I have Aetna, are you in-network?

I am an Aetna provider. Please contact Aetna to confirm that our visits will be covered. Aetna usually offers up to six consultations, with no charge to you, virtual and in-person.

Will my insurance reimburse me for your services?

Contact your insurance company to discover what portion(s) of your consultation will be covered or potentially available for reimbursement. Use this script, developed by the National Women's Law Center, when calling your insurance company to find out what level of reimbursement you might expect. Your insurance carrier may ask about my credentials, specifically my NPI and EIN Susan Howard, RN, MSN, IBCLC Registered Nurse and International Board Certified Lactation Consultant
National Provider Identifier (NPI) 1932473543
Tax ID (EIN) 46-4048039 Please note that full payment is expected at the conclusion of our visit. As a courtesy, my biller will submit the claim for our visit.

I don't have Aetna. What does the visit cost?

Virtual visits are $225 for the initial 1-hour visit. In person (temporarilty suspended): The home visit fee is $325 for the initail 2-hour visit. Follow ups are discounted to $300.

Are you knowledgeable about tongue tie?

Navigating the complexities of a tongue tie diagnosis may seem overwhelming, especially in a virtual setting. ​ I'm here to help. Tongue and lip ties fall under the umbrella of Tethered Oral Tissues (TOTs). TOTs are one of my passions. I've had extensive training to identify and support families with ties and am trained in working with clients virtually to identify, treat, and recover from TOTs. ​ A tie savvy lactation consultant is an expert in infant feeding and oral function. We are the only professionals who look at how the mother-baby dyad are functioning. We can help with not only latch, positioning, milk supply, maternal pain, feeding progression, caloric intake, sleep, pumping, and starting solids and weaning. We can help with breastfeeding, bottle feeding, spoons, solids, cup, straw skills, and oral aversions. ​​ The first step is proper identification and evaluation of oral function. Noting oral function allows the lactation consultant, parent and release provider to montior progress after a release. In a pre-frenectomy visit, it is much easier to teach the parent and child stretches and and aftercare when everyone (parent & baby) is calm. The initial visit allows for optimal care coordination and a support network for after-care. ​ Tie savvy lactation consultants are not common. We are often booked weeks in advance. ​ Post-frenectomy support is important to 1) avoid reattachment 2) prevent scarring. Post-op laser therapy has two phases 1) aftercare/stretches and 2) suck training to improve tongue function and stamina. ​ In most cases, tongue function doesn't just miraculously self-correct from a frenectomy. The release is one piece of the the puzzle. The aftercare techniques vary based on the age of the infant, toddler, or adult. ​ Bodywork is the third integral part of the tongue tie puzzle. A bodyworker is a professional who has a hands-on license to touch and extenive continuing education hours in CrannioSacral therapy, myofascial release, etc. TOT's trained bodyworkers such as occupational therapist, physical therapists and chiropractors can assist with how to the tonuge tie can impact fascial tension around the mouth muscles and alignment of the whole body. ​ Many tongue tied babies have torticollis, a head tilt, head asymmetry, or other body tension and they often hate tummy time. Including a tie-savvy body worker on the team can support the work of lactation. Tummy time is important for babies with ties and tie-savvy bodyworkers underrstanding how everything in the body is connected and how the tongue can cause issues. ​ Bodyworkers also work on natural pain managaement (massage for example) and are essential in both pre and post-op goals. These are specialty areas and not all OTs or (SLPs) are well versed in ties.

Help! My baby won't take a bottle. Is there anything we can do?

If you've tried everything to help your baby take a bottle and nothing has worked. ​ Perhaps it is time for a fresh set of ideas. I've helped hundreds of bottle-refusers learn to take a bottle. ​ First, choose a good-fit nipple shape. Bottle refusers often tolerate a soft, flexible, shoulder-less bottle like this this one. ​ Start with a fed and rested baby. Learning a new skill is hard. Contrary to popular lore, hunger is not a motivator for the bottle refusing baby. ​ The breastfeeding parent SHOULD offer the bottle. You know your baby best. Together you have shared hundreds of feeding sesions. Your baby trusts you more than anyone. Your baby will work hard for your praise. Let's utilize that trust. ​ Respect your baby. Sneaky tactics are rude. Allow baby to see the bottle, touch the bottle, touch and explore the bottle. Babies are mammals. Mammals see, touch, smell their food before consuming it. Placing the bottle nipple across baby's lips and wait (patiently) for baby to bring the nipple in the mouth. Until baby can quickly and willingly suck on the empty nipple, refrain from offering milk. Milk is not a motivator to a bottle-refusing baby. ​ Myth buster #1: sucking on an empty bottle does not fill the belly with air. Gulping and chugging causes gas bringing air and fluid into the belly with each swallow. Sucking on an empty straw or nipple does not trigger a swallow. ​ If you are still feeling stuck, let's meet. I cannot make your baby take a bottle, but I can help you figure out why your baby is struggling. In a virtual or in-person vist, I can offer strategies and help you make a plan to move forward. ​ During a bottle consult, I will evaluate your baby. This includes a full oral evaluation, observing a feeding session, recommending a good-fit nipple, and giving you and your baby some 'homework' to start on right away. We will stay in touch during the process.

What kinds of things do you cover during a home visit?

Some common breastfeeding troubles include:

• Worries about low milk supply or slow weight gain

Can I see you before my baby is born?

Discovering you are expecting for the first time or for the fifth time brings on waves of joy, excitement, and sometimes feelings of uncertainty about the breastfeeding process. Let me help you virtually or in person to build the bridge to your new normal, whether it be for the first time or for a multiple time! My preparation options include classes, one-on-one in-home prenatal consultations, and a system to guarantee a newborn consultation with me via my retainer system. Contact me to schedule an in-person prenatal visit and see my current class listings here.

I'm ready to stop breastfeeding. Can you help me?

Ideal for families in search of a judgement-free plan for weaning regardless if your 'baby' is an infant, toddler, preschooler or a big kid. Weaning is best thought of as a transition that takes place over time, just like other stages motherhood. Weaning has many facets that impacts mom, child, and the whole family. For some families weaning begins with saying farewell to the pump. There is also night weaning, day weaning, partial and full weaning. Sometimes weaning is necessary for medical reasons, family planning, or lilfe circumstances. Whatever your reason, In a virtual or in-person vist, I can help. Together, we make a plan that works for your family.

Can you help me learn how to use my breast pump?

Expressing milk for your baby is a learned skill, and I'm here to help. In a virtual or in-person vist, I will teach you:​

• How your pump works

Are you able to teach me about bottle feeding?

Lactation consultants know about more than just breastfeeding, and I'm ready to help you with all the different ways you might want to feed your baby. ​ In a virtual or in-person vist, I will teach you:​

• Choosing the right bottle for your baby

Where can I find your free virtual support groups?

Located at the Virginia Hospital Center, these free groups include a virtual community for between-meeting support. View the calendar here. ​ Mother & Baby Support Group​

• Wednesdays, 12-1:30

What kinds of virtual classes do you offer?

View our full calendar here. Breastfeeding Basics​ ​ Taking a breastfeeding class while pregnant is just as important as taking a childbirth class. Birth is over in a day or so. Feeding is a long-term endeavor. Learn the basics of making milk, latching, positioning and the essentials for getting breastfeeding off ot a great start. Monthly at Virginia Hospital Center​ ​ Starting Solids ​ Whether you prefer the baby-led weaning method or traditional purees, this class has it all. Discover ideas about what foods to offer, how much, and when. Great to take when when baby is about 5 months old. ​ Tummy Time ​ Tummy Time Basics (0-3 months): Learn how to make tummy time fun and enjoyable Tummy Time Boot Camp (8+ weeks) for babies who hate tummy time and can't meet the recommended 60 minutes/day Led by Dr. Stephanie Morici, a physical therapist specializing in infants and toddlers ​ Work, Pump, Repeat ​ Strategies for returning to work Tips and ideas for maximizing pumping ​ Bottle Skills: The Good, the Bad, and the Ugly ​ Learn about bottles, bottle skills, and prerequisites necessary for successful transitions between breast, bottle, and pacifier. Learn about various bottle brands and nipple shapes and how each impacts milk flow and a baby’s ability to drink effectively from a bottle. ​ Flange Fitting & Beyond ​ Bring your pump and learn how to make pumping more comfortable and effective ​ Breastfeeding the second time around ​ Preparing the older sibling Managing a routine with two kiddos How to get things off to the best start possible​ Monthly at Virginia Hospital Center​

Do you recommend any online breastfeeding courses?

Kick back and relax in the comfort of your own home, as you prepare for the breastfeeding journey with your newest arrival. This online Natural Breastfeeding Program offers over 60 short videos to watch on your tablet, computer, and/or smartphone. Use it to help you prepare for your first time or to refresh your memory. ​ Normally $97, I offer the chance to access it for $65. This is a lifetime membership, granting you access for use even after baby arrives! Contact me to enroll.

What's your service area for home visits?

Due to Covid-19, home visits are temporarily suspended. Please consider scheduling a virtual visit, which allows us to maintain social distancing while you get the expert breastfeeding support you need.

What do your credentials mean?

RN means I'm a registered nurse, a licensed professional trained to perform comprehensive assessments of you and your baby. IBCLC stands for International Board Certified Lactation Consultant. That means I have the highest level of training and am specially equipped to help manage ALL lactation scenarios ranging from general concerns to more complicated and high risk situations.

Do you offer virtual visits?

Yes! Click here to schedule a virtual breastfeeding consultation.