For Your Visit

Answers to commonly asked questions, info and what to expect

After we have found a good time to meet, virtually or in person, I will send you a link to my electronic medical records, MilkNotes. I ask that you fill out the record as fully as you possibly can.

Virtual visits

 

Virtual visits are perfect for prenatal classes and almost every feeding challenge. For a virtual visit, we will set the appointment time in MilkNotes. I will show up in the app about five minutes prior to the visit and open the “room.” I’ll text you and you can enter the room. If the baby gets hungry ahead of time, text me real quick and we can change the time.

  • Try to be in a well lit spot with all of your equipment handy (Haakaa, pump, shield, ointments, supplements and medications, pillows, blankets, baby).
  • If you have a helper, that’s awesome, because they can do the camera work. I like to get extreme close ups of baby mouths and feeding.
  • We’ll work on latch and positioning and get all your questions answered.

In home visits

Has your family been secluded/sequestered, or have you been tested recently? Great. If you are being very careful, and you have no COVID symptoms, we may be able to do a home visit if you agree to the following:

  • Only the lactating parent and one support adult may be present. NO other adults unless they have been strictly quarantined and tested.
  • Siblings under 2 do not need to mask up. Older siblings should mask up when possible.
  • Masks. I’m militant about masks. You must wear a mask during the entire visit unless you want to sit far apart outside, and even then, I will wear a mask. Your mask must fit. If I can see gaps around the side of your mask, I will give you a cloth mask that fits 99% of people properly.  If your partner’s mask doesn’t fit well, I’ll give them a well fitting mask, or they need to be in another space. This is not negotiable. If you cannot wear a properly fitting mask, make a virtual appointment.
  • I will be sitting as far away from you as I can for most of the visit. Normally I spend most of the visit sitting right next to my clients. I now minimize that time as much as possible.
  • Provide cross ventilation — one window and one door, two windows.
  • Provide paper towels or a dedicated cloth towel.
  • If any adult present is not willing to wear their mask properly despite me asking, and I feel threatened, I will conclude the consult, request payment, and leave the space. We can set up another virtual consult or I can refer you to another provider. There are only a few IBCLCs doing home visits during COVID and we all need to keep our families safe. (I wish I didn’t have to include this clause, but having had this experience, I need to make this very clear).

A few facts about our consultation:

  • It is my business to go into homes of new families. I am accustomed to messy houses, parents who haven’t bathed, and dishes in the sink. Don’t clean up on my account (although I’m deeply grateful if someone cleans the litter box). I adore dogs and they tend to sit on me during visits. If you have a nervous dog, please secure it ahead of time. I love cats too.
  • You are the only family I will visit that day. I will give you an appointment at a specific time, however, that time is flexible.  I will contact you first thing in the morning to see how your feeding schedule is going. I want to arrive shortly before the baby feeds so they are still resting while I wash my hands, sanitize my equipment, and set up my scale and log in to your network. I like to have a chance to chat with you prior to having to feed a hungry baby. So I’d rather change the appointment time half an hour in one direction or another to accommodate you.
  • If the baby absolutely cannot wait to eat right before I arrive, please call me at 206 353 9334. If you need me to watch the baby eat, and the baby is full, we might need to reschedule.
  • I normally weigh the baby before and after a feed. It’s ideal if the baby is dressed only in a diaper and wrapped in a blanket when I get there. I like to see baby skin to skin, plus, it will make weighing baby so much simpler.
  • We’ll go over lots of background questions and give you plenty of time to get your questions answered.
  • If you are comfortable doing so, please wear a bra or tank top you can easily slip off or down to your waist, with a shirt or sweatshirt that zips or buttons. If you are not comfortable with this much bare skin, please wear whatever clothing you wish. At minimum, I will need to be able to see your nipple and any other affected area. When babies nurse in a skin-to-skin situation, it triggers the mother and baby’s innate reflexes and enhances breastfeeding success.
  • While it is usually necessary for me to touch you during my work, if you become uncomfortable at any time you need only let me know and I will stop immediately. I will ask your permission prior to touching you or your baby and will check with you frequently to make sure you are comfortable.
  • Your partner or support person is welcomed and encouraged to join the visit.
  • I will send you a written plan via MilkNotes within 24-48 hours of our visit.
    I will fax a report to your health care provider(s) within 24-48 hours of our visit.
    You should feel free to text or email me for follow up. MilkNotes contains a secure portal and you can drop questions to me there any time you need. If you would like, I am really happy to do follow up visits to make sure the situation continues to improve.

If you have any other questions prior to my visit, please let me know.

Insurance: I am a preferred provider with Aetna! I will do the billing for you, and Aetna covers up to 6 visits in your home. Some Aetna subsidiaries do not cover the entire visit. Call or look up on your HR website to make sure I am in your network. They usually cover all but a very small amount.

Almost all other insurance companies are trying to evade the ACA by only covering “licensed” IBCLCs. Please ask your insurance what type of lactation consultants they cover. I am an IBCLC, the highest standard of lactation support — but Washington State does not yet license IBCLCs. We are working on it! Most insurance including Regence, Premera, BCBS, Cigna (ugh) and others may tell you they cover lactation, but what they mean is they will pay for a doctor or a nurse who is licensed but not necessarily a lactation consultant. Frustrating. If insurance coverage is vitally important, I can help you find a provider who may be in network.

Fees

Please contact me regarding the fee structure. If you have lost income as a result of the pandemic, I will discount the visit for you.

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