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The smart way to create a compassionate and professional lactation private practice, hosted by private practice IBCLCs Annie Frisbie and Leah Jolly.
Leah Jolly is a private practice IBCLC with Bay Area Breastfeeding in Houston, Texas.
Annie Frisbie is a private practice IBCLC serving Queens and Brooklyn in New York City and the creator of the Lactation Consultant Private Practice Toolkit.
Tune in each week to learn all the ins and outs of running a successful private practice lactation business!
Connect with Leah and Annie:
On Instagram: @lactationbusinesscoaching
On Facebook: https://www.facebook.com/lactationbusinesscoaching
On YouTube: https://youtube.com/playlist?list=PLv3-4pMgjlzbXD9KWFCIV3-1LipsTbgsj
Annie: Well, hey Leah.
Leah: Hey Annie. How are you doing this week?
Annie: I am good. You know, I'm always good when you ask me the question, because what am I going to do? Say well I'm terrible? You know I have my ups and downs like anybody. I have my moments when I'm so tired and bad things have happened, but it's not hard to get positive when we're recording these podcasts because of how much I love talking about this stuff and love talking about it with you, and especially today because we are doing part two of our listener questions and I just can tell you that having a hard week but then opening up a spreadsheet and seeing survey results filled with people who are asking amazing questions out of their deep desire to be great lactation consultants. It's good medicine.
Leah: It really is. It's such a reminder that we're all in this together. I mean sometimes when we're in the deep, deep drags of day in and day out lactation work, and these struggles and feeling overwhelmed with maybe too much work or not enough work, it can sure feel nice to come home to my family of LCs. That's what this feels like. Like just coming home to my crew and we're getting to chat and talk about these things. So I love these listener questions. I can't wait until the next time we get to ask more and do more of these, cause this has been such a fun one to do.
Annie: Definitely. Well today's episode is sponsored by the Lactation Private Practice Essential Toolkit with resources, trainings and all kinds of goodies designed to make your lactation consultant private practice efficient, enjoyable and sustainable. And we're giving you 10% off if you use code podcast at checkout and you can go to paperlesslactation.com/toolkit to learn more.
Leah: Awesome. And that is like an essential, if you have a private practice, you need the toolkit. I use it all the time, refer back to it all the time. It has been such an amazing help for my business as well. So thank you Annie for creating that and thank you for sponsoring today's podcast.
Annie: Sure thing. So speaking of making your business strong, Leah, what's your marketing tip for us this week?
Leah: So my marketing tip is to create memes and add your logo and website to the meme and share on social media because it's a great way that it will circulate around. Certainly if you can do something more local based is great too because you might get more local circulation, but no matter what, I think it's something fun and catchy or really neat fact. So I just literally crack open textbooks and start trying to find a fun fact and then I can reference the textbook and stick my logo and my website on there, and there you go. You're off and rolling with a meme that hopefully will get shared widely.
Annie: I love to share a good meme made by another lactation consultant. I have to say that is content creation for me too. It's like, Oh look, you know, Leah made this great meme. Now I've got something to share on my Instagram feed and everybody wins. And so definitely share the love, make your own memes, share other people's memes. And while you're on social media, check out our Facebook page for Lactation Business Coaching because we'll share your meme. We'll totally share your meme. We like to share anything that's going to help you with your business, and also keep you up to date on local events that we're involved in, so we'd love to interact with you there and get to know you better. And speaking of getting to know all of you better, so we've got our listener questions part two today. Leah, what is our first listener question for this episode?
Leah: What is in your home visit kit? And I assume they mean bag or kit or what do you bring to home visits? And I think this one is so good and I know we're only going to have just mine and yours, but I can't wait to hear people share comments or start threads about what are in the home visit kits, cause I'm sure we all kind of have some different things in our tool bags. So for me personally, I carry a small tote bag that has like a more solid bottom. in the bottom of it, I have a couple of things. I have a legal note pad in case I ever need to write down or if my computer were to give out something, I would have that. I actually have a paper chart, a full paper chart in case my iPad ever died. I have a stack of care plans in case the family would prefer us to hand-write a care plan. And then I have some pins and my box of gloves. I have a couple of handouts that are ones that I bought that you can't scan in and send out. So I have a couple of those. I have a paced bottle feeding one. I have a pacifier one and a bottle introduction one that I really love, so I keep those with me and we'll sometimes hand those out.
Annie: I have those same handouts and I love them and we are going to make sure there's a link in the show notes so you can find them because no, you cannot scan them, you can't make them PDFs, you can't attach them and they're great. And a lot of them have English on one side and Spanish on the other side.
Leah: Yes. That's the ones I got. I love those. Okay, so then I have my demo boob. My colleague Heather, she found these squishy stress balls from China that's are actually a breast, but they are the best demo boob ever, and so I have my demo boob in one little pocket - it's got pockets all around - so I have got my demo boob in one pocket. I carry a noggin stick and another little rattle if I'm working with older babies. That has come in so handy. I cannot tell you how much that works so well. Did I say my box of gloves? I have my box of gloves, probably the main thing. And then I have my stethoscope. I have a little bag that has my checkout stuff. So it has my card reader and the charger for my card reader and all that stuff is all put together and it also has business cards in there. Oh my goodness! I'm trying to think. I should've written down a whole list cause I'm trying to go around the pockets of my bag, and then because of where I work, and I know this is different for you, I actually keep a big tote in my car. It has a lot of the excess supplies. I don't carry in a million nipple shields and all this stuff. I just have it all on my tote. So I might have one or two nipple shields in my bag. I have a couple of baggies with the Mamie vac nipple shields in them in my bag at all times, and I carry my masterclass cards with me everywhere I go.
Annie: So do I. I've got that little masterclass cards on a ring, and my baby doll
Leah: Oh yes. And my baby doll, that's the other thing. I'm like, there's something giant in there that I can't figure out. It fills up this bag. I think that's everything that I carry in my bag. But again, if I need something else, I have a big tote in my car that I carry everything else that I could potentially need because I don't like dragging around a lot of stuff in my bag with me. And oftentimes I don't need more than those items right there. What do you carry? Oh, you know what? I lied... one more thing. My lactation aid set up. So the five fringe feeding tube. I carry the Modela two and a half ounce sterile bottles in case they didn't have a bottle. I mean that rarely happens, but I do have that like an emergency backup and one of the disposable nipples if I was going to rig up a whole system for them, but in my car, I have a whole SNS in there. I have hand pumps in my car. I have a bunch of other supplies. Okay. So what's in your bag, Annie?
Annie: I have a lot of the same things as you. I've got the five fringe tubes, I've got the syringes for finger feeding. I have the little tiny ones for colostrum and I've got the larger ones that can connect to the tube. I have the curved syringes. I have a lactate and an SNS that I use just for demo purposes, because honestly I can't afford to be giving those out; they're too expensive. So just to show them the setup and then they have to buy it themselves. and I'll come back and work with them on it, but I do give out the tubes and the syringes. Those I have enough, and they are in the sterile packaging. I've got my gloves, I've got my baby doll, my masterclass card. We're going to link to the IBCLC masterclass in the show notes. It's a training that Leah and I have both done that we highly recommend. They do it several times a year. I have my demo boob. Mine is a crocheted demo boob and I do use it all the time. My children were playing catch with it the other day. I keep my stuff and I had a time when I had something in the trunk of my car just for storage mostly. like I would restock, but now I just keep everything in my bag. I have nipple shields in there. I have a terrible bag situation right now. I'm constantly on the hunt for a great consult bag and I've seriously tried everything. I will buy a new bag like it's my job. So my scale that I have is - I do bring a scale to visits - I know that in some countries that's not happening as much as it is here in the U S because you've got better postpartum care for families. They get to actually see healthcare providers more than one week and two months, so I do bring a scale with me. I've got the Marsden scale. That's in a rucksack, which is great because, I've also worked with a Tanita and the Modela baby way and carrying a scale on one shoulder, like if I have to walk 10 minutes to get back to where I parked my car, it's too much. I know that some of my colleagues, they'll keep their scales, they get the big rolling suitcases for their scales and I am just not coordinated enough currently to navigate a big suitcase, even a small suitcase on crowded city streets. So my scale is in the backpack cause that's the biggest item I carry. And then I've got a tote bag that has all my stuff in it. But honestly it's very hard to manage my scale in my backpack, my tote bag and then my purse and get it and just walk down the streets, and I have my coffee in my hands. Refer to last week's episode to learn more about my bad coffee habits. But I'm juggling a million things and my car keys and my phone to find out where I'm going, walking down crowded streets in the rain, in the snow and my carrying situation is not working for me right now. I really need help there. I'm definitely open to recommendations. I would love to find a big, big backpack that could fit my scale and the stuff I want to bring to the consults. I was looking at softball bags and baseball bags for sports, and I found one that was the perfect size, but apparently baseball bag's opening at the top is baseball bat dimensions. I can't fit a scale through there. So anyway, post in the comments if you know the bag for me. I did have flyers in there, but recently we only have one car in our family and my husband was using it, so I was using ride share to get to a consult, because hats off to my colleagues in New York City who take public transportation from Queens to Brooklyn. You can't do it by public transportation. I don't have all day. My babysitter costs way too much money. I will save money by paying for a ride share versus the childcare that it would take me to get somewhere by train. Sometimes, they offer you water, and I always say yes to the water - unless it's Nestle water - but it's usually the Costco water.
Leah: I will say though, on the whole purse situation. So what I've been doing is I just take my wallet out and there's a little side pocket on my bag that I stick my wallet in and then I hide my purse. There's nothing else in it. So even if somebody took it, it's whatever, but I just carry that. So I have that in my bag, on my work days. My wallet stays in my bag the whole time, so at least I don't have an extra bag. And I know my situation is so different because I'm driving up to people's houses or their apartments and parking right there, so can't imagine lugging all my stuff as far as you lug. I guess your chiropractor is staying employed.
Annie: Yes. I do see the chiropractor. No, it is. It's bad and it's not good. And my water bottle that I got from this ride share driver opened in my bag and melted all of my paper handouts that I have to now replace. And that's why my kids were tossing my demo boob around because I took everything out of my consult bag, and they're like, what's that? This is our new favourite thing we've ever had. They're like, it's a boob. Throw the boob!
Leah: You know what? My kid thought it was an onion. It was a crocheted boob and I had set it on my counter. This was a couple of years ago, and we had a bunch of pretend food, and some of it was crocheted and some of it was not. And so they're like, why do you have an onion on your desk, Mom? I was like, it's not an onion, and I don't know why you think it's an onion, but it's a boob. That's awesome. Whoa! We need to really work on...maybe we need to have a whole show just about the ins and outs and life hacks of consults, because it definitely sounds like we all need everybody's help for sure.
Annie: Definitely!!
Leah: For sure.
Annie: So we're going to move on to the next question. So speaking of home visits, we talk a lot about home visits. And thank you to the listener who said, I love the episode about home visits. After doing home visits for a number of years, I could totally relate to so many of those little nuances. Thank you. We've gotten that feedback from a lot of people and it's just so nice to hear I do it the same way and then I feel like I'm not just making this up, I'm doing something real. So this listener says, I've recently began working in a paediatric office and I'm learning how to make those consults more efficient. I would love to hear Leah walk us through a typical office consult, and so would I, because I don't do one but it's my dream to have an office one day. So maybe you could tell us what makes office consults different, cause I do see a lot of people having their office consults are shorter than the home visits. So what makes that difference?
Leah: And you are all going to cringe because you're going to think I'm crazy, but in our paediatric clinic, we do one hour initial visits and 45-minute follow-up visits. So I know you all are all going, how could you ever do a full visit? Let me reassure you first that rarely do we ever see a family one time. So it's basically like we're doing probably what we always do, but we're doing it broken out in multiple visits. So most of the time we're seeing families two to three times. So if that helps anybody, because whenever I say that people are like, there's no way you could ever do a full visit and then there's a lot of structure around what we do. So I have people come in that have already put all demographic information, like everything's already in my computer ready to go. I don't have to review a whole lot of, did they put this in that? Did they put that in? Did they sign the consent? Somebody else's worrying about all of that stuff so that takes some time off. And also the environment's all set up for me to be very efficient. I don't have to go set up a scale. I don't have to find a place that we're going to meet. I don't have to make sure the mom has what she needs. So there are some things that just with the structure of how an office visit is set up that makes it much more efficient. So right when we get into the visit, I usually try to get the history, and I have kind of a really structured approach when it's in my office because we're not going to have those nuances of like, well, where would you like to meet? Oh, you have a beautiful home. I love this picture. You know, like those little things you don't do as much. but I definitely greet the family and try to connect with them in some way. Usually ask like, Oh, is this first baby for you? It's so exciting. You guys got out of the house safely and made it here. That's a great first step as a parent. Just things like that to get them welcome. And then I let the family know how the console is going to run. So I'll tell them first I'm going to get just some health history for you moms, what's happened in the past prior to pregnancy, during the pregnancy, to delivery and then we'll talk about breastfeeding since then. So I just have my own little script and then I just start going down my questions. Bamboo Bama has pretty structured questions in my template on their EHR. So it's really nice cause I can just go through really quickly, and then we can jump right in to the breastfeeding. And usually once that starts, when did they start hearing about that? Then I'll have whoever the support person is with the breastfeeding parent, I'll ask them to start getting the baby undressed. We have a little changing table in the room, so while the breastfeeding parent and I are still talking, then the support person will be getting the baby undressed down to just a clean diaper. That usually takes just a couple minutes and then the baby's ready to eat. So we go out, we weigh them, I get their weight put in, and then we start working on whatever issue there is. So if it's latching or milk transfer, whatever the issues are, so it's really quite efficient. The longest thing is the feeding time. So I think that can only, that can be where the challenge is, but I know that I can get all that first part done in 15 or so minutes. And so I have 45 minutes and if the feedings are taking 45 minutes or more to get done, then I know that might be a red flag that the baby's not being so efficient. So it actually helps me a little bit too. Cause sometimes in a home visit I feel like time just kind of goes away, and next thing I know, we've been doing this for a really long time. I have to be more mindful. So the structured environment really helps as well. And then, on the follow-up visits we already have all that history there and we're able to just like kind of pop back in to right where we were last time. So that's how I make it work. I know it seems, if you've only ever done home visits, it seems completely insane that you could do a visit in an hour, but please know that we see them multiple times. They usually come back within three or four days, usually the same week. We see them two times in the same week for almost everybody that we see there. So that's really great cause we kind of break it up for the family as well and get to check in on them. But I love my office visits and super-efficient. We see usually like eight families a day when we're in the office, and we're there five days a week now.
Annie: Wow.
Leah: Yeah, it's busy,
Annie: My personal dream is I would love to get to where I'm doing initial visits are home visits, and then all follow up is happening in an office, but I don't know when that would happen. My kids will have to be a lot bigger for me to even think about that, but to carve out one day a week where I'm definitely going to be in a place, it's kind of hard to think about. But I am drawn to that, but as you said in our episode on home visits, home visits, they have your heart for a reason cause they are just so special. And it is something that I just wish more health care was like what can happen during a home visit.
Leah: Yeah. And they are just so different to me. The way I am in a home visit I feel is almost different, cause just the efficiency aspects of the office visit, everything's a bit faster paced. So I think I am drawn to both of them, but definitely the home visits are more chill and relaxed. It's just a nice environment. But I encourage anybody who's doing office visits and has more insight on how they help it to run efficiently, definitely share with us. We'd love to hear from others. This is just the one aspect of it all. So please, please share with us. But we have one more question that we're going to answer today and that is an unresolved question from the imposter syndrome podcast. So if you didn't listen to that podcast or don't know what the heck we're talking about when we say imposter syndrome, please refer back to that podcast because it was a really great one as well. But the question is, as a newer IBCLC, how do you deal with the fact that you let your clients down because you don't know as much as experienced IBCLCs. I'm still learning. If I knew more, I could serve them better. And I think this is such an important question because I feel like we probably all feel like this even though you're saying I'm new and this is why I'm feeling like that. I have this thought all the time that there is probably some LC out there that would have the magic booby fairy wand and ding all these issues away, and I just don't know how to tap into the magic booby fairy wand and I'm not using it. So I just think it's so, so important for us to all acknowledge that you are not alone and even us that have been doing this. I've been working with moms and babies for 15 years and I still feel like there's more I could know. I don't know everything. Annie, how do you feel about this? I'm sure you're with me on this one.
Annie: Yeah, I mean there are definitely times where I'm like, I just don't know as much about this as I need to, or find yourself facing a situation where you're like, Oh my gosh, I've never had this before. And so I have to look it up. And that's really stressful. And just to kind of address the heart of the question is that you're worried that you're going to let your clients down and you're feeling like your lack of experience or knowledge is going to hurt your clients. I think that that's good that you're worried about that. I think we all should be worried about that, because we're aiming to provide the best possible care for our clients. So I don't think any good clinician is out there saying, I know everything.
Leah: I can do everything. I know everything. That should not be coming out of your mouth.
Annie: So as good clinicians, we should be asking questions. We should be seeking out support. We should be looking things up. And if there are areas where you feel like you need to learn more, then learn more, and what you're not going to do is you're not going to reach out to the most experienced IBCLC you know, and say, Hey, can I pick your, pick your brain. You're not going to do that. You're going to offer to pay for the training that you need because the people who have the skills that you want to acquire earn those and value their time, and ask them what compensation they want for teaching you what they know, and helping you on your journey to becoming a better lactation consultant.
Leah: Absolutely. And I think it's important that we remember that the world of lactation is always changing. We're always learning and we all should be questioning like, is there more I can learn about this aspect or that aspect? If you're feeling a lot of imposter syndrome around something, let that be a guide for you to like, well, maybe I want to feel more confident in this area where I'm not feeling like an imposter. Okay, let me go look at what classes I could take about that or what I could learn about that. So I think this is a really good question and we're all started somewhere. You know, we all started in the beginning and had to learn and grow. So having a resources to, you might connect with maybe an ongoing mentor that you have some arrangement with how you're going to compensate them for their time, but as you're starting out, that's a great way to just have like a dial in when you're having a hard case and this person has agreed to kind of mentor you as you're starting out. And then those of us that have been around a long time, this is a great way to support those newer LCs coming in and doing this hard work that we're doing is to offer some mentorship. It doesn't have to be on the phone with them every day, but when they run across maybe some harder cases that you're saying to them, I'm available and this would be my fee to talk to you for X amount of minutes or whatever. And I think this can be a really great way that we can help other newer LCs acquire good skills because we know just taking the test does not give you this book knowledge. You really have to have all these "in the trenches" kind of learning that happens, and it's great when you can do that in an environment that's supported by mentors.
Annie: And if you're in an area where there are other lactation consultants, this is a great place for your local USLCA chapter to do some work and have some in-person meetups, and invite another kind of care provider to come in and talk to you about what they do or what they have to offer, and network with your other lactation consultants and learn together with them and building those relationships locally. And if you are in an area where you don't have local colleagues, then finding ways to build that virtual community, that safe place where you can explore clinical ideas, and grow together with other people. I definitely think you can't do this on your own. You need other people and other people need you.
Leah: Absolutely. That is a great way to put it, Annie. So as we wrap up today, Annie, I know that you have a wonderful tech tip that we need from you, so let us know what you got.
Annie: So my tech tip is more on the mechanical side of things. If you are using a scale in your practice, I just want to have you put a reminder in whatever kind of system you have to get your scale calibrated regularly, sending it into a licensed company that will do scale calibrations to make sure it's working properly. They'll put a sticker on it that says it was calibrated and to just not let that fall by the wayside, because if you are using scales to do weighted feeds and if that's an important part of your clinical process, you want to make sure your scale is doing what you are saying that it does, and that you're not working off of faulty information. So when you're looking for a scale calibration service, you want to look for a company that is licensed. Definitely check the reviews and make sure they're familiar with how your scale works. I went through the process recently. It was terrifying, to send my baby away.
Leah: I know what that feels like. It feels like you're sending away this precious bag of gold. Don't hurt my baby.
Annie: It came back and it was fine.
Leah: I know. I had to do it. I actually ...would you believe this? I dropped my scale and I had to send it in too. It was Modela scale and so I had to send it all the way in. They kept it for a whole month. I had to rent another scale while it was gone. But you know, the crazy thing is I have a calibration tool that I check my scales on, and it's a certified weight that I do checking. No, I can't do calibration cause I need two of them and I didn't want to buy two of them, but it was still reading right, which was crazy because I could see that it was not right, but I still sent it in. So you just don't want to just trust it, like, Oh it's fine. It doesn't look too banged up. You really want to make sure that our tools that we're using that we're saying are legitimate tools are actually calibrated in and being used in the recommended way
Annie: Everybody is going to drop something. It happens.
Leah: I was so sad when I dropped it, cause I was going into a visit and I was like, Oh my gosh, I can't use this scale now. But right around the corner - just pure luck - was the place that I know rent scales. I literally called the client. I'm like, I'm going to be 15 minutes late. I had an issue with my scale and I ran around the corner. I rented a scale, ran back to the client and still made it on time. It was pure luck. Well it's been so great talking to you again today Annie, and getting to answer these fun listener questions. I can't wait until our next round of this so stay tuned guys so that you guys will hear when we're going to be calling out for more listener questions, cause I'm sure these questions have sparked more questions and things or topics that you would like to hear Annie and I talk about. So stay tuned. We'll make sure that we get that announcement out to you. But it's been great talking with you today, Annie
Annie: Great talking with you too, Leah. Have a great week.
Leah: You too. Bye.