Question 1

How do I prepare for a consultation?

Accepted Answer

After booking online, you will receive a confirmation email. Please read through it carefully to make sure your requested appointment time has been accepted.
Be sure to fill out the intake and consent forms. It is important for this step to be done in advance so we can spend more time talking during the consult, and less on paperwork!
 
There is not much on your part that requires preparation, all you need to do is be there with a baby ready to eat! I will just need a sturdy surface (like a table) to place the baby scale on.
 
For baby to be interested in nursing while I am here, it is best to nurse him/her 1.5 to 2 hours prior to the consultation, but breastfed babies can’t tell time! If baby is hungry and frantic, go ahead and feed him/her! We’ll make it work!

If you are using a breast pump, please do not pump immediately before my arrival. Please record the milk yield in the last 24 hours prior to the consult. If you have been partially bottle feeding with expressed breastmilk or formula, please record how much baby has been taking in the last 24 hours prior to the consultation. These are very important pieces of the puzzle!

Please, DO NOT clean your house for this consultation! I expect the house to be messy – mine was for sure during the early post-partum period!
In fact, one of my advice is to let go of house chores to best take care of yourself and your new baby.

Question 2

What happens during a consultation?

Accepted Answer

Upon my arrival you can expect me to ask where I could wash my hands. Actually, I may do so quite a few times throughout the consult.

We will start by chatting unless baby is ready to nurse as soon as I arrive!
We will review the health and medical history (yours and baby's) including birth and labor; as well as your breast/chestfeeding concerns.
 
I will observe you and your baby in your environment (where you usually nurse, probably with your favorite pillow, blanket...) I need to see what you have been doing so far in order to assess the situation correctly and suggest improvement if needed.
 
I may need to take a close look at your breasts and nipples before and after a feed. Besides evaluation of potential nipple damage, this will give a great indication on baby's latch and where the nipple is placed in baby's mouth while he/she is nursing.

I will put on latex-free gloves and do a manual assessment of your baby’s mouth ONLY if I see the need to assess baby’s oral anatomy and function more closely.
 
I will weigh your baby before and after the feeding and evaluate milk transfer. I use a pediatric scale with the highest resolution (0.1 oz or 2 grams).

We will go over all of your breast/chestfeeding questions.
 
Your support system is welcome! Spouse, grandma, BFF, even post-partum doula can stay during the consultation. They may learn a few tips on how to support a lactating parent and be a great help to entertain older siblings if needed!

Question 3

What happens after a consultation?

Accepted Answer

At the end of the visit, I will give you a written plan of care that you feel comfortable implementing and we will go over the next steps.
 
Within 24 hours:
- I will send a report to your baby's pediatrician (and any other relevant providers of your health care team) and provide you with a copy of that report for your records.
- Self-pay clients: I will provide you with a superbill (an itemized form that describes the services rendered) for you to seek any reimbursement you are eligible for under the Affordable Care Act. (Check the FAQ "Do you take insurance?" for more info).