Your pump motor has a warranty for the number of hours it will provide strong suction for pumping. Each company has a different motor warranty for how long their pump will suck. Most pumps have a 2 year warranty for regular use (3-4 pumps a day while working a 5 day a week job) and this would get you through pumping while breastfeeding that baby. Each manufacturer should have this information on their website or in the pamphlet that came with your pump. The Spectra, one of my favorite pumps and very commonly used, has a motor life of approx 1500 hours with general use. For most, they find this pump will provide good suction for about 3-4 years. For Exclusive Pumpers (EP), many find the pump will wear out around 700-800 hours of use. If you only occasionally pumped with your first baby, you may find the pump works great for your second baby. You may also then get a different pump, like a portable or wearable. But if you pumped a lot, consider getting a new pump for each new baby born.
How long did you use your pump for before it wore out?
Used pumps are considered electronic waste. Disposal options include recycling through the manufacturer, or contacting your local recycling center or electronic recycling site to see if they will accept it.
Don’t fall for the marketing. There are so many bottle systems out there that are marketing themselves as “just like the breast” and even “shaped like the breast”. In truth the ones that look like a boob often function the least like it.The good news is there are some really good bottles out there that even though they don’t work LIKE the breast, they can PROMOTE a latch similar to it to help baby go back and forth between the two.
There are many bottles marketed as “most like breast.” The bottle part may “look” like a breast, but the nipple typically has a wide neck and and short nipple, which is how some nipples look like at rest before a baby latches. I call these shoulder nipples. The baby tends to latch just to the short nipple in a straw-like latch because they can’t latch deeply to the wide base (breast tissue expands and fills baby’s mouth, but the rigid silicone of the bottle nipple doesn’t). If baby’s lips are super rounded and there’s dimpling in baby’s cheeks while they suck, they are in a shallow latch. They may still pull milk from the bottle, but this shallow latch back at the breast results in painful nipples and leas efficient feeding.
Want to learn more? Take my Latched class to help find the right bottle for your breastfed baby.
Bottle nipples that have a more gradual slope from tip to base and a cylindrical shape are preferred for all babies, whether breastfeeding or not. Why cylindrical? We want your nipple to go in and out of baby’s mouth round. If your nipple is coming out pinched, creases, or flat, we’re talking about improving a shallow latch or releasing a tongue tie. Bottle nipples that are lipstick shaped,flat, creased, or pointed are going to promote incorrect sucking patterns which can transfer back to breast. Now hear me on this: while a round, tapered nipple are optimal, there are times when a different shape nipple is appropriate, especially if they’re the only shape baby will successfully take. We want all babies to have a wide latch to the bottle for more efficient feeding and better use of their facial muscles for skill development. I usually prefer the narrow neck to the wider versions for the majority of babies, as it helps promote better lip flanging, although some babies they will do just fine on the wider version. If your baby is struggling to take a round, tapered nipple, please seek the help of a qualified and specially trained IBCLC lactation consultant, occupational or speech therapist. CLICK HERE TO BOOK WITH ME NOW
When a baby is at the breast, they create a vacuum in their mouth with negative pressure by making a seal with their tongue to the palate. They then use positive pressure by compressing the breast as their tongue moves in a wave like pattern from front to back called peristalsis. Positive and negative pressure are essential for a baby to efficiently feed from the breast. They need to maintain the tongue protruded over the bottom gun line and in that vacuum seal through the duration of the feeding, and the middle of the tongue needs to pump up and down to help compress out milk. This is why babies with tongue ties can struggle to feed both breast and/or bottle. Bottles work totally different than the breast and many only need the compression piece for baby to move milk. Some bottle nipples do a better job of approximating the breastfeeding latch and do require more suction in order to remove the milk. In general, bottles that require a combination of suction and compression to remove milk better promote breast feeding by using a more natural and functional sucking pattern. Those systems that use compression only promote a chomping sucking pattern or the baby squeezes the nipple harder to move milk, which can make it difficult (and painful) when transitioning back to breast.
What nipple “level” should my baby take? Nipple flow levels are not standardized across the bottle industry. Each company has their own set rate and it is completely different from company to company.A level one will flow simple tell different across every brand of bottle. What is “slow” on one nipple can be very fast compared to “slow” on a different nipple. Britt Pados has done multiple research studies that measure flow rates. Turns out there are some brands “Slow” that are actually faster than other brands “Level 3” . Remember: don’t fall for the marketing. If your baby is coughing, choking, leaking milk or struggling to drinking from a nipple, try going to a slower flow nipple in the same brand and if that doesn’t work, switch brands.Do you ever need to go up a nipple level?No. They are marketing nipple levels by age like Carter’s does with onesies. If it fits, use it. No need to level up if your baby is content. Ever.
From a lactation perspective, we generally want breastfed babies to use a nipple that matches the flow of their mothers milk back at that breast. This is USUALLY the slowest flowing nipple (remember, this will vary from brand to brand). We want them to take a bottle slowly since breastfeeding is usually a slow process, and we want them to actively suck to get milk out. Although for those with a fast let down or over supply of milk, it’s totally fine to use a faster flow nipple that matches the speed at which your baby takes the breast.
Babies are masters at compensating to feed. They learn very quickly what works and what doesn’t to get milk. But sometimes this comes at the cost of them compensating with their muscles which can lead to symptoms like lip blisters, two tone lips, lots of gassiness and reflux. Clicking while swallowing, leaking milk, coughing and eating too fast are all symptoms that something isn’t right: either with the nipple shape, flow level or their latch OR something else may be going on in their mouth like a tongue and lip tie. If baby is doing well with their bottle and you have no concerns, keep doing what you’re doing! No need to start fresh and buy new. Some babies do a really nice job of going back and forth from breast to bottle, despite requiring different mechanics. If you are seeing any red flags and something doesn’t feel right about your baby’sbottle feeding skills, either breast or bottle, schedule a consultation. There is help and guidance for you to get things back on track.
Your milk can be a variety of colors which can be caused by a variety of things.
💛Diets high in yellow-orange vegetables (yams, squash, carrots, etc) can lead to high levels of carotene in your milk, which can turn it yellow or orange.
💛Frozen milk may look more yellowish when thawed.
🧡Food dyes used in carbonated sodas, fruit drinks, and gelatin desserts have been associated with milk that is pink or pinkish orange.
💙Blueish milk is often just a higher water content in the milk. It could also be caused by food dyes.
💚Greenish milk has been linked to consuming green sports beverages, seaweed, certain herbs, or large amounts of green vegetables (such as kale or spinach). I had mine turn green from a plant based multivitamin!!
💗Pink milk, some times called “strawberry milk” be a sign of blood in your milk. This can occur with or without cracked nipples. Seeing blood in your milk may be alarming at first, but it is not harmful to babies. If you have any concerns or other symptoms associated, such as pain or mastitis, set up a lactation consultation right away.
💔Occasionally blood in breastmilk is caused by things other than nipple or breast trauma. Papillomas are small growths in the milk ducts which are not harmful but can cause blood to enter your milk. In the vast majority of cases, blood in human milk is not a concern. However, some forms of breast cancer can cause blood to leak from the nipples. Breast milk can also turn pink if a bacteria called Serratia marcescens is present, although rare this bacteria can be extremely harmful to young babies. If you’re experiencing pink milk without noticeable nipple damage, please reach out to a health care provider immediately.
🤎Brown milk may be caused by what is known as rusty pipe syndrome. During pregnancy and in the first few days after birth the ducts and milk making cells in your breasts grow and stretch. As blood flows to your breasts it can sometimes leak into your milk ducts, making your milk look brown or rust-colored. It usually clears within a few days as more milk flows through your breasts. Continue feeding your baby your milk.
Did you know? Around 70% of women produce more milk in the right breast. Which means 30% make more in the left. It is VERY common for one side to produce more than the other. Some times double on one side. We don’t know why. This is not a reason to neglect one side. You want to make sure you rotate which breast you offer first. Babies may prefer one side over the other for various reasons:
👶🏽They like to lay with their head in a certain direction or their body is uncomfortable in the opposite position
👶🏿They prefer the flow (one side may flow faster or slower than the other)
👶🏼They may prefer the flavor (YES!! Milk can taste different form each breast during the same feeding!!)
If you want to help balance out a slacker boob:
🔆Offer the slacker first more often.
🔆End on the slacker can also help, especially if baby just wants to use you like a pacifier.
🔆Pump the slacker side during or after feedings can also help stimulate more milk production
🔆Make sure you have the correct sized pump flange on the slacker side. Our nipples can often be different sizes and using the wrong sized flange can drop supply on that side
🔆Hand expression on that side at random times of the day even for a few minutes will jump start increased production.
🔆If it’s positional from your baby (they only want to lay cross cradle to the right and not the left, experiment with other positions like football or side lying to help baby compensate for their body. If your baby prefers one side of the other from a positional perspective, consider taking your baby for some infant bodywork like chiropractic or craniosacral therapy.
There are people that will struggle to or never make a full milk supply. From 1 month to 1 year, exclusively breastfed babies average 25oz of breast milk per day. True low supply means making less than this when the breasts are stimulated at least 8 times in 24 hours. Chronic low milk supply is linked to either a greater health concern or something out of your control which you cannot change or fix with cookies, teas or even medications and pumping.
🗝Low milk supply that can be increased with time and support:
💡Taking certain prescription medications with a side effect of dropping milk (Sudafed, Benadryl, antibiotics)
💡Baby not feeding efficiently from lack of oral motor skill or tongue tie
💡Taking certain prescription medications with a side effect of dropping milk (Sudafed, Benadryl, antibiotics)
💡Not feeding or pumping enough, especially over night
💡Scheduled feedings or over use of a pacifier
💡Birth. Many medications designed to help you labor and deliver actually inhibit baby from latching and feeding effectively for hours to days after birth. Hemorrhage or birth trauma can also cause low supply in the beginning
💡Supplementing, especially in the two weeks after birth
🗝Reasons for chronic low milk supply that may NOT increase even with maximal support:
💡Breast or nipple surgery, augmentation, reduction, trauma
💡Insufficient glandular tissue (IGT). Breasts never developed during puberty and look tubular or widely spaced. Signs of IGT include breasts did not grow in puberty, or increase in size during pregnancy. No engorgement in the week after birth
💡Uncontrolled or undiagnosed thyroid disorder
💡Hormone or endocrine disorders, including severe PCOS
💡Hormonal birth control placed/used too soon after delivery
💡Nipple piercing that scars shut instead of staying open
There is a mistaken belief that prescription galactagogues, teas, or herbs can cure ANY chronic low milk supply. Before self-prescribing or taking Domperidone, Reglan, fenugreek, or any other lactation supplement, consider having your serum prolactin levels tested and a full evaluation by a skilled lactation consultant. Continue to follow @lalactation in Instagram or see my videos on YouTube for strategies of breastfeeding with chronic low milk supply.
Colostrum is thick and sticky. Pumps are great for stimulating milk but they’re not the best at removing it from the breast and it can be very frustrating to pump and not see anything filling the bottles. Don’t be discouraged. Stimulation is super important in the early days after birth and the work will pay off. hand expression is the key to emptying colostrum when pumping. The pump will do a good job to stimulate your hormones to make milk and your hands will help empty it.
If you’re engorged or have an oversupply, you may need to pump to relieve the pressure in your breasts. Using the pump wisely can reduce your engorgment while not causing you to make too much milk and perpetuate your problem.
You can also pump to increase milk supply by pumping for an extra 5 minutes after milk stops flowing to signal to your body that it needs to produce more milk. If you’re breastfeeding and pumping after, aim for a 10-15 minute pump. If you’re exclusively pumping, shoot for a 30 minute pump.
Whether you’re pumping at work to maintain supply or trying to increase your supply, using the settings on the Spectra can help you reach your goals. Have you played around with your settings? What works for one person may not work for another. Try alternating back and forth between the settings and play around with the suction and cycle levels. If you need to have the suction cranked to the top, you’re most likely using too large of a flange.
Everyone responds differently to pumps. Play around the settings and cycles. What works for one person may not work for every person. Make sure your suction level is comfortable and you’re using the correct sized flange. If you have to crank the suction all the way up, you’re pumping with a flange that’s too large. Pumping should be comfortable. You should not have pain or damage from pumping. If you have any pain or damage, try a different range size, shape or cushion and try lowering the suction. If you’ve been pumping on a particular set of settings and start to notice a decrease in supply or suction, change the soft pieces of the pump like the duckbill or membranes and the tubing.
There are lots of bottles on the market. And so many of them are marketed to be “most like the breast”. Let me tell you a secret. There is no bottle that works like the breast. Don’t fall for the marketing. The breast is a complex organ that works with hormones, compression, suction, positive and negative pressure. It is controlled by the baby and how the baby sucks. Baby can make your milk flow or not depending on how they suck. It is never empty and constantly making more. It is hormone driven. A bottle is passive. It has a hole that will drip when turned over. Your nipple changes shape to fill baby’s mouth. Your nipple can help fill a high palate. your nipple and a good portion of your areola/breast also need to be in baby’s mouth in a deep latch for milk to be transferred. Your nipple should go in round and come out round. Baby’s tongue should cup and protrude past the lower gums and stay out to massage your nipple/breast in their mouth Baby has to change the shape of their tongue to accommodate the firm bottle nipple. Baby can chomp or mash the nipple and doesn’t need to keep the tongue out because they can compress milk out. Baby can also latch just to the tip of the bottle nipple and still get milk.
We can make the bottle work like the breast, though. By slowing the feeding down or “pacing” the feeding, we can help baby go back and forth between bottle and breast. You want a straight nipple that tapers wide at the base for a “deep” latch. If your baby is just latched to the tip of a bottle nipple they can still get milk. But then their muscles will learn to latch shallow and that’s often why you’ll get a shallow latch with a “small” mouth at the breast. The bottle nipples that are already pinched or tapered are also not good choices. If your nipple came out of baby’s mouth looking like, that you’d have damage within a few days. If your baby struggled at the breast and will only take a bottle nipple that looks flat and pinched there is usually something going on in baby’s mouth and the bottle nipple is compensating for it. Tongue tie is the most common culprit.
LATCHING TO A BOTTLE
Having an optimal latch at the breast reduces nipple pain and prevents damage. Your nipple should go in baby’s mouth round and come out round. If we want to encourage good latch when breastfeeding, we want to do the same when bottle feeding. This helps baby go back and forth without “confusion”.
This can be difficult when a bottle nipple abruptly changes in shape from narrow to wide. Bottle nipples like the Playtex Baby Ventaire Bottle,Tommee Tippee, Avent Natural, Nuby Comfort, and Chicco Naturalfit have narrow nipple tips and wide bases. Babies usually end up latching onto the tip and sucking it like a straw. If baby’s cheeks dimple or suck in when feeding from these bottles, they’re drinking but not demonstrating a wide latch and optimal mouth posture. If they had that same mouth posture on your nipple, they would cause pain and damage. Baby’s don’t drink from the breast like a straw. Conversely, they may try to fit the base of the nipple in their mouth and end up with air pockets where the tip meets the base. This can result in breaking the suction and swallowing excess air while feeding. Nipples like the Nuk Simply Natural and Mam are not round, but pinched or flat. If your nipple looked like that coming out of baby’s mouth we’d be talking about deeper latch or tongue tie.
Bottle nipples that gradually change in shape from narrow at the tip to wider at the base promote a deeper latch. If the nipple stays narrow at the base, like the Similac nipples many hospitals give at birth for supplementing, you’ll want baby’s lips to be able to come up almost to the collar (plastic o-ring base). If the nipple is sloped to gradually widen at the base, baby will be able to get the nipple deeper into their mouth with no air pockets. My favorite sloped nipples include the Pigeon SS Nipple, Lansinoh, Dr Brown’s Original Narrow, Dr Brown’s Wide Neck, Munchkin Latch, and Evenflo Balance, which promote a deeper latch mouth on the nipple.
So what does this mean?! If your baby is already bottle feeding and going back and forth from bottle to breast, don’t sweat it! No need to change anything! If your baby is struggling at the breast and preferring a narrower or non-round nipple, having a full oral motor assessment may help you get back to breast.
What pump do you have? What size flange are you using? The answer can make a huge difference in pumping success.
Not all pumps are created equal. Prior to the ACA, there were few pump choices. Once laws said people needed to be provided with a breast pump, and insurance would fit the bill, lots of companies flooded the market with pumps. Not all of them are good, and some will even sabotage your supply. You want a pump with a good motor in it that has lots of variability in the cycle (how fast or slow it pumps) and suction (how strong it sucks).
You also need to be mindful of the flange you’re pumping on. Most companies will send a standard 24mm flange. Sometimes they’ll send a larger size as well. In reality nipples, and thus flanges, are not one size fits all. And in my practice I hardly EVER use the 24 or bigger flanges. For almost all of my families we’re sizing down. Some times significantly smaller.
Flanges are the horn shaped part that actually touch the breast. The fit of the flange can make or break your pumping experience. Too small and friction can cause pain and even damage (and pain makes it difficult for milk to let down). Too large and the breast may not be stimulated well, which inhibits your let down to have milk flow. When too much areola is pulled into the flange, the tissue swells around the nipple pores and can prevent milk from efficiently emptying from the breast, resulting in plugged ducts, pain, tissue breakdown, and eventually a reduced milk supply. Using too large of a flange from the beginning may even prevent you from bringing in a full milk supply. Do you ever pump for 20+ minutes and still feel like there’s milk in there? Most likely too large of a flange. The stimulation from the pump is triggering you to make more milk, but the size of the flange is preventing you from emptying that milk efficiently. Poor flange fit can also impact the suction of your pump and how well it functions with your body. If you have the suction all the way to the highest level and aren’t emptying well, you flange is too big.
Flange fit tips:
🗝Flange fit isn’t based on your breast or areola size, it is JUST the size of the nipple and how it changes with suction. Some nipples are dense and don’t stretch much. Some are super elastic and swell a lot. How your nipple responds to suction can make a difference in which flange you select and if other products are needed to happy pump
🗝Proper fit isn’t as simple as measuring your nipple, but it’s a start. See a trained IBCLC to help if you haven’t found the right fit or are struggling with poor output, pain/damage, or plugged ducts
🗝A small amount of space around your nipple in the flange tunnel is good. There should be no space around the areola or in the larger bell part of the flange. If your breast tissue recoils back into the horn part of the flange with every cycle, the flange is too large. If the tissue is white where the tunnel meets the horn, the flange is too small
🗝Pain or blanching means it’s the wrong size
🗝Nipples rubbing against the sides of the flange tunnel mean fit needs to be improved and there is a risk of pain and damage
🗝There should only be a small amount of areola pulled in the flange tunnel space. The bell or horn part will have most of the areola held back so it doesn’t get pulled into the tunnel
🗝The nipple tip shouldn’t hit the back of the flange. This means you have an elastic nipple. Sizing up isn’t necessarily the right answer. Using a pump insert, cushion like @beaugenmom or @pumpinpalofficial may be a better solution
🗝Evaluate as you pump. You can changing flange size mid-pump to improve comfort if you’re between sizes. You may also need to change the flange size the longer you pump. Our nipples can become more elastic and larger or smaller with time.
🗝Every nipple is unique and each side may use a different size (or shape/brand!). There are all kinds of flange sizes, inserts, and cushions to improve the pump experience
Paced bottle feeding (meaning you’re setting the pace for how fast/slow baby drinks) helps prevent over feeding baby: it takes 20 minutes for the stomach to tell the brain that it’s full. If a baby takes a bottle too quickly, the mouth can still be “hungry” and wanting to suck when the stomach is actually full. Like going to an all you can eat buffet and eating a lot of food quickly and then realizing half hour later you ate way too much. A baby that happily sucks down too much milk from a bottle can make you think you don’t have enough breast milk even if you make a normal amount. It can also make baby frustrated by the flow of milk from the breast and inadvertently sabotage breastfeeding
These pictures are the same baby in two different positions for paced feeding: semi upright and side lying. Side lying is my favorite position to use as it puts baby in the same position as breastfeeding. Many parents feel baby is more supported in this position. Baby is supported by your leg or breastfeeding pillow.
🍼Never feed baby on their back
🍼Keep the bottle parallel with the floor with about half the nipple filled with milk
🍼Use the slowest flow nipple baby will tolerate
🍼Rub the nipple gently on baby’s lips, allow baby to latch at their own pace, don’t force it into their mouth
🍼It should take 15-20 minutes to finish the bottle
🍼Watch the baby and not the bottle, stop when they show signs of being full
🍼Resist the urge to finish the bottle, even if there is only a little left, when baby is showing signs their tummy is full
🍼Take short breaks to burp and give the tummy time to fill naturally
🍼If baby is gulping or chugging, slow down
🍼If baby has taken a good volume of milk (2-4oz) in a short amount of time and is still acting hungry, offer a pacifier for a few minutes to help them digest and give the tummy to to tell the brain it’s full. If they’re still hungry, slowly offer more in 1/2oz increments
As babies grow, there needs for milk also change. During the first year of life, after one month of age, babies need 20 to 30 ounces of milk per day. This need does not change until your baby reaches the first year milestone. From 1 to 2 years, babies need approximately 15 to 25 ounces of milk per 24 hour period. They get the rest of their nutrients from solid foods taken right from the table. Interestingly enough, infants need more calories but less protein than toddlers. Toddlers need fewer calories, but more protein in those calories. Just as your child’s nutrient needs to change, so does your breast milk. I have noticed a big drop in my pumped milk supply even though my daughter is still nursing. My daughter still nurses voraciously when she wakes up, kind of nurses when I get home, and usually nurses once in the middle of the night. When I’m home all day with her she does fewer nursing sessions and is SO easily distracted by herself and the environment. But she’s growing, is still having good wet and dirty diapers, and is happy!!! She is like a solid food vacuum. She LOVES all kinds of berries, fruit, peas and carrots, beans, pasta, cheese and yogurt, chicken, beef, pork, and eggs. She eats a nice variety with good toddler portions. Happy Pumping!!!