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.

Home Visits: I usually can see clients in Seattle and surrounding areas within 24 hours of the initial call–and very often the same day. Clients are responsible for payment at the time of service. An insurance superbill and instructions for submitting an insurance claim are provided. Most insurance plans cover my visits in part or in full.

*Office Visits at Docere Center for Natural Medicine No upfront fees! Insurance is 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-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 video conferencing (similar to 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

General support for moms in Seattle area–No appt. necessary. For a virtual breastfeeding support group, please request to join my local (Seattle area) facebook support group:  Breastfeeding and Pumping Support in Seattle. Over 400 moms will welcome you!

 

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

Guest Post: Two Big Reasons to Skip Rice Cereal

The following is a guest post from Beth Martin. Beth is a certified Nutritional Therapy Practitioner (NTP) and the owner of Small Bites Wellness in Seattle, Washington. She is passionate about whole food nutrition for the whole family and believes that ANY change you make in the pursuit of your health, or your child’s health, is worthy. Health is a journey, not a destination. Thank you Beth, for this great information!

I recently shared the most common reasons pediatricians recommend rice cereal as a first food for infants.

IMG_1091I advocate feeding children nutrient dense whole foods that naturally contain the macronutrients, vitamins, and minerals they need to grow and develop. Rice cereal does not fit into this paradigm as a first food, and here’s why. Continue reading

Guest Post: Why Pediatricians Recommend Rice Cereal (and Why I don’t Agree)

The following is a guest post from Beth Martin. Beth is a certified Nutritional Therapy Practitioner (NTP) in Seattle, and the owner of Small Bites Wellness. She is passionate about whole food nutrition for the whole family and believes that ANY change you make in the pursuit of your health, or your child’s health, is worthy. Health is a journey, not a destination. Please contact Beth for questions about your family’s nutrition.

IMG_0117For decades, rice cereal has been the recommended first food for infants, sometimes as early as two months of age. In recent years, some doctors, nutritionists and the American Academy of Pediatrics (AAP) have begun to change their stance on rice cereal. Continue reading

Frenotomy Aftercare: Effective and Respectful

Your baby has had a frenotomy/frenectomy (frenectomy is the term for laser frenulum release and frenotomy for scissors) and the last thing you want is for it to heal incorrectly–possibly requiring a second procedure.  You probably got a handout with instructions for aftercare. It sounded simple when your IBCLC was discussing it with you.  But now that you’re home with baby, it all seems so confusing. What are all these “stretches” and “exercises” people are talking about?

Your provider might call them “stretches,” or “sweeps” or “exercises”. Whatever they are called, there is one purpose–to ensure that the frenotomy site heals as open as possible; which, in turn, will give baby more mobility (movement) of his tongue. We want that beautiful diamond that was created with the frenotomy or frenectomy to stay a beautiful diamond. Just like the one below.

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This photo was taken just a few days after a laser frenectomy. The color of the diamond is normal. It will be white or yellowish for a few days before it fades to pink.

 

 

 

 

Doing effective aftercare means you have to get your fingers in your baby’s mouth.  You’re not used to it. It feels strange. And baby likely won’t be thrilled about it either. Keep in mind, however, that there are probably a lot of things that your baby objects to, but you do it anyway, right? You change her diapers, bathe her and put clothes on her–all with some degree of protest from baby.

A few pointers to make this easier for both you and baby. Ask permission–verbally or by gently tapping on mouth with your fingers. Be matter-of-fact about the process and let baby know what you’re doing. Keep it short. Lastly, no need to be rough–you can be gentle and still be effective.

Here’s a short video of a tongue tied baby who is graciously helping to demonstrate aftercare. Most babies–including this one–really dislike anything under the tongue. She lets us know that she is not happy about the “forklift” maneuver, but she is not in any pain. Note: This is before the frenectomy so the frenulum is still present.

 

 

The photo below shows the forklift maneuver from the perspective of the parent. Note that the IBCLC in the picture is approaching from the top of the baby’s head. This is the most effective way to get complete separation of tongue and the floor of the mouth. The middle fingers are holding the chin to get separation–not merely a lift of the tongue. If you only lift the tongue, the jaw will follow and separation will not occur.

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Gloves are not required if you are the baby’s parent! But some parents do use gloves to do the aftercare because of concerns about fingernails. It’s up to you. Do whatever works for you to ensure that these “exercises” happen at least 6 times per day.

Finally, whether laser or scissors, please schedule a follow up with your IBCLC and your frenotomy/frenectomy provider about 5-7 days post procedure. You and your baby will benefit most from the procedure with timely follow up.

See also: “My Baby is Tongue Tied?”, “Twenty Things You Don’t Know about Tongue Tie”

If you suspect that your baby is tongue tied, I’m happy to help! No matter where you are around the globe, virtual consultations are available. If you’re in the Seattle area, we can meet in your home or at Docere Center for Natural Medicine.

For frenotomies in the Seattle area I highly recommend Dr. Chenelle Roberts at Docere Center for Natural Medicine in the Greenlake neighborhood.

Virtual Lactation Consultations

Meeting with a terrific IBCLC in person can be a game-changing moment for a parent struggling with breastfeeding challenges. But what if there is no IBCLC in your area?Maybe you’ve had a less than helpful experience with your local lactation professional. Or, perhaps you’re looking for a very specialized type of expertise. In all of these situations, a video conference may be perfect for you! With the advent of video conferencing platforms similar to skype and facetime, I can now see my clients and their babies from 1000’s of miles away!

Here’s what Dani had to say after a recent remote consultation with her and her baby who was refusing the breast:

“Renee was able to help our family tremendously even through cyberspace! She was very professional and respectful, I felt very comfortable– almost like she was in the same room with us. She also had great follow-up and support with our family. We were able to start exclusively nursing again after a several month break and other barriers in just a few days!”

This parent was able to show me frenulum of baby from afar.

This parent was able to show me the baby’s frenulum from afar.

If you like the idea of a remote consultation, here’s what you need know:

  • Consultations need to be scheduled in advance. I can usually schedule w/in 24-48 hours of your request. Be sure to let me know your time zone when you request an appointment!
  • I use a HIPAA-compliant platform so you don’t have to worry about privacy. There are no recordings made during your session.
  • Once your consultation is scheduled you will receive an invitation via email. You’ll be asked to download a small file so you can use the platform and we can see each other. This process is simple and takes less than a minute.
  • You will need to have high-speed internet to participate in a virtual consultation. A laptop, tablet or phone can be used as your camera. A helper to aim the camera can make things go smoothly.
  • Good lighting is essential—especially if I need to look into the baby’s mouth. Have a flashlight handy just in case.
  • If you’d like to bill your insurance company, you will be provided with a superbill and instructions for how to complete it.
  • Consultations last about an hour. Follow ups can be scheduled as necessary.
  • Payment for your consultation is made in advance through paypal. If you don’t have a paypal account we can make other arrangements for credit card payment over the phone.
  • I will do my best to locate professionals in your area who can help support the plan we develop together.

If this sounds good to you, shoot me an email to schedule. I look forward to meeting you soon!

 

Ten Facts You Must Know about Insurance and Breastfeeding Support

My dear colleague and friend, Joy Funston, recently attended a webinar to understand the rights of the breastfeeding mother under the Affordable Care Act. (In the US) She graciously shared what she learned with her colleagues. We collaborated to write this post and bring this important information to as many mothers and mothers-to-be as possible.Thank you Joy!!

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If you are in the U.S, you have probably heard that the Affordable Care Act (ACA) mandates insurance coverage for lactation support. You are correct! Unfortunately, the details of the law are vague,and that has created loopholes for insurance companies to jump through.

For example,  the law requires that insurance companies develop a network of breastfeeding professionals. The may “say” they have a network of lactation consultants, but on closer inspection, it is found that lactation services will only be a covered expense if they are provided by a licensed medical professional such as an M.D.  As we know, the vast majority of M.D.’s do not provide lactation services.

Another important aspect of the ACA is mandated coverage for breast pumps & supplies. Unfortunately, no details are included. What type of pump?  Who decides?

The National Women’s Law Center in Washington, DC has attempted to be a resource for moms trying to access coverage and to IBCLC’s offering assistance. The following information is from a webinar that they provided. 

Know your rights! If your insurance company has denied lactation services by an IBCLC, here are the points that you can argue with your insurer:

1.The lactation portion of the ACA states that specific benefit are covered “for the duration of breastfeeding.” Insurance companies are not in compliance with the law if they have arbitrary rules for a set number of consultations or certain age of the baby. There are a couple of exceptions: “Grandfathered plans” and some private “self-insured” plans do not always have to follow the ACA.

2- IBCLC’s are ready and available as trained experts in lactation. No other credential comes close. And no other credential is needed. 

3. While not the intent, ineffective breast pumps satisfy the law. The ACA does not specify the quality of a pump.  Note from Renee: Given the law as it is now, I recommend purchasing your own pump if your insurance company will not provide the type that you need. .

4. The ACA does NOT include a requirement of return to work or school for breast pump coverage.

5. Tricare, insurance for military personal, is NOT covered by the ACA. But things are changing. Recently there was a mandate for covered benefits by the armed forces appropriation’s bill.

7. New marketplace plans ARE, in fact, covered by the ACA.

8. The law mandates “no cost sharing” for lactation support services. This means no co-pay, no deductible and no co-insurance cost. Period.

9. Each insurance company is supposed to provide in-network professional lactation support options. If there is no in-network option provided which is geographically accessible, you may go out of network for support. Keep in mind that the vast majority of insurance companies do not allow IBCLC’s to become in-network providers. The insurance company can use this to deny benefits. This is a “Catch 22” situation and needs to be reported.

10. Any complaints about insurance noncompliance should go directly to your state’s insurance commissioner.  Every time. Every mom. Every problem. Note from Renee: Washington state’s insurance commissioner is very responsive! Documentation of insurance noncompliance can also be reported to www.coverher.org.  They hope to continue to compile data & to be a resource.

And finally, part of the ambiguity in the implementation of the ACA is that the insurance companies are not acknowledging who actually is the expert breastfeeding professional. IBCLC is an international recognition– the only professional qualified to step into the role the law envisioned. But IBCLC does not come with a “license” and in the USA, Insurance companies traditionally reimburse the services of licensed professionals only. Please support state licensure of IBCLC’s when you can.

Sadly the law was not precise… But the intent was very clear. Mothers are absolutely entitled to healthcare benefits for lactation support. Consumers need to demand the coverage their premiums are mandated to provide.

Joy Funston, RN, IBCLC. RNC is in private practice in Charlottesville, VA.  She can be reached at www.joyfulstartlc.com.