It's a subject that Shannon Thomson talks about with a passion and although she retired from her position as a midwife and child and family nurse late last year, happily for the mothers and babies in the Bega Valley, she continues to share her vast knowledge.
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Ms Thomson refers to herself as "the girl from the bush" but in fact has influenced and connected internationally bringing practises to the Bega Valley to help mothers and their babies.
Ms Thomson has spent 46 years in nursing, of which 14 years were spent as the Community Health child and family nurse based at Pambula. During that time she completed her Bachelor of Health Science in Nursing by distance education.
From her training as an RN at Wagga Wagga Hospital in 1972, she went on to do a post graduate course in paediatrics at Princess Margaret Hospital, Perth, returned to Wagga Wagga Hospital's paediatric ward before working at Pambula Hospital, studying midwifery and then taking up a position as the child and family nurse at Pambula Community Health.
She started in Pambula Hospital in 1986 working in theatre and then in A&E.
"It was a very acute hospital; you did everything. I hadn't worked in A&E before and they sent me away to do an A&E course. In smaller hospitals you had to do a lot more. We were the eyes, ears and hands of the doctors in A&E and did first line treatment," Ms Thomson said.
"It was so fulfilling. You would do an assessment, ring the doctor and present a picture. I worked there for about 10 years and it was absolutely wonderful."
For the first six deliveries an experienced midwife put her hands over yours to guide the baby out, it was literally hands on.
- Shannon Thomson
Then in 1996 Ms Thomson went to Dubbo to do a Graduate Certificate in Midwifery which was linked with Charles Sturt University in Wagga Wagga.
"It was the best thing I could have done. They didn't have any medical students and so the student midwives had all the deliveries we wanted. There were 680 births a year in the hospital and it was very much hands on," Ms Thomson said.
"I loved it so much, with a passion. I had gone from being a senior nurse to a mature age student but it was very liberating in a way. You were treated with respect and there to learn.
"For the first six deliveries an experienced midwife put her hands over yours to guide the baby out, it was literally hands on. It was lovely to have that protection and security."
Students were expected to make a certain number of deliveries including high-risk deliveries. Ms Thomson's passion for her work translated into academic success and she received both the academic and practical award that year at the hospital.
"Delivering babies and looking after mothers is an honour, just lovely," she said.
When she returned to Pambula Ms Thomson moved into Community Health and applied for the position of child and family nurse.
"It's the best job in the world looking after new mothers, and babies until age five."
Her focus turned to breast feeding and in 2007 she sat and passed the International Lactation Consultants exam which opened up a new world of international experience.
At her first conference in Orlando,Florida, Ms Thomson was lucky enough to be chosen to give a presentation and chose a poster presentation on the koala breast feeding position, which had been taught in Dubbo.
I was just this girl from the bush. It was a pretty amazing thing to happen and showed me anything was possible.
- Shannon Thomson
It was a great advertisement for the following year's conference which was to be held in Melbourne and with a title of the 'Koala Hold from Down Under' gave a flavour of the Australian approach and expertise.
Rather than breast feeding the baby in a prone position, the baby is positioned on the mother's thigh and is more upright. It's a good position for babies who suffer reflux, have a cold and keeps the baby's head in a neutral position.
After the presentation she found she was sharing information with a large group of interested participants "eight people wide, three people deep for over two hours".
The presentation and the attention it attracted impressed the editor in chief of the Journal of Human Lactation and Ms Thomson ended up having a peer reviewed paper published in the international journal.
"I was just this girl from the bush. It was a pretty amazing thing to happen and showed me anything was possible. You shouldn't every think the world can't be your oyster," she said.
The entire poster presentation is now on display in the maternity ward at South Eastern Regional Hospital, Bega.
It was during her time with Community Health that Ms Thomson realised a need for serious consideration of a condition known as tongue tie where babies cannot move their tongue freely because the amount of skin linking the tongue to the lower part of the mouth. It can also affect the lip and its connection to the upper section of the mouth.
In both cases it can affect breast feeding with detrimental results for both mother and baby. It can also have long term effects on a range of dental conditions, as well as jaw development, speech and even migraines. Untreated, it can result in early and unnecessary weaning.
Ms Thomson said it is a very common condition but it wasn't until she visited Melbourne's Royal Women's Hospital on a study tour that she realised how simply the issue could be solved.
"I noticed them performing the snip or frenotomy on the piece of skin that was causing the problem. I came back and thought we needed to do this in the Bega Valley," Ms Thomson said.
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"The nearest place to have a frenotomy was Canberra which meant a hungry and crying baby had to travel over Brown Mountain with a tired mother for a consultation and then return at a later date for the procedure. I quickly realised that we needed to do something in the Bega Valley," she said.
Ms Thomson arranged for some experts from Canberra, Dr David Todd and lactation consultant Monica Hogan to conduct in-services to local health staff on the management of tongue tie and Dr Rob Morton was educated in the procedure.
"It was about finding someone who could do it in a timely manner," she said.
"Some tongue ties are border line. Staff would follow the local pathways for management of tongue and lip tie then arrange for a further assessment and if appropriate, intervention in either the doctor's rooms or at SERH. We prioritise these babies because the longer you left the condition, the longer it would take for the tongue function to return to normal.
"There are three doctors doing the procedure now. We started with between three and 10 babies a year and now are doing about 45 a year.
It's taken me all my life to get to this level and this is why I am going back and teaching. It would be a shame to have got to this point and not give back.
- Shannon Thomson
"We're getting better at picking this condition up and intervening earlier, although we do not snip all cases, tongue function is paramount. It's been a really lovely journey and just evolved out of need," Ms Thomson said.
In 2016 Ms Thomson attended a conference in Melbourne with the midwifery unit manager from SERH, explaining the work that had been done on tongue and lip ties in the Bega Valley.
"We realised that we were one of the few areas at the forefront in regional Australia."
On Tuesday Ms Thomson will be once again sharing her knowledge on tongue and lip tie when she talks with local staff at Pambula Community Health, staff from doctors surgeries and health workers.
Although she officially retired from her position as child and family nurse, she continues to do relief work and attend seminars on her specialist subject.
"It's taken me all my life to get to this level and this is why I am going back and teaching. It would be a shame to have got to this point and not give back," Ms Thomson said.
