81 | Stocking Your Office

Leah - Well. Hey there, Annie.

Annie - Hey there, Leah. How's it going?

Leah - Doing pretty good. How about you guys?

Annie - I am Good. I'm getting excited for this month's deeper dive with Nichelle Clark. We are going to be going deep into flanges and pumps. And as if you've ever talked to Nichelle for more than 10s, you'll know that she's like a massive expert on all the pumps because she's tried them all. She's ethically tried them all. She doesn't take samples or free pumps from anybody, and she knows how they all work. And she's she knows not just how they all work, but why they all work the way they do, and also has great insight into how to really fit people for flanges and make sure they're getting the right fit. So she's coming in for our deeper dive this month and we'll have the link in the bio. And so for today's episode, we thought it would be fun to talk about stocking our offices. I'm a little over a year into my office. I just got a little bit more storage space inside the office. I went to Target and I bought some fun, like boxes and storage things, and I reorganized everything and which is something that I really enjoy doing. So we thought it would be fun to talk about what's, what's in our offices. So Leah, you've had your office spaces obviously a lot longer than I have. What are the bare minimum things that you know from experience like you have to have in your office?

Leah - Yeah, I mean, I think the first and foremost just all comes down to safety things. So you're just going to need your PPE like gloves and if you're wearing mask masks, but then also like ways to clean your office safely and well. So you want to make sure that you have a way to clean your scale and any diaper changing surface that you're using. And then just those basic things that help you keep up with everything like trash bags and stuff like that. I think if you were going to do the bare, bare minimum, that would probably get you by. But there's a lot of other really helpful things that you could have on hand that will make your job even easier. And a lot of that will come down to how you run consults for like everybody's a little bit different. Some people love to have tons of visual aids, so you might have an entire basket with different sized baby dolls and different sized boobs and a mouth model and all these puppets that are available. I mean, you just might stock your office with visual aids. Like I even have a foam hamburger, which is one of my favorite things to pull out and show people how some breast shaping can help and like, just eat on this hamburger. I do it all the time. It's so funny and it really gets a good laugh out of everybody in the room. But then other people, they might be like, I talk people through or I like to be kind of like showing them with their own child. So a lot of the things that you're considering to use in your office or to purchase in your office shouldn't necessarily come from a list of like you need to have X, Y and Z, but like here's all the potential things you may want and then think about how you run your practice. Because I will tell you from experience, you can waste a whole lot of money buying all the gizmos and gadgets and props and things that people talk about. And then guess what? They just sit in that beautifully organized drawer for millennia. And then it or have to be tossed out because they don't work anymore disintegrated or all the things. I have a lot of stuff that I bought very early on that I literally have never used and it's still sitting in a box somewhere, which is really sad.

Annie - I'm more of a talker and I know this about myself, but I sublet my office from some home birth midwives, so I do use the baby doll a lot to just mirror positioning. Like kind of like I'll show you and then you can copy me. But they keep the baby doll because there really isn't a lot of room in this office. So on the shelf, the baby doll is always inside the pelvis.

Leah - Pelvis. The other thing that was like being birthed.

Annie - Yeah, well, no, it's like it's not even that way. It's like they've got the pelvis and then where they always put the baby back is they put the head in the pelvis. And so I'm always like, reaching up, like grabbing this pelvis, pulling the baby out and like and it's just always makes me laugh because I'm like, I don't know what this I don't know what to show you about this pelvis. I know nothing about childbirth stuff. But the one thing that I bought, I did have the puppet during when I was doing virtual, but my puppet had no eyeballs. It kind of was like, I need to I need to for my own like, sanity. I can't look at this puppet anymore.

Leah - And then that same one, it's it's.

Annie - I mean, it's good. It's a great mouth but like the eyes. It just needs eyes that maybe not quite such a bulbous head. But that's fine. I couldn't have made it. So I'm grateful to the person who did make it. The other one that I can't handle. One of my interns had the, like, the real feel breasts that you can, like, put on your own breast.

Leah - It has, like. It's like all behind it.

Annie - No, not the big one. But it was just like one breast. But it was like it had like, feel to it, like. And it was like jelly. Yes. And I was like, I tried it once. I was like, I can't. I can't touch this. I can't, like, funny because really I cannot handle this.

Leah - Yes, I have those. And I literally as a gift, I bought a case of them and gave them to doulas for a gift. When I was doing this class, it was like a class for doulas about breastfeeding as part of their gift for coming to the class was everybody got this big squishy boob, but they're not intended for the use that we're using them for. And so it was really funny when I bought like an entire case of them, I thought the person packaging this up is probably like, look at somebody be doing with this mini boob.

Annie - It was too much for me And then it got, oh, got a tear in it. And I was like, Oh yeah.

Leah - It's like inside of that.

Annie - It was giving, giving me like uncanny valley vibes. I just couldn't handle it. I have been keeping like a double electric breast pump. One of the ones that I know is a good brand in my office. I keep it there. Not because I don't actually use it during the consult, like, let's express your milk, but I have people coming in where they're like in desperate straits and they got a bad pump through their insurance and it might take a little time to like get a replacement pump or I had one person who came in and she's like, I ordered my pump through my insurance before my baby came. It was like two weeks postpartum. It hadn't shown up yet. So then in that case, I keep that pump on hand because I'll send it home with them. And then I'll say when you get your pump, you keep my pump. Bring me your, your pump replace it with the new pump that swap it out The first time it worked great and I was like that was great. And the second time I gave somebody a pump like six months ago. I haven't gotten it back yet. And now I'm kind of like, I just went and ordered a new one. I was like, I'm just going to like, whatever. Yeah, it's whatever. So I do keep that. I don't have a lot of room. I know some people with bigger offices have like a lot of pumps, like all the different ones to try, but I just don't have room for that. Do you keep big pumps?

Leah - We don't. We don't. I keep some emergency, like hand pumps. Like if I was to have somebody like, I don't know, in some crisis situation or we got to get this milk out or something like that, which doesn't happen very often. I feel like in my 11 years I've had like maybe 2 or 3 times where something like that happened. But it has always given me a little bit of peace of mind. And it's just like the sterile pack, little hand pumps that somebody could just grab and use right then, which is something that just allows me to like know that I have a backup plan If all the other tools or the things that the parent has aren't working, then I know that we have a backup plan. I like having that in my office. But yeah, I mean, I know like some people will also have pillow options that they're using to show different positioning and things like that. And I've found that helpful. And also, like sometimes I don't want them to feel like they need to have any of those things. So it's like we have a basket that has like some pillow options, but don't use them a whole lot. But they're there because some people are like, that's the only way I want to do it. So I want to make sure that their desires are respected. It is like sometimes I want to hide that, like put something over it and be like, I'm only going to open this curtain if.

Annie - I don't keep pillows at all because I don't really have a good way to wash them because I don't have a washer dryer in my apartment.

Leah - And you have to be like toting it all around. We only wash.

Annie - Things once a week and it's too much, so I just don't keep them. I find I have had people bring them to the office. Like I kind of say like if you're using one, bring it, but I don't use them unless absolutely necessary. So if anything, I might say like if you want to use your pillow, like here's where you would put your pillow at home. My goal is always to try to be like, You don't need it. That's my own, my own bias.

Leah - People are like like really attached to it and like, they can't listen.

Annie - I use it. I use mine with my older daughter until she was like 18 months old. Like, I tell everybody like this, I'm like, no shade on the pillow. Like, I totally get it. It worked for me. But that was also in the days before we knew about laid back breastfeeding. Nobody taught me I was doing the Cross Cradle, of course, so I need my pillow for Cross Cradle. Didn't know any better. What? Okay, so what about small things like accessories? Like, I feel like I'm always having, like, way too many. Size 21 flange inserts when what? And then like, where am I, 17? Like I never.

Leah - Like small like we do keep flange inserts again for like those like emergency situations where I'm like they only have like the biggest size possible and then they have like the tiniest size needed. And so I actually carry like mostly just the really small ones, the ones that you're not going to be able to get quite as easily because like Target, you can you hear, you can get like a 19 and 20 at Target. So I don't carry those sizes. I carry the 17 and the 15 because then I can send them home and be like until you can get a whole flange, you can use these or you can continue using and nipple shields. I mean, we don't use them very often, but I do have those on hand because I just like there's those really crazy situations where nothing else works. And I do like to have just the sterile pack ready to go. I can just open it and use it in those urgent situations. Luckily, that usually only have to buy those once because I'll get a case and I'll buy them like once every couple of years.

Annie - I just found and finally discarded like a Ziploc bag full of nipple shields that remember when we would go to like and there was the, the Irish lactation consultant who was always like, How many shields do you want? You have the mama vac cherry nipple shields and found.

Leah - Them, get them. You couldn't get them anywhere else. You couldn't get them anywhere.

Annie - And I had like I had gotten so many of them and then wasn't using them because I didn't do in person for like two years. And they and I found them and they were like yellowing. I was like, yeah. And then felt so sad. I was like, I have to throw these away. But I was like, I first need to just like thank these nipple shields and I need to thank Jerry Cahill for bringing them to Pennsylvania from across the oceans to make it traveled the seas to turn yellow in my bag.

Leah - Because I totally have some of those in this big box. I told you like it's all this stuff that like somebody in some conference somewhere was like this changed my practice. It made everything so much better. And so then I was like, Great, I'm going to buy that. And then ended up it's still in this like, random box of things that I'm like, Maybe someday I'll utilize this tool. We don't really carry like a whole bunch because I don't charge for these things. These are giveaways. So because I just like don't want to deal with the whole sales tax and reporting that because in Texas one, you have to have a license to sell anything to you have to report that orderly. And three, it's a big freaking hassle. And I just was like, I am not going to put myself through that when and now I feel like it's so much easier because people can get things so quickly. It's like we're in that situation where for them to go out and get this item, it's going to take a super long time. And I also was always like, ethically, I didn't want to be tied to any commercial products. Like people would be like, Oh, well, my lactation consultant selling this, so you know that, I feel a little weird. And I just like to kind of give I always give like three options of everything and, and really try to not have I just don't do any kind of sales.

Leah - How about you do sell?

Annie - I don't do sales and it's really it's the sales tax thing more than anything else. But I just cannot I can't add one more thing to my list. But also, I don't think I, I don't like, have the room. Like, let's say I have like a much bigger office where I could be like, here are multiple different options. Then I would feel like I have a store. You can buy things for me, but otherwise, that just feels too hard and too tricky and like.

Leah - Exactly. And stock enough to make it worth it because that's the thing.

Annie - It's like. Exactly.

Leah - You can't just have this really thing. It's just so hard to make it work.

Annie - And I can just, like give it away and write it off as a business expense. The grand scheme of things like I'm not spending that much money on flange inserts that I'm giving away in my office, and especially for my self-pay clients. Like I could never charge a self-pay client for a supply like that. I'm giving out in the office because it's like you're paying me a lot of money. Like I'm not going to be stingy about this. Nipple shields like all the nipple. Here's seven like, yeah.

Leah - I feel like it’s not awkward to use a tool because like if you're going to charge them for it, well then you need to like, well do you want to use this tool? And it might be in the moment where their kid is screaming and like now you have to have this whole conversation about like. Use this nipple shield, you're going to have to pay for this nipple shield. So like, while your kid is screaming at you, do you want to make this really hard decision which for some people, spending 10 or $12 might be a hard decision and I don't want to put that added stress on them and the situation.

Annie - So it's just not my I know people do it ethically. I know like there's no you can have a retail operation in your private practice. It is not there are ways to do it that are very ethical. There are certainly some things to do that would cross the line of ethics. I mean, one of them would be for me as an elk without a medical license, I don't even carry herbs in my office. I don't give them I would never give them out. I don't feel comfortable with that. I also feel like I could get in a lot of trouble in the state of New York for doing that. So I just stay. That's something I do. And even like Meta honey, I don't keep that and give it out. Like I tell people about it and they have to like, I'm like, Ask your doctor if this is safe, but I'm not going to be the one that gave you the herbs or the meta honey. I think like the kind of, like, furthest I'll go into that is like I keep the hydrogel pads. Like that's like the most like, medical thing that you're going to get from me.

Leah - Yeah, yeah, yeah. Same. I don't go into any of that either. And I think that it's such, such a and each state is different with all their laws and requirements and everything, but I have not felt comfortable with that either. And I really feel like our job is so much about like giving the information and then being part of the health care team and encouraging family. Like, here's some information that I have now. You go take that information and talk to your the rest of your healthcare team to find out if it's appropriate versus like I am telling you, to use X, Y and Z at this interval and here you can take it home with you, but you hit anybody else about it. And I'm like, No, no, watch not. And with what I feel comfortable with for my practice as well. So same. And the other thing that I like to keep on hand is the other forms of supplementation. So it might be like some syringes. So if a family comes in and the baby like we got to feed them right that second, some things like critical mass like I have some safe tools to use if the family doesn't have anything at home because some people like I never intended to use bottles. So I have like literally no way to feed my child that I have some different options for them, whether that be through finger feeding or something like that, where they can have something to get them started because there are those scary cases that walk in and like the kids. Yeah, excessive weight loss. And we're like, something has to happen right now. We're going to be using that hand pump that I have sterile pack ready to go my syringe and glove finger. We're going to, like, get this kid fed if latching at the breast or something isn't possible.

Annie - So, yeah, definitely like that.

Leah - But I like to have emergency use purposes.

Annie - Definitely. And I just recently ordered I've never done this before, but I ordered some breast milk storage bags because then I thought like, oh, if we're practice working on pumping like a way to send it home, have a way to send it home with them if they don't want to have it in the bottle or whatever, I don't know, just seem like that seems like an easy thing to have on hand if it doesn't cost much money. And that's where the doesn't cost much money is the next. And the most important ethical thing to consider is that there's nothing that I am showing to a client or giving to a client, or if I did retail selling to a client that was given to me for free by any commercial entity, like I will not take a free pump. I will not take a free sample. I got in the mail. I think I heard a lot of people got these test strips for mastitis just like showed up in the mail. And I was like, well, listen, I'm never going to use it.

Leah - Because I want it.

Annie - Because they gave it to me for free already. It's suspect. And also I'm like, I don't really see the need. Like this is like maybe you don't, don't even know. But I was like, Well, don't send it to me for free. This is something I didn't really know when I was first starting out. Like I definitely like would get the free samples of lanolin from Lance Snow and I would give those out. And that was something that I just learned with time. It wasn't taught to me. But when you know better, you do better. And this is a case where all of these companies want to give you stuff for free. Don't take it. Don't take it.

Leah - Because they know. They know that you're an influence. They know that that will work for their marketing plan. And so it really is a slippery slope and it feels like, hey, but this gives me a chance to test out new products and to see if I like them and things. But it is just a slippery slope into that kind of gray, dark area where we don't want to end up being unethical about how we're serving our clients. So it's an important reminder, definitely.

Annie - Well, our deeper dive guest, Michelle Clark, is super ethical, super knowledgeable. We can't wait to see her. We're going to have a link so you can sign up in the show notes. You can come just to this one. You can subscribe to our subscription or you can join us in our Patreon. And all of those things will get you all kinds of fun, access and past episodes and past deeper dives. And so thank you again for listening to us when we put these podcasts out. This was a really fun conversation. I'm also going to put a link in the show notes to a Serp course that I offer that is by Rachel O'Brien. That is also about supplies for what's called the Right Stuff and it supplies for your home and office. And it's a great talk and you can get a Serp for it. So that'll be in the show notes as well. So until next time. Thanks, Leah. It was great talking to you.

Leah - Great talking to you. See you soon.

Annie - Bye.