Lactation consulting business opens Moorhead office to make services more accessible to all

MOORHEAD — While pregnant with her first child, Carissa Finck decided one way to give her baby a healthy headstart in life was to breastfeed.

So she did what any self-respecting millennial would do: She turned to social media.

"I was like, ‘I want to follow all the trends. I’m going to start looking and seeing what’s going on,'” the 29-year-old Fargo woman said.

But as she scrolled through the conflicting advice on the “right” way to nurse and the moms who said they could produce 60 ounces of milk a day, Finck felt more anxious and confused than ever.

Then Finck spotted a Facebook post from Jaci McCaskell Kulish, an international board-certified lactation consultant and owner of Northern Prairie Lactation Services.

Finck reached out and they made a prenatal appointment, which was covered by Finck’s insurance.

Since Finck’s little boy, Onyx, was born Dec. 29, McCaskell Kulish has been a reassuring resource on Finck’s motherhood journey.

“It provided me with a sense of freedom," Finck said. "Like, I can do this. I don’t have to pump all this milk. I don’t have to do all these things. I can just feed my baby and if he gains weight, he’s happy.”

McCaskell Kulish founded Northern Prairie Lactation Services in 2021, offering services via virtual and in-home visits. On March 1, she opened a physical location at 2704 12th St. S., in Moorhead.

An office setting will make breastfeeding support more accessible to lower-income families, McCaskell Kulish said, as they cost less than the home visits she provides. She also offers discounts and a sliding-fee scale to make her services more affordable.

She provides services like prenatal lactation education, lactation support immediately after baby is born, problem-solving for moms and babies when little ones struggle to “latch” — or attach properly to the nipple for feeding — and weight checks to ensure baby is getting enough nutrition.

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“I do follow-ups with every client, if they want it,” Finck said. “Because sometimes we don’t fix everything on the first visit, or sometimes parents need a little more reassurance.”

Depending on how long families opt to use her services, she will guide clients through other milestones, such as pumping, bottle feeding, back-to-work plans, introduction to solid foods and weaning.

Along the way, McCaskell Kulish aims to offer calm, evidence-backed support in a world where any Google search could lead a parent down a rabbit hole of self-anointed experts and unreliable information.

“I tend to be very laid-back when I speak to parents. I'll say, ‘You don't have to do all that,’” McCaskell Kulish said. “Let's make it as easy as possible, right?”

McCaskell Kulish’s interest in the field stemmed from her own struggles nursing her own three children. She and her husband had taken a prenatal breastfeeding class and figured they’d be fine.

But in 2007, after her first-born arrived, “one thing I discovered is that it is really hard to latch a baby when you’ve never done it before,” she said. “That, plus a baby who wanted to eat all the time, latched well or not, left me extremely sore.”

By the time they left the hospital, she said, “I was in toe-curling pain each time I put my baby to my breast." She added that it took "weeks, and a whole lot of lanolin, before I was able to nurse my baby without pain."

McCaskell Kulish said she looked for support everywhere, but struggled to find it. When pregnant with her second son, McCaskell Kulish became connected to La Leche League, which provided peer-to-peer support. She became a La Leche League leader in 2010.

She would have been fine as a stay-at-home mom and La Leche League leader, but started wondering what she would do herself when her youngest child entered kindergarten. So she decided to pursue becoming an international board-certified lactation consultant, which is the highest certification available in that area. 

To do so, she needed to take 90 hours of lactation-related education, which she did through a full 90-hour course, plus needed to amass 1,000 hours of direct-breastfeeding support.

She then took an international proctored exam for certification. Initially, it was scheduled for March 30, 2020, but thanks to COVID, she took it virtually via webcam in September 2020 and passed.

She opened Northern Prairie Lactation Services May 1, 2021.

While every case is different, Finck’s experience helps illustrate the type of support McCaskell Kulish provides.

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During the prenatal appointment, they talked about hunger cues, what to expect the first few days after the baby enters the world, the best start for a full milk supply and how to tell if the baby is getting enough milk.

As it’s common for new parents to worry they aren’t feeding their babies enough, McCaskell Kulish reassures new parents by showing them a gold bead, roughly the same size as a cherry, to illustrate the size of a newborn’s tummy.

The consultant and Finck also talked about ways to encourage “latching” and discussed the best positions for holding the baby while nursing. McCaskell Kulish measured Finck for a breast pump flange, the plastic or silicone shield that fits directly over the nipple to form a seal.

Once Onyx entered the world and mom and baby were at home, McCaskell Kulish did a home visit to ensure everything was going OK. At the time, Onyx wouldn't latch onto his mom's right side, so the consultant worked with them to find a solution.

In subsequent appointments, they’ve weighed Onyx on an ultra-sensitive scale to gauge how much milk he consumes in a single feeding, and planned how McCaskell Kulish will pump milk to return to her job as a financial manager at a chemical-dependency treatment center this week.

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While the majority of the consultant's clients are first-time moms like Finck, she also has worked with parents who are on their second, third or even fourth child. Some tell her they’ve never been able to breastfeed before, but would like to try it at least once.

McCaskell Kulush is sometimes called in to troubleshoot unexpected hurdles, such as moms suffering from mastitis (a painful inflammation in the breast which can lead to infection), “milk strikes” — when an older baby suddenly refuses to nurse — or little ones who refuse the bottle. In cases where she suspects there might be a physical issue that prevents nursing, she will connect with the client’s healthcare team to share information.

“I’m not floating off into space as part of my own little world,” she said. “I communicate my findings to their chosen pediatrician, and refer to various other providers when necessary."

Northern Prairie's sessions cost $100 for a 60-minute virtual visit, $120 for a 60-minute office visit and $225 for a 90-minute home visit. She also offers a sliding-fee scale for those on lower incomes and will offer a $50 discount on their main visits for anyone who qualifies for WIC or medical assistance.

Finck's insurance has covered her lactation sessions with an independent provider, although that’s not always the case. Though lactation support is considered preventative care by The Affordable Care Act, and therefore covered under insurance, "many insurance companies find ways around it," McCaskell Kulish said.

According to the Lactation Network, a business-support organization which McCaskell Kulish bills her insurance through, comprehensive breastfeeding support pays off for working parents and the companies they serve. Companies with lactation programs have a higher post-maternity-leave retention rate —94% — than those without them, according to that organization's website.

In the meantime, McCaskell Kulish aims to help those who are committed to breastfeeding to feel supported when they most need it.

“I want people to feel seen and heard with me,” she said. “That’s why I do this.”

Learn more at www.northernprairielactationservices.com.