The purpose: To collect techniques, verbiage and tips from an IBCLC that I can emulate with my own patients in the future.

The mission: I spent a day shadowing IBCLC, Sarah Glenn at her private practice, Lactation Station and more in Summerville, South Carolina.

The results: Walking into Sarah’s office my eyes linger on the large painting that faces the one cozy recliner in her room. The focus of the portrait is five or so women and one man lounging outdoors in a beautiful landscape. One of the women is nursing a newborn, one woman is pumping, still another is nursing a toddler who is standing on a stone to reach the breast, the man is baby wearing with a bottle in his hand, another woman is offering her baby a bottle, and another is nursing multiples. It is a beautiful depiction of the many different ways parents can feed littles. It sends a clear message: there are many ways to feed your little one, and every way is beautiful. Sarah reinforces this message all through out the day as she encourages and guides moms as they follow the feeding journey that works best for their family.

Sarah has a wide range of services to offer her patients at her practice, you can read all about those on her website LactationStationandMore.com. The unique components of her practice that piqued my interest were Walk-In Wednesday and therapeutic ultrasound. And so, I spent a day with her on a Wednesday to see the ‘Walk – ins’ in action. In each section below you’ll find the notes and techniques I took away during my day spent in her office. I observed multiple different appointments, some previously scheduled full visits while others were brief walk-ins.

Quotes

I overheard these phrases through out the day while observing a variety of lactation consultations. Her support of the family unit was obvious, you’ll get a feel for this as you read the quotes I took directly from Sarah:

“I understand what you’re saying.”

“This is a safe space, you can say anything, do anything, rant or rave.”

“What can we do to make that a little bit easier for you?” This question came after discussing the supply and demand dynamic of breastmilk production. This mom had been exclusively pumping 1-3 times a day and wished to increase her supply and start latching. Sarah recommended more breast stimulation.

“In a perfect world, pretend you’re not having any problems, what do you want [feedings] to look like?”

“It sounds like mental health right now is our primary focus… your mental health is more important to me right now than any of this.” Stated after an in depth conversation about mom’s mental health history and her current symptoms of anxiety and depression.

“What if she only had half a sandwich, and an hour later she wants the other half? I do that sometimes.” Stated while Sarah was encouraging on-demand nursing.

Walk-In Wednesday:

Let’s talk about Walk-In Wednesday. She charges $25 per 15 minutes and no appointment is required, new patients and returning patients can just drop in while she is in the office from 9 am to 2 pm on Wednesdays. Upon arrival, she explains the pricing structure to the patients, she typically does not run these specific visits through insurance. She then jumps straight to “What’s your main question for today?” I saw a mom drop in for therapeutic ultrasound and one parent drop in who was concerned her baby had a lip tie. Sarah offers this service as a convenience for her patients because she is ‘in the office anyways’, and she does typically have 1-2 appointments scheduled during that time period. Walk-In Wednesday will occasionally turn drop-in patients to full blown future appointments; but, it is more likely that they will come back for her free weekly Mom Circle. The walk-ins are not a driving force of income, it is really just an additional way that Sarah cares for the parents in her community.

Infant Reflexes:

During some appointments, I noticed Sarah assessing infant reflexes. Honestly, that is not something I have focused much on in the past, except for maybe the gag reflex. She learned more about this after attending a Master Class with Jennifer Tow about Intuitive Parenting. Sarah utilizes infant reflexes in her assessment to help determine what next steps may be needed for a baby who is having difficulties. Are all of the reflexes firing appropriately? If so, we may just just need to focus on positioning and latching and we will see improvement. If the reflexes are not all firing appropriately, it is possible that baby may need some additional support or referrals or body work, before seeing improvement.

Therapeutic Ultrasound for breast inflammation

She offers this at her practice: see this blog post to read more.

Props Used During Lactation Appointments

• Nursing necklace: Sarah showed this to a mom who had a 10 week old. She recommends long necklaces that the parent can wear while the baby nurses that are made of silicone or wood, as it usually ends up in baby’s mouth. These can help prevent twiddling and maybe even help with distracted nursing.
• Baby doll: After helping baby get latched (for the first time in weeks! Insert huge tearful, smiley face from mom) and while baby was settled and nursing, Sarah used the baby doll to demonstrate latching and positioning techniques that mom can replicate.
• Picture hanging on wall that gives a visual of neuroendocrine regulation of lactation: Sarah pointed this out to a patient when she was describing how to increase milk supply.

It was such a treat to shadow Sarah Glenn, this IBCLC who goes out of her way to provide many services for the parents in her community and who has had over 35 years of working with families in the perinatal season. May this post inspire you to implement one or two new techniques for your patients.