1997 Annual Report
Joanna Koch
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Joanna Koch is a long way from the wheat and barley fields of Great Gransden, England. "I grew up in a little village near Cambridge," Koch says in a soft English accent. "It has been a circuitous path. I don't think anyone wakes up as a teenager and decides to be a lactation consultant." Yet that's precisely what she now does: As PAMF's first breastfeeding consultant, Koch works with parents of newborns to help breastfeeding go smoothly and provide perspective on the ups-and-downs of having a new baby.
Dispensing baby advice was not on Koch's mind when she left rural England at 20 for the United States. She did office work near Pittsburgh, Pa., before moving to California in 1976. "I told a college counselor I would like to go into health care. He asked, 'How much time do you have and how much money do you want to make?' " He urged her to pursue a better-paying career in business.
"It was a very short-sighted piece of advice," Koch says in hindsight. "But I was in my 20s and took it at face value." She earned a B.A. in marketing and an MBA from San Jose State University, and she was successful, eventually working as a product-line manager for ITT Qume Corporation in San Jose.
She did find time for romance and marriage, and in 1985 she and her husband, Bud, had their son, Michael. Her life changed. "I realized I couldn't return to the 60-hour-a-week corporate environment," Koch says. "I just couldn't go back."
At home, though, Koch had trouble breastfeeding, she recalls: "He was hungry and crying a lot. He couldn't sleep. I'd feed him and put him down and he'd start crying again. I call it the jack-in-the-box syndrome. He was huge, a 9-pounder. He was born at 43 weeks, and 43-weekers are notorious for being extremely hungry immediately. The main advice I got was to give him formula:" `It's OK, go ahead and wean him. I can still hear those voices: `Just give him" the bottle.'
"With my corporate MBA background, I started looking for answers: Where's the resource I can go to? Where's the person or book that's going to solve this for me? But, no, the Yellow Pages did not yet contain a listing for breastfeeding. And I discovered that all the books dealt in black and white, not shades of gray. I was definitely in shades of gray," she says, smiling.
Koch found help in a volunteer group, Nursing Mothers Counsel (as in "advice"). After a year she became a volunteer, eventually running the community-education group and giving talks. She soon decided to make it her new career, as a breastfeeding, or lactation, consultant. It is a new field, growing as rapidly as the newborns it helps nourish, and includes a challenging certification" process by the International Board of Lactation Consultant Examiners--which" Koch completed.
"My mother brought me up with the philosophy that we only get out of life what we put in, with a strong emphasis that not all rewards are monetary," Koch says of her career-change decision. "It was not easy for us financially, but I felt I was putting effort where it truly mattered." She also discovered that staying at home was much harder on me than working. Society values us according to our `job,' it often seems.... Having a first child at 36 has its disadvantages and, for me, difficulty in adjusting smoothly to full-time motherhood was one.
"I still take parenting classes. My first child will always be just that--my 'first.' I have found it took me a great deal more than common sense and deep love to support and guide my very different children," she says. Michael, now 12, recently earned his black belt in tae kwon do and his sister, Rebecca, 8, is on a local swim team. "She's always been a little fish. She just loves it," Koch says. Koch is involved in school activities, volunteering in classes and in the PTA. She and her family reside in Los Altos.
Koch was hired in 1995 by PAMF's Education Division to set up a "lactation program" as a support to physicians and patients, and as a service to the community. She works closely with pediatrician Jane Morton, who pioneered breastfeeding assistance at PAMF and who created a video on breastfeeding in 1994 that is still used. While based in PAMF's Pediatrics Department in Palo Alto, Koch works with any family. Most referrals are from within PAMF, but some come directly from the community. She is available for advice in person or by phone seven days a week.
When a baby is not feeding properly, it can be nightmarish. After sleepless nights and the exasperation of trying vainly to feed that wailing infant, parents often start to unravel as well. Koch, in a gentle, capable way, helps turn things around--often quickly. "People are very relieved to hear that it's OK that the baby is crying--and that you are crying. A lot of mothers are just exhausted. They are sometimes wondering why they had a baby, at that point. They're just so tired.
"I think the fact that breastfeeding is learned is one of the biggest surprises to most new parents. The baby and the mother have to learn how to do it together. Sometimes it's as though the baby went to a school of dance where" they taught the waltz while the mother is tango-ing. Sometimes all people need is help 'attaching' the baby. They need to know the baby is not being deliberately uncooperative but is being purely responsive to stimuli. So when I show parents the reflexes to stimulate to create a feeding response, it's simple. There's the baby, feeding rhythmically, steadily--blissed out--and the parents are delighted."
Yet more may be involved than breastfeeding. Not only do children cry for different reasons--"They're as individual as snowflakes," Koch points out--but parents' worries about feeding may indicate an "adjustment to parenthood" problem.
"A great deal of my work is assisting that adjustment, and that's really a fun part of it. Most new parents don't know what's normal for a newborn, so I help them understand 'normal.' I help them see who their baby is, its temperament, what the baby's cues mean. When they begin to understand their baby and their own concerns and feelings, then they begin to enjoy and have fun. That's my goal, and it's just such a privilege to be part of it. For me, that's a very real measure of success."