One RN shares her 40 years of experience, advice, and tips on all things breastmilk

As part of our Breastfeeding Awareness Month Series, we decided to go back to the hospital for some advice! We are featuring Pauline Kopsa RNC, BSN, RLC, IBCLC–an RN for the past 40 years and lactation consultant for the past 20 years–from a community hospital in Colorado. Not only does she a give a great reminder that you are not alone on this journey, but she also works at a hospital that functions as a breastmilk donation depot. Read on no matter where you are on your motherhood journey. We are sure you’ll learn something new!

How have you seen nursing and the acceptance of it evolve over the years? Formula feeding was the norm back in the 1950’s, especially in white middle and upper classes. Formula companies touted that they could produce a product superior to a mother’s own breast milk. It was almost a stigma to breastfeed.  

Since the 1970s there has been a steady increase in breastfeeding rates. This is in part due to campaigns by international organizations and governments to encourage women to breastfeed, as it has many benefits for both the baby and the mother. Recognizing the health benefits of breastfeeding, the Patient Protection and the Affordable Care Acts were developed.

“Effective March 23, 2010, federal law requires employers to provide break time and a place for most hourly wage-earning and some salaried employees (nonexempt workers) to express breast milk at work. The law states that employers must provide a “reasonable” amount of time and that they must provide a private space other than a bathroom.” More than half of the 50 states have specific workplace breastfeeding law. See “The United States Breastfeeding Committee (USBC)” for further information about specific state breastfeeding regulations.

The Affordable Care Act makes breastfeeding more accessible and affordable. This law requires that all new health care plans cover breastfeeding support, including lactation counseling, and supplies. All 50 states have some form of protection for public breastfeeding; that is, to protect a woman’s right to feed her child anywhere that she and her baby have a legal right to be. In short, if you’re allowed to be there, you’re allowed to breastfeed.

The science of Lactation has come a long way over the past 20-30 years.  The benefits of breastmilk and the act of breastfeeding have been scientifically proven over and over again.

The field of Lactation and the emergence of lactation counselors, provide education and assistance to mothers based on research and evidence, rather than what worked for “Aunty so and so.”

What is the biggest misconception you’ve seen in your years as a nurse when it comes to breastfeeding? Most women believe that because it’s instinctive to breastfeed it must be easy. Even though babies are born with the instinct to nurse and suckle, it doesn’t mean a mother has the knowledge of how to breastfeed. Every mom/baby is different, and the effort involved can be substantial, but so worth it!

What are your 3 tips for mentally preparing a mom to nurse?

  1. Stay flexible, be patient with yourself
  2. Make sure your spouse/support person is on board with your decision to breastfeed
  3. It’s OK to ask for help

What are some untapped resources new-moms can go to help get local 1:1 advice on nursing? The place you delivered your baby will have information and resources available to you. Also, local community resources, whether it’s a breastfeeding peer support group or home health agency. Additional, online sites might seem overwhelming during this time. Some of my favorite ones include:,  La Leche League and CDC.

If you could share a message with a new-mom who might be struggling with nursing, what would you say to her? First, ask for help from a lactation specialist. Remember any amount breastmilk is better than no breastmilk at all.  Finally, be flexible and do what works for you. Breastfeeding and giving your baby breastmilk is one of the best things a mom can do for her baby. From experience I also know that breastfeeding can be a struggle for some moms. But, stick with it for as long as you can, and be proud of whatever amount of breastmilk you can give to your baby.

What is your professional experience with milk bank donation? In 2013, the facility I work at became a breastmilk depot. That is, a place where moms who have been cleared to donate can drop off their milk. It is then forwarded onto the Mother’s Milk bank.

Infants at our facility often receive donor human milk for a variety of reasons, including but not limited to preterm infants, and medical reasons for supplementation.

As a medical professional, what are the negatives? Other than the cost of donor human milk ($4 to $5 per ounce), which is not charged to the infant if hospitalized, I don’t know of any negatives to using donor milk.

And the positives? When a baby needs supplementation and his/her own mother’ s milk is not available for whatever reason, it’s nice to have another option other than formula.

How can a woman identify if she is a good candidate to donate to an authorized milk and location? Go online to Human Milk Banking Association of North America to locate a milk bank closest to you.

How can a family who is a recipient of milk donation identify that it is safe and coming from a reputable place? All mothers who donate their milk have been screened and undergo a detailed medical and lactation history to ensure that she meets the donor requirements established by Mothers’ Milk Bank (MMB) and Human Milk Banking Association of North America (HMBANA). They must be non-smokers and take no medications. All donors are blood tested for certain illnesses. All banked milk is pasteurized to eliminate any bacteria or other organisms that may be present in the milk. It is screened and processed in accordance with current international milk banking standards and recommendations by the FDA and Centers for Disease Control.

Don’t be afraid of donor milk if your baby needs supplementation for whatever reason. The evidence is constantly proving the benefits of breastmilk. Mom’s own breastmilk will always be the optimal nutrition for her baby and then secondly donor human milk.

Image by Heather Gallagher

Post Author
Alexandra Repetto
I'm Alexandra: a mother, wife, native Washingtonian turned New Yorker, raised Puerto Rican, beauty marketer by trade. I write those in no particular order, because they are all equally important and make up our family's every day. While juggling motherhood and working full time, I love connecting with other parents who have the same thoughts, struggles, questions and concerns! As I've learned, it takes a village to make this whole eco-system moving and I'm proud to be another parent on this journey with each of you.