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Nurture Travel Area

Thank you for considering Nurture to support your family! We serve Franklin, Delaware, Coshocton, Muskingum, Licking, Knox, Guernsey, Holmes, and Tuscarawas Counties with in-home lactation, accepting both self pay and insurance. Currently, Physical Therapy is available for Franklin County.

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COVID19 In-Home Consultation Safety Protocol

Nurture In-Home Lactation and Physical Therapy Consultations are available with safety protocols in place for both staff and clients. Virtual consultations will continue to be available, allowing families to choose the service that fits their needs. Please reach out with any questions on how we can best serve you!

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Resources

Local Resources:

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Navigating Insurance and more with Nurture Columbus

Navigating insurance is confusing! When Allyson and I (Julie) first sat down to create Nurture Columbus, one of our main goals was to figure out insurance coverage and creative ways we could offer quality, in-home lactation services to ALL families. We have made some great progress working toward this goal, and are continually working each week to improve access to IBCLC lactation services. Here are your current options for covered or discounted services with Nurture:

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Breastfeeding Basics

Allyson Wessells, PT, IBCLC

Breastfeeding is a developmental milestone that optimizes the health of baby, mother and the environment. Understanding why a baby breastfeeds, knowing how to be prepared to get breastfeeding started, and being familiar with signs that milk supply and baby’s growth are plentiful help minimize challenges that may occur with this natural progression.

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FAQ

What is an International Board Certified Lactation Consultant (IBCLC)?

A healthcare professional who specializes in the clinical management of human lactation and breastfeeding. An IBCLC is certified by the International Board of Lactation Consultant Examiners, which is considered the “gold standard” in the field. This certification requires rigorous education, hands on training, and re-certification every 5 years.  Learn more here: International Lactation Consultant Association, United States Lactation Consultant Association

Why choose an IBCLC?

An IBCLC is trained to help establish and sustain breastfeeding, create a care plan for complex feeding issues, and remain sensitive to each individual’s unique needs and goals. The benefits of breastfeeding to baby, mother, family, and the environment are well known. Strategies for overcoming difficulties that can sometimes arise with breastfeeding are not always well known or identified by other health professionals. An IBCLC has the expertise to help with these specific challenges.

What are some difficulties Lactation Consultants help with during a visit?

Lactation Consultants address persisting painful latch, slow weight gain, clogged/plugged ducts, mastitis, low milk supply, insufficient mammary tissue or hypoplasia, inverted/flat nipples, tongue tie, and many more complications. An IBCLC can help identify underlying causes to these problems and provide you with an effective plan for moving forward.

Does insurance cover the cost of a Lactation Consultant?

As part of women’s preventative services, coverage options made possible by the Affordable Care Act are required to cover breastfeeding support, supplies and counseling. Learn more here: Breastfeeding Benefits. For Nurture Columbus Insurance options click here: Navigating Insurance. For any out of network plans, Nurture Columbus will provide you with a Lactation Visit Receipt (LVR) for you to submit to your insurance company or if you provide your insurance information on your intake for we will submit your insurance claim on your behalf for possible reimbursement depending on your plan’s coverage; however, Nurture Columbus is not responsible for reimbursement.

What is Craniosacral Therapy for Infants?

Allyson Wessells, PT, MPT, IBCLC

What is Craniosacral Therapy (CST)?

Craniosacral Therapy (CST) is a gentle, hands-on on therapy guided by touch and intention. CST can optimize space and cerebrospinal fluid circulation within the cranium and throughout our spine where our nervous system is originating and directing our bodies to move. It has origins in osteopathic medicine which values respecting the body as a whole but with intricate structure and function relationships. It is a treatment that can be helpful throughout the lifespan but especially in infancy when bones and ligaments are continuing to form with direction from muscles and the nerves that guide them. Sensory or touch input can create a better motor or response output. Parents are doing this inherently all day long as they caress their new babies! Those trained in craniosacral therapy will often provide additional exercises and methods of touching to promote comfortable movement.

Why consider CST for your infant?

Movement is essential to function but can become restricted due to prenatal fetal constraint, birthing challenges, and limited postnatal movement opportunities often associated with excessive time in swaddles and containers. Any or all of these situations can cause strain and compression on the 12 cranial nerves exiting the base of our skull and guiding our initial purposeful movements. CST can decompress these important nerve outlets to improve and restore mobility and help a baby feel comfortable in their body. CST can help babies who:

  • Engaged early into the pelvis during pregnancy and therefore had less room to move and refine reflexes essential to birthing and functional feeding
  • Experienced birth trauma or excessively short or long births
  • Struggle to initiate and sustain a comfortable and functional latch at breast or bottle
  • Demonstrate asymmetry at head, neck, or jaw which may include torticollis, plagiocephaly, brachycephaly or dolicocephaly
  • Have oral restrictions such as ankyloglossia, also known as tongue tie

How is CST provided?

CST is very much an in the moment treatment. Family descriptions, observations and hands on assessment to detect imbalance in what is known as the Craniosacral Rhythm (CSR), inform the person trained in CST to proceed with intentional, light touch that can optimize movement. CST can proceed in any setting and position that feels comfortable to infant and parent, whether during a feeding, during floor time, or while being held. Signs of release and better movement can be widely variable but include: yawning, deep breath, sneeze, burp, gas, calmness, crying. Ultimately, for the purposes of infant CST, maternal reports of improved feeding function and comfort can result.

When is a good time for CST?

At Nurture, CST can be provided anytime from birth and beyond during a visit with a trained lactation consultant or therapist. Allyson is our resident CST provider having trained at the Carol Gray Center for CST Studies in Portland, Oregon. With a background in physical therapy as well as being a lactation consultant, she combines expertise in biological infant feeding as well as early human movement to help optimize function. A CST session with her will look different every time as every baby is unique and every day is a new day of growth for them! While always thinking about the exquisite neuroanatomy and cranial nerve function of the infant, her ultimate goal is to listen to your goals and help you find comfort and connection as you adjust to a new life with your little one.

Further reading:

Hawk C, Minkalis A, Webb C, Hogan O, Vallone S. Manual Interventions for Musculoskeletal Factors in Infants With Suboptimal Breastfeeding: A Scoping Review. J Evid Based Integr Med. 2018 Dec 12;23:2515690X18816971. doi: 10.1177/2515690X18816971. PMCID: PMC6299335.

Genna CW. The influence of anatomical and structural issues on sucking skills In: Genna CW, ed. Supporting Sucking Skills in Breastfeeding Infants. Burlington, MA: Jones & Bartlett; 2022.

About the author: Allyson Wessells is a physical therapist and International Board Certified Lactation Consultant (IBCLC) with Nurture Columbus, in Columbus, Ohio.  As a PT and IBCLC, she focuses on optimizing nourishment and growth for lifelong health. Other services include presentations emphasizing the importance of breastfeeding and infant neurodevelopment as foundations for preventative healthcare.

Reflections on Breast Cancer Awareness Month

Allyson Wessells, PT, MPT, IBCLC

Breast Function:

Breast Cancer Awareness Month continues to be important for awareness of the most commonly diagnosed cancer among women in the United States. Understanding the function of the breast and its relation to disease prevention is equally important. The breast can be considered an organ of the immune system uniquely transforming beyond pregnancy to nourish a new human with vital nutrients and antibodies, among thousands of other protective factors.1  Longer duration of breastfeeding is associated with optimizing a child’s physical and mental health for a lifetime ahead while also reducing a mother’s risk for many diseases, including breast cancer.2,3,4 Awareness of human milk as species specific nourishment that equips our immune systems to better defend our bodies is something everyone should promote. Mothers who choose to breastfeed should have easy access to skilled lactation care and community support proven to help meet breastfeeding goals, improve maternal and infant health outcomes, and contain healthcare costs.5,6,7

Lactation Care Access:

Government health policy leaders promote breastfeeding and recommend it for at least 1-2 years for its advantages to mothers, babies and society.8 Equitable access to and coverage for skilled lactation care to assist in achieving recommendations lags, especially within state Medicaid plans.9 This is despite a 2013 Affordable Care Act (ACA) provision to contain cost and improve health outcomes through health plan coverage for comprehensive lactation care.9 Direct advocacy with the Ohio Department of Medicaid (ODM) ultimately revealed inability to reimburse the most advanced level of care for breast function, the International Board Certified Lactation Consultant (IBCLC), due to a lack of state licensure for this credential.10 Many private insurers recognize and reimburse this provider with oversight through the International Board of Lactation Consultant Examiners (IBLCE).11 Efforts to establish solutions for ODM recognition are underway but licensure requires legislators to introduce a bill to license IBCLCs, passage through a complex General Assembly, and a state board to oversee the licensure.

Local Service:

Reimbursement is important to sustaining credible, evidence-based IBCLC care. Private health plan coverage for Nurture Columbus IBCLCs has grown the volume of families accessing our services and achieving their goals such that the Nurture team is expanding! We hope public health plan reimbursement becomes proportional so the IBCLC field can grow across diverse communities and more equitably fulfill a mission to reduce socioeconomic and racial health disparities, including breast cancer rates, through better access to care that improves breastfeeding rates.12 There can be many barriers to successful breastfeeding, but public health plan coverage for IBCLC care should not be one when breast cancer prevention is a most prominent goal of this important month of awareness.

At Nurture, we hold all who have been affected by breast cancer close to our hearts, and strive to be a small part of reducing cancer risk by helping people reach their breastfeeding goals💗

References

  1. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am. 2013 Feb;60(1):49-74.
  2. Czosnykowska-Łukacka M, Lis-Kuberka J, Królak-Olejnik B, Orczyk-Pawiłowicz M. Changes in Human Milk Immunoglobulin Profile During Prolonged Lactation. Front Pediatr. 2020;8:428. Published 2020 Aug 7.
  3. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002 Jul 20;360(9328):187-95.
  4. Anstey EH, Shoemaker ML, Barrera CM, O’Neil ME, Verma AB, Holman DM. Breastfeeding and Breast Cancer Risk Reduction: Implications for Black Mothers. Am J Prev Med. 2017;53(3S1):S40-S46.
  5. Wouk K, Chetwynd E, Vitaglione T, Sullivan C. Improving Access to Medical Lactation Support and Counseling: Building the Case for Medicaid Reimbursement. Matern Child Health J. 2017 Apr;21(4):836-844
  6. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, Miles N, Leatherwood S, Reese L, Baker T. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021 Feb;16(2):156-164.
  7. Dylan D Walters, Linh T H Phan, Roger Mathisen, The cost of not breastfeeding: global results from a new tool, Health Policy and Planning, Volume 34, Issue 6, July 2019, Pages 407–417.
  8. Office of the Surgeon General (US); Centers for Disease Control and Prevention (US); Office on Women’s Health (US). The Surgeon General’s Call to Action to Support Breastfeeding. Rockville (MD): Office of the Surgeon General (US); 2011. PMID: 21452448.
  9. Hawkins SS, Dow-Fleisner S, Noble A. Breastfeeding and the Affordable Care Act. Pediatr Clin North Am. 2015;62(5):1071-1091. doi:10.1016/j.pcl.2015.05.002
  10. Wessells, A., Smith, C., Gladney, J. Lactation Care: Advocating for Equitable Access at the Ohio Department of Medicaid. Clinical Lactation. (2020) Volume 11, Issue 3.
  11. International Board of Lactation Consultant Examiners (2018). Scope of Practice and Clinical Competencies for IBCLCs. https://iblce.org/resources/professional-standards/
  12. Chetwynd EM, Wasser HM, Poole C. Breastfeeding Support Interventions by International Board Certified Lactation Consultants: A Systemic Review and Meta-Analysis. J Hum Lact. 2019 Aug;35(3):424-440.

About the author: Allyson Wessells is a physical therapist and International Board Certified Lactation Consultant (IBCLC) with Nurture Columbus, in Columbus, Ohio. As a PT and IBCLC, she focuses on optimizing nourishment and growth for lifelong health. Other services include presentations emphasizing the importance of breastfeeding and infant neurodevelopment as foundations for preventative healthcare.

Making Milk & Accessing Human Milk

Caring for an infant can be stressful at times, but the recent formula shortage has really amplified all the normal infant feeding stressors. We see you all struggling with the extra pressure to make milk or know where you’ll find the formula your baby tolerates best.

Here are some tips for making milk and accessing human milk:

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Welcome, Lisa!

Nurture is excited to grow our team by bringing on Lisa Sheer as a contractor! Lisa is an International Board Certified Lactation Consultant (IBCLC). She has a background working with WIC and private practice as the owner of Latching On. She serves Coshocton, Muskingum, Licking, Knox, Guernsey, Holmes, and Tuscarawas Counties. We are excited to bring Lisa’s expertise to Nurture and expand insurance coverage by bringing affordable lactation care to more Ohio Counties. To schedule with Lisa,

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