Pamela Poe writes:

I am  wondering how long each of you spend on an initial visit...I spend 
1.5 hours  to 3 hours on average.  Is there something wrong with my 
approach...am I  taking too long???
~~ My average is 1 1/2 to 2, but with some families I am there more like 2  
1/2 to 3. 
 
Hi Pamela,
 
I get background on this mom and baby, and any other  babies mom had. I 
watch everything from before baby wakes, to  the breastfeeding attempts, to how 
to supplement with an eye towards future  breastfeeding skills, to how to 
normalize/maintain milk supply, to norms and  patterns of normal babies ( vs. 
cultural expectations issues), the unique  anatomy/physiology of the 
nursing dyad she is part  of,   to how to use the pump ( or where to rent one), 
and point  out how to use it best for her. I watch a full pumping/expression 
session,  and talk about storage issues, kinds of AIM options if needed. I 
refer  if it seems needed as well, to ENTs, or CST, or mention what they might 
be  helping with if things don't change in time ( depending on what I've 
observed  and palpated).   I leave when all moms immediate questions  and 
immediate concerns are answered, and she feels she  understands what is 
happening, and perhaps why things are currently so hard and  how that might be 
expected to change over time and a plan on how to get there. 
 
I hope that's helpful.
Peace,
Judy 
 
Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA
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