Q: When should I call for a prenatal visit?
A: The best time to make these arrangements is at the end of your second trimester to the middle of your last trimester. It is best to not wait to the very end of your pregnancy because some women may be placed on bed rest at the end of their pregnancy, or may deliver earlier than they anticipated.
Q: How quickly can I get an appointment for an inital consultation?
A: It is understood that when you call, you are needing help as soon as possible. Phone calls are returned at the earliest available time. Every attempt will be made to see you as quickly as possible, usually between 24-48 hours. After hours and Saturday appointments may be made for an additional $25 emergency fee.
Q: What form of payment do you accept?
A: I accept cash or check at the time of service, or prepay with PayPal. You will be provided a receipt that you can submit to your insurance carrier for allowable reimbursement.
Q: Will my insurance pay for lactation services?
A: You will need to contact your insurance carrier for allowable services. Brenda Dalton, RNC, IBCLC, RLC is not a provider with any insurance company. It is the responsibility of the client to seek insurance reimbursement. CPT codes are the language used by the health care insurance industry to describe types of reimbursement. CPT code #99341 is used for a consultation in your home. Some health plans will reimburse for an RN home visit and not a lactation outpatient visit. The diversity of plans available does make it confusing, and therefore I cannot know for sure how much coverage is available for every plan. No guarantees are made for insurance reimbursement.
Q: What are the benefits of Breastfeeding?A: Breast milk is the most complete form of nutrition for infants. A mother's milk is optimal for a baby's growth & development and maximize thier health potential. As a result, research shows that breastfed babies have less respiratory infections, less occurrence of juvenile diabetes and childhood obesity, less asthma and allergies, less Sudden Infant Death (SIDS) as well as many more benefits for baby. In addition, mothers who breastfeed show a decrease in postpartum hemorrhage, decrease in postmenopausal breast cancer, ovarian cancer, diabetes and osteoporosis.
Q: I have very small breasts. Will I still be able to breastfeed?
A: Generally speaking, there should be no problem with breastfeeding your baby. The size of your breasts has nothing to do with the quality and quantity of milk you will produce. Small breasts do not produce less milk than large breasts do.
Q: When will my milk come in?
A: Mature milk production begins several hours after delivery, however, most moms can tell their milk is in by day 2-5, depending on your baby's ability to latch-on properly and how frequently and effectively your baby sucks. In general, your milk may “come in” sooner if this is not your first baby. Keep in mind; your baby is receiving the first milk, colostrum, until mature milk is present, which is perfect for meeting your baby's needs during those first few days.
Q; How often (and how long) should I nurse my baby?
A: Babies need to be nursed as often as they demonstrate feeding cues. These feeding cues include: rooting, opening his eyes, brushing a hand across his face or mouth, or making little sucking motions. Crying is a “late” hunger cue and can cause your baby to have an uncoordinated suck, making it more difficult to initiate feeding. Most babies need to breastfeed at least 8 to 12 times (every 1 ½- 3 hours) in 24 hours for the first few weeks. Breastfeed as long as your baby wants to on the first breast; your baby will let you know when he is finished, either by spontaneously coming off the breast or by sleepily moving into non-nutritive suckling. You can offer your baby the second breast. If he takes it, fine; if not, that is okay too. The next time your baby is ready to feed, you can offer the side he finished on, or did not take. Generally speaking, most babies will breastfeed every 1 ½ to 3 hours for 10 to 20 minutes per breast. These frequent feedings will not last forever, but are very important for most newborns.
Q: What if I don't have enough milk or my baby is gaining weight poorly?
A: Remember, it is very common for a newborn to eat frequently, sometimes every hour and a half in the very beginning. Such frequent feedings are necessary because breast milk is easily digested. Nursing as often as your baby wants will keep him content and you comfortable. Be in contact with your lactation consultant. She is a valuable resource to help you get through any difficulties. Most delays in milk production result from an upset in the balance of the law of supply and demand. These first few weeks of establishing your milk supply are crucial; therefore focus your energies toward establishing a breastfeeding routine with your baby. Some suggestions are: Baby should sleep near you. Night-nursing are time-tested remedies for enhancing a baby's weight gain. Remember the law of supply and demand, and increase the frequency of feedings to at least one every 1 ½-to 3 hours. If your baby goes three hours during the day between feedings, wake your baby. Even a sleepy baby will nuzzle at your breast and help stimulate milk production. While your baby is nursing, stimulate him to suckle by keeping him undressed (skin to skin), rubbing his back, legs and talking to him. These maternal behaviors stimulate milk production because they encourage your baby to suckle. Watch for your baby's feeding cues and capitalize on the times when baby seems ready to eat. Above all, stay relaxed during breastfeeding. This allows you to have an effective milk ejection reflex.
Q: Is my baby getting enough milk?
A: After the first month or so, you will intuitively know that your baby has been getting enough. However, in the first few weeks, as you and your baby are learning how to breastfeed, it is not always easy for new moms to tell. Signs that your baby is getting enough milk are, your baby will have six to eight wet diapers (at the end of his first week) and at least 3 bowel movements every 24 hours, after day 3. The color of the stools will vary, changing from tar like dark green to yellow to tan with a mustard-like consistency. Urine should be pale yellow to almost clear in color. Your baby will gain 4-7 ounces per week. Your breasts may feel less full after your baby has nursed. You will feel your baby suckling and hear him swallowing. Often your baby will drift off to sleep at the breast, a good indication that he is satisfied. Your baby may fuss after nursing and this could indicate his need to be held. If your baby is showing any signs of concerns, contact your lactation consultant for further advice.
Q: Why does my baby want to nurse all the time?
A: Your baby will breastfeed more frequently during a growth spurt. Breastfeed as often as your baby shows a desire. Your milk supply will catch up to the increased need. Giving bottles of formula at this time will only sabotage the balance of supply and demand, making it difficult to catch up with your baby's needs. Some babies love to be held and nursed frequently. Remember your babies wants are his needs. During their first year of life, babies go through several growth spurts. During these “growth spurt” days, set aside other obligations and focus your energies on your baby.
Q: What is a growth spurt?
A: This is a time of physical as well as developmental growth for your baby. During a growth spurt, breastfed babies nurse more often than usual (sometimes as often as every hour) and often act fussier than usual. This increase in feedings is only temporary and usually last about 2-3 days, sometimes a little longer.
Growth spurts occur most anytime, however, most growth spurts occur at predictable times, 7-10 days of age, 3 weeks, 6 weeks, 4 months, 6 months and 9 months of age. Growth spurts continue every few months during the toddler years and periodically through the teenage years. Remember, how you were always opening the refrigerator door as soon as your own mother had put the food away and cleaned the kitchen.
Q: Should I give my baby a Bottle?
A: Giving your baby supplemental bottles in the early days may lead to a nipple preference and this can adversely affect your milk supply, especially during a growth spurt. Unless you are advised to do so for a medical reason, you should not give a breastfeeding baby bottles for the first 3 to 4 weeks. If supplementation is necessary, it can be done with a small spoon or a medicine cup. Giving bottles every day or every other day so your baby "gets used to taking a bottle" is not necessary or recommended. After the first few weeks, giving baby a bottle of expressed breast milk periodically, when it is convenient for both of you, is all you need to do. If your baby balks at taking a bottle, let someone else feed him.
Q: What should I eat while breastfeeding?
A: The rule is drink water or other beverages when you are thirsty; eat when you are hungry. There are no special foods to eat when you are breastfeeding.
Q: Are there foods should I avoid while breastfeeding?
A: Contrary to what others are telling you, there are not any foods that a mother should avoid. You should eat a healthy well balanced diet. Any food in moderation is usually fine. Babies can be fussy and can have excess gas and it is not because you had broccoli and chocolate cake for dinner last night. Infrequently, a baby may be sensitive to something in the mother's diet. The most common sensitivities are to protein antigens that are found in cow's milk/dairy products, wheat, fish, corn, eggs and nuts. If you believe your baby is reacting to something in your diet, eliminate that food for one to two weeks. If your baby continues to be unusually fussy and gassy, contact your lactation consultant.
Q: What type of breast pump should I get?
A: There are many types of breast pumps available depending on your needs. Breast pumps are helpful in stimulating, maintaining and expressing milk in cases involving working mothers or mothers with engorged breasts, and premature or sick infants. Before making an investment on a breast pump, contact your lactation consultant for advice on what your particular need is.
Q: When should I wean my baby?
A: Around the world, babies are breastfed an average of two to three years; there is, however, no "right" time to wean. Weaning is an individual decision for each mother and baby. The American Academy of Pediatrics (AAP) recommends breastfeeding for at least one year, and slowly introducing foods after six months. When you or your baby decides to wean, you should do so gradually to prevent the discomfort of engorgement and to help maintain your baby's sense of security. You can schedule a consultation to help you make a plan. As a reminder, iron fortified formula is the only appropriate substitute to use if you wean your baby before 12 months. Cow's milk should not be fed to babies under one year of age.