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Lactation and Infant Feeding Services

I have 25+ years of experience with babies and advanced training in complex infant feeding issues.

In addition to teaching you how to breastfeed, I can help you with pumping, bottle feeding, returning to work, and weaning.

No matter where you are; we can work together to reach your feeding goals.

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Breastfeeding...

 

Breastfeeding is a dance between a mother and her baby, but sometimes one or both partners find it more challenging than they imagined. That's where I come in to help.

In a typical visit, we:

  • discuss your goals

  • talk about your current feeding practices, sleep, and general routines 

  • work together on breastfeeding and/or bottle feeding

  • develop a plan that works for your family

...and Beyond

 

With over 25 years' experience helping families, I can help you feed your baby no matter what your situation

  • Bottle feeding and bottle refusal

  • Exclusive pumping

  • Adoptive or induced lactation

  • Medical issues impacting lactation and feeding, such as breast surgeries, hormonal imbalances, and anatomical challenges

  • Introducing solid foods

  • Weaning, sudden or gradual

Every visit comes with 2 weeks of follow up message support.
  • How does a virtual visit work?
    Covid changed many things, for me it was virtual visits. If you are feeling skeptical that a virtual visit will work, you are not alone. My job is to teach you how to feed your baby. When I did in-person visits, it was far too tempting for me to latch a baby on the breast or bottle, but this approach didn't actually teach a family how to latch, or do suck training, or pace bottle feed. During a virtual visit, I use a variety of props and models (mouth, tongue, baby, pelvis, breast etc). I ask families to copy me when it comes to positioning and latching. We learn best by modeling and doing things together so that you can replicate it again and again. Before we even meet, I ask that families share a few video clips of feeding so I can see what is going on. We use a secure platform for all of our communication--your privacy is important to me. While a picture may be worth a thousand words, a video is worth ten thousand words. Families can literally 'show me' the issue rather than hoping the problem will occur during the visit. Video clips are so powerful. Sometimes I can identify the issue before we even meet. Doing an oral evaluation virtually can be equally successful. Families upload 5 specific videos clips of their baby. Video examples may include the upper lip, baby crying, under the tongue, and a top view of baby. Click here to schedule a virtual consultation.
  • I think my baby has a tongue tie, can you help?
    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 are trained to evaluate both the mother and the baby. 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 monitor 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 to develop 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-release 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 extensive 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 tongue 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 understanding how everything in the body is connected and how the tongue can cause issues. ​ Bodyworkers also work on natural pain management (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.
  • Are you able to teach me about bottle feeding?
    Yes, I'm an expert on bottle feeding. I encourage families to introduce a bottle early, especially if your baby will have bottles in their future. Bottle skills, like any other skill, is a learned skill and needs to be practiced. So many families will do a trial bottle around 4-6 weeks, and then never try again until day care starts. To their dismay, baby refuses the bottle. This happens because the suck reflex fades around 12 weeks and babies can choose to suck (or not). I can help families: Choose a good-fit bottle for your baby Teach bottle skills to the bottle refusing baby Decide when and how to introduce a bottle Feeding their baby in a way that protects both breast and bottle feeding skills Select alternative methods for the older baby Wean from bottle Transition to open cups and straw cups
  • Can you help me learn how to use my breast pump?
    Yes! Pumping or expressing milk for your baby is a learned skill, and I'm here to help. It might seem intuitive to put the pump to your breast and turn it on. Bam! You get milk. But pumping is a little more nuanced. I can help you Choose the breast pump that best suits your needs and lifestyle Find the right-size flange. A good-fit flange allows for more milk in less time. Pale or purple nipples are not normal. Pumping should not hurt. Ever. Incorporate pumping into your feeding for the occassional bottle or the regular bottle Increase your milk supply Manage an oversupply Maintain your supply when exclusively pumping Navigate pumping and travel Wean from the pump
  • 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. Schedule your bottle skills consultation here.
  • I'm ready to stop breastfeeding. Can you help me?
    You worked hard to breastfeed. When you are ready to change course, I can help. Whether it's time to wean your infant, toddler, preschooler or a big kid, having an exit strategy is key! 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, growing your family, or life circumstances. Whatever your reason, I can help. Together, we will make a plan that works for your family.
  • Can I see you before my baby is born?
    Yes! I offer an array of options to support you before baby arrives. A little preparation goes a long way for a smoother start to breastfeeding. The number one comment I hear from new parents is, "I wish I had taken a breastfeeding class, I thought this would be easy." Breastfeeding may be natural, but there is a steep learning curve. I have on-demand classes to help you prepare. First time parents take my breastfeeding-basics class: Babies, Boobs & Breastfeeding: What You Need to Know. For second timers, I offer a refresher class called Breastfeeding: What to Expect the Second Time Around. For families seeking a newborn visit immediatly after discharge, I offer a newborn retainer. For a small fee, I agree to keep a 'floating' spot on the calendar to see you and your newborn after you arrive home. Learn more about my Newborn Reservation system here. A prenatal visit allows for the ultimate preparation for birth and breastfeeding. Together we will identify any risk factors and make a newborn feeding plan to get breastfeeding off the the very best start possible. Visit my scheduling page to schedule a prenatal visit and see my current class listings here.
  • Where can I find your free virtual support groups?
    ​ ​The Feeding Flock is a weekly parenting support group. My goal is to create a safe place for parents to get feeding support as well as develop friendships and community. We are not meant to have children in isolation and, let's face it, the feeding journey is not always smooth. The Feeding Flock welcomes all families. No matter how (breast or bottle) you are feeding your baby or what (human milk or formula) you are feeding your baby, we are hear to support you. The Feeding Flock meets: * Wednesdays from 10:30am to noon ET on Zoom. * Thursdays from noon to 1:30pm ET at The Toy Nest in Falls Church. * The Working Mom edition of the Feeding Flock meets virtually on the 1st and 3rd Sunday of the month at 8pm on Zoom. Register here.
  • What kinds of virtual classes do you offer?
    View our full calendar here. Breastfeeding Basics aka Babies, Boobs & Breastfeeding: What you need to know.​ ​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 to a great start. ​ 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 and you are thinking about staring solids. ​ Work, Pump, Repeat The logistics of pumping and returning to work can feel overwhelming, but with a little planning and preparation, the transition can be smooth. In this class we talk about strategies for returning to work, pumping, daycare, getting out of the house, and the weekend routine. ​ Bottle Skills for the Bottle Refuser Not all babies take a bottle easily. Bottle shape, baby's skills, and parent's techniques play a big role. If you feel that you have searched the internet for solutions to your bottle refuser and are still struggling, this class takes a gentle approach to help you and your baby find a good fit bottle, teaches bottle skills and does NOT employ a 'let 'em get good and hungry' approach. I teach a version of this class to professionals and this method works! ​ Wondering about Weaning ​You have worked hard for your feeding relationship, but many start to wonder about weaning. This class takes you through the process of weaning. Weaning can mean many things: there is rapid weaning, slow and gentle weaning, mother led weaning, baby-led weaning, night weaning, and of course pump weaning. We also talk about weaning and fertility when you are ready to grow your family. ​ Breastfeeding the Second Time Around ​ Many families say they forgot about the little things when it comes to feeding a newborn. In this class, we talk about preparing the older sibling, managing a routine with two kiddos, how to get things off to the best start possible​, partner involvement, and so much more.
  • 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.
  • I have Aetna, are you in-network?
    Yes! I am an Aetna provider. Aetna usually offers up to six consultations. Please contact Aetna to confirm that our visits will be covered.
  • I don't have Aetna. What does the visit cost?
    Initial and bottle visits are $275. Follow up lactation visits are $225. Shorter visits are pro-rated based on time.
  • Will my insurance reimburse me for your services?
    Contact your insurance company to learn about covered services or potential 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. For an additional $10 fee, my biller will submit the claim for our visit on your behalf to optimize reimbursement.
  • What's your service area for home visits?
    During Covid, I transitioned to 100% virtual support. I can literally see you any where in the world thanks to technology.
  • What kinds of things do you cover during a visit?
    Some common breastfeeding concerns include: Worries about low milk supply or slow weight gain Pain from engorgement or plugged ducts Figuring out why it hurts so much when your baby latches Unhappy baby who doesn't seem to be able to stay on the breast Colic, gas, and sleepless nights that have everyone exhausted I'm here to help!
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