I had the pleasure of participating in this webinar with a midwife and lactation consultant, and we talked about how parents can get breastfeeding off to a great start in the hospital and beyond. Stay tuned for Part 2 later this month.

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​Most lactation consultants, including those working in outpatient hospital clinics, have switched exclusively to virtual modes (video and phone) as a way of protecting everyone during the COVID-19 outbreak. You may be wondering if it’s possible to get good lactation support without sitting in the same room as a lactation consultant, and the answer is definitely YES! During a video consult, I can still:

• Offer reassurance, empathy, and emotional support (always important, now more than ever)
• Take a complete history
• Visually assess breasts and nipples
• Visually assess baby’s mouth and latch
• Help with positioning
• Help with pumping
• Help with bottle-feeding
• Advise on breast and nipple care
• Answer questions about feeding and general newborn behavior
• Talk with partner/support person about how they can help
• Provide a written care plan to keep baby well-fed and maximize milk supply

My support doesn’t end after we hang up! Following all consults, I still:

• Send an email summary about our session, including useful videos and information
• Share my clinical notes with your family’s health care providers (pediatrician, midwife, and/or obstetrician)
• Provide two weeks of unlimited follow-up communication by email and text

To make the most of our virtual lactation consult:

• Hold off feeding your baby for 60-90+ minutes beforehand.
• Set up yourself and your baby in a place with adequate lighting.
• If possible, have a support person available to hold your electronic device and point the camera.
• If you need help with pumping, have your pump set up nearby.
• Don’t worry about cleaning your house or looking “camera ready”!

Weight checks

I bring my sensitive pediatric scale to all home visits, and weight checks and measurements of milk intake at the breast are helpful for assessing your baby’s well-being and feeding skills. If we meet virtually, I can’t weigh your baby, but I will ask you lots of questions to guide my assessment. Please keep track of:

• Your baby’s last recorded weight, including the date
• The number of times your baby feeds each day by breast and bottle
• The general length of feedings
• Diaper changes, including color and consistency of stools

 
If you have concerns about weight and milk intake, regular visits and weight checks with your baby’s pediatrician are recommended. Another option is to rent or purchase a baby scale, and I can guide you through checking your baby’s weight and milk intake during our session.
 
Some of my clients have bought this $55 scale on Amazon and found that it is adequate for regular weight checks but not sensitive enough to measure milk intake during breastfeeding. The Hatch changing pad and baby scale is also popular among my clients and is $150. I have done side-by-side weight comparisons with my pediatric scale and found it to be accurate within an ounce or two.
 
Payment and insurance

I am offering my virtual services at a discount since I do not spend any time driving or paying for gas or parking. As of this writing, I understand that telehealth services are being covered by most insurance carriers. I am billing Aetna and Meritain for my services as usual. If you have another insurance carrier, you may prepay for your session when you book an appointment, and I will provide you with a SuperBill to submit to insurance for any reimbursement you qualify for.

 ​Ten years ago, I was teaching writing classes at the University of San Francisco and doing the final copyedits on my first novel. The written word was my world, and I was getting paid for my art. I was an artist. It was pretty awesome.

I continued my writing endeavors after my first baby arrived, but I found that I was spending at least as much time reading about breastfeeding and parenting. When my novel hit the shelves in 2009, I was working on a second manuscript and had also applied to become a La Leche League Leader. I eventually ditched the manuscript to make more head space for learning about breastfeeding, and I welcomed a second baby. At that point, I told myself that I could go back to writing novels whenever I felt called to do so. I expected I would also return to teaching writing.

The families that I have supported through La Leche League have been some of my greatest teachers, and they have changed me in ways I never could have imagined. I learned the art of listening (REALLY listening) and keeping the conversation focused on the family’s situation rather than sharing something personal. No one needed to tell me that word choice matters, and I learned language for the art of reflective communication. I learned the art of praising new parents without being overly flowery or giving false hope. Most of all, I learned the art of holding space for people in times of need.

What really came as a surprise was that I was also learning A LOT of science. I had never considered myself a “science person.” Math was always fun for me, but science just wasn’t. I did okay in the science classes I took in high school and college and paid a bit more attention when learning about human sexuality. Ultimately, though, science was not my jam. Not yet, anyway.

Most of the families that I support have babies that are two weeks old or younger. There's a lot going on: recovery from the birth, figuring out who this little person is, and of course, round-the-clock feeding. It's an intense time for everyone, and new parents want so badly to do everything right. They took the classes, read the books, bought the gear. They're feeding every 2-3 hours, tracking all of baby's meals and diapers on an app. Breastfeeding often happens in a chair with a nursing pillow using a position that a nurse or lactation consultant taught them at the hospital. If there are issues with milk supply or baby's ability to breastfeed, pumping and bottle-feeding sessions are thrown into the mix as well.

It often takes a few weeks to get feeding sorted out, and my role as a lactation consultant is to support families through this time. After an initial home visit to assess a family's needs and put together a short-term plan, I provide unlimited for two weeks as part of my service package. Parents can email, text, or call with questions and updates. I frequently do follow-up home visits to provide more hands-on help and do a weight check on baby. A lot of the families I see have multiple concerns around breastfeeding, so I encourage parents to address one or two issues at a time. I see very good results with families that get ongoing support.

I have also observed a common phenomenon: difficulty letting go of newborn breastfeeding practices. Particularly when parents have worked very hard to reach their breastfeeding goals, they can be reluctant to make changes that seemingly loosen their control around feeding. Those changes include feeding on cue, letting their baby sleep longer stretches, reducing pumping or bottle-feeding, trying new nursing positions, venturing out of the house. And it makes sense that parents would be hesitant to rock the boat, as they've probably had some very rough moments trying to feed their babies. They may know, logically, that they have the milk supply and a capable little nurser, but their past experiences give them pause. Can they really trust their bodies to make enough milk? Can they trust their babies to feed well at the breast? What does that even look like?

One amazing new mama that I recently supported told me that transitioning to exclusive breastfeeding was like jumping off a cliff. What an apt comparison! Even with the safety of the shining water below, taking the plunge is terrifying. I took this mama's hand in mine, and we jumped together.

You don't have to jump off that cliff alone! Book an appointment with me.