Question 1

Do you offer in-home lactation visits?

Accepted Answer

Chaya is office-based but offers virtual visits to those who need to stay close to home. 
Mimi does offer home visits and there is an additional convenience fee not covered by insurance.

Question 2

What is the difference between breastfeeding medicine and lactation consultations?

Accepted Answer

Breastfeeding medicine providers utilize their medical training to address complex problems facing lactating parents and their babies. As a PA, Chaya can order labs, imaging and prescribe medication when necessary.  It is also within her scope as a PA to diagnose things such as tongue tie etc. Board Certified Lactation Consultants (IBCLCs) are the only clinical lactation providers and are experts in optimizing latch, milk production & positioning.  Some have additional training in oral motor function evaluation, bottle refusal, pump fitting, infant reflexes etc.  The synergy between these two approaches is crucial to our mission of helping families achieve their unique feeding goals.

Question 3

What happens during a lactation consult?

Accepted Answer

In-person visits include history taking, oral evaluation of baby, breastfeeding parent exam, observed feed with pre- and post-weights, experimenting with different techniques and practicing ones that work best. Parents will receive a plan of care and a written report will be faxed to both pediatrician and OB-GYN.  Prenatal consults, pump consults, therapeutic ultrasound, bottle refusal, and baby/toddler-only visits are also available.

Question 4

Can you diagnose my baby with a tongue tie?

Accepted Answer

Chaya has extensive oral motor training and experience, and it is within her scope of practice as a PA to diagnose tethered oral tissues (TOTs). As with any symptom or medical complaint, it is important to come up with differential diagnoses- to think like a detective to come up with a list of all the possible conditions that might be the cause and then narrow down the possibilities.  Using this broad "diagnostic lens" can help prevent the over- or under-diagnosis of TOTs. Being able to collaborate with bodyworkers within the same practice offers several options to help improve infant oral motor function and optimize the results of a frenectomy when that is the chosen therapeutic path.

Question 5

Are lactation services covered by insurance?

Accepted Answer

The following plans are accepted for lactation services:
~ Aetna and Aetna Better Health
~ Blue Cross Blue Shield
~ Cigna
~ Oxford
~ UnitedHealthcare Commercial (from an employer) and Community (Medicaid)
~ UMR
~Qualcare

Please check with your specific plan to see if Chaya Mueller (NPI 1689838229) is in network
We do not perform prior authorizations and it is the patient's responsibility to verify benefits.

Question 6

How can a virtual lactation appointment be helpful?

Accepted Answer

Long before COVID-19, we began offering video consults over our HIPAA secure patient electronic healthcare record platform and are well-practiced in the nuances of this form of telemedicine. We are able to work with you to solve problems such as a painful latch, slow weight gain, pumping challenges, and low milk supply. We can also utilize videos and pictures to assess for tethered oral tissue and other structural problems.  An in-person follow-up visit is always welcome when you are up to leaving your home!   In most cases, these consults are covered by commercial insurance plans.  Please check with your specific plan to confirm the details. We can provide you with some insurance codes upon request.

Question 7

Can you help with bottle feeding too?

Accepted Answer

Yes! Many of the babies we help are not breastfeeding. This includes bottle refusers! Give us a call before you buy yet another bottle.

Question 8

How can bodywork support breastfeeding challenges like a tight mouth or poor latch?

Accepted Answer

At Togethernest in New Jersey, gentle bodywork helps release tension in the jaw, face, neck, and tongue, which can support babies with breastfeeding challenges related to a tight mouth.

Question 9

Is bodywork helpful before or after tongue, lip, or cheek releases?

Accepted Answer

Yes. Pre and post tongue, lip, or cheek release bodywork at Togethernest supports whole body infant balance and may improve feeding outcomes and comfort.

Question 10

Can craniosacral therapy help infants who struggle with reflux during breastfeeding?

Accepted Answer

Craniosacral therapy offers an infant reflux alternative to medication by gently supporting digestion, diaphragm function, and vagus nerve regulation.