What is a Breastfeeding & Baby Care Consult (BBCC)?

A "Breastfeeding & Baby Care Consultation" is an in-depth 90 minute consultation for you and your little one (first baby OR subsequent babies!), where you can thoroughly unpack any difficulties you're having in those tricky early days/weeks/months. Typically, I find the visit revolves around challenges relating to breastfeeding (or other types of baby feeding), unsettled behaviour, or sleep. You may have one specific concern, or a few concerns. Early parenting is hard! I know from first-hand experience. Let's spend an hour and a half together getting to the bottom of your worries. I like to allow enough time, so that our conversation isn't rushed and I can properly observe a feed. The question of tongue ties often arises in consultation as well. Although tongue tie is rarely the root cause of breastfeeding difficulties, I'm able to thoroughly assess for tongue tie and refer for surgical release if we think it may be of benefit to you and your baby.

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Common concerns:

• My nipples hurt/burn/are cracked/are ulcerated/are shredded/are making me cry!

• I feel like I'm failing at breastfeeding/I'm on the verge of quitting/how do I offer a bottle safely

• I think my baby has reflux

• I think my baby has a tongue tie

• My baby's poo doesn't look right

• My baby is always unsettled, am I doing something wrong?

• I have no clue what I'm doing and there's too much conflicting information

• and more...

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Do I bring my baby to the session?

Absolutely, yes, I look forward to meeting your little one.

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Can I bring my other children as well?

If you need to bring other children, we can work around them as much as possible. Keep in mind, these sessions are over an hour long and involve quite a bit of talking, gentle observations and examinations, and counselling on various matters. I don't have any share toys in my room to play with, due to infection risk. If your other children are able to be looked after by somebody else for the duration of the appointment, that's ideal. If not, we can make do, please don't let this deter you from seeking help.

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Do I bring my partner?

You're welcome to, in fact, I'd encourage this. Your partner is an integral part of your life as a parent and we can keep them involved in our discussions and plans.

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What if my baby needs a sleep or a feed or a nappy change during the consultation? What if he/she cries?

I'll be guided by your needs and your baby's needs. We can easily work around what baby needs to do. I aim to make these sessions as comfortable and calm as possible for everyone. I don't have a strict agenda to follow, it's fluid and adaptable. Babies aren't going to stop being babies just because we need to have an important conversation. I'll work with you!

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Do I need a referral for the consultation?

No, a referral isn't needed.

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Can I squeeze other things into this consultation, like immunisations?

No. Please, if you have a specific medical issue or procedure to discuss outside of the scope of this visit, for example, you need to get baby's immunisations done or there's a matter relating to another of your children, kindly make a separate appointment for this. 90 minutes seems like a long time but, in fact, it goes very quickly considering the ground I like to cover in these sessions.

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What do I need to bring?

• Yourself +/- partner or support person

• Your baby

• Baby's Blue Book

• Any baby feeding equipment you use at home (e.g. nipple shields, bottles, breastfeeding pillows - if possible)

• A photo of where you feed and sleep baby at home

• Medicare cards (you and baby)

• Anything else you think is relevant to the consultation (for example, medications if you or baby are on any)

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If you accidentally forget to bring something, not to worry. I have water, snacks, emergency nappies and wipes and a changetable. We can tackle anything. The only thing I can't substitute is you and your baby!

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How much does a consultation cost and does Medicare help me pay for it?

Breastfeeding & Baby Care Consults are extra-long to allow for assessment and care of both baby and parent. Breastfeeding, especially, needs meticulous care of both mum and baby to troubleshoot problems. For this reason, both parent and baby need their own file on record and both will be billed for the consult. You (e.g. Mum) will be charged a private fee and get some of your money back from Medicare. Your baby will be bulk billed (meaning the gap fee for baby will be waived to reduce your out-of-pocket expense). KFMP is a privately billing practice - this is a unique exception to practice fee policy.

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Full payment is required on the day of the appointment. These fees and rebates are accurate at the time of writing (December 2023). Occasionally, fees and rebates may be subject to change to comply with Medicare billing regulations. If you've already reached your Medicare Safety Net Threshold for the calendar year, your rebate will be much higher and your out-of-pocket expense much lower. It's worthwhile understanding how your safety net works.

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Initial Visit (90 minutes)

Total fee (what you - Mum or other carer - will be charged, before receiving your rebate): $380

Medicare rebate (what the Government refunds you to help cover your healthcare costs): $118

Gap fee (what the consult will cost you out-of-pocket, after receiving your rebate): $262

Gap fee if you've already reached your annual Medicare Safety Net threshold: $52.40

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Your baby's gap fee will be waived and their Medicare rebate accepted as payment for service (also known as bulk billed). In order to claim baby's rebate immediately, they need to have a Medicare number, therefore it's handy to have this ready prior to your appointment.

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We may decide together that a follow-up visit is needed. This can be booked online and is usually 30 minutes long.

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Will you teach me about about sleep training?

No. My gentle approach to infant sleep guidance is based on Neuroprotective Developmental Care (the Possums approach), the Circle of Security Parenting attachment theory, sleep anthropology and other evidence-based learnings. Promoting traditional sleep training (also referred to as "the cry-it-out method", "gradual extinction", "controlled crying/comforting" and "camping out") is not part of my practice and not something I align myself with, although I'm happy to have an open discussion with you about the reasons why this is my position.

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What about Covid-19? Do I need to wear a mask?

Myself and KFMP will be guided by the latest advice of NSW Health and the Chief Medical Officer on matters relating to the pandemic. Protocols may change at short notice and we appreciate your cooperation very much. Please call the practice to discuss if you have an existing BBCC booking and your circumstances change, e.g. you or anyone else planning to come to the visit becomes sick. BBCC visits need to be rescheduled if you're acutely unwell. Masks are no longer mandatory in the practice; I choose to still wear a mask but you're welcome to make your own choice.

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I look forward to helping you!