Tag: pumping mom

The Importance of Lubrication While Pumping

- Julie Matheney

Breastfeeding can be a rewarding but challenging journey, especially when it comes to using a breast pump. One often overlooked aspect that can significantly enhance your pumping experience is lubrication. Here's why lubrication is essential while using a breast pump:

1. **Prevents Nipple Damage**: Dry pumping can lead to friction, which may cause nipple soreness, cracking, and irritation. Using a lubricant can help reduce this friction, keeping your nipples healthy and comfortable.

2. **Enhances Comfort**: Lubrication can make the pumping process much more comfortable. A smoother, less abrasive experience means you’re more likely to stick with your pumping routine, ensuring your baby gets the nourishment they need.

3. **Improves Suction Efficiency**: A properly lubricated nipple can help create a better seal with the pump flange. This can enhance the efficiency of the pump, allowing for better milk extraction in less time.

4. **Reduces Pumping Time**: When the pump is working efficiently and comfortably, you may find that your pumping sessions take less time. This can be a significant benefit for busy moms juggling multiple responsibilities.

5. **Prevents Plugged Ducts**: Consistent lubrication can help maintain a steady flow of milk and prevent issues such as plugged ducts, which can be painful and may lead to mastitis if not addressed.

### How to Properly Lubricate

1. **Choose a Safe Lubricant**: Opt for a nipple-friendly lubricant such as medical-grade lanolin, coconut oil, or a water-based lubricant specifically designed for breastfeeding. Avoid using lotions or products with fragrances and additives.

2. **Apply Before Pumping**: Before you start pumping, apply a small amount of the lubricant to your nipples and the inner part of the pump flange. Ensure even coverage without over-applying.

3. **Reapply as Needed**: If you’re pumping for extended periods, you may need to reapply the lubricant to maintain comfort and efficiency.

4. **Keep Clean**: Ensure that your pump parts are clean before applying the lubricant. Proper hygiene can prevent infections and ensure the longevity of your pump.

5. **Consult a Professional**: If you’re unsure about which lubricant to use or how to apply it, consult a lactation consultant for personalized advice and recommendations.

Incorporating lubrication into your pumping routine can make a significant difference in your comfort and efficiency. By taking this simple step, you can ensure a more pleasant and productive pumping experience, ultimately supporting your breastfeeding goals and your baby’s health.

Why does my breast pump hurt? Can my breast pump cause plugged ducts and mastitis?

- Julie Matheney

You would think that the stronger a breast pump can suction, the better. But before you crank that pump to the highest setting, make sure you know the benefits (and risks) of doing that. Breast pump suction power is measured in mmHG (millimeters of mercury), the standard unit of measuring vacuum pressure. Studies were done on babies sucking at the breast and breasts pump suction levels are based off what we know of how babies remove milk from the breast. The suction level, or vacuum, is different than the cycle speed, which is how fast it pumps. This is why breast pumps should have two settings: cycle (speed) and vacuum (strength). Most pumps will cycle at 40-70 cycles per minute. This is based off of the average number of sucks a baby does at the breast in that same amount of time. Every baby sucks are their own pace and with their own vacuum strength.

Every pump has its own max suction strength that it can reach. “Hospital grade” pumps generally have maximum suction levels in the 300+ mmHg range while personal grade pumps are generally in the 200+ mmHg range. This doesn’t necessarily make a pump better or worse. The highest suction level on most pumps are actually above the comfort zone of the majority of pumpers. Most people feel comfortable expressing in the range of 150 – 200 mmHg regardless of whether the pump can reach 250 or 350 mmHg at its max. Using the suction too high, especially in combination of the wrong size flanges, can hinder milk flow and be the root cause of plugged ductsmastitis, dropping milk supply and breast/nipple damage!

Think of it like drinking from a milkshake with a narrow straw. When you suck too hard, the straw starts to collapse on itself and the shake is really hard to drink. Milkshakes move better with gentle, consistent sucking that doesn’t collapse the straw. Milk ducts are like compressible straws inside the breast that move milk from the milk-making glands called alveoli to your nipple pores in your nipple to your baby. Not only does everyone have a different number of these ducts, but the diameter of the ducts also varies from person to person. Too much breast pump suction compresses the areolar tissues which pinches off the ducts and actually decreases the flow of milk to the pump. With time this can cause milk to back up in the breast, increasing the risk of plugged ducts. This can also foster inflammation and risk damage. This also leaves milk behind which eventually can drop your overall milk supply. Having the right size flange AND using enough suction to move milk but not compress the ducts is essential to a happy pumping journey.

Need to treat mastitis fast? CLICK HERE FOR MY VIDEO ON MANAGING MASTITIS

 

Click the picture for the new mastitis protocol from the ABM

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Which is the best breast pump?

- Julie Matheney

Pumps are machines designed to help establish and maintain milk supply to feed your baby. They are not perfect and no where near as efficient as a baby If they are not used correctly they can fail you (and your supply). Make sure you’re using the correct sized flange and alternating between the settings. Pumps don’t measure milk supply. They also don’t measure your worth as a parent. If your milk supply dropped because of the pump, the pump failed you. You are not a failure.

Pumps are a modern invention and are far from perfect. They’re still seem like rotary telephone technology in an iPhone generation. The first pump was patented in 1854, and the second patent in 1864 was literally for cows. New pumps were created every few years, typically as improved medical devices used to treat inverted nipples and to help babies who were too small or too weak to nurse, but comfort was not the priority. Widely available products for personal or home use have really only been around for about 30 years. It wasn’t until 1991 (around the time most of y’all who are reading this were born) that the Swiss manufacturer Medela introduced its first electric-powered, vacuum-operated breast pump in the US for personal use. Prior to that pumps were limited to select hospitals. Pumps have become such a common tool that many of us think you have to pump if you want to be successful at breastfeeding. While pumping may be needed for some to help establish and maintain supply or for when away from baby, if all is going well and you’re with your baby there’s never a need to pump.

Best bottle for the breastfed baby

- Julie Matheney

DON’T FALL FOR THE MARKETING

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.

If Goldilocks Needed a Breast Pump

- Julie Matheney

IF GOLDILOCKS PUMPED

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:

Some of the flanges I tried

🗝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