What’s more, health insurance must cover those services, says Katie Cohen, BSN, RN, IBCLC, the founder of Thrive Theory Lactation & Infant Feeding in Tucson.
Under the Affordable Care Act, insurance plans (except “grandfathered” plans) must cover lactation support services in full as a preventive service, says Cohen, who adds that most plans will cover at least six appointments, which ideally start before the baby is born.
“When we take a preventive approach and families know what to expect, some of the problems that are so common can either be prevented or I can give them tools to deal with those problems,” she says. “It doesn’t snowball into something that derails their whole breastfeeding journey.”
If appropriate, Cohen likes to involve spouses/partners and grandparents in her work.
Cohen moved to Tucson in 2014 after earning her nursing degree from Drexel University in Philadelphia, where she met her husband, Zachary Cohen, when both were freshmen.
As a public health nurse, she worked primarily with mothers and babies, first as part of Pima County’s Nurse-Family Partnership and then as the pediatric nurse team lead for the Tohono O’odham Nation.
Cohen had already started her training as a lactation consultant when she gave birth to her daughter almost six years ago. She describes her breastfeeding journey as “challenging,” with several hospital stays that separated her from her baby. This meant she had to revise her original intention of exclusively breastfeeding for the first six months.
The experience gave her the impetus to complete the certification process, which included 14 college courses in the health sciences; 95 hours of lactation-specific education; 1,000 clinical practice hours; and passing the International Board-Certified Lactation Consultant exam. She was certified five years ago and recently renewed her certification after completing 75 hours of continuing education.
Before starting Thrive Theory Lactation in 2023, she worked with a startup that used telemedicine to expand access to lactation support. She is also a professional development coordinator for the United States Lactation Consultant Association.
Cohen emphasizes that her approach to working with families is personalized, relationship-based, and judgment-free.
Although she has firsthand experience with many of the challenges her clients face, “it’s not one size fits all,” she says. “Just because they are experiencing a similar challenge doesn’t mean what worked for me will work for them.”
Cohen provides same or next-day appointments for urgent problems such as shallow latch and nipple pain, low milk supply or oversupply, tongue tie, bottle refusal, and poor weight gain. Other common issues she helps families deal with include knowing if their baby is getting enough to eat, choosing a breast pump, preparing to return to work, beginning solid foods, and weaning.
For some Jewish clients, additional issues may include pumping on Shabbat and handling kashrut when starting a baby on solids.
“Katie is great. She is very much a problem solver,” says Alexis Tuo, a mother of twin boys, who appreciates that Cohen seeks the root cause of problems instead of treating the symptoms.
“When I had clogged ducts or blisters she was able to find the reason behind it, and that was inflammation,” she says, adding, “Most people would just say, ‘OK, you need to put ice on it.’”
Cohen did recommend ice after feedings plus an over-the-counter nonsteroidal anti-inflammatory drug. She also suggested two new dietary supplements instead of one Tuo had read about online.
“There’s a lot of conflicting information on the internet,” Tuo says. “It’s nice to have someone whose job it is, and who is passionate about studying to find the most current, evidence-based research.
Cohen helped Tuo experiment with different flange sizes for the breast pump to reduce irritation.
“She also taught me how to use the settings on the pump correctly, which was huge,” says Tuo. “I was able to increase my milk supply once the inflammation went away, almost double.”
Tuo, whose twins were initially on oxygen, also appreciates that Cohen’s services include the option of in-home visits in addition to telemedicine and in-office visits.
Cohen, who also shares breastfeeding tips on social media with the handle @ThriveLactationTheory, sees her work as a calling, “all part of that repairing the world philosophy.”
She finds that when she tells people what she does, women are always eager to share their breastfeeding stories, even if they are now grandmothers or great-grandmothers.
“That’s a vulnerable, tender, and important time in our lives and it sticks with you,” she says. “Getting to be that person who makes a difference is very special to me.”
