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What's the Buzz? Tell me what's happening: Online resources for lactation and breastfeeding

4/13/2018

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We’ve all done it - we look to google for answers and information. The internet has provided us with the ability to access information more than any other generation. We have information and knowledge at our fingertips. But what if that information is incorrect? What if that information sends us down the wrong rabbit hole?

​Breastfeeding used to be a normal part of everyday life in a community; grandmothers, mothers, aunts, friends, all breasted around each other and learned from each other. We are physically more separated now, but the internet does provide a place we can ask questions and find answers. So where do we find accurate and helpful information?
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I’ve gathered just a few of the websites where you can find helpful, trusted information about lactation and breastfeeding.

Kellymom.com - Kellymom is one of the top sites for evidence-based information. Kelly Bonyata, owner and creator of Kellymom, is an International Board Certified Lactation Consultant (IBCLC). Her articles help many families navigate issues and concerns and provide further references for follow through.

LactMed - Did you ever want to know how a certain medication might affect your milk supply or baby? From the National Library of Medicine at the National Institute of Health, you can search for both prescribed medications and over-the-counter products to determine whether or not they are safe to use while lactating.

CDC (Centers for Disease Control & Prevention) - While the CDC is not a support website, if you are looking for the latest official regulations and recommendations, it is worth visiting.

AskDrSears.com - Dr. Sears and his team are well respected pediatric practitioners. Visit his site for understanding normal infant behavior and common issues associated with breastfeeding and parenting.

La Leche League International - La Leche League has been providing peer-to-peer support for over 60 years. Along with their in-person meetings, they have forums and online groups for breastfeeding information and support.

Breastfeeding Medicine of Northeast Ohio - This organization provides in-person appointments and support, but they also have online information and resources from experienced IBCLCs. They are well-known and respected for their therapeutic breast massage and hand expression.

Information garnered online can be helpful in handling minor issues, or even reassuring yourself everything is going well. Online education is not a substitute for an in-person consultation with an International Board Certified Lactation Consultant (IBCLC). Please reach out to an IBCLC in your community for assessment, evaluation, and care.

What online resources do you find most helpful for lactation and breastfeeding?
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Trouble Trouble Trouble - With a Bottle

1/14/2018

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Ohhhh, We’ve Got Trouble, My Friends, right here in River City!
...With a capital T and that rhymes with B and that stands for Bottle!

You’ve gotten breastfeeding off to a great start; baby is happy, healthy, and gaining well. You’re feeling great about your breastfeeding relationship and that awesome milk you provide. A couple months down the road you decide to give baby and bottle, and she refuses!

For some families, bottles are essential for when the nursing parent goes back to work. For others, it may not be needed every day, but parents want to have some time to run errands, go to appointments, spend time with friends, and be able to leave baby at home. So what do you if baby won’t take a bottle?
For this blog, I will focus on tips and tricks to giving a bottle to a baby who isn’t interested. These tips are not about introducing a bottle to a breastfed baby for the first time, paced bottle feeding, or which type of nipple/bottle to use. We will discuss those topics in future posts. You’ll notice that some of these tips contradict each other. All babies are different, just as their likes and dislikes vary, so what works for one baby may not work for another. Take some time to find what works for you and your baby.
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Bottles & Milk
  • Use a small amount of milk when so that you don’t waste your precious pumped milk
  • Try slow-flow nipples since baby is more likely used to the slow flow of the breast
  • Warm the nipple
  • Try cold milk
  • Soak the bottle nipple in breast milk overnight
  • Use freshly pumped milk
  • Use unscented dish soap to wash the bottle and nipple
  • If the milk has been frozen, check for Lipase issues (Kellymom has good information on lipase issues)

Alternatives to Bottles
  • Sippy cup
  • Straw cup
  • Open cup
  • Finger feeding

Offering the Bottle
  • Nursing parent offers the bottle
  • Caregiver other than the nursing parent offers it
  • Nursing parent leaves the house
  • Distraction - music, standing in front of a mirror, playing
  • Movement - bouncing on an exercise ball, walking around, swaying
  • Wear baby facing outward
  • Offer when sleepy or completely asleep, in a side position
  • Let the baby play with the bottle
  • Skin to skin
  • Wrap bottle in nursing parent's clothes
  • Offer while bathing
  • Offer when baby is not hungry
  • Start the feeding at the breast and then move to the bottle
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Reverse Cycling
Some babies choose not to take a bottle. For short periods of time, they may not need to have milk. For extended time, they may choose to go without milk when away from the breast, and get all their milk in the evening and overnight. This situation may not be ideal, and may be more tiring for the nursing parent, but fortunately baby is still getting all his nutrients and is happy during the day.

Take your time
Your baby cannot be forced into taking a bottle through hunger and persuasion. You may have to work on it over time. It’s ok to let baby play with the bottle and nipple in her mouth, getting used to the idea.

All of these tips are for babies refusing the bottle out of preference for feeding at the breast. If it seems your baby is struggling with a bottle for other reasons, please speak with an IBCLC or your pediatrician to rule out anatomical concerns. Some IBCLCs (including myself) do bottle consults to work with your baby and help you develop a plan for guiding your baby towards taking a bottle. Bottle refusal is yet another time you are not alone. Always reach out for help.

I’ve also included this information in the attached PDF for easy printing and reference.

bottle_not_taking.pdf
File Size: 87 kb
File Type: pdf
Download File

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It's Breastfeeding Time at the Holidays

12/18/2017

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Silver Bells, Silver Bells, It’s Breastfeeding time at the Holidays


​The holidays are upon us. The errand-running, food-making, family-gathering busy season. It can feel joyous and special, even among the craziness of it all. When you have a nursing baby, especially a newborn, the excitement grows even more. Family wants to see the baby, give gifts, and be a part of this special time. The busy holiday season can also be a challenge for new parents as you navigate time with the baby, breastfeeding, and keeping away sickness. I’ve collected some of the best tips for maintaining your breastfeeding relationship, keeping baby fed, and maintaining your supply during the holiday season.

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  • You are the Parent - As we spend time with family, many well-meaning family members give advice and offer to care for the baby. Take them up on it if it fits your parenting style, but remember you are the parent. Some people may suggest things that don’t feel right to you, and it’s ok to politely decline, or nod and smile, and then continue doing what you are doing.
  • Set a Timer - Normally I recommend watching the baby and following his/her cues, rather than watching a clock, however during the holidays time can get away from us. If you are running errands or travelling, your baby may fall into a lulled sleep and may not show you signs of hunger. The same may happen in a swing during a holiday celebration, or when being passed around from family member to family member. Set a timer on your phone to remind you to feed the baby. (Your breasts may also serve as a natural timer when they start to feel full).
  • Keep Baby Healthy - Most people nowadays are cognizant of passing germs to babies, but you may want to be proactive. Don’t be afraid to ask people to wash their hands, use hand sanitizer, or not kiss the baby. While we want babies to build a strong immune system, newborns are more susceptible to germs. It’s a good thing you are providing them with all those strong antibodies through your breast milk!
  • Wear Your Baby - Use a wrap or carrier to keep your baby close. It will help keep baby calm, you can easily respond to his/her hunger cues, it’s an easy place for a nap, and it’s a polite way to keep many hands away in case of sickness.
  • Take Time Away - Nursing a baby is the perfect reason to excuse yourself and spend some quiet time with your baby in another room. Holidays can be overwhelming even for adults, and as a new parent, you may need a few minutes to rest quietly and breath. All of the activity may also over-stimulate your baby and s/he may need some quiet time with you.
  • Nurse Where You Want To - Although the previous tip mentioned moving to another room, remember that it’s also okay to nurse where you are most comfortable. If you don’t want to miss anything, find a comfortable spot amid the group and nurse your baby. Breastfeeding is a normal part of you and your baby’s life, and you have every right to nurse your baby where you see fit.
  • Accept Help - Hopefully with family and friends around, people will be willing to help. Don’t be afraid to tell them what you really need - hold the baby while you take a shower, or let you have time with your baby while they change the laundry or load the dishwasher. Most people want to do something truly helpful and will appreciate your candor.
  • Enjoy a Drink - It’s okay to drink alcohol while you are breastfeeding. It stays in the breast milk a similar amount of time it stays in your blood. A great time to have a drink is right before, or while you are breastfeeding. It takes a bit of time to get into the milk, and then by the time baby is hungry again, it will have dissipated. Don’t be afraid to enjoy a drink during the holidays.

In the end, the most important tip is to treasure the holidays and this time with your little one. I know it can feel overwhelming, especially if you are struggling with breastfeeding or the postpartum period. Take a moment to breathe and know you have created this little being, or you brought him/her into your home to love. Through breastfeeding, you are sustaining your baby’s life and giving him/her all s/he needs. That is something to celebrate!

Happy Holidays to you and yours!
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Extra! Extra! Hey Look at the Headline!

11/10/2017

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I am thrilled to share that I am now an in-network provider with Aetna and its subsidiaries. Aetna members are eligible for up to six lactation consults, with no out-of-pocket costs.

While I am happy to be park of the insurance network, I know many of my clients, and many of you out there, are members of other insurance providers. So what does that mean for you? Can you get your lactation consult covered by insurance?

For many new parents, having access to a consult with an IBCLC (International Board Certified Lactation Consultant) is a crucial step in continuing their breastfeeding journey. Several years ago, breastfeeding support, supplies, and counseling were added to the Affordable Care Act. This change in insurance law has made it possible for more parents to get the care they need, however, there are some bumps in the road and coverage is not always available. Understanding how lactation care and insurance intertwine can be confusing, so hopefully I can shed some light on the issues and provide not only resources for getting your consult covered, but also an inside look into the issues facing IBCLCs.

  • General coverage - While the Affordable Care Act did place lactation coverage into law, there are many companies and plans that are exempted from required coverage, or who have found loopholes around that coverage. They also vary in how much they will cover, and by whom. Some people are able to see an in-network provider, others are are able to get their consult completely reimbursed, and others are reimbursed for some of the cost. Call your own insurance company before seeing a lactation consultant so that you are aware of the coverage extended to you.
 
  • In-Network Providers - Each insurance company creates its own rules about how it will credential providers to be in-network with their company. Some allow all IBCLCs to apply, while others require another license, such as RN or LPN. Some companies place a cap on the number of in-network IBCLC providers in a geographic region. If the IBCLC you work with is not in-network, it may due to the limits of the insurance provider.
 
  • Remuneration - Just as coverage and network status are governed by each company, so is the payment extended to the IBCLC. We, as IBCLCs, often feel a calling to assist new families with lactation care. We believe in empowering families to continue their breastfeeding journeys as they see fit. It is often a passion, not just a job. That passion is also a way that we financially support our own families. Some insurance companies provide scant remuneration, which can vary across geographic regions. For some IBCLCs, if they were in-network, the amount of remuneration may not allow them to financially support their own families, thus prohibiting them from providing the much-needed lactation support to other families. They may choose to remain out-of-network in order to continue providing care.
 
  • Reimbursement - Since the rules are so different across companies, and even within branches of each company, I always suggest that my clients call their insurance companies to discuss what will be covered, and how much will be reimbursed. Most of my clients are reimbursed for some or all of the consult fee. I, and most other IBCLCs, provide each client with what is called a superbill (receipt with insurance codes) that can be sent to an insurance company for reimbursement. We encourage you to submit it, and re-submit if you run into issues receiving reimbursement.
 
  • Resources - We all know the insurance world can be confusing and time-consuming to track down answers. The National Women’s Law Center has put together resources to help you as you navigate the insurance world. https://nwlc.org/resources/new-benefits-breastfeeding-moms-facts-and-tools-understand-your-coverage-under-health-care-law/

As previously mentioned, if you are unsure of the coverage extended to you, call your insurance company, and reach out to a local IBCLC for guidance. The insurance market is ever-changing. While we don’t know what changes will unfold in the next few years, IBCLCs will continue to promote lactation coverage for all families to ensure equitable care for everyone.

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With a Little Help From my Friends

10/16/2017

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Whether you are singing out of tune, falling in love, or breastfeeding your baby, you can get by with a little help from your friends! Being a new parent is not easy, and the breastfeeding relationship is part of that. Finding a support group or friends group can help you have a more successful breastfeeding relationship. How can you benefit from being with other lactating families?
  • Information - There is an plethora of information out there, but sometimes we need to hear it face-to-face. Reading about issues and how to fix them online can seem like it will help, but it is often too much information. By discussing it with other parents you will be more able to figure out the cause and solution to your issues, or know when it’s appropriate to seek professional assistance.
  • Support - Sometimes we just need someone to say, “You can do this. You’re doing great.” Parenting is the toughest job in the world, and when we are surrounded by other people doing the same job, telling us we can do this, it gives us the confidence to continue.
  • Experience - We can learn from the experience of other parents. Support groups are usually a mix of people with infants and those who also have older children. Their experiences can help us come up with solutions to issues, as well as help us see that other people go through the same stages, and there is light at the end of the tunnel. As my Grandfather used to say, “This too shall pass.”
  • Camaraderie - According to the Oxford Pocket Dictionary, camaraderie is “mutual trust and friendship among people who spend a lot of time together.” Although information, support, and experience are all essential aspects of a support group, over the years I have found camaraderie to be the most important tool in new parents’ lives. The trust and friendship you build with other parents can be some of the most vulnerable and rewarding friendships in your lives. The experience of becoming a parent is like no other, and when you share that with a group of people, they may become your lifeline, the friends who understand you the most, and the people you trust with your struggles, fears, and joys of parenting.

Even for people for whom breastfeeding comes easily and may not need professional support, a parent-to-parent support group can make a big difference in their parenting journey, especially that first year.  

While most communities have formal support groups, an informal group of parents going through the same stages may also be just what you need. Check your local facebook groups and parenting sites for peer support groups.

I’d love to have you join me at our Breastfeeding Support Group. All lactating parents and their babies are welcome. It’s an opportunity to get out in the evening, whether you work outside the home or in the home, and you get the best of both worlds - professional advice and support from other parents!

Breastfeeding Support Group
1st & 3rd Tuesdays, 6:30-8:30pm

Wellsview Cottage, Annapolis

Check the Lactation Life website and/or Facebook page for up-to-date changes

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    Cynthia Bischoff, IBCLC, is the owner and provider at Lactation Life, offering lactation consults in Maryland.

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Helping you meet your goals. No guilt. No pressure. Just personalized care.

Serving Annapolis, Edgewater, Davidsonville, Lothian, Deale, Crofton, Severna Park, Millersville, Glen Burnie, ​and all of Anne Arundel County, ​as well as
​Chesapeake Beach, Prince Frederick, Dunkirk, and other areas of Calvert County. Also serving Bowie, Upper Marlboro, and other areas of Prince George's County.

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Cynthia Bischoff

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Email

cynthia@lactationlife.com

Lactation Life LLC

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