Do You Have BlueCross BlueShield!? READ THIS!

Here is the thing. I am in-network with them, ask anyone! My name is listed, and your policy representative will tell you I am in-network all day long! However, there is a catch. I found out today that while I am in-network, most individual policies have a clause that excludes my provider type (Non-RN IBCLC) from rendering lactation services.

So, what this means is, that as an “in-network provider” I will bill your insurance directly for my services, but most likely, I will also have to charge the credit card you have on file for services rendered and you will have to battle it out with BCBS for this shady practice.

I apologize for the inconvenience and I hope you choose me to take care of your family!

(Hand) Express Yourself

This is .1ml of colostrum, so proud!

I am an International Board Certified Lactation Consultant. I have had extensive classes in hand expression. I have been teaching women how to hand express for the past 7 years in a clinical setting. I have handled my breasts on a daily basis as a teaching tool for seven whole years. I am also 2 days postpartum. Last night, at 4:37am, I finally was able to express 1ml of milk for the baby I just birthed (please see previous blog for story). My hand was cramped, I was bleary eyed, my breasts were sore, and I was so proud of this HUGE accomplishment. And then, I immediately spilled it ALL OVER MYSELF. It was then I realized, I have to come clean about hand expression.

For seven years, I have been telling new parents who are struggling to get their babies to latch, “just hand express your colostrum” for extra food. For seven whole years, I counseled them in how to do this. Massage the breast, juggle the breast, nipple stimulation and then voila! instant syringes full of milk. I treated it with the cavalier attitude of a woman who has never been separated from their newborn. I acted as if handling ones own breast and assuming it would cooperate, a few hours or days after a traumatic birthing, or even a good birthing experience for that matter was no big deal. I was so wrong.

Let me tell you now, I am sorry, hand expression is a big deal, and it is HARD TO DO. Even if you are well taught in how to hand express (which many birthing people are not), you may not be able to do it. Colostrum is sticky and stubborn and pumping will feel completely defeating – keep doing it anyway, you need the stimulation, use coconut oil for lubrication so you don’t blister.

Sure, Colostrum may flow in the first hours after birth because you are riding high on that oxytocin wave, giving you false security. It may then crash along with your hormone levels and you get less than drops and your confidence in your ability to make milk for your baby will be crushed. You may look at the tiny syringe in your hand and think, “this is surely not enough!” Tablespoons doesn’t look like a tiny amount, it looks like an insurmountable barrier to providing your baby with what they need.

Things that have helped me through this stage:

  • Look at the colostrum as a vaccine, not food. There are MILLIONS of anitbodies in every single tiny drop.
  • Pumping is for you as much as anyone, it will help your uterus shrink to the correct size and set up your supply for later.
  • I really like the thin 1ml syringes for sucking up the milk the thicker ones are hard to manipulate and make you feel like you’re not doing enough.
  • Pump for 15 minutes every two hours during the day, 1-2X at night and then hand express for 15 minutes. You get what you get, then get some sleep.
  • USE LUBE WHEN YOU PUMP DRY
  • Pumping will not get the colostrum out. It just won’t.
  • Use both hands to hand express, keep trying, and get comfortable with your syringe.
  • Suck it up after every drop is squeezed.
  • You will mess it up, you will spill it, you will.
  • This only is for 3-4 days tops.
  • You can do this, you ARE doing this.

And to that sweet mama I saw during my first year in private practice, who’s hand squeezed colostrum I accidentally spilled, I am so so so so sorry.

Maternity Leave, sorta…

Pregnant woman holds up sign saying “maternity leave” in office.

Surprise! I am going on maternity leave…sorta. It is true that I am 35 weeks pregnant, and it is also true that I am no longer taking new clients as of now. I will continue seeing current clients as needed, because I don’t want to abandon any of you, and also because I struggle with professional/personal boundaries.

So why is this maternity leave “sorta”? Well, it isn’t my baby! As a gestational surrogate I am carrying a baby for some friends of mine (their bun, my oven!), and even though I won’t be getting up in the middle of the night to feed and change and rock this time around, I will be preparing my mind, heart, and body for the next four weeks for this final step. And after the birth I am embarking on a journey I have never taken before, that of exclusive pumping.

I don’t have to tell most of you that this is not a journey that will be easy, but it will be so worth it for this precious baby I have been entrusted with for these past 9 months. It will be difficult, and labor intensive, and exhausting. I will be healing! And while my workaholic personality says I should work until birth and get back to it as soon as humanly possible, I must take the advice I give all of you. Rest. Recover. Give yourself grace and time because you matter too! Put your oxygen mask on first!

Therefore, I can not in good faith keep serving you, my precious parents, to the best of my ability while also splitting my time in this way. I can not wait to serve my community again doing the thing I love the most when I am at 100% again. See you in December!! Below I have listed the names and numbers of referrals to AMAZING IBCLCs in the area who I have absolute faith in who will help you reach whatever feeding goals you have for your infant.

Naya Weber http://itsmorethanmilk.com/index.html

Naiomi Catron https://www.milkdiva.com/

Look ma, No hands: Home Visits via Telehealth

The Bad News

I know a telehealth consultation with an IBCLC isn’t what you were expecting. It wasn’t what you had in mind when you made plans for the first couple of weeks home with your baby. You knew that if you had issues with breastfeeding, that you could call me, and I would be there within 24 hours, ready to offer hands on help, a shoulder to cry on, and gentle words that would guide you through the difficult first days. I know you feel alone, and scared, and maybe in pain, and I am so sorry for that. 

To be honest, this is not what I was expecting either. I love going to your nest and helping you in an environment that makes you feel safe and supported. I love holding your baby, and holding you, the parent, if you need it. It feels unnatural to counsel you through something so physical without using my hands. 

The Good News

I don’t need to use my hands to help you learn how to feed your baby. I don’t need to use my hands to teach you how to latch comfortably, check your baby for oral ties, or to help you prepare for the next steps in parenting. Using my props, and my words, I will guide you through all of this. Think of it this way, if I used my hands to place your baby where they needed to be, to hold your breast while they ate, we may be able to quickly get the baby to eat. However, when my hands left your house, you would be no better off than you were in the first place. My job is to teach you how to do these things, to empower you through feeding for the rest of your parenthood journey, and I can do all of that through telehealth. 

Mother And Baby Playing With Digital Tablet At Home Smiling

How does Telehealth Work? 

  1. You book an appointment the same way you always did! Go to my website and select the type and time of the appointment that works for you. 
  2. If you are with Aetna, don’t worry! They will still pay for telehealth! If you are paying out of pocket, telehealth is cheaper than a home visit.
  3. Once you have booked, I will send you a link to all your intake and consent forms. Fill those out and I will send you the link for our call. I use Google Meet which is HIPPA compliant. I will never film or take pictures without your consent. To be honest, I don’t know how to do either of those things anyway. 
  4. When it is time for our meeting, click on the link in your calendar for our appointment. 
  5. Enable both the video and microphone so I can see and hear you! 

Some Tips on Telehealth

  1. Have a camera person. This can be a partner, a family member, or friend but it absolutely makes a difference to have someone hold the phone, ipad, or computer so that you do not have to. You will need access to both your hands and I will need access to more than one angle to properly assess the baby. 
  2. A well lit room is better than a dark one, but I will work with where ever you feel comfortable. 
  3. If pumping is getting you down, have your pump parts out, washed, connected, and ready to go. This saves on “dead air” time and we can easily assess the fit and effectiveness.
  4. Have all your questions written down. Of course, you will always think of more at the time of the call, but this way you don’t forget anything. Your brain is set on baby mode right now, and this isn’t the best time to trust your memory!
  5. Have the baby changed, and in a clean diaper with no clothes on. I usually do this for weighing reasons but skin to skin feeding has numerous benefits and often that is all we need to get a baby who is unwilling to latch, to suddenly be interested. 
  6. Choose to have the consultation in the room of the house you feel most comfortable in. If that is your bedroom, let’s learn to nurse in there. There is no reason for you to be in an office chair in a room you never nurse in, just because this is a telehealth call. If you are using a nipple shield, pillow, etc. have it ready to go!

Why Should I use Telehealth?

Besides the initial, postpartum, OMG-my-nipples-are-on-fire-and-the-baby-won’t-open-wide-enough appointments, there are a ton of reasons why calling an IBCLC during this time for a telehealth visit might be a good idea!

  • Prenatal appointments to get you ready for your baby
  • Weaning or weaning delay 
  • Relactation (if you are regretting weaning early and want to try to start again)
  • Induced lactation
  • Exclusive pumping help
  • Solid introduction
  • Sleep help
  • Suck training after a tongue tie

Ultimately, I am here for you through this crisis and beyond to help make sure that you meet your feeding goals and you feel supported and uplifted. No one should be alone at this delicate time of their lives as new parents, and I am here for you.

 

Prevention of Infection Policy

In light of recent events, we have updated our cancellation policy for illness. We want all of us to be safe. In addition to continuing to practice good hygiene when we are in your home, we are adding the following safety measures to our home visit prep list:

– I will be washing my hands as often as necessary during the consult. Please have liquid soap (dish soap is fine) and paper towels available in your kitchen and/or bathroom.

– I will use a clean swaddle blanket on my scale. I will wipe down the scale before every appointment.

– I will offer to wear gloves for the entire visit, but I will continue to wear gloves any time I touch baby’s mouth, or any skin that is open.

– I get a flu shot every single year and my entire family is fully vaccinated to keep you and your little one safe.

– I prefer not to conduct the visit in your bedroom. I will teach you how to adapt any position I show you to do in your bed. If you are not mobile, I will conduct the visit in your bedroom, in this case, please have a table available to put my scale.

– Please let me know in a timely manner if you or anyone in your family is symptomatic for any illness.

– If you or anyone in your home is sick with the flu, fever, vomiting, or diarrhea when we arrive at your home, the visit will be canceled and your credit card will be charged a $75 fee.

– If you or anyone in your home has symptoms of illness, please disclose them to us at your earliest convenience so we can create a plan to keep us all safe and illness-free. No cancellation fee will be charged if you communicate illness in a timely manner and we choose to cancel or reschedule.

– In case of our own illness or family emergency, we will communicate with you in a timely manner and will make every effort to reschedule you or refer you to another IBCLC, and no cancellation fee will be charged to you.

The Perfect Formula for Breastfeeding

“I just fed him every two hours or when he woke up, then everything went much better!”

“We were trying to get him to sleep in the crib for naps, but I missed him too much so he sleeps in my arms now.”

“My pediatrician said he should be sleeping 5 hour stretches by this time, but he is so much happier when I feed him, is this a bad habit?”

Woman bites nails with furrowed brow
I read 500 books, but I forgot the right way to take care of my baby!

You read all the books, scoured all the websites and got all the (sometimes unsolicited) advice from your friends. Now, you feel you are going into this big, important, life changing thing prepared and knowledgable. Filled with confidence about breastfeeding, you are ready…and then the baby arrives.

Nowadays, new parents believe that knowledge gives them the best chance to feeding their babies easily. The more information the better right? Education is not bad, and it is good to know what to expect. However, downloading the perfect app, going to the perfect class, and creating the perfect schedule will not ensure perfection. What if I told you there is no perfect baby?

A parent who goes into breastfeeding with absolutely no expectations is a beautiful thing. These parents go with the flow! They give their baby whatever they need, whenever they need it.  This ease allows them to hold their babies close, sniff their little heads, and get to know their cries. Parents who respond to their babies, instead of trying to force them into a box, tend to have less stress.

Skin to skin isn’t just about all the great benefits like temperature and blood sugar regulation. When you hold your baby close, you learn who they are. When a baby is away in another room, swaddled, pacified, and monitored electronically, you may miss the little nuances. You might even miss early feeding queues that are so obvious when the baby is nestled on your chest, resulting in a very unhappy little camper.

The thing is, a perfect formula to breastfeeding just doesn’t exist. Every parent and every baby is different. So often to solve an issue, it takes an IBCLC. We will look at all the variables to make a specific plan for your family. It isn’t as simple as just consuming all the information you can find, because here is the thing, no book or blog has ever been written about your baby. No math equation will work without fail with every single baby and parent. There is no perfect class, app, or professional who can predict what kind of baby your baby will be. A good IBCLC will teach you what is normal, help you get comfortable, and show you how to interpret cries and cues. I can’t wait to help you to write your own book.

Learn Breastfeeding the Old Fashioned Way

Three largely pregnant friends stand back to front

When my two best friends and I got pregnant at the exact same time with our babies, everyone joked about us having made a “pregnancy pact”. The truth was we actually DID have a conversation about two weeks prior to our announcements about how we would all love a third pregnancy. The thing is, no one wants to go through something as big and scary as parenthood alone, and you shouldn’t have to. No, I am not offering to rent out my womb again, but I would love to be the friend that you need during this time.

Breastfeeding is not something you can learn well from a book, or a website, or (dare I say it?) a doctor. Historically, breastfeeding is something we learned from other women we loved and trusted. We had a question, we immediately had hands-on help from our auntie, or sister, or mother, often with a baby clinging to them as an education tool.

Learn to breastfeed the old fashioned way with my Breastfeeding 101 class. I designed it to get you what YOU want out of it. I want to hear what questions are keeping you up at night, and I want to put your mind at ease and set your expectations with compassion, intelligence, and honesty. You will learn confidence  when nursing your new baby.

Normally, I only do private, in home, prenatal breastfeeding classes. However, the wonderful women at Blooming Tree Maternity and Wellness have graciously opened their facility for me to hold this class (at HALF PRICE!) at their center. So come join us and learn how to feed your baby!

When: Feb 17 at 11am
Cost: $50 per expecting parent, partners are FREE!
What do you need: All your questions and fears and worries so I can put them at rest immediately!

Space is limited, so call or email today to reserve your spot!

I can’t wait to see you all there!

Now in Network with Aetna!

I am proud and excited to announce that Milk Maven is now an in-network provider for Aetna! Aetna will cover up to 6 visits (prenatal included) with me. So if you are one of my Aetna clients, book your appointment today!

What IS Breastfeeding Success?

Source: Danny Kennedy Fitness

Being successful is part of who we are as a culture in America. We want to be successful in all our endeavors, especially that most important one of parenting. So, it stands to reason that I get a lot of questions from new parents regarding how to be successful at breastfeeding*. Things I hear a lot:

  • “I wasn’t successful at breastfeeding my first two kids.”
  • “I am so worried I won’t be able to successfully breastfeed.”
  • “How many of your clients are successful, I mean, what is your success rate?”

Our culture is one that praises the Type A overachiever. We, as a culture, like weights and measures, and we measure productivity as precisely as we can, because that is how we can tell if we are being successful. When we are in school, we strive to get good grades. In sports, we aim to be  the fastest or the strongest. At our jobs, we put in those extra hours to impress the boss and we fill every moment of our days with meetings and planning and cram sessions.

This is not how breastfeeding works. Despite what you may have read, despite what your mother/grandmother/sister/best friend/wife of the guy who works across the hall may say, breastfeeding is not all or nothing. Success in breastfeeding is not determined by whether or not your baby has never had a drop of anything other than milk from your teat since the moment they were delivered into your arms. I have seen breastfeeding success mean so many things to so many people.

  • A mother who induced lactation for her adopted baby, and her surrogate baby…at the same time.
  • A father who uses an SNS to feed his baby at his chest.
  • A mother who has insufficient glandular tissue and decides to nurse at the breast for comfort but to give formula in a bottle for the majority of her baby’s nutrition.
  • A working parent who pumps during the day for bottles, and then breastfeeds at night and in the morning.
  • A parent struggling with PPD who decides to wean early.
  • A parent struggling to wean her 4 year old.
  • A baby who was in the NICU for several weeks before latching for the first time at a month old.
  • A mother who survived cancer, who pumps to increase her supply on her remaining breast to satisfy her baby’s needs.

I will never give a potential client  my “success rate”, because I am not the one who defines what success means to my clients. I will sit down with them, evaluate their situation, their life, their home and their goals. Together, we will come up with a plan to help them define, and in many cases, redefine, successful breastfeeding. Sometimes, this doesn’t involve a breast at all, and that is ok. No matter what happens in your early parenting journey, I will help you feel supported, loved, and empowered. With me, parents define their own breastfeeding success.

*I use breastfeeding, for brevity’s sake, but this includes all forms of lactation, including chestfeeding.