education Support and Training (BEST) Program, where lactation consultants and physicians who are IBCLCs visit pediatrician offices for in-service training.

This program helps to combat the inconsistency in pediatric advice to mothers. We discuss the benefits of breastfeeding and how to get more moms to succeed, how to support them. Something I’ve been excited to see is many pediatrics offices hiring lactation consultants to meet with new mothers and discuss breastfeeding issues.

Unfortunately, as long as there is money on the table from the formula companies, we’re always going to have problems. I sometimes see pediatricians giving sponsored talks about new formula products at conferences…you can gussy it up all you want but it’s still not breastmilk! I wish I could say there was a simple answer.

KRL: What’s the biggest thing you’d like to see change locally?

RM: What I would really like to see here in Allegheny County would be home health visits, especially up until the 10-day mark. Breastfeeding, particularly in the first few weeks, is a confidence game. Even in the hospital with support from our lactation team, mothers are exhausted and frustrated–taking in all sorts of information–instead of relaxed. Then they get home and the baby is crying, Mom is crying, and Dad is hearing a lot of advice to just give the baby a bottle. Then, baby appears to be happy and we all know how that is a downward spiral.

That’s when moms need the most support! 95% of my moms are having trouble with getting a good latch in the beginning, so going into homes to make assessments could make a huge impact.

Have you had the good fortune to work with Bob? Leave us a comment to share your experiences!

4 comments to Interview with Robert Monteverde: Pittsburgh’s Male IBCLC

  • Tara Garczewski

    I went to Bob’s breastfeeding classes before my daughter Victoria was born. My husband and I were the first to enter the classroom on that day, and were surprised to see a man. I completed the class with Bob and the attitude that I’m going to breastfeed! After delivering Victoria, Bob came to see me and I was so happy to see him! I also was a proud new mother when he told me that I was doing wonderfully!! She is 8 months old and has only had breastmilk, and I will continue my journey till she is one!! Thank you soooo much Bob!!!

  • Judi Matelan

    Bob…..we graduated from Carlow College in 1981! My maiden name was Chicko….so happy to see that you are blazing trails among our noble profession! Great article! Congrats… Judi

  • Wendy Eson

    I worked at West Penn Hospital from 2007-2012 where I taught childbirth education classes. Over the years I got to know Bob and he became one of my mentors as I prepared to sit for the IBCLE exam in July 2011. Along with the other wonderful LCs that work at West Penn, Bob’s guidance and support were invaluable. I’m happy to say that I’m an IBCLC today thanks to Sandy, Julie, Lill and Bob!

  • Mark Olson, RN

    I had the privilege of being “oriented” as a new nurse to the NICU at West Penn Hospital in 1994 by Bob. His knowledge and approach has made a profound effect on me and many others and I am very grateful for his time and friendship.

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