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.
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:
My support doesn’t end after we hang up! Following all consults, I still:
To make the most of our virtual lactation consult:
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:
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.
Positioning a newborn for breastfeeding can be an awkward affair. Their little bodies are wiggly and floppy. They love to put their hands by their faces and sometimes bat at the breast, sabotaging their own efforts to latch. After a few minutes of getting baby into the right spot and (presto!) achieving that latch, they come off the breast after a few sucks. And so the process starts again.
Once baby is finally sustaining the latch, a lot of moms still have a “pinchy” sensation. They usually consider two choices: A) unlatch the baby and start over, or B) grin and bear it. Neither option is particularly appealing, particularly if it took a lot of effort to get the baby on the breast in the first place. Let me offer choice C) snuggle and slide.
This simple maneuver works in any breastfeeding position. All mom needs to do is put her hand on baby’s back (not the head, which can lead to arching and fussing), and slide her baby’s body in the direction the feet are pointing. Sometimes, baby just needs to move an inch or two in order for that pinching sensation to subside.
Why does this work? Bringing baby in closer to mom’s body often deepens the latch, and sliding creates a bit of space between baby’s chin and chest to allow baby to open wider. This move also gives baby a better airway and swallowing ability, both of which are essential for good drinking.
Breastfeeding is a dynamic activity, an interaction between two live bodies, so it makes sense to continually adjust throughout the feeding. I encourage my clients to experiment with moving their babies’ bodies across or slightly up or down and course correct if that pinchy feeling returns. It’s an empowering and effective strategy that gets moms to drop into their own bodies and find their own ways to breastfeed comfortably. And lest you think that I coined the adorable term “snuggle and slide,” it actually comes from one of my favorite papers by Dr. Pamela Douglas and Renee Keogh in the Journal of Human Lactation.
Need in-person help with positioning? Book an appointment with me!
One lactation consultant's musings about milk.