I prefer to refer moms to an IBCLC in their area, but if they have 
exhausted local options, I have done Skype consults. As Micaela notes, 
it's best when there is another adult available to move the webcam to 
optimize the view. I find it frustrating not to be able to touch and do 
a suck assessment, and that the video quality is variable, but mothers 
have usually found the consultation helpful.

My favorite use of videoconferencing is to do a brief follow up with 
moms if they are having difficulty replicating what we did in my office 
in their home. Five to fifteen minutes on Skype can save a lot of 
frustration!

Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com

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