Welcome!

Welcome, and thank you for visiting The Second 9 Months in Seattle, Washington! Now accepting insurance* for office visits!


If you need help with breastfeeding, call now! (206) 356-7252. Now accepting insurance for office visits!* 
I answer calls and emails promptly. (Phone is fastest!) Breastfeeding support is available 7 days a week: Home or office visits, phone consultations or drop-in support groups.  You decide.  I usually see clients in Seattle and surrounding areas within 24 hours of the initial call–and very often the same day. 

*Office Visits at Docere Center for Natural Medicine No upfront fees! Insurance billed for you. Office visits are appropriate for initial or follow-up visits. You will receive the same individualized care in a comfortable setting with plenty of time allowed. Initial visits are about 90 mins and follow up visits are about 60 mins. The following insurance plans are accepted: Aetna, Blue Cross, Cigna, First Choice, Group Health, Lifewise, Molina, Premera, Regence and United Healthcare.  Co-pays are collected at the initial visit only, and co-insurance or deductible may apply for all visits, as required by your insurance company. If you’d like to schedule an office visit, please call Docere Center for Natural Medicine at 206-706-0306 to make an appointment. Appointments are available 9:30a-12:00p and 1:30p-4:30p.

Not in Seattle? I do phone consultations anywhere in the U. S. and Skype is available all over the world! You deserve an experienced, professional lactation consultant who will listen to you and honor your priorities.  AND you deserve to breastfeed comfortably–without pain.

If there was a <3 (heart) button for the amount of help you provided to my family, I would totally click it!  LB

Weekly drop-in support groups in Seattle.   “Breastfeeding SOS” is there for you every Monday morning. Moms-to-be and breastfeeding moms and babies welcome!  Monday mornings, 10:30 – 11:30 at Dragonfly Holistic Healing. 760 N. 34th St. Seattle, WA  98103.  (Fremont)  Suggested donation: $15.00 Please arrive on time! I wait for moms for 20-30 minutes only! Call if you know you will be late! For a virtual drop in group, please request to join my local (Seattle area) facebook support group. Breastfeeding and Pumping Support in Seattle.
 

I wish you had been at the hospital with us when our baby was first brought to us for breastfeeding. Your manner was very patient, incredibly understanding, superbly attentive, and extremely calm. You shared an incredible depth of knowledge. Thank you!

Experience Counts!  Seattle area mothers choose me because of my vast experience and my reputation in the community. Over 20 years helping breastfeeding adds up to over 4000 babies! 

My pediatrician called you ‘one of the best lactation consultants in the region.’  Wow!

Be a Breastfeeding Booster! Donate to the Lactation Fund to help more moms get the support they need.  Any amount will help low income moms with breastfeeding challenges.

If you’d like more information on how I can help you, visit the services pageFrequently Asked Questions,  or simply give me a call!  (206) 356-7252

Renee Beebe  second9months@gmail.com

 

 

The Lactation Consultant is Coming! How do I Prepare?

Featured

Getting some reassurance from an IBCLC

You have just had a baby. You’ve always known you would breastfeed, but things are not going well. Perhaps your nipples are sore. Or you’re struggling with engorgement. Maybe you’re worried about milk supply. Or your baby has hard time latching. Or maybe you just have a lot of questions. In any case, you and your healthcare provider have decided you need the help of an expert. It’s time to call a lactation consultant.

You’re happy to hear that the lactation consultant (IBCLC) your doctor recommends will come to your home to help you. You make an appointment with the consultant, and then you wonder….”What should I do in preparation for her visit?” Continue reading

Low Milk Supply: Tricky to Treat!

Supplementing at breast

Supplementing at the breast.

When a mom is experiencing difficulty making enough milk for her baby, the usual suggestion from well meaning professionals is often, “Nurse your baby more —your body will rally and you will make more milk in just a few days.” This suggestion is based on the law of supply and demand. When more milk is removed from the breast, the breast will respond by making more milk. While this advice can be legitimate in some situations, many times it can result in an exhausted baby who, despite mom’s best efforts, can’t get enough milk to gain well. Continue reading

I’ve Lost my Milk! Is it Possible to Relactate?

From first-time mom, Shelly:

In honor of World Breastfeeding Week, I’m making a toast: Here is to trying again. Here is to providing the best for my baby. Here is to hard times. Here is to when you thought it was all over and starting anew.

Shelly's baby--latching again!

Shelly’s baby–latching again!

The back-story from Shelly:

I am in the process of getting some health issues under control which I know has contributed to declining milk production since about 5 months. So now, at 7 months, my daughter shows little interest in the breast. If I completely stop providing milk for her now, would it be possible to re-establish in a couple months once I can get my own body under control? I have PCOS and thyroid issues and it has taken a while to get into a doctor to re-test hormone levels and get it treated. I would love to keep giving her breast milk once I can produce again, but I really need to focus on me right now.  I am exhausted every day to the point where I can barely take care of my daughter. Adding in pumping would be too much!

Renee’s response: I think what you’re saying is that pumping would be too difficult for you with your health issues? Yes it’s possible to re-lactate. but not easy.

It’s nice to know it is possible. I just didn’t want to get my hopes up if there was little to no chance at all.

Here’s an update from Shelley.. a month later:

After my milk supply decreased, I started my baby on solids and tried formula, but wasn’t happy with it. I switched to a EU (European) brand that I still use now. Over the past 2 1/2 months, not surprisingly, my supply dwindled to just about nothing.  I had realized that getting to 6 months with breastfeeding was a huge thing to be proud of; something most women in my family never got to experience.  After learning that it was possible to get my milk back,  I decided to try last week. It was time to get back into it, no matter how hard it was. So I started pumping again. She needs my milk. If I never can 100% breastfeed again, that is fine. But I want her to want me when she is hungry, not the bottle. This morning I tried to breastfeed for the first time in many weeks. She latched on!! It only lasted a minute or two, but it was something. It was a start. There is now hope that I am not insane and this could actually work.Thank you for your support and encouragement!

 

Thank YOU, Shelly for sharing your story with us!

Note: If you are interested in resuming breastfeeding after cessation, please contact an IBCLC experienced in helping with relactation and inducing lactation. She can help you develop a plan that is right for you.

Take off and Let Downs–Pumping and Air Travel

Breastfeeding: Sweet. Intimate. Close connection between mother and baby. It’s a lovely soft-focused kind of image, right?

DSCN1910Unless you have to be separated from your baby for work or school. Then it’s all business. Maintaining milk production. Tallying the ounces in the freezer. Strategizing about how to get one more pumping session in every day. Stressing if you have low output at lunch or if someone schedules a meeting during the time you’re supposed to be pumping.

And what if you need to be away from your baby for more than one day? What if you need to travel for your job sans baby? What if you need to be on an airplane for more than a few hours? Is it possible to pump on a plane, maintain your milk production, save your milk AND bring it home for your baby? Continue reading

Adrienne’s Story–Tongue Tie and Beyond

This is a story from a former client. She wants to encourage other moms to aggressively seek help for breastfeeding challenges. She wants you to know that if you’re having trouble, it’s not your fault! And, finally, she wants you to know that you and your baby don’t have to suffer and struggle in order to breastfeed

20131224_140733By the time I saw Renee, I’d already been to 4 lactation consultants and I was losing hope I’d be able to breastfeed my baby girl for even another month, let alone her first year. We were on week 9 of pain, frustration, and tears. When Renee said my girl had a tongue tie, I didn’t quite believe her for a moment. Then I wanted to cry, I was so relieved to have a concrete, fixable solution. Continue reading

Breastfeeding SOS: A Glimpse into a Monday Morning

Breastfeeding SOS

Breastfeeding SOS

I facilitate a breastfeeding drop in group in the community room of Dragonfly Holistic Healing. Dragonfly is a lovely and skilled community of holistic healthcare providers.  The group meets Monday mornings 10:30-11:30. Since it’s a drop-in group I never know what to expect or who will show up. Sometimes clients pop in for a quick follow up, but often I’ve never met the moms before. They are referred to the group by their Drs, their doulas, the acupuncturist or their friends. This is a glimpse into a recent drop in.

After moms straggle in with their babies somewhere between 10:20 and 10:45. They get settled in the comfy chairs and I ask them to introduce themselves and their babies.  They admire each other’s babies. A mother with a 3- month- old marvels at the smallness of another mom’s 8-day-old baby. She congratulates her for making it out of the house to get support with such a tiny baby.. I ask the mothers to talk about why they are here. Here is what I heard last week.

“I just want to make sure I’m doing it right.”

“I want to make sure my baby is gaining weight.”

“My nipples are really sore.”

“My baby has a hard time latching and he’s really fussy at the breast.”

“I’m using nipples shields and I want to breastfeed without them.”

Babies begin to get restless and fussy.  I assure them it’s totally fine to breastfeed in this setting!  A question is asked about latching. All eyes are on me as I  bring out my knitted breast and demonstrate for all to see. I can see mothers trying to replicate the technique I demonstrated.

There is concern expressed about using some formula. Everyone is quick to assure the mom that any amount of breast milk is great and the important thing is to feed the baby.

There is a discussion about milk supply and how to know baby is getting enough.

More questions.. I give general answers. If a mother is having a complex breastfeeding problem, I recommend a consultation with an IBCLC. She can make an appointment with me if desired.

A mom shares that she isn’t getting enough sleep and she doesn’t know what to do. Three other moms nod their heads with empathy and give her suggestions. I merely listen, because it seems the mom is getting exactly what she needs.

A conversation about pumping ensues. One mom says.. “I have a love/hate relationship with my pump!”  There is laughter and more pumping discussion.

A baby poops loudly which results in more laughter.

A mother asks me to help with latching her baby so that it’s not painful. I help her make a few adjustments and she looks up at me and says, “That feels better! Thank you!”

A mother confesses she doesn’t know how to determine if her baby is swallowing. So I sit with her and interpret what’s happening as her baby nurses. Another mom listens in, then asks me to watch her with her baby as well.

Every few minutes a baby is weighed. When it’s good news all of the mothers rejoice.One mom cries after learning her baby didn’t gain enough weight—other moms cry with her or grow silent.  One reaches out and gently pats her back. They always seem to know the right thing to do.

A mom asks me to check if her baby has thrush. I don’t do oral exams in drop in groups, but this baby took one look at me and stuck out her tongue and showed me the thick white patch!

When one baby cries loudly, the other babies look worried and begin to whimper. I hear things like, “Yes, that baby is sad, but his mother is helping him.” and “That is a loud sound and it’s scaring you.” and “I’m right here, you are ok.” I marvel at the intuition and skill of these first-time moms.

Babies fuss and cry with diaper changes. A mom goes to use the restroom and hands me her baby to tend. He smiles and coos at me.

It’s 11:30… time to end the meeting. But the moms linger… asking one more question, enjoying the company of other moms and babies. There are hugs and word of encouragement.

When they leave they look a little happier, a little lighter and more confident. They have a plan. They know who to call if they need more help. They entered the space as strangers and as they leave, I hear 2 of the moms exchange phone numbers.

I hope they are all doing well. I hope I see them next week.

Breastfeeding Twins: Getting off to a Good Start.

Tandem nursing.

Tandem nursing twin boys.

You’re expecting twins!  How exciting! After the shock wears off, you may start wondering about how you will breastfeed 2 babies!  No need to worry. With some preparation and lots of support, most mothers of twins have plenty of milk for their babies. Here are a few general tips for ensuring ample milk supply when breastfeeding twins:

  • First of all, don’t listen to anyone who says you won’t be able to do this! If you can make enough milk for one baby you can make enough for two! In fact, the research shows that mothers with twins make MORE than double the amount of milk for one baby and moms of triplets make more than triple. Yes, our bodies over-compensate. Another cool thing. Your breasts know you are carrying twins before they are born and prepare accordingly!
  • Find other moms who are breastfeeding twins and enlist their support. La Leche League may be a good resource to connect with moms of multiples. Many communities have support groups for families with multiples. In Seattle, it’s Seattle Families of Multiples. Get connected while you are pregnant!
  • It would be a good idea to meet with a Board Certified Lactation Consultant (IBCLC) while you’re still pregnant. Especially true if this will be your first experience breastfeeding. She will help you find resources, locate the best breast pump and help you develop a plan for success.
  • Read books about breastfeeding—general books as well as books about twins. One of my favorite twin resources is “Mothering Multiples” by Karen Gromada.
  • Plan on renting a hospital grade pump to use until your milk supply is established. If the babies are born early, or one or both have trouble breastfeeding at first, you will have a machine that can act as a substitute for your babies. Pump as often as your babies eat! Of course, if your babies are both nursing well from birth, you will have no need for a pump. Remember if only one twin is nursing well, you will still need to pump to simulate 2 babies at the breast!
  • Research shows (as well as the experience of my clients) pumping 8x a day will yield the same amount of milk as pumping every 3 hours. So if babies can’t breastfeed yet, give yourself a break and sleep for 4 hours in a row at night. You can pump more often during the day to get in those 8 pumpings!
  • Hire an experienced, trusted lactation consultant (IBCLC) as soon as possible after the babies are born. It’s very important to get things off to a good start. Expect the LC to be supportive of your efforts and positive about your desire to exclusively breastfeed. I recommend asking her about her experience/philosophy before you meet with her. Your local twins group may have some recommendations.
  • Plan on doing nothing but feeding babies, feeding yourself and sleeping for the first 3-6 weeks. (Longer if the babies are premature) You will need help for meals, laundry, cleaning and errands. Let your wonderful helpers do everything non-baby. Your babies need you! Everything will feel much easier and you’ll be able to cope well if you take good care of yourself. Hiring a postpartum doula who is experienced with twins is a great investment!
  • If you’re having trouble with supply or babies aren’t breastfeeding effectively, try pumping for 5-10 minutes immediately after breastfeeding them. This will help you remove any milk they left behind and tell your body to make more milk.
  • Breastfeed simultaneously as much as you can. This tells your body definitively that you have twins and you need to make a lot of milk NOW.
  • Familiarize yourself with lactogenic foods. Milkmakers are one delicious way to help your supply. Foods that are rich in calcium and iron are also supportive. There are a variety of herbs and medications that can help increase your milk production, but please check with your IBCLC for advice!
  • Yes, it’s true that some mothers are not able to make enough milk for their babies. If that is your situation, you can still breastfeed. You can use donor milk or formula for supplementation when necessary.

Note: Many sets twins or triplets were conceived with the help of IVF or some other technology. If you have fertility issues, please be extra cautious the first week or so after the birth of your babies and seek help from an IBCLC immediately after birth.  Some causes of infertility are correlated with low milk supply. If you are prepared, you can avoid unnecessary newborn weight loss.

See also, “Breastfeeding Twins? Yes!”

IGT: Four Stories from Moms Who Have Been There

Nursing with homemade SNS

Nursing with homemade SNS

This post is dedicated to the incredible moms I have met over the years who have IGT.

The stories below are as uniquely individual as the mothers who wrote them. Even so, they do have many elements in common. All of these moms were very committed to breastfeeding. None of these moms were screened for possible IGT prenatally or early enough postpartum to avoid severe infant weight loss. All of these babies lost a significant amount of weight—a weight loss that was completely avoidable. All of the mothers put an extreme amount of effort into producing enough milk for their babies. All of these mothers have felt guilt and remorse—even though none of this was their fault. All of the mothers received inappropriate advice from the professionals they trusted to help them with a very basic function—feeding their babies. These mothers have no reason to feel shame. It is our system that has let them down. Continue reading

Low Milk Supply: Could it be IGT?

Baby and mom breastfeeding with IGT

Baby and mom breastfeeding with IGT

Your breast anatomy was determined even before you were born. During the early months of fetal development, breast buds are formed. If the breast buds do not develop properly in utero, development in puberty may not occur normally. Breasts may develop minimally or not at all. And future milk making ability may be compromised. Continue reading

Thankful for Breastfeeding

Thankful for baby bliss.

Thankful for baby bliss.

Recently a client sent me a nice note with a generous check. She had been feeling gratitude for the help she received to breastfeed her son. There were multiple lactation consultations in her home, a frenotomy (the procedure to release a tongue tie) and body work for baby. There were many up-front costs–some of which were not covered by insurance. Here’s what she wrote: Continue reading

Choosing and Preparing Formula for your Newborn

DSCN1955You may be wondering… why is a lactation consultant writing about formula? Because in my world of breastfeeding difficulties including chronic low milk supply, mothers often find they need to supplement breastfeeding with another source of nutrition. Sometimes that’s donor milk from another mother, sometimes banked human milk. But most often it is commercially available formula.

All formulas are not created equal. There are pros and cons to various brands. There are milk-based formulas, soy formulas, organic, non-organic and special formulas. But the most important distinction in my mind is liquid vs powder. Why is this so important?

It turns out that powdered infant formula (PIF) is not sterile. The manufacturing process does not allow for elimination of all germs. In addition, preparation of the product in the home can lead to further contamination. The most concerning bacteria found in PIF is called Cronobacter bacteria.

Cronobacter bacteria is an organism that thrives in dry conditions and it’s very prevalent. The bacteria is found in dry herbs and spices, herbal teas, dry milk manufacturing facilities and household vacuum cleaners. It has also been found in waste water. It can thrive on plastics, rubber and silicone bottle nipples. Clearly it is difficult to avoid this little beast.

Becoming sick from Cronobacter is a rare event, but it can be deadly in young infants. Premature babies and infants younger than 2 months are most vulnerable to Cronobacter illness. Cronobacter illness can lead to blood infections or meningitis. According to The Center for Disease Control (CDC) there are about 4-6 reported cases of Cronobacter illness in infants per year, but it may be under-reported. Recently more awareness has led to higher reported numbers. There were 13 known cases in 2011.

Breastfeeding is the best protection against Cronobacter infection. If possible, provide your baby with breast milk—especially for the first 2 months. “Almost no cases of Cronobacter infection have been reported among infants who were being exclusively breastfed.” (Center for Disease Control and Prevention website).

If your baby uses formula, choose formula that is sold as a liquid. Liquid formula is sterile so is less likely to transmit the bacteria. This is especially important for very young or premature babies.

If you choose to use powdered formula, please do so safely with good hygiene in mind.

  • Always wash your hands prior to preparing formula.
  • Use clean tongs to fish the scoop out of the container. Wash the scoop after every use.
  • Clean bottles in hot dishwasher or hot soapy water plus sterilization.
  • Use only clean work surfaces when preparing the bottles.
  • Use hot water to prepare the powdered formula—at least 158 degrees F(70 degrees C) This temperature is necessary to kill the bacteria. Cool to room temperature before feeding to baby by placing closed bottle in ice bath.
  • If you make the formula ahead of time, refrigerate it immediately and use it within 24 hours.

The Center for Disease Control and Prevention: has more information on this topic. The World Health Organization (WHO) has created a PDF in several different languages that includes guidelines regarding formula and breastfeeding.