My archives might be a little outdated especially the older blogs. My links above are all new and current.

I have only positive things to say about Permission to Mother, an autobiographical account of a thoughtful mother and clinician who courageously writes from her heart, soul, brain, and personal experience; who is open to change in her views and opinions and is not guided by the safety of rules of any group or the status quo; she is guided by love and openness to the experiences life brings her and her family. Her process benefits her and those around her and those who read her words. And to add to that, the writing style and story telling ability here make it a very enjoyable read speckled with both the humor and seriousness of life. ~Laura Keegan RN FNP, author of Breastfeeding with Comfort and Joy

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Tuesday, August 21, 2012

A Suprisingly Long List of Why One Would Come in to See Me!

 Breastfeeding support can come from a variety of different disciplines (volunteer, allied health, medical) and within a discipline the services vary; I may not provide the same services another breastfeeding medicine practice does.
We all work as a team providing different kinds of support.

These are reasons why one would come to me:

You (and/or baby) need an assessment quickly.
Baby won't latch (even if other breastfeeding support have watched a full latch).
Mother is in persistent pain (breast, nipple, perineum, incision, other).
Baby is exclusively bottle feeding, using a shield, or finger feeding; and mother desires to breastfeed.
Another health care provider told you to stop breastfeeding because X, Y, and Z reasons (or told you to supplement). There is usually a way to make it work.
For your breastfeeding evaluation, you or your baby need labs, cultures, x-rays, or medical prescriptions.
Abscess of the breast and diagnosis of other dermatological conditions of the breast and infants mouth (wounds, rash, viral& yeast)

Management of chronic breastfeeding issues
Supervision of breastfeeding while another specialist manages other medical problem
Integrated approach to postpartum depression and other psychiatric disorder or hormonal problems
Counseling after traumatic birth
Grieving Lactation Failure
Too many breastfeeding issues

You'd rather not post personal scenarios on networking sights and forums.
You're uncomfortable with Google/forums/phone.
You're in need of a confirmation pregnancy test; you want to discuss pregnancy plan and referral to midwife, OB, doula and resources.

Pre-conception planning
Birth control planning (or not)
Prenatal visit; planning for the actual birth/well child care
Support for unassisted birth 
Birth Plan to optimize breastfeeding
Idealistically, scheduling the prenatal appointment and at least the first appointment after birth to get breastfeeding started with the fewest complications possible

Over the counter/herbal remedies not working or endorsement of proper use
You need help sorting out conflicting information from many sources

Mother has history of unsuccessful breastfeeding
Chronic low milk supply in successive babies
Individual counseling on how to supplement (Lact-Aid vs bottle, Haberman or other), what to supplement (formula, home-made formula, donor milk, milks, mylks)
Prior breast surgery

DCF is involved.
You've been discharged from another medical practice.
Mother or baby is in hospital (for any other reason other than routine childbirth and routine newborn care).
2nd opinion on jaundice, allergies, rash, digestive problems, etc.
Tongue-tie and upper tie, corrected in office
Opinion on vaccination (medical exemption)

Needs support from a medical professional
Well child care and care for the whole family

Teething resources :)

Needs research for a preemie, NICU situation, or other unusual and anticipated congenital situation
Needs a medical clearance note "ok to breastfeed" ei, after dental work, surgery, or diagnostic test
Needs a prescription for banked donor milk
Medical clearance to donate your milk to a bank
Slowly but surely building a local network with specialists who respect my input on breastfeeding

Slow weight gain/failure to thrive/developmental delay
Support for extended breastfeeding/bedsharing/co-sleeping lifestyle
Support for vegan, vegetarian, elimination diet, etc
Maternal weight loss supervision
Maternal newly diagnosed medical condition

Just wants to establish just because (I like easy, too)
I empower you to take charge of your health. Thus, down the line less visits are needed to the doctor.
You take pride in supporting mom (and pop) business; in medicine it is no different than any other business.
I'm not owned by the gov't, university, hospital, or medical association and like other local business I support the local economy  (sports, recreations, educational, religious, other local health providers).
Chances are good that I have seen your particular problem and more than once.

My certifications and experiences:

I've earned more than 75 formal hours of breastfeeding CME and CERPS in the past year, way beyond my requirements for family medicine.
I have clinically mentored CLC/IBCLC/Midwives/LLL/ ARNP students.
14 years CONTINUOUSLY breastfeeding my own children, nursing through 2 pregnancies, seven years tandem nursing, full-time employment x 2, and self-employment x 1, pumping, donation, extended co-sleeping, babywearing, and experiencing my own children needing sedation for [fortunately] minor surgery.
Fluent in Google, Facebook, blogging, and technology in general; knows what current issues are relevant to moms today.
MD for 20 years
IBCLC for 12 years
Member with LLL, FLCA, ABFM, ILCA for 12 years

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