All posts by Nancy Holtzman

Tummy Massage for Gas

Breastfeeding, Infant Health & Safety, New Moms, , , , , ,

Tummy massage for gas

Unlike other types of infant massage, this one has very specific hand movements and a very specific purpose. To gently stimulate peristalsis, to encourage motility of intestinal contents (BM and gas),  to provide a “cueing sound”, and finally to offer something for baby to strain against.

Here’s how to do my very specific “Tummy Massage for Gas”

  • Hand-Over-Hand on the Lower Belly: Gently stroke your baby’s tummy from top to bottom using first one hand, then the other, like a paddlewheel. As the belly first tenses, then gradually relaxes, press your hand deeper using a scooping motion.
  • Whoosh! Add your ‘whooshing” sounds during the which soon baby will recognize signals relief or relaxation.
  • Straight Across: Now stroke from YOUR left to YOUR right – straight across, gentle but moderate pressure, just at or below the belly button.
  • Now, Across and Down: Continue the Straight Across stroke, but now ADD the downward stroke, now moving across and down, ending inside the baby’s thigh crease. It’s like a sideways “L” or “7”.
  • Legs Up and Hold’em In Place: Flex baby at the hips and knees toward the tummy, gently press and hold in place, counting slowly to twenty. Repeat the entire sequence two or three times.
    (video coming soon)

Many babies will pass gas during the exercise or have a BM a few minutes later – success and relief for everyone!

Blocked Ducts and Clogged Nipple Pores

Breastfeeding, New Moms

Blocked Duct Care Plan

“Heat, Rest, Empty the Breast & Add Ibuprofen”

  1. HEAT before nursing or pumping
  2. COLD after nursing or pumping
  3. Ibuprofen 600mg every 6 hours with food/snack, for 48 hours as an anti-inflammatory (though will also help with discomfort)
  4. Frequent nursing or pumping with gentle breast massage and strokes toward nipple.
  5. COMBING the breast: get in the shower, soap up the breast, and use a wide toothed comb (or the long flat handle of a toothbrush) to comb from the base of breast down toward nipple, from each quadrant of the breast.
  6. DANGLE FEED (or pump) after shower/combing the breast. Lay baby on her back on floor, get over her, hands & knees with breast “dangling down” in free-fall, no bra, and nurse (or pump). Gravity helps draw any blockage down and out.
  1. Clogged Nipple Pore too? If you ALSO see what looks like a tiny white or yellowish “dot” on the nipple immediately after nursing or pumping, that is likely a related “clogged nipple pore” or “milk blister”.
    ADD the following to the treatment above:
  • Warm Soaks twice daily (shower counts) – warm/hot compress (wet washcloth or soft paper towel) or “dip”/lean nipple into a bowl of warm water for 2 minutes.
  • wear a cotton ball dipped in olive oil over your nipple for an hour (or longer is ok) after the warm soaks to help soften the local blockage. Then,
  • Apply a tiny dab of Hydrocortisone cream 3x/day to (only) the sensitive “clogged pore” dot.

Notes:
When a blockage clears, the breast still may feel bruised and tender for several days.

Do not “over-enthusiastically” massage/comb too hard – you don’t want to bruise already sensitive tissue.

Remember, a sore breast + fever and chills and flu-like symptoms = mastitis

 

© Nancy Holtzman RN IBCLC CPN

 

Why I LOVE the NuRoo Pocket

Baby Sleep, Breastfeeding, Infant Health & Safety, New Moms

 

1. Skin to Skin for Parents and Preemies

The NüRoo Pocket is one of the only products truly designed to be completely NICU-friendly, allowing safe and uninterrupted Kangaroo Care for tiny preemies. Various secret openings allow nurses access for lines and monitors, and baby’s face is visualized the entire time.

Skin to skin care has many (many!) evidence-based benefits for baby (brain development, weight gain, heart and breathing regulation) and for mom (milk production, postpartum recovery) – these things are especially important for preemies, but are highly beneficial for every newborn or young infant. Skin to skin care is not just for premature babies, but when used in the NICU setting, the NüRoo gives a new mom a comfortable, discreet Kangaroo Care experience.

2. Truly the Perfect First Baby Carrier: Safer Babywearing from Newborn to 15 lbs

It’s quick, easy and secure and very simple to use, which helps new moms feel more confident with babywearing and soothing. Learning to use a wrap or ring sling can feel overwhelming to a new mom, and the inserts needed for soft structured carriers add a lot of bulk. Young babies need to be held, cuddled close and kept moving so much of the time! It’s important for a new mom to be able to put her baby into a carrier swiftly, easily and safely positioned. This carrier is designed specifically for tiny newborns through about 3-4 months – it’s rated to 15 lbs. Use it as a baby carrier, but at home, take advantage of the ability for true skin-to-skin babywearing, which helps with breastfeeding and milk production.

3. It feels sooooo good to wear baby in this “garment”

I’m a chronic baby-wearer and advocate, both personally and professionally. For the past 25 years, I’ve had the persistent desire to scoop up young babies and pop them in a sling. And I’ve always looked at various objects (scarves, bags, backpacks) and pieces of clothing and said “wow, I could make a baby carrier out of that!” (and, frankly, have been known to do so, with varying levels of success…)  This is exactly the shirt/system I’ve created “makeshift” numerous times in the past. Baby slipped inside a snug stretchy shirt, then safely secured by the tails of a sweater or over shirt. And, like magic, here it is.

I’m calling it a baby carrier, but it’s really a shirt (and fashionable, at that). Stretchy, lightweight fabric feels comfortable on, but once you have baby in the pocket and secure the waist-band support belt snugly, it truly feels wonderful. You can run your hands over that sweet baby bump and with your baby cuddled so close, secure and content, look down and kiss that sweet head, then go take a walk or make a sandwich in the kitchen.

4. I’ve watched it grow and develop – and now, be born!

The NüRoo Pocket is the result of several years of hard work, research and love by two Rhode Island mamas Daniela and Hope (moms, health care providers, and kangaroo care/skin to skin specialists), who asked to meet with me at Isis Parenting in 2011. I admit to being initially skeptical (Do we really need another baby carrier? Do we need a special garment to facilitate skin to skin care?), but after seeing the early prototypes, I fell in love with their vision. And over two years of development, they returned again and again to show updated prototypes, discuss features and fabrics, and bring samples for me to try and comment on. In 2013, I finally saw the end result and I was blown away. This is the perfect product for safe, easy newborn and infant babywearing, and a wonderful gift for a mom with a baby in the NICU. Available at Babies R Us and online at NüRoo Pocket.

Take a Bath with your Baby!

Infant Health & Safety, New Moms

Does bathing with your baby seem like an odd idea, strangely appealing, or both?   Even a very young baby can go in the tub with either parent. The warm, deeper immersion is very relaxing yet stimulating to newborns and infants, perhaps reminding them of time floating in utero. You and your baby will love it, and it’s the easiest way to bathe your baby without screaming, while also earning you a nice hot soak at the end – that alone should make you a convert!

Why take a bath with your baby?

Baby’s happiness: Newborns often cry in the infant tub because only half their body is submerged in the warm water while the other half is cool. Also, the smaller amount of water tends to cool off quickly. Floating in a warm deep tub with a parent is a very different and enjoyable sensation for your baby. In the bathtub, watch your baby, with wide open eyes, calmly stretch out her arms and legs and float. It’s also very easy to wash your baby head to toe in the big tub, and it’s certainly a beautiful photo opportunity!

Bonding: Skin to skin in warm water is a delicious feeling for both parent and baby. In a breastfeeding family, having the non-nursing parent take a bath with baby offers physical closeness and is a bonding activity that has nothing to do with feeding and changing diapers. Partners enjoy having a special activity to share with baby, and being the one to have a regular baby-bathing routine. If dad feels a little funny about it, he can wear boxers or swim trunks.

Start any time: Some parents begin co-bathing during baby’s very first week – you don’t need to wait for a newborn’s cord to fall off before giving an immersion bath. Simply dry the area around the cord gently after bathing. Some parents find co-bathing a perfect remedy to a young baby who screams in the infant tub, or who no longer fits in the baby tub but is still too young to sit alone in the big tub. At any rate, there’s no age or time limit on co-bathing – it’s neither too soon nor too late to give it a try.

How to do it: Set up for Safety and Success

Prepare the tub: Your bathtub doesn’t have to be especially large or pristine. Rinse out the tub, and then fill it deeply with water that is quite warm – not as steamy as you’d like if you were bathing for relaxation, but not lukewarm either. Don’t use bubble bath, this is irritating to baby skin.

Prepare the room: Gather what you’ll need for washing your baby, and set up a diaper, lotion and clothing for afterwards. Keep the bathroom door closed while you’re filling the tub, to create a warm and humid room environment. Set up your baby’s bouncer seat or car seat, lined with a bath towel and cloth diaper, right next to the tub. Place your naked baby in the seat and then get into the tub yourself.

In and out safely: Once you’re safely sitting in the tub, reach over and pick up baby from her seat. When exiting the tub, do the same thing in reverse: while still sitting in the tub, lean over and place baby back in her lined seat and cover with the towel before exiting the tub yourself. This way you’ll avoid needing to climb in or out of the tub while holding your baby.

Floating in the Bath: With your hand behind baby’s head, allow your baby to freely float – she’ll LOVE the deep warm water. Watch her arms and legs stretch out, wave and kick. Your baby’s eyes may open wide open in amazement while she remains calm and alert throughout the bath. This is the perfect time for your partner to take some photos!

Don’t drink the water: Always keep your baby’s chin above the water line. Babies may try to lap at water they feel near their lips. Try to avoid your baby’s drinking of the bath water (though a lap or lick of water will not harm your baby). If you notice that your baby pees, don’t worry! Baby urine is a tiny amount and essentially sterile and is no problem in the tub. Poop, however, does end the fun – fortunately, it’s a rare occurrence!

The Hand-Off: If your partner is home, arrange to “hand off” baby after her bath. Your partner can get baby soothed, moisturized, diapered and dressed – all without your interference. All the while, YOU can add more hot water to the tub and soak for another 20 minutes! This may be the only time all day you’ve spent caring for yourself or having your own space. When you’re in the tub, you also can’t hover, help, critique or multitask. Just sit there, relax and soak.

 

The Gassy Baby: Such Digestive Drama

Baby Sleep, bottles, Breastfeeding, Feeding, Infant Health & Safety

“Why is my baby so GASSY?”
Is your young baby gassier than the average baby? Most newborns are both gassy, and dramatic about it, with lots of grunting, straining, arching, thrashing and tooting, and so it’s not surprising that most moms believe their new baby must be “gassier than normal”.

If your baby is gassy, it’s probably not from something in your diet, nor a sign he wasn’t burped enough after a feeding. Intestinal gas is a normal byproduct of food or milk digestion rather than from air swallowed while eating or crying. Most swallowed air will eventually come up as a burp (sometimes with milk attached) either with or without your help.

The Gastrocolic Reflex – or –  Why young babies are squirmy, grunty, gassy little people who are dramatic about their digestion

Most newborn gastrointestinal distress is caused by the sensations of motility, called the Gastrocolic Reflex, rather than gas. These peristaltic wave-like muscle contractions of the stomach and intestines propel stomach contents and stool through the small and large intestines. The gastrocolic reflex is triggered when your baby begins swallowing during a feeding and the stomach receives the milk. Inch by inch, the entire GI tract begins to wake up and contract, all the way from the stomach to the rectum. This is why babies may get squirmy or fussy 5 or 10 minutes into a feeding, and why feeding often prompts a bowel movement in a young baby.

Young babies are still getting used to the strange sensations (and products) of digestion, and aren’t shy about letting you know it. Once you see the “contents under pressure” explosion of poop some babies produce, it’s not surprising that they may react to the feeling of contents moving through their intestines at such high velocity with some distress.

Gentle Tummy Pressure can help: 

  1. Try laying your baby tummy-down across your lap, with her face turned to the side, so that her tummy is gently resting against your thigh. Pat or rub her back.
  2. Do you have a yoga/gym/physioball? Stabilize the ball and place a small receiving blanket over it, then carefully lay your baby tummy down over the ball on the blanket. Keep both hands on your baby, and rock your baby gently forward and back.
  3. The “colic hold” – drape your baby over your arm so that her face is supported by the inside of your bent elbow, and your hand is supporting her side and thigh between the legs. Her belly should be resting against your forearm. Gently press your arm, and baby, in towards your body, applying gentle tummy pressure, and either walk or sit on a physio ball and bounce.

Tummy massage for gas

  • Gently stroke your baby’s tummy from top to bottom using first one hand, then the other, like a waterwheel. Add your ‘whooshing” sounds.
  • Stroke from YOUR left to YOUR right – straight across, gentle but moderate pressure, just at or below the belly button.
  • Add the downward stroke, now moving across and down.
  • Flex baby at the hips and knees toward the tummy, gently press and hold in place, counting slowly to twenty. Repeat the entire sequence two or three times.

Many babies will pass gas during the exercise or have a BM a few minutes later – success and relief for everyone!

Is Burping Always Necessary?

bottles, Breastfeeding, Infant Health & Safety, Uncategorized

I’m often asked about burping: when to try, how long to try, what if baby doesn’t burp?  Burping is optional, not mandatory every time for all babies, and your baby may or may not burp at any given session. Chances are, you’ll learn the ins and outs of your own baby soon, and will decide how important (or not) burping may be to your baby.

Though most young babies are “gassy” (ahem: Gassy Baby: Digestive Drama) this is only partially due to swallowed air that might come up with a burp. Much of the gas experienced (and passed) by infants is related to digestion and motility, rather than swallowed air. If you are trying for a burp for a minute or two with no luck, try another position (see below) or give up and continue with the feeding or next activity.

When breastfeeding, most babies don’t take in a lot of air (though some might, especially if there is a lot of on/off at the breast during feeding) and might not have a big burp to release. However, it’s worth trying for a burp most of the time. Sitting your baby up to burp after nursing on the first breast may help to rouse her for the second breast, helping her take in a little more milk. Then, burping after ending the feeding may help the milk to settle in her tummy and prevent extra spit up. Or not.

When bottle-feeding, it’s definitely a good idea to take a pause midway through the feeding for a burp, and at the end of the feeding as well. This helps to “pace” or slow down the bottle feeding, allows for additional interaction, and may help to reduce spit up.

Whether breastfeeding or bottle-feeding, use the baby’s natural pauses to time a burp break. Don’t pull away the nipple from a baby who is busy eating – she may protest, cry, and take in air, likely defeating your goal! Instead, when she begins to fall asleep, flutter-sucks with long pauses, or releases the nipple from her mouth, that’s a good time to try.

Try these favorite burping positions for newborns. In these positions, pat your baby’s back gently, or a little more firmly, or alternate pats and circle rubs on her back, while putting a little gentle pressure on baby’s tummy area.
And, baby may not burp – it’s ok!

  1. Resting with her tummy HIGH up on your shoulder (for gentle tummy pressure) with her head cuddled near your neck.
  2. Sitting upright (or slightly leaning forward) on your lap with her chin/cheeks supported in your hand. (this one is good for helping to rouse a sleepy baby)
  3. Laying tummy down over your lap with her face turned to the side.

A note about Spit Up:
Some babies tend to spit up a lot, with or without regular burping. If you have a spitter, you’ll know!
If your baby is a spitter, position a burp cloth, receiving blanket or small towel over your shoulder or lap when burping. It’s common for a mouthful (or more) of milk to come up with a burp, and this doesn’t mean your baby overfed. Expect to see more spit up, not less, by the 3rd or 4th month as baby is eating larger volumes and jiggling her body, arms and legs more.

Freaky Baby Things to Worry About

Feeding, Infant Health & Safety, New Moms,

I spend so much of my time helping new parents understand and demystify normal baby behaviors to (hopefully) reduce their anxiety and concerns, while increasing parenting skills and confidence.  But just for fun, today I’ll just go ahead and scare you with a few freaky things that are serious enough to be real worries.

1. Hair Tourniquet.

A what? Yes, a Hair. Tourniquet. One of mom’s long hairs gets wrapped around baby’s finger or toe, cutting off circulation. (New moms – don’t be surprised when your hair begins mass shedding a few months after giving birth…) Baby’s finger gets swollen, cold and blue, but you can’t even see the culprit – the tightly wrapped hair – anymore because the finger swells around it, so parents usually have no idea why baby is screaming. Off to E.R. you go. The treatment? A nice dab of “NAIR” dissolves the hair quickly & safely without having to cut near baby’s swollen finger or toe.  If your baby is ever screaming inconsolably, after trying your usual approaches, take baby to the changing table and strip completely naked, then examine carefully, head to toe. Sometimes it’s as simple as a sharp corner of a diaper pressing into baby’s waist. But be sure to check those little fingers and toes for wrapped hair, and all the skin folds too.

2. Nail-Clipping Fail.

Nipping baby’s finger when clipping nails. Usually I’m all “Don’t worry about this; Don’t worry about that” so parents may be surprised when they tell me they nicked the baby’s finger and I’m not casual about it at all. A tiny cut at the tip of baby’s finger actually CAN be a big deal. Why? Baby fingers go everywhere and are very prone to infection. So keep your eyes on any cut around your baby’s finger or nail bed. Do warm soaks or compresses several times a day and watch the area closely.  If the fingertip becomes warm, pink or swollen and tight, call your pediatrician right away. This infection is called “Paronychia” and requires oral antibiotics to prevent a worsening infection. So if you have a little “oops” when clipping your baby’s nails, you don’t need to freak out, but do keep it clean and keep a close eye until it heals to make sure an infection isn’t setting in.

3. Febrile Seizures.

These are typically not serious in the big picture but can seriously freak out a new parent who has never encountered a febrile seizure before. Febrile seizures are most common in babies and toddlers between 9 months and 3 years.  Surprisingly, the seizure may occur at the very beginning of the fever when temperature is rising rapidly and may be the first sign of fever or illness in a toddler: a young child can go from playful to cranky to seizure in under an hour. It may be a relief to learn that febrile seizures are not related to epilepsy or lifelong seizure disorders. Keep your baby or toddler safe on a soft surface but put nothing in or near the mouth. Of course you’ll call your pediatrician after witnessing a febrile seizure, but these are usually able to be managed at home and are not a medical emergency. If the seizure is lasting more than 2 minutes, or if you are worried about your baby’s breathing, call 911.

4. Projectile Vomiting 3 times in a row.

Most babies spit up plenty, and many will randomly projectile vomit every once in a while just for kicks and giggles, but if the milk comes shooting back out quickly and with force after most feedings, that is different and concerning.  If a young baby projectile vomits 3 times  in a row,  call your pediatrician and pack your bags – you’ll be going to the hospital to have your baby evaluated for Pyloric Stenosis, a blockage between the stomach and the small intestine. This is more common in male babies, may be genetic, and most often occurs at around one month of age. Don’t worry about the rare, random projectile vomit episode, but if it’s frequent and persistent, call your doctor.

5. Nursemaid’s Elbow.

Radial head subluxation (official name, for medical-geeks) is a common injury in toddlers, caused by a simple tug, pull or jerk on the child’s arm. This can and does occur even during normal active physical play, like swinging a child by the arms for fun (not so fun in this case, and not recommended!) or if you quickly need to pull your toddler out of danger. Because infant and toddler joints are still quite loose, it’s relatively easy for the ligament to slip over the  radial head, making the elbow bone move out of place. Suspect a Nursemaid’s Elbow injury if you see that your toddler refuses to use one arm and keeps it tucked close to the body. There is usually no visible injury or swelling and very little pain as long as the arm is kept still.

I hope you’ll never need to know more about any of these issues, but at least this practical list of real-life concerns can take the place of Common Freaky Newborn Things Not To Worry About. You also may like to explore 12 Freaky Things You’ll Find in Baby’s Diaper During the 1st Year.

 

Common Freaky Newborn Behaviors NOT to Worry About

Baby Sleep, Breastfeeding, Infant Health & Safety, New Moms, ,

Normal newborn behavior can seem concerning and sometimes alarming to the uninitiated. Is she eating enough? Is she eating too much? Why is she crying? Why won’t she sleep? How much spit up is normal?  With so much to worry about, it might be refreshing to learn about some newborn behaviors that often make parents wonder, but are usually nothing to worry about. Of course, if you like to worry, here are Freaky Things Parents of Babies and Toddlers CAN Worry About.

Don’t worry (much) about…

  1. Breastfed babies over 1 month old that don’t poop every day, or even every few days. As long as they’re eating well and wetting plenty of pee-diapers, poop will happen, eventually – Probably requiring a full bath and several changes of clothing. Some dramatic babies poop only once or twice a week (but continue to eat and urinate as usual).
  2. Happy babies that spit up a lot. Whether it’s a lot of milk or a little, if the baby is otherwise happy and thriving, consider spit-up a Laundry Problem, not a pathology. If milk’s been down less than an hour, it will look and smell like milk. If it’s been down there longer, it will probably look and smell like curdled cottage cheese. Normal.  Spitting up – even 20 times a day –  is a normal baby behavior, and some healthy babies spit up far more than others.
  3. Infants who love the pacifier (once breastfeeding is well established). Give it or don’t give it, as you see fit. Don’t stress and agonize too much. It’s a just little piece of plastic, not crack cocaine. If it works for your baby, go with it. Around six months, your baby will begin to learn to self-comfort herself by sucking her fingers or thumb, and you can remove the binky altogether if you desire. If you choose to keep the pacifier, begin to restrict use to the car and crib once your baby is mobile.
  4. Occasional random projectile vomit. Yes, Exorcist Baby just likes to keep you guessing. And mopping up. As long as baby seems comfortable and is able to later eat normally without further projectile vomiting, just shrug it off  and mop it up. Repeated projectile vomiting, when milk seems to “shoot out” with volume and force, means a call to the pediatrician but a one-time occurrence doesn’t have to mean anything.)
  5. Sneezes and snuffly noses. A baby’s nose is a (mostly) self-cleaning device. Babies produce lots of thin mucus and a have reflex which causes them to sneeze a few times in a row when you step out into bright sunlight, essentially causing them to “blow” their cute little noses. Thin clear mucus, sneezing and snuffly sounds are normal for infants and are not the sign of a cold.
  6. Babies who spit up through their nose. Rarely discussed in baby books, and very normal (albeit kind of freaky). It must not be too comfortable for your baby, but there’s not much you can do about it. Remember when your friends made you laugh while drinking Pepsi and it would come out your nose? Yeah, like that. It’s all connected back there.
  7. Newborns who fall asleep but forget to shut their eyes, leaving only the whites showing. You can gently close their eyelids, it won’t bother them. They’ll grow out of this one fairly quickly. Thankfully, right? Looking for things to worry about? Here’s some Freaky Things Parents of Babies CAN Worry About.

Pumping and Working? Here’s What to Pack

bottles, Breastfeeding, New Moms, Uncategorized, ,

Heading back to work, messenger bag on one shoulder, breastpump bag on the other? There’s a surprising amount of extras to pack to make pumping at work more efficient!

What to pack in your pumping bag

  • Hands Free Pumping Bra: the Simple Wishes Hands-Free Bustier is truly a must have for those who pump regularly. Watch 5 Tricks for Better Pumping  to learn the benefits of hands-free, hands-on, double pumping.
  • Hand Sanitizer – alcohol-based, like Purell.
  • Medela Quick Clean Wipes – an easy way to clean pump parts between use, may also be used to wipe down a desk or table before expressing milk.
  • Enough milk storage bottles for the day (typically six are needed – one pair of bottles for each of three pumping sessions during a full work day) plus extra zip seal milk storage bags.
  • Lids. For some reason, moms often pack the bottles but forget the caps. Milk storage bottles don’t work so well without the lids!
  • Baby’s receiving blanket: Drape this over your lap when pumping to protect your clothing from drips, and to serve as a tactile reminder of your sweet baby.
  • Nursing cover-up, scarf or shawl for semi-private pumping locations (your cube, staff room, car in parking lot…).
  • Alternate Power Source: Extension cord or vehicle lighter adapter – Pumps that use AA batteries quickly begin to lose cycling speed and efficiency as the batteries drain down. It’s better to plug directly into the wall, or use the car battery (not while driving!) instead of an external battery pack, when possible. Pack spare batteries just in case. Pumps with internal lithium-ion batteries, like the Medela Freestyle, have the clear advantage here.
  • Non-perishable snacks or protein bars. Keep your bag stocked with high-protein snacks easy to eat with one hand.
  • Olive oil in a tiny Ziploc bag. Dip your clean finger in and lubricate the flange to reduce friction.
  • Large cooler to hold your milk and pump parts. Use several frozen water bottles as your ice packs – you can sip the ice water as it slowly melts throughout the day, while pumping.
  • Headset or earphones so you can make phone calls, listen to music or podcasts or participate in webinars (like my weekly baby chats!) while pumping.
  • Your keys or bus/train pass: store these in your cooler bag so that you cannot leave work without your day’s milk!
  • Packing List: Tape a printed checklist of everything YOU like to pack in your pumping bag, to take a quick audit when packing your bag for work each day – much less chance of forgetting something!

 

Home Visit Info (Boston or San Francisco areas)

Breastfeeding, Feeding, Infant Health & Safety, New Moms, , , , ,

Only By Direct Referral.

Home Visits for New Parents –
To help answer some logistical questions about a home visit, here’s some general information.

Who am I?
I’m a board-certified pediatric nurse (RN, CPN) as well as a board-certified lactation consultant (IBCLC), with over 25 years of experience helping new mothers, families and babies.

My areas of focus are maternal health and lactation, newborn and infant care and development, infant feeding (breast, bottle, solids) and newborn sleep. (Learn more Here and Here)

Initial Home Visit: During our consult, I will come to your home for about 2 hours, complete a detailed history, observe or assist with a breastfeeding and/or pumping session, including pre/post feeding weights with a highly accurate scale if indicated, answer all your questions, and together we will come up with a workable plan you are comfortable with. After the consult, I’ll email you a visit summary with reminders, suggestions and resources based on your specific situation. A check-in by phone or email is included after your visit, and Follow Up visits are available as desired.

Consultation Fees (San Francisco)
Initial Home Visit is $350 for the initial visit (about 2 hours) including phone/text/email check-in.
Follow Up Home Visits are $250 and about 75 minutes.
Phone consults are $150 and 50 minutes.
Day, Evening, Weekend and Next-Day Appointments May Be Available

For questions or to schedule, leave a message at 617.803.5614. 

All consults, including phone consults, include a brief summary and resources, receipt for insurance or FSA reimbursement and a check-in by phone, text or email within several days of the consultation.

I do not accept insurance, however, your insurance company may reimburse you if your policy covers lactation visits. Clients are expected to pay by cash or electronic payment at the time of the visit. I will provide you with a detailed receipt appropriate to submit to your insurance company or Flexible Spending Account (FSA) to request reimbursement.

Please DO:

  1. Have baby’s weight history and any recent feeding, supplementing and pumping  app data or logs available. (If possible, email me any summaries ahead of time)
  2. Plan to have baby ready for a feeding about 30 minutes after the start of our appointment. I will want to collect information first – but – babies are not predictable! Don’t try to “hold off” baby for too long, we’ll make whatever the situation work.
  3. Have pump and pump parts ready to use in case we want to also observe/improve a pumping session.
  4. Plan for payment at time of visit (cash or electronic payment please).
  5. Your partner, friend or a support person is welcome to be present during our consultation.
  6. Keep pets in another room. I love animals, but they are often curious or anxious with a stranger in their home and near their “people”.
  7. We’ll visit and feed where you typically care for your baby, using your usual chairs, pillows and environment.
  8. If possible, have available: a cloth diaper or burp-cloth, a receiving blanket (thin cotton),  a firm bed pillow, and a small pillow such as a couch pillow or decorative pillow. Don’t stress over this though!

Please Don’t:

  1. Worry about clutter, laundry and dishes – your home should look lived in!
  2. Shower or dress yourself or baby specially for the visit.  Be comfortable.