When is a Feeding Consultation Needed?
While breastfeeding may be "natural", there are two people learning how to do it. Some folks make plenty of milk and babies latch fabulously and grow well and don't need help, which is awesome!! If you are pregnant and have risk factors for feeding challenges (previous breast surgery, PCOS, diabetes, planned Cesarean, previous breastfeeding or milk production issues) or just want a one-to-one session before you give birth to ensure you have as much information as possible, schedule a Prenatal Consult.
BUT if feeding or pumping IS NOT going as well as you hoped it would and if you have any of the following concerns (this is not a full list of issues one might have, of course), then it's an appropriate time to schedule a consultation as soon as possible.
Some key reasons to schedule a visit
- sore or damaged nipples painful latch
- nipple/breast pain
- concern that there's not enough milk to feed your baby
- oversupply of milk or baby sputtering/gagging on milk due to heavy sprays
- recurring plugged ducts or mastitis (inflammation of the breast)
- baby isn't latching (breast refusal)
- suspected tongue-tie and lip tie--it is ideal to see an IBCLC before any release is done, as there are important things to discuss before rushing to hav a procedure done
- pumping concerns or to have a flange fitting to see if there's a flange that would help you yield more milk and be entirely comfortable
- baby isn't gaining weight appropriately
- learning about alternative feeding methods
- going back to work questions
- baby is refusing the bottle or leaking from bottle or gagging when feeding on bottle
- reflux, colic or excessive crying
- baby losing weight or not gaining weight even though baby was gaining well previously
- you to ask a bunch of questions, try some new positions, and/or have the undivided attention of an International Board Certified Lactation Consultant
What happens during a feeding consultation?
During a feeding consultation, we'll observe a feeding, assess your baby's latch and suckle, work with you on latching and positioning your baby to find the most comfortable approaches, and we'll talk about your concerns. We can weight your baby, too! If your milk supply isn't where you'd like it to be, we'll come up with a plan together to improve it. If your baby needs to be supplemented to grow more, we'll talk about pumping milk, finding the best flange size(s) for you, and even discuss the options of donor milk and/or formula. Of course, the #1 rule is FEED THE BABY, however that can happen We also want to focus on YOU, making sure you have the information and support you deserve. If you have questions before scheduling a consultation, please email Jeanette Mesite Frem, IBCLC and owner of Babies in Common.
Who are the IBCLCs at Babies in Common?
We have two IBCLCs you can choose to work with: Jeanette Mesite Frem or Chere Jalali. Both see clients in the Babies in Common office in Northborough, Massachusetts. Jeanette sees clients virtually, as well. And Chere is also available to do home visits in the following towns:
- Group A Towns: Ashland, Dover, Framingham, Holliston, Medfield, Medway, Millis, Natick, Newton (west), Sherborn, Wellesley
- Group B Towns: Hopkinton, Needham, Southboro, Westboro, Westwood (or ask about your town)
PLEASE NOTE
If you are being seen in-person (as most of our clients choose to do), we ask that if you have any symptoms of contagious illness or known exposure to COVID-19, then let us know and we can either reschedule the appointment or change it to a virtual consult. Your IBCLC-lactation consultant and any of her mentees will sanitize any equipment they are using, wash/hand-sanitize their hands often, and wear gloves when doing an oral exam of your baby.
Preparing for Your Feeding Consultation
1. Schedule the appointment below, by clicking on the photo of the type of consultation you'd like.
2. Fill out the two forms below, definitely by the evening before your first consultation--having this filled out in advance is required, because it saves a lot of time so the focus can be on the issues once we are together vs. answering basic questions.
Answer the Intake Questionnaire
If you are scheduling a bottle-only feeding consultation, fill out the Consent Form (link above) AND this one: Complete the Bottlefeeding Consultation Intake Questionnaire
3. Have your baby with you. It's very helpful to have your partner or another helper with you, especially if we're doing a virtual consultation. If you are doing a pumping-specific consultation, you do not need to have your baby with you, but if you do, it would be helpful to have another adult there to hold/care for baby so we can focus on pumping, if at all possible--an evening appointment can be requested if needed, just email jeanette@babiesincommon.com.
4. Have extra milk or formula ready if you are supplementing or have been supplementing recently. Also have whichever bottle or other device you have been using when feeding baby (bottle, cup, syringe, tube, nipple shield, etc.)
5. If we're talking about pumping at all, have your pump and all the parts (including bottles!) and the cord and any records of your pumping schedule and output, if you have been tracking that.
6. If you've been tracking your baby's feedings and diapers, please have that record handy, too.
7. Dress comfortably and don't feel pressure to shower!
Frequently Asked Questions
What if I want to ask questions to my IBCLC after the visit?
All visits include unlimited communication via HIPAA-secure messaging for questions indefinitely, however, if it becomes obvious that you need another consultation, your IBCLC will let you know that.
How do I know what kind of consultation to choose?
Initial Consults are for the first time we are meeting a parent with a baby, unless you only want a bottle, pumping, or weaning consultation.
What is included in the Mastering the Pump consult?
This is purely for pumping concerns. This DOES include the flanges (we have all of them to try, as appropriate for your nipple size and other specifics) but does NOT include observation of a nursing session nor an oral assessment of your baby. However, if you choose a VIRTUAL consult for pumping, you'll need to measure your nipple tips and communicate with your IBCLC ahead of time because you'll also need to get several sizes of flanges to have with you during the virtual meeting. Your IBCLC will give you guidance about what sizes you should have available, as a true flange fitting requires you to be pumping WITH different sizes!
What is a Bottle Consult?
If your baby won't take a bottle or has difficulty when bottlefeeding, but nursing seems to be going fantastically (no pain, baby gaining well), then you are eligible for a bottle consult.
When do I pay for the consult?
The fees for consultations are expected to be paid at the time of scheduling the consultation (you'll have an opportunity to pay when you sign up online). If you pay via HSA card or FSA card, you must reimburse that account if your health insurance reimburses you for the visit.
Are there special rates for MassHealth/Medicaid or Military?
Yes!
We offer a 50% discount for MassHealth or Medicaid subscribers. Enter MASSHEALTHAPPT and send a photo of your MassHealth or Medicaid card to jeanette@babiesincommon.com. If MassHealth/Medicaid is your secondary insurance, this discount is NOT applicable, as your primary health insurance is likely to reimburse you fully for consultations with an IBCLC-lactation consultant (there are exceptions, email if you have questions).
We offer a 20% discount for military families, if either parent is active duty or in the Reserves AND you have Tricare insurance. Jeanette, the owner of Babies in Common, is a 20-year "Army Brat" herself, so she is happy to give a discount to thank you for your service. Enter MILITARYAPPT and show your IBCLC your military ID when you see her. We cannot bill Tricare, but you will receive a Superbill to request reimbursement.
Is there a special rate for inducing lactation?
~ If you are inducing lactation for an adopted baby, we offer a 50% discount. Enter MAKEMILK as your discount code. Only for office or virtual, with Jeanette.
~ If you are transgender and want to induce lactation or work on chestfeeding, if you are a lesbian and want to work on inducing lactation in addition to the birthing parent, or if you are gay and want to work on chestfeeding, we offer a 50% discount. Enter PRIDE as your discount code. Only for office or virtual, with Jeanette.
The IBCLCs of Babies in Common
Jeanette Mesite Frem
I started my journey helping families feed babies in 1992, serving as a health volunteer in the Peace Corps in a village in Côte d'Ivoire, West Africa. I continued my studies at the graduate level at Johns Hopkins School of Public Health and received my master's degree in public health, which focused on nutrition for maternal and child health, including lactation.
After having my first child, I became a birth doula (attended ~120 births), childbirth educator (teaching in hospitals for 7 years and then on my own since 2006) and volunteering as breastfeeding counselor for over ten years. After studying and fulfilling many requirements, I became certified as an International Board Certified Lactation Consultant in 2013. In order to stay up-to-date on the latest research and techniques in lactation, I attend many continuing education conferences (8-15 days per year in-person plus online seminars). I also nursed my two children for more than two years each. I have been honored to work with thousands of families over the years in different capacities and absolutely love getting to know parents and babies and doing what I can to help them achieve their feeding goals through breastfeeding and pumping, but also using donor milk and formula when needed.
Hey, really, what I'm trying to say is that I have some experience and knowledge and I'll work my hardest to help you and your baby as much as I can to maximize your success, however you define it. Babies need to eat. Sometimes that means 100% human milk and other times it means formula is needed. Let's figure out what your story will be. I work for you and your baby and just give you my professional opinion and recommendations: you do the rest...because this baby is YOURS! :) I'm honored to be asked to be part of your parenting journey. Thank you for considering to invite me into your world.
Jeanette Mesite Frem, MHS, IBCLC, RLC, CCE
Cellphone: 617-686-0052 (texts strongly preferred!!
Fax: 833-229-2297 (833-BAY-BAYS)
Secure email address: jeanette@babiesincommon.com
Chere Jalali
"I see the awesome power and messy grace of birthing and parenting. I have been supporting birthing and new families since 2002 and these years have taught me that there are a million ways of "getting it right." My job is to dispel myths, to explain options, to validate, and to honor each person's choices.
My "birthy" career began when I took childbirth class and found the content fascinating but the delivery flat. I knew I could do it better and soon I got the "nudge" to make big life changes in the aftermath of 9/11. While my loved-ones and I were safe that day, I felt a calling to dedicate to something more "meaningful." I got certified and began teaching birth preparation classes and LOVED it. Since then, I have added Hypnobirthing, birth doula, yoga teacher and finally the crown jewel of IBCLC.
Lactation Specific Trainings Taken:
- Oral Habilitation of the Breastfeeding Dyad A Master Class: November 2023
- Structure & Function Comprehensive Infant Assessment: September 2023
- Gentle Manual Therapeutic Techniques in Lactation with Maya Bolman: June 2023
- Advanced Clinical Concepts in Lactation Therapy with Lisa Lahey: June 2023
- Pumping and Feeding Gear with Jeanette Mesite-Frem: June 2023
Chere Jalali, IBCLC, RLC, CCE, AHA Instructor
Cellhone: 508-216-4961
Fax: 833-229-2297 (833-BAY-BAYS)
Secure email: chere@babiesincommon.com