Breastfeeding. It’s what I’m all about as a lactation consultant. I have built an entire career around helping you to breastfeed your baby. Part of the reason that lactation consultants even exist is that our culture didn’t always place such a high value on breastfeeding. But now it seems like the pressure to avoid formula is everywhere. In fact sometimes it seems that everyone around you is concerned about whether or not your baby gets your precious milk. Continue reading
Category Archives: Lactation Consultants
Filing a Claim with your Insurance
INSTRUCTIONS for PATIENTS FILING FOR REIMBURSEMENT
You are encouraged to file a claim for third party reimbursement. By filing a claim, you may receive partial or full reimbursement and you help to establish the need for reimbursement of lactation services. You may find it helpful to contact your insurance company first. Some companies have specific forms that they require you to fill out when filing a claim on your own and most companies have a filing time limit. The following details will get you started. Continue reading
Updated: Video Consultations: How do They Work?
The family in this video “met” with me from two different countries. This is the last few minutes of a consultation. The client is talking about meeting with a local IBCLC for follow up to our meeting.
I can do a virtual consultation with you no matter where you are on the planet! We are not limited by long-distance fees—only by time zones and a decent internet connection.
Ideally every breastfeeding parent and infant would have access to high-quality in-person lactation care. The reality is that many people do not have this available in their communities. Virtual consultations are just like in-person consultations except we’re not actually in the same room. They are appropriate for any type of breastfeeding challenges you may have including, latching difficulties, questions about tongue mobility, frenotomy care, sore nipples, milk supply or pumping difficulties. These consultations are not recorded. Continue reading
Frenotomy–Parent Perseverance Pays Off
Breastfeeding always hurt for first- time breastfeeder, Tina. She was given a nipple shield to help with the pain. And it did help. Even so, she knew a nipple shield was not a long-term solution. She kept trying to get rid of the shield. She hated the thing! But every time baby latched without it it, it resulted in intense nipple pain and wounds—her nipple was painfully creased after feedings as well. So, understandably, she continued to nurse with the shield.
Meanwhile, baby Carolyn wasn’t gaining weight well. At every appointment she was gaining about ½ of expected weight gain. Baby was breastfeeding frequently—over 10x/day and still not gaining appropriately. She was having infrequent bowel movements, was gassy, and uncomfortable. Tina felt that something was very wrong. 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.
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.
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.