Virtual Consults: What I’ve learnt

Due to the current situation with the You-Know-What Virus, a lot of lactation consultants are having to turn to virtual support to serve their clients. I’ve been giving virtual consults for two years now (in addition to face-to-face) with hundreds of clients, all at different points in their feeding journeys. This post is for all those LCs who are looking for some little tips, with a couple of things I have learnt along the way.

Things I have learnt:

  • Create a good space for your virtual consults. Decent lighting (any back lighting = BAD), charger cable (battery will drain very fast!), avoid any surprise head-high laundry piles in the far corner that you really thought wouldn’t be in the screen… and get a cup of tea 😉
  • Once you have started, check in with them continually about how they are doing — if they are understanding you okay, if they have questions or need clarification, and mostly, how they feel about what you just said. You can miss a lot of the non-verbal cues, and it can also help them to keep focus during a time when they are probably sleep deprived, stressed, etc. Remember that online consults are also harder for them to focus too.
  • If your video starts playing up and you notice any kind of delay, then ask (at an appropriate moment) if you can quickly hang up and call back immediately — you really need to be able to see their reactions in real time.
  • Around every 10min, I do a quick summary of what we have covered so far. I find that this works really well for all of us. I don’t tend to need to do this in face to face consults so much.
  • Seeing as you won’t be able to accurately assess a feed, ask a billion open questions about their actual feed. Like, ‘How would you describe any sounds that you hear during a feed?’ and, ‘How are you feeling about the way your feeds are going at the moment?’
  • Keep your usual consult-bag with you — you can still show tools, and demonstrate positions and tips using your own body. I often use my own (clothed, covered) breasts to show things like breast compression, or tips for how to hook up a supplemental nursing system. I use my thumb and my mouth to demonstrate the effectiveness of ‘nose to nipple’ (thumb = nipple).
  • About oral assessments: This clearly depends on what the consult is for. But if it is a situation where you’d normally really be wanting to do an oral assessment, just be really straight about this. Tell them that you’d love to be able to, but you can’t. Explain what an oral assessment is and what you’d look for, and give them your knowledge! If you suspect oral tethers, let them know what you have found in other clients, what the pattern tends to be, be transparent about your thought process, but don’t be closed-minded about it — explain that it is a possibility, but without doing this assessment, we can’t know for sure. I also make sure to explain that an oral assessment is to assess FUNCTIONING, so a photo won’t be able to give me the full picture (because they almost ALWAYS want to send photos afterwards), but it can give some clues. Discuss suck training.
  • It is handy to have a way to type to them simultaneously (particularly because there are 4 official languages where I live, and English isn’t one of them, so they often need the words in Swiss German, for example.)
  • Allow for yourself to go overtime a little so you aren’t stressed, and have time to replenish your tea! Leave enough time between your consults to either write notes, or do as I do and send yourself a voice message.
  • Remember that so much of this job is about emotional support, listening to the wants and needs of our client, and guiding them. Sometimes you may feel that you haven’t done much because you weren’t able to offer hands-on support, and yet these clients then go and tell others about how wonderful and helpful that consult was — don’t underestimate it, or yourself!

These are just a few of the little things I have learnt along the way, and would love to hear if you have others you’d add to the list. Good luck to everyone who is navigating these new uncharted waters!

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