Sleep-deprived and anxious about feeding their babies, tens of thousands of moms in Illinois and elsewhere recently turned to a variety of Facebook groups offering support for breastfeeding, pumping breast milk and postpartum care.

Direct responses were often remarkably prompt from the creator and admin of these groups, a Facebook user named "Cathy Marie Chan," whose profile featured a smiling picture of a woman purporting to be a board-certified lactation consultant and founder of Chan Lactation LLC.

Via Facebook Messenger, "Cathy Marie Chan" would request photos and video recordings of the mothers' naked breasts—and in some cases vaginal areas—for supposed health care purposes, according to multiple members of the groups and screenshots of private messages.

Some of the images of breasts that women sent were bare, others were taken while expressing milk or feeding infants; some women received specific instructions to include their face in the shot, according to group members' recollections and screenshots of messages.

In one Facebook Messenger exchange captured in a screenshot, "Cathy Marie Chan" offered to perform "a quick assessment of your vagina with you" for a postpartum mother who was worried about a possible prolapse, a medical condition in which one or more of the pelvic organs slip down from their typical position. Multiple lactation experts said a lactation consultant would not be qualified to provide this type of assessment.

Soon members of the Facebook groups—including at least two board-certified lactation consultants—began asking for more details about "Cathy Marie Chan's" credentials. They also questioned the nature of some of her requests for videos and photos, which seemed unnecessarily sexual and had dubious clinical or therapeutic value, according to several lactation experts.

Shortly after these questions surfaced, the "Cathy Marie Chan" Facebook profile suddenly vanished. The Facebook account was deactivated in early March and many of the various lactation and motherhood groups it created and ran—at least 17, by one group member's count—were "archived" by Facebook because they lacked an admin, according to messages posted on some of the group sites.

"You can only review posts but not react, create new posts or add members," the archive messages stated.

Now many of these new moms fear they were victims of what appears to be an elaborate and well-researched scam: They're left wondering who was actually behind the now-defunct "Cathy Marie Chan" Facebook profile—and how all of the nude images and recordings they sent are being used.

A few days after her Facebook profile disappeared, "Cathy Marie Chan" admitted she wasn't actually a board-certified lactation consultant to one Facebook group member in an email, using an email address that has since been deactivated.

"Cathy Marie Chan" is similar to the name of a real lactation consultant who is listed on the public International Board Certified Lactation Consultant Commission certification registry, though they have different middle names. Several Facebook group members told the Chicago Tribune they had assumed that the real credentialed lactation consultant was the same person they were communicating with on the social media platform.

The Tribune reached the real lactation consultant, who said she was "aware of this situation," adding that she was not affiliated with "Cathy Marie Chan."

"I was never a part of these Facebook groups, and I have no leads to who this person is, therefore I have no further information about what occurred," she said.

The Tribune searched all 50 states and could find no business named Chan Lactation LLC. The website once used by "Cathy Marie Chan" to accept payment for services shows an "error" message.

"I felt hurt. Betrayed," said Christina Gonzalez, 35, of northwest suburban Des Plaines, who was a member of several of these Facebook groups, including one for mothers of multiples.

Gonzalez said she sent the "Cathy Marie Chan" Facebook account video of her breastfeeding her twins via Facebook Messenger; she said "Cathy Marie Chan" had insinuated doing so would help promote education and better lactation support for other moms.

Many mothers describe feeling tremendous pressure to breastfeed their babies. The Chicago-based American Academy of Pediatrics recommends exclusive breastfeeding for approximately the first six months of an infant's life, citing numerous health benefits for the mother and baby.

Yet following those recommendations can often be difficult for a plethora of reasons. Some moms have a low milk supply. Babies can have trouble latching on to the breast. Breastfeeding moms can develop mastitis, an inflammation of breast tissue that often causes pain and swelling.

"All of these women are coming together because they have similar problems and they want help," Gonzalez said. "And you form like a connection with them because you're all going through the same thing. Motherhood is tough. You want to know that you're not alone."

Looking back, Gonzalez was just grateful the videos she sent were low-quality with poor lighting and didn't show her face. Gonzalez still has no idea who was behind the Facebook profile. She never spoke with "Cathy Marie Chan" on the phone nor had she ever seen her in a video.

"I think that's the scariest part," Gonzalez said. "She—and I say she, because that's how I perceived her, everyone perceived her. That's how she presented herself. Who knows? It could be—I would say they/them, because it might even be like a group of people. It might be a guy. It might be a girl. We don't even know."

Gonzalez also fears for the fate of all of the sensitive videos and photos the "Cathy Marie Chan" Facebook account might have collected; one of the Facebook groups lists its creation as December 2022, though others appear to have been started more recently.

"That's the part that makes people question everything," Gonzalez said. "Because she could have sold them. She could have put them on the dark web. … She could have done anything."

Magnitude of scale

It's unclear how many women were impacted by these Facebook groups.

One that focused on breastfeeding and pumping support had more than 43,000 members, according to screenshots. There were groups designed for different populations: Young moms. Older moms. Asian moms. Another focused on postpartum sexual health and self-care, with discussions about healing after childbirth.

Since the "Cathy Marie Chan" profile was deactivated, some members started a new Facebook discussion group for those who feel they were victims, which has grown to more than a thousand members.

The Tribune has interviewed eight women—three from Illinois and the rest from other parts of the United States—who said they sent naked photographs or videos of their breasts to the "Cathy Marie Chan" profile through Facebook Messenger.

One lactation consultant said some of her clients had sent pictures of their breasts and vaginal areas to "Cathy Marie Chan" on Facebook. Another woman said she never sent images but recalled some of "Cathy Marie Chan's" comments to her in private messages seemed oddly sexual and inappropriate for a supposed health care professional.

Several of the women the Tribune interviewed said they filed complaints about the Facebook groups with the FBI. An FBI spokeswoman said in a written statement that the agency's policies prevent "confirming the existence or nonexistence of any specific investigation that may be occurring."

"Scammers regularly target society's most vulnerable citizens during times of increased stress, and lactation scams certainly follow this established pattern," the statement said. "As with any business transaction, anyone seeking lactation assistance should be wary of services offered online by unknown individuals. Many hospitals and nonprofit organizations maintain lists of locally based, vetted providers who can provide feeding assistance to new parents."

The statement also encouraged "anyone who believes they have been a victim of an online lactation service scam" to file a complaint through the FBI's Internet Complaint Crime Center.

A spokesperson for Facebook parent company Meta said in a statement, "We have strict rules against soliciting, sharing or threatening to share someone's intimate images." The statement also said the company has worked with experts to develop online tools such as StopNCII.org, which was designed to help people take back control of their intimate images and try to prevent them from being shared online.

The spokesperson added that "we work with law enforcement to investigate criminal activity."

The Illinois attorney general's office has not received any complaints about the Facebook groups or a user named "Cathy Marie Chan," but recommends anyone impacted contact local law enforcement, a spokesperson said.

Some lactation experts say part of the problem is a lack of state licensing of lactation consultants across much of the nation, including in Illinois. While most health care professionals are licensed by state agencies, only three states—New Mexico, Oregon and Rhode Island—license lactation consultants.

Proponents of licensure believe that having this layer of government oversight in more states could help prevent problems, as well as offer another avenue to report lactation support practices that seem inappropriate or suspected fraudulent behavior.

"If a (state) board gets information that someone is impersonating and it's in their auspices of authority … they have the authority to investigate and to send cease-and-desist letters, and perhaps even initiate court proceedings," said Merrilee Gober, board member of the National Lactation Consultant Alliance. "Clinical patient care needs to be delivered by licensed practitioners."

As for Gonzalez, the new mother of twins, she said "Cathy Marie Chan" contacted her on Facebook Messenger in November asking about how she breastfeeds her son and daughter at the same time, ostensibly to learn more about tandem feeding.

"If you could just record that first like minute or so as you get them onto the breasts and then the minute or so of you getting them off," one message said. "I think I'd love to learn from you on how to easily get them on and off."

"I really wanna (sic) help mommas with twins and tandem feeders but I can't have tons of exposure to them," reads another message.

At one point, "Cathy Marie Chan" asked about the size of her breasts, Gonzalez recalled. She said she gave that information because she believed she was communicating with a health care professional.

'Just trying to feed my child'

After giving birth in October, 24-year-old Sophie Harpster of central Illinois found breastfeeding to be a struggle.

Her baby wanted to feed frequently and for long stretches, so the first-time mom decided to supplement with pumped breast milk in bottles. To get advice, Harpster said, she joined three Facebook groups with 30,000 to 40,000 members each that focused on breastfeeding and pumping.

She recalled the admin of the groups, "Cathy Marie Chan," was offering help with sizing for breast pump flanges, the plastic or silicone shield that goes on the breast when pumping milk. So Harpster sent the admin a message on Facebook Messenger requesting that service, which cost $25 for priority sizing—paid through "Cathy Marie Chan's" website—or free for those willing to wait a few days.

Harpster opted for free sizing but was surprised that "she actually got back to me super-fast anyway."

Via Facebook Messenger, "Cathy Marie Chan" sent a list of instructions: Harpster recalled she was told to send photos of her bare breasts to compare nipple symmetry, images of the breasts alongside a coin for sizing comparison and recordings of each nipple while pumping. She said she didn't send any recordings or photos with her face included. Several other group members described receiving similar instructions for flange sizing from "Cathy Marie Chan," and some sent the Tribune screenshots of the list.

"Based on her credentials and how many women were in the group, I trusted what she said and sent the photos and videos," Harpster said.

"Cathy Marie Chan" responded with a recommendation for a specific flange size, and that was their last message exchange, Harpster recalled. She said she was never asked to sign any patient consent forms or other paperwork.

Harpster said she didn't think about the photos and recordings again until a few months later when the "Cathy Marie Chan" Facebook account was suddenly deactivated and the Facebook groups were archived.

Then Harpster saw posts on Facebook from other moms warning that "Cathy Marie Chan's" credentials couldn't be verified.

"My heart just sank and my stomach turned. I felt … extremely violated," recalled Harpster, who added that she had previously survived sexual assault. "So having something like this happen where I was vulnerable and trusted someone with something … it just felt awful."

She describes herself as typically very careful with whom she trusts and what she puts on the internet.

"As a new mom who just wants to feed her baby, also being in a postpartum fog, it's really hard to have the best sense of judgment," she said. "You're so tired. You don't think clearly. You're emotional. You have lots of hormones going on."

New moms are an "extremely vulnerable population," Harpster added.

"In retrospect, I'm just trying to give myself grace," she said. "Because I was really just trying to feed my child."

These kind of requests for nude images and recordings via private message on a public social media site were red flags, which would constitute inappropriate behavior for a real board-certified lactation consultant or any type of health care professional, according to several lactation experts.

The "Cathy Marie Chan" Facebook profile used the credential IBCLC, or International Board Certified Lactation Consultant, which requires 95 hours of lactation-specific education, 300 to 1,000 hours of lactation-specific clinical practice, health sciences education courses and passage of an exam.

An IBCLC should require patients to sign consent forms before providing any kind of care, said Katie Cohen, professional development coordinator for the United States Lactation Consultant Association.

Cohen said IBCLCs in the United States must also comply with the Health Insurance Portability and Accountability Act, national standards that protect sensitive patient health information. They should only be providing care online using secure, encrypted platforms, she added.

An IBCLC failing to provide care in this manner would risk being stripped of their credential, Cohen said.

"We have a pretty strict code of ethics. …. We're allied health professionals," said Cohen, an IBCLC and registered nurse. "So an IBCLC would never—and really no legitimate health care provider—would ask somebody to send, not even photos or videos, but even just discussing in any way protected health information on Facebook. Or anything like that that's not secure."

'Still conflicting'

Each IBCLC has a credential number that's available on the public certification registry, where names and credentials can be verified. But there was the IBCLC listed on the registry with a name that's similar to "Cathy Marie Chan," and several Facebook group members said they had just assumed that this was the same person as the Facebook admin they were interacting with.

Nicole Santana, a registered nurse and IBCLC in Rockford, was a member of some of these Facebook groups. She said she emailed "Cathy Marie Chan" asking her to verify her credentials after her Facebook profile disappeared in March.

In response, "Cathy Marie Chan" said she was not a credentialed IBCLC but had started training to become one and never finished, adding that she had "inflated in some places," according to the email.

The Gmail account "Cathy Marie Chan" used included the acronym "IBCLC" in its username.

"Cathy Marie Chan" went on to claim in the email that she "had become an RN" but stopped practicing after having her son, though no documentation of her having been a registered nurse was provided in the email.

She also said in the email that she had "a certificate in lactation" from an online program but added that she "would rather not say which" program and offered no proof; someone with this kind of certificate would not qualify to use the credential IBCLC, which requires much more education and training.

"Cathy Marie Chan" also claimed she had deleted all the photos and videos and "made sure to wipe down my computer," according to the email to Santana.

"First of all, I apologize. What I did was wrong," the email said. "In an attempt to feel better about myself and feel helpful, I created this so I could stop being a stay at home and feel like I was actually working and helping others. My husband won't let me work so I needed some outlet."

Another Facebook group member said she had used the same email address to contact "Cathy Marie Chan" and sent the Tribune screenshots of her own email exchanges with the same account from March.

When the Tribune sent an email in April to the address to try and seek comment from "Cathy Marie Chan," the email bounced back with the message "the address couldn't be found, or is unable to receive mail."

Santana said she didn't find any of "Cathy Marie Chan's" explanations or promises in the email exchange reassuring, since nothing could be proven.

"Her story was still conflicting," said Santana, owner of Soak Lactation. "I just want moms to find qualified, appropriate care."

About 83% of infants born in 2020 were breastfed at some point and roughly 45% were breastfed exclusively through three months; by six months, only about a quarter of babies exclusively received breast milk, according to the Centers for Disease Control and Prevention data. Roughly 21% of breastfed infants received formula supplementation within the first two days of life, CDC data showed.

International Board Certified Lactation Consultants can be a critical source of support for breastfeeding moms, according to the 2011 U.S. Surgeon General's Call to Action to Support Breastfeeding.

"Research shows that rates of exclusive breastfeeding and of any breastfeeding are higher among women who have had babies in hospitals with IBCLCs on staff than in those without these professionals," the report stated.

Yet data indicates there aren't enough IBCLCs to keep up with potential demand.

The report cited the need for 8.6 IBCLCs for every 1,000 live births nationwide. As of February, there were 19,930 IBCLCs in the United States, according to the International Board of Lactation Consultant Examiners; that's about 5 IBCLCs for every 1,000 live births, based on the roughly 3.6 million births in 2023, according to the CDC.

Several women the Tribune interviewed cited various barriers to accessing a lactation consultant including poor internet service, cost in cases where their insurance wouldn't cover lactation care, a lack of nearby providers in more rural areas and the challenge of leaving the house to seek in-person care while parenting.

One Facebook group member, a 28-year-old mother from New Jersey who wanted to remain anonymous, commented that "Cathy Marie Chan's" services had been easy and accessible.

"She seemed like a good person that was there to help," the mom recalled. "I thought, "She's so busy, how nice of her to follow up with me. She's nice.'"

Unknown identity, dubious tests

After a traumatic cesarean section in September, 23-year-old Rose Baxter of Kalamazoo County, Michigan, had lost so much blood she didn't have the strength to hold her newborn daughter right away, let alone breastfeed.

Following a blood transfusion and a little time to get her energy back, Baxter tried to nurse but her daughter wouldn't latch, she said. So the new mom began exclusively pumping but developed milk blisters, mastitis and clogged milk ducts, which she attributed to poor flange size fitting in the hospital.

She had joined several Facebook groups created by "Cathy Marie Chan" to get "help and support through this new, beautiful, exhausting journey of motherhood."

"Everyone had recommended 'Cathy' for flange sizing. I was very, very on the fence and was very hesitant to go to her," Baxter said. "I went back and forth on it for about a month but decided I needed to do this so I can feed my precious baby girl."

Baxter said she checked online and found a LinkedIn profile for a lactation consultant with a similar name to "Cathy Marie Chan."

"I again hesitated, but I knew my baby needed me to get sized so she can have my breast milk," Baxter said. "I went ahead and sent "Cathy' pictures and videos of my breasts and while pumping."

Baxter said she believes "Cathy Marie Chan" did size her correctly. Afterward, her problems with pumping went away. But ever since the Facebook profile was deactivated, Baxter has been wondering who gave her this advice and what would happen to her photos and videos.

"She seemed genuine, but I still had this weird (gut) feeling that I pushed aside in order to get help," Baxter said, adding that she filed a complaint with the FBI. "Unfortunately, in the situation I'm in, it's hard for me to be able to get out and go to a lactation consultant in person, and I don't have the greatest internet connection for an online consultant."

Baxter cautioned others to "be wary of who you trust, even if they come with hundreds of recommendations."

"This "Cathy' person now has pictures and videos of my breasts and I have no control over what they do with it," she said. "I feel helpless, embarrassed, and full of shame. This isn't something I would wish upon anyone."

Jessica Anderson, an IBCLC in Hawaii and owner of Genuine Lactation, said she first encountered "Cathy Marie Chan's" Facebook groups close to 18 months ago; Anderson said women had come to her in the past trying to figure out if the admin was a legitimate provider.

Then, after the profile was deactivated, more women began sharing strange or off-putting encounters with "Cathy Marie Chan," Anderson recalled.

Screenshots of messages show "Cathy Marie Chan" giving a mom instructions for what she refers to as an "emptiness and pain test," which specifically request the woman show her face in the video recording.

"Record yourself hand expressing on each side for 45 seconds. Prop the phone up in front of you so that you can use two hands," the message said. "One to express and one to catch the milk. Also include your face in the frame so I can look for any pain cues as you are expressing. Talk aloud about how it feels and if there is any pain. This way I can understand how the milk is flowing as well as understand if you are giving any pain signs."

Anderson and Santana said there would be no clinical reason to request this kind of recording.

In another message, "Cathy Marie Chan" asked someone to record herself topless with no bra on and to trace her fingers over her breasts.

"Keep your full face in frame so I can watch your reaction as you do it," the message said, according to screenshots.

Anderson, who reviewed the screenshots, called these requests "sexual exploitation."

"There was nothing clinical about some of these photos or videos that were obtained," she said. "There would be no therapeutic value in it. It is strictly stuff that would be of a sexual nature."

Lack of state licensing

Anderson said 40 to 50 clients have contacted her about their encounters with the "Cathy Marie Chan" Facebook profile. Roughly 10 of them told her they sent images of their breasts or vaginas to the Facebook account via Messenger; Anderson said those clients have also sent the images to her via a secure patient portal, because they wanted to know if this was appropriate care.

"That's why I can tell you, without a shadow of a doubt, this is not lactation care," she said.

One client who Anderson had recommended see a physician about a medical condition turned to "Cathy Marie Chan" for help, but "Cathy Marie Chan" was actually "exploiting her for weeks and weeks on end," Anderson recalled.

"She's like 'I thought about telling you, but then thought that if there was something wrong you'd think that I was stupid. So I just kept my mouth shut.' And I feel awful for her," Anderson added. "This person was supposedly meeting with (the client) nightly via Facebook chat to get these videos, for weeks on end. Which is not the behavior of a professional."

To Anderson, part of the problem is that very few states license lactation consultants, a landscape she believes makes it easier for someone to pose as a lactation professional.

Most health care professionals are licensed by state agencies, which means the public can typically search a government site for their name, address, when the license expires and whether they've been disciplined. The National Lactation Consultant Alliance says this kind of state regulation is needed to protect the public and profession.

"Licensure validates a minimum standard for education, training, and expertise, upholds the integrity of a profession, and helps assure the provision of competent care," states the organization's position paper on licensure.

Measures to license lactation consultants are pending in Connecticut and New Jersey. Illinois does not license lactation consultants, according to the Illinois Department of Public Health and the Illinois Department of Financial and Professional Regulation.

Yet licensing can be controversial. Georgia in 2016 passed a law requiring providers of lactation care and services be licensed by the state and that only International Board Certified Lactation Consultants were eligible to receive a license.

But in May 2023, the Georgia Supreme Court determined the law was unconstitutional because it violated the due process rights of other types of lactation care providers to practice their profession.

"Thus, it may well be true that regulations promoting quality care are desirable as a policy matter, but that is not a sufficient interest to justify an unreasonable burden on the ability to pursue a lawful occupation," the ruling states.

'Critical, emotional situation'

Thirty-three-year-old Hala Hardy of Virginia, another member of some of the Facebook groups, said she was never asked for images or recordings. But she recalled that "Cathy Marie Chan's" conversations with her on Messenger became "really, really unprofessional … just very sexual."

"Conversations started turning into a lot of talk about masturbation and sexual things," Hardy said.

Hardy said "Cathy Marie Chan" began sending her direct messages in the middle of the night.

"She would talk about how she has a fetish for Black women. And I am Black," Hardy said.

One 25-year-old first-time mom from Tennessee who asked that her name be withheld said she was embarrassed that she sent photos and video recordings of her naked breasts to "Cathy Marie Chan."

"Now someone out there has photos and videos of me," she said. "And who knows what they're doing with them?"

Yet she's still puzzled by how knowledgeable "Cathy Marie Chan" seemed, at times.

"What's crazy is … a bunch of people say they got good advice. And I feel I got kind of good advice from this person," she said. "It's almost like they did their research to know, this is what I need to know in order to get these pictures and videos sent to me."

Nick Nikiforakis, associate professor of computer science at Stony Brook University in New York and a cybersecurity expert, said these Facebook groups "have all of the earmarks" of a social engineering scam, where an online actor uses deception and manipulation to get another individual "to act in a way that's not in their best interest."

After the truth comes to light, the online profile is often deleted, he said.

"They can just delete it and create a new one with a new identity," he said. "And then again, ultimately, the problem is they can claim to be whoever they want to be or whatever they want to be."

This becomes "kind of a whack-a-mole game," he added, because there are so many versions of the same scam.

"The onus unfortunately, for better or for worse, is on users, on members of the Facebook platform to kind of cautiously use the site in a way that makes sense," he said. "I don't foresee a world where it makes sense to send pictures of your naked breasts lactating to a stranger. … I think people fall for this because they are in this critical, emotional situation, where probably they feel they need urgently to give milk to their babies. And then they do things they wouldn't normally do."

2024 Chicago Tribune. Distributed by Tribune Content Agency, LLC.