I just want to make one thing clear before I start writing this blog. I am writing here about my experience as an IBCLC in private practice of doing online breastfeeding consultations. I’m not starting a debate on the merits of face-to-face visits Vs online consultations – I know there are benefits and drawbacks to both. I am just offering up thoughts and insights for what their worth into my experience thus far doing online consultations. And I’m writing for myself, as a form of catharsis, to help me better understand what I’m feeling and what I can learn from my experiences. I suppose it’s a form of therapy.

On 12th March this year I had been due to fly to Philadelphia for a breastfeeding conference – ‘Lactation Consultant in Private Practice.’ However, even though the conference was actually going ahead, I had decided the previous weekend that I wouldn’t travel. I was disappointed but it felt like the right decision. So on that Thursday morning as I was driving to see a client for a follow-up visit, I listened with a feeling of shock and fear as our Taoiseach Leo Varadkar came on the airwaves to inform us of measures that were to be implemented as a response to the COVID-19 pandemic. Schools and colleges would be closed. Social distancing would be introduced. Life as we knew it was to change dramatically. And one of the consequences that was to impact my work as a lactation consultant in private practice was that I would no longer be able to do home visits or see clients at The Rowan GP Clinic.

With all that was going on, the impending changes and the prospect of being at home with my kids, I found it hard to think straight. I decided I would do online consults. And then changed my mind and posted the following on my Facebook page:

“……….I’ve made a decision to not offer online consults. My kids are at home from school and the reality of that is only beginning to sink in for me. I know many of you will empathise! So while we are transitioning to this new reality, I won’t be doing online consults as I just don’t feel I would be able bring the same level of professionalism and focus to them as I would like to. I am, I have to admit, a little bit anxious right now and I need to put my energy into minding myself and my family. I will, however, continue to provide support to existing clients.

Whenever life gets back to normal, I very much look forward to seeing clients again.

Be gentle with yourselves folks.
xCaoimhe”

The next couple of weeks were tough. I experienced a great deal of anxiety and bouts of insomnia. But eventually I started to feel some sense of calm and managed to find the where with all to start coping and adapting. My husband closed his business so would be at home with us. And I felt able to start providing some support online. I got myself set-up with Zoom, put online booking on my website and started scheduling consults.

Initially I felt really positive about the online consults. I was pleasantly surprised at just how much could be achieved during a video consult. I was glad to be able to provide some help to mums, many of whom were struggling with breastfeeding and still feeling upset about not being able to have their partner visit them while they were in hospital. I was so impressed by how determined many of the mums were and how hard they were prepared to work to meet their breastfeeding goals. But, I was finding the online consultations more tiring than face-to-face visits. And there was something about them that I couldn’t quite put my finger on, and I’m going to try and articlate that now.

I’m an intuitive sort of person. I trust my gut. And I think I’m good at reading people and being able to sense what they are feeling. Empathy. When I do a home visit, I naturally assess breastfeeding, assess the baby, talk to the mother about her health history, and I listen to all she has to tell me. I look and listen. However, I also intuit and imbibe. And I feel and sense. I speak to the baby and try to interpret their body language and what they are trying to tell us. I often experience strong emotions during the consult – pain, loss, trauma, anger are often released during the process. And I am able to put breastfeeding in a big context of the mother, the family, the birth and hospital experience, the mother’s health history and her emotional life. Everything is connected. I can’t always put my finger on what I’m sensing or what I feel is going on, but I trust that my intuition and my gut is as important during the consult as the clinical assessments that I do. The home visits can be tiring, but after each one I usually feel a sense of completeness, of being whole – that even though I may be emotionally tired, there was a beginning, a middle and an end, and a flow of emotion. And the big dose of oxytocin I’ve been exposed to (simply from seeing a beautiful baby or from being exposed to the love between the parents and between them and their baby) fills me up, fills my heart, gives me a deep sense of gratitude for the work I do, and for humankind. I suppose it’s the feeling of being connected to others. The love. All of this makes me love working in private practice.

But, I am not getting the same feeling from online consults. They can be effective in terms of helping with breastfeeding, but I honestly feel quite depleted after them. I find it hard to achieve the same kind of connection with the baby that I get during home visits. I put all the effort in, but I don’t get back the same love plus oxytocin plus the sense of having had a shared experience with other humans. I often feel tired, depleted and lonely after online consults.

I know there are other factors – the background stress of a global pandemic which is affecting us all in a myriad of ways, and the fact that I am working from home, often conscious that my husband and kids are elsewhere in the house while I’m working. I’ve tried to be positive about the online support – posts on Instagram and Facebook (hey…I’m doing online consults! hooray! they’re great!) – but for me, it’s just not the same. I know that for now the online support is all we’ve got. And I wish I could be better at it and feel differently to how I do. I wish I could have the same experience with online consults as I do with home visits, but I just can’t pretend that they are same. I’m living in hope of being able to do home visits again soon, and to be able to once again tap into that indefinable thing that is missing for me with online support.

I’m taking a break next week so maybe having had some time out I’ll feel more positive about doing more online consults. We’ll see. I’m going to focus on self-care and on enjoying life at home with the family. And take it from there.