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–Anywhere in the World!

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

Meeting with a terrific IBCLC (Lactation Consultant) 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 secure video conferencing platforms similar to Skype and Facetime, I can now see my clients and their babies from 1000’s of miles away! Continue reading

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.