Breast Pump Comparison - Which Insurance Pump Should I Choose?

Moms often ask - "Of the pumps that are offered free with my insurance plan, which pump is my best choice?"  This is a great question because there are several factors to consider when choosing a breast pump.

Most importantly, hygiene needs to be considered when choosing a breast pump.  Is this a pump that won't contaminate my breast milk?  The answer is in whether it has an open or closed system.  Closed system pumps protect your milk from having dust or bacteria blown into the bottles while you are pumping.  The biggest offender in this area are the Medela pumps.  They do not offer a closed system and the Medela company does not comply with the codes set up by the World Health Organization so it is easy to rule this brand out.

The next consideration is the function.  Is it a double electric auto-cycling breast pump with at least 250mmHG which is milligrams of mercury, a measurement commonly used in measuring strength of suction. Most commonly infants do 220mmHG when they suckle, but since breast pumps suction can depend on which type of power you are using and whether or not the valves and filters or diaphragms have been changed regularly, starting at 250mmHG gives you a little wiggle room.  Lansinoh breast pumps only do 220mmHG, so you can rule that one out as well.

Another big consideration is flange fitment.  Newer brands like Motif Medical only offer flanges in 24mm and 28mm size.  You will want a brand that offers at least four sizes ranging from 20mm to 32mm to find the size that works best for you.  In addition as I was doing research on the Motif brand, I noted that several of their replacement parts were out of stock on their website including the all important double pumping kit.  In addition, this brand is new on the scene so until more parts and information is available on this company, I would rule them out as well. Evenflo also does not offer a small flange size and not many parts are available individually without buying an entire double pumping kit.  I would rule out Evenflo because of this and because they are typically a bottle company so not as invested in your breastfeeding success as you would want them to be.

Ok, enough of the "don't choose this pump" warnings.  With 25 years experience 
in the breastfeeding industry, which pumps do we recommend?

#1 Choice - Spectra S2 Plus Breast Pump
Pros:  The Spectra pump has a two year warranty on the motor, does 250mmHG and offers a wide range of breast flange sizes and replacement part options.  We love the night light on the Spectra S2 Plus for exclusively pumping moms or for moms with babies in the NICU that have to pump at night. This pump offers a hygienic closed system using a backflow protector.  In addition, a Spectra breast pump parts subscription service for the most important and commonly replaced parts.  Cons:  Spectra company does not offer a combination cooler carrier tote bag or a car adapter for power, but there are great aftermarket options that cover those needs.

#2 Choice - Hygeia EnJoye Breast Pump
Pros:   Quality breast pump with a one year warranty that not only does 250mmHG, but also cycles up to 80 times per minute (the average baby does 60 sucks per minute).  Also offers a closed system with an apparelled bacteriostatic filter.  Cons:  Only three flanges sizes are available in this brand, but the flange connector does fit the Pumpin' Pal brand of angled Supershields, so smaller options can be obtained.  To see if your insurance qualifies you for the Hygeia EnJoye, visit the Hygeia website.

#3 Choice - Ameda Finesse
Pros:  Ameda has been the most consistently breastfeeding forward company since double electric breastpumps were invented 75 years ago by Einar Egnell who founded the company formerly known as Ameda Egnell.  While Ameda pumps do not offer the most whistles and bells on the market, they are consistently good and their quality control is apparelled.  They offer a two year warranty on the Ameda Finesse and offer flange sizes and inserts in a wide range of sizes including the Flexishield silicone insert that not only reduces to 22 mm, but is the best made silicone insert on the market today.  I have personally seen moms with smaller nipples get an ounce of extra milk with the Ameda flexishield.  Ameda was the first to offer a closed system with a diaphragm barrier to protect breast milk.  Cons:  Not as smooth or quiet as some other pumps, but definitely gets the job done!

#4 Choice ARDO Calypso
Pros:  Closed system double electric breast pump with a wide range of flange sizes from 22mm -31mm.  They have a one year warranty on the ARDO Calypso and are the only company to offer a insert in a 26mm size silicone flange insert called the Optiflow.  Considered quieter than the Ameda Finesse.  Cons: This pump is not as popular with moms as the top three choices.  I would only choose this one if the other three were not available.   Having sold breast pumps for 25 years, I can see the writing on the wall so while this pump may work well for you, I do not know how long this company will be around.

Power is also important!  All four of our recommendations: Spectra S2 Plus, Hygeia Enjoye, Ameda Finesse and ARDO Calypso have an AC adapter and either a branded or aftermarket car adapter available.  If you need battery power regularly, the Hygeia EnJoye LBI model is a good investment even if it not covered by insurance.  While most pumps include a battery compartment, don't rely on AA or AAA batteries for good suction if you can't plug in to an outlet or a car lighter as your pump will not have the same power and your milk supply will suffer. The Hygeia EnJoye LBI Breast Pump model with battery is not usually available through insurance as it is a more expensive model.

This review is for the breast pumps most frequently offered by insurance companies and includes information on Medela, Lansinoh, Motif Medical, Spectra, Hygeia, Ameda and ARDO.  If your insurance company offers another brand that you would like us to review, please include it in our comments section and we will update this review as needed.

Best wishes for the best milk expression!
Tanya

Drinking Water While Breastfeeding: Too Much of a Good Thing?

Moms often ask, how much water should I be drinking while breastfeeding?  What they are really asking is how much water do I need to make more milk.  The answer:  water does not make milk.  Breastmilk is made from blood and while your body does not function well at any task if dehydrated, drinking too much water can have several negative effects on breastfeeding.

The first was over-hydration can negatively effect breastfeeding is actually reducing milk supply.  Not only is there no data to support the assumption that increasing water intake significantly increases milk supply, there are actually studies showing the opposite. One significant study by Illingworth and Kilpatrick tested 210 postpartum mothers.  Half of which drank an average of 69 oz daily and the other half exceeded 100 oz daily.  The mothers forced to drink beyond normal amounts produced less milk and their babies gained less weight.  

Another disadvantage to too much water while breastfeeding is the increased elasticity in the nipple tissue.  This can negatively effect latch as well as cause the nipple to be swollen and draw too far into the breast flange.  While some mothers naturally have more elasticity to their nipples and need a smaller breast flange or a flange that grasps the tissue better such as a silicone breast flange to prevent the nipple from drawing too far into the flange, over-hydration can actually exacerbate this problem increasing the need for smaller and smaller flanges to be used.  

This over-hydration often begins at delivery as many insurance companies are insisting that patients receive IV fluids to prevent dehydration during delivery even if it is not indicated in that particular patient.  

What is the answer?  First of all drink to thirst rather than force fluids.  If you are taking in more than 70 oz per day postpartum, reduce your intake to one 8 oz glass when you are feeding your baby so 8 times per day.  You should notice the elasticity in your nipples return to normal after 10 days.  

How do I know if I am drinking too little?  If your mouth is dry and you are licking your lips, chances are that you are not drinking enought.  Your urine should also be pale and not dark if you are properly hydrated.

What about milk supply?  First, know what your baby actually needs - not what the mom next door produces.  An infant needs 2.5 oz per lb of body weight.  Between 3 weeks and 6 months should be gaining 5-7 oz per week.  If your baby is gaining this amount without supplementation, then your milk supply is good.  After all, the proof is in the pudding!

If you need additional help with increasing milk supply, please visit our website and contact us with your questions.  Make sure to give us your baby's date of birth, birth weight, current weight, feedings and any other pertinent information so that we can assist you.

Here is to drinking to thist!

Tanya

Top 5 Best Buys for Breastfeeding - Best in Breast Pumps & Nursing Bras

Are your bags packed for the hospital?  Moms tend to read extensively about what they need for labor and delivery, but let's not forget about after the birth.  Breastfeeding can be easier if you have a few essentials to help a mama out.  So what should you take to the hospital for breastfeeding?

1.  Breast Pump  

It is not an uncommon occurrence for moms to want or need to pump in the hospital.  Perhaps you have an exceptionally sleepy baby, are separated from your baby for health reasons, or have noticed you have flat or inverted nipples and need a little assistance.  Taking your breast pump to the hospital is a great way to ensure you have one if you need one.  There are limited "floor pumps" and since insurance may not cover the extras, you won't be billed for a personal collection kit if you have your own pump at hand.  Make sure you choose a good quality pump such as the Spectra S2 Breast Pump or Spectra Synergy Gold Breast Pump.

2.  Nursing Bras

You are going to want both a sleep nursing bra that offers comfort and easy pull down nursing access.  You will also want to pack a daytime bra to wear home from the hospital.  Choose one with multiple cup sizing because this is the time your breasts will be changing the most.  The first week postpartum can see your breasts go from a C cup to an DDD cup in some instances!  

3.  Nursing Pads  

While I love 100% cotton nursing pads for their breath ability and economy, disposable pads are the way to go while you are in the first days after delivery.  You will want this convenience while you and your baby are learning to breastfeed.  Choose a quality brand such as Ameda or Bamboobies to prevent harboring yeast with inferior products that do not allow air to flow well.  Since this is short-term time to use these, don't buy Evenflo or others that my have waterproof plastic liners or other materials.  

4.  Breast Cream

Baby moon tenderness is not uncommon while you and baby are learning to latch so having a little assistance from a quality breast cream.  Our favorite is Motherlove Nipple Cream. It has high quality ingredients that are organic and safe for mom and baby.  The lubrication and healing properties in this breast cream is a must have.  

5.  Burp Pads

While sometimes overlooked, burp pads are essential and versatile.  Not only are they great for spit ups while burping, but they can be use to roll up and lift large breasts or to wrap around baby instead of a big receiving blanket. This wrap technique just involves baby arm's so that you can keep little hands our of the way while latching.  Great to use instead of a receiving blanket because a newborn will quickly become warm and sleepy under a blanket.

Other items can be helpful for breastfeeding such as a pillow from home.  You can also substitute a nighttime nursing bra with a nursing nightgown that has an integrated pull down nursing bra built in such as the Amamante Nursing Nightgown and Nursing Pajamas have.  

What is not helpful at this stage is a nursing scarf or nursing cover.  There will be plenty of time for those items later on, but at first you need full view of what you are doing to help you both learn to latch well.  

Here is to a great start!

Tanya

Pumpin' Pal Super Shields for Spectra Breast Pumps

Although we love Pumpin' Pal Super Shields, some brands were just not working well with them.  The reason is that when you have a one piece breast shield that does not come apart, you had to insert the Super Shield into the primary breast shield to get the angled comfort of the Pumpin Pal breast shields.

Not any more!  Pumpin' Pal now makes an adapter for Spectra so that you can use this system with your current Spectra parts avoiding any reduction of the suction on your breast pump when using the Pumpin' Pal Spectra Super Shields.

These Pumpin' Pal Spectra Super Shields are offered a wide variety of sizes from x-small 15-22mm to x-large 35-40mm.  So now you can have the size that fits perfectly to properly compress the milk sinuses in a comfortable angled breast shield that allows you to sit back and pump instead of leaning forward which can cause back pain and fatigue.  The proper compression of the areola in this angle offers better milk transfer which in turn helps maintain a healthy milk supply.  Win, win!

Lactation Connection offers great prices and a huge selection of Spectra breast pump parts.  Check out the reviews on Trustpilot for quick delivery and fair prices!

Here is to hoping your pumping journey is a success!
Tanya

Replacement Parts for Ameda Breast Pumps: Mya, Finesse, Purely Yours, Platinum & Elite

Need to troubleshoot your Ameda Breast Pump?  When you rely on your breast pump for exclusive pumping or working and breastfeeding, you need to know how to start with the correct flange size, maintain and troubleshoot any issues that may come up while you are using your breast pump. These issues can often be solved with maintaining your breast pump with genuine replacement parts.

Let's start with breast flange size.  First you need to assess your nipple size at rest.  Most women fall between the XS and XL size for their breast flange so although there is no way to know for sure without trying out the flange while you are pumping, the rule of thumb (pun intended) is to compare your nipple size to the size of your fingers.  This works particularly well if you wear the average size 6 ring finger for a woman.  If you nipple is the diameter of your pinky, start with a smaller 21-22 mm flange.  If your nipple is the diameter of your ring finger then the Ameda standard 25 mm breast flange should work for you.  Are you closer to the diameter of your middle finger, then go 28-30 mm large breast flange and if your nipple diameter is akin to your thumb, try 32-36 mm breast flange.  The chart below shows the different sizes you can purchase in Ameda flanges.  One think I really love about Ameda is that all of their parts fit all of their pumps.  That way if you were using an Ameda Platinum in the hospital, you can switch to the Ameda Mya when you go home and the milk collection system is interchangeable.  

Next last talk about maintaining your breast pump.  With each pumping, the Ameda valves should be removed from the breast flange and all parts that come into contact with the milk should be rinsed with warm water.  Once a day, those same parts should be sterilized in top rack of the dishwasher, pre-boiling water for 5 minutes, sterilizer, or microwave steam sterilizer bag.  The instructions say boil for 20 minutes, but that often leaves a film on your plastic parts making them difficult to see through when you are pumping.  As long as the water is already at a boiling temperature, 5 minutes is adequate.  Set your phone timer to keep you from melting your parts if you are using the boiling method.  

In addition to maintaining pump parts by clearing, drying is also a factor. Breast pump parts should be allowed to air dry if you are not using the dishwasher to dry your parts.  You can use an air dry bag or two clean dish towels.  One towel is placed on the counter and the other covers the parts to prevent dust or insect contamination.  If you are using a drying rack, make sure it is being routinely cleaned once a week as well.  If you take the adapter cap and diaphragm off before removing the bottle and laying down the flange, you can save yourself a lot of time in having to clean and replace the diaphragms as offer.  If you take your bottle off first, and lay your breast shield down with the adapter cap still attached, milk dribbles onto the Ameda diaphragm causing it to need cleaning each time.  Some women have a heavy spray so anytime you get milk on the diaphragm clean it along with the other sterilizable parts.  You should never boil your Ameda tubing, tubing adapter or adapter caps.  There is no need to sterilize these as they do not come into contact with the milk as per Ameda's superior closed system design.  

What about troubleshooting?   Quality pumps like the Ameda Mya breast pump, Finesse breast pump, Ameda Platinum and Ameda Purely Yours work on a vacuum regulated system which means any breach of that system will cause loss of suction.  If your duckbill valves have a tear, do not close properly or are worn out, you will loose suction.  If your diaphragm does not seat properly or inflate and deflate without sticking together when you pump, it will cause your pump to loose suction as well.  Replacing the valves every 4-6 weeks and Ameda diaphgrams every 8-12 weeks is a good schedule to help maintain your breast pump's performance at optimal level.  Why is that important?  Loss of suction = diminished milk supply if you rely on your pump for working or exclusive pumping.  A poor performing pump will also slow down your pumping time.  Your double breast pump should be able to empty both breasts in just 10-15 minutes.  However, you should not pump for less than 10 minutes even if the milk stops flowing because not demanding more than you are producing also lowers milk supply.

Here is to trouble-free pumping and a healthy milk supply!
Tanya

Managing Working and Pumping: Hands-Free Accessories and Other Helpful Items

The working pumping mama has more to consider than the mother who is able to put her baby to breast for each feeding.  After all, have milk will travel is a great lifestyle.  But for those who must or choose to work outside the home, managing their breast milk expression and storage is something that must be considered.  Here are some helpful tips and accessories to make this journey a little easier.

1.  Obtain an effective breast pump.  The first consideration is an effective breast pump.  Don't settle for a manual, single breast pump or a used breast pump.  These types of pumps can actually sabotage your results before you start.  Double pumping increases prolactin levels and since working mothers do not get as much non-nutritive suckling to assist milk supply, this feature is a must.  What about a used pump.  Non-hospital grade pumps meaning professional pumps that are under $800 are meant to last a certain number of pumping hours which for one working mother is about a year.  Their efficacy is reduced by using them too long and not replacing parts frequently.  You want a pump that works at full strength.  Not to mention some open system pumps like Medela's can actually cause your to transfer a yeast infection even when you buy new pump parts.

2.  Replacing breast pump parts is a must.  Certain parts affect suction and therefore milk supply.  If you are a pumping three days a week or more, you should replace duckbill valves or valve membranes every 6-8 weeks and diaphragms or filters every 8-12 weeks so a good rule of thumb is to replace the two parts that most effect your breast pump function every 2 months like clockwork.

3.  Size matters.  You may be reducing your milk supply if your breast flange AKA breast shield is not the right size.  If the size of your breast flange is too big, too much of the areola is being drawn in and not compressing the milk sinuses correctly.  The same goes for if your flange is too small.  Then not enough tissue is being drawn in to compress the milk sinuses correctly.  If the correct compression does not occur, milk is left in the breasts and your body responds by reducing the amount of milk produced.  A good rule of thum is that if your nipple is the size of your pinky, then 24-25 mm should work.  If your nipple is larger such as the diameter of your ring finger, then try a 28-29 mm flange.  If even larger such as your thumb, then choose a 31-32 mm.  These are just rules of thumb (pun intented), but a great place to start.  Even smaller sizes such as 20 mm breast shield are available in Spectra.

4.  Relax!  Just as a watch pot doesn't want to boil.  Milk doesn't want to let down when you are stressing out and watching the bottle fill or not fill.  Put a used receiving blanket around your neck to mask the bottles and to smell which will aid in let-down.  A hands-free pumping bra is also very helpful because you can read, breathe and relax your shoulders and wrists while pumping. 

Here is to all our mamas! 
Tanya

Breastfeeding Pain Diagnosis and Treatment: Yeast Infection and Thrush

I would love to tell you that breastfeeding is always easy, but unfortunately that is not always the case.  When you look up the word tenacious (te·na·cious) in the dictionary, I picture the nursing mother who has been tried by the challenges that sometimes come with breastfeeding.

Today, I am addressing a challenge that literally tries a mom by fire, yeast infections.  Yeast on nipples often exhibits itself as a burning sensation and sharp shooting pains in the breast even in-between feedings.   If you have pain only during the feeding, you need to address the latch.  Yeast naturally occurs in our bodies, but the overgrowth of yeast often as a result of oral or IV antibiotics can be a real challenge.  The good news is that it is fairly easy to diagnose and curing the overgrowth is manageable, especially if you know how to avoid a recurring incidence.

Lets start with the diagnosis.  As I said, the mother with yeast will normally have burning sensation on her nipples and sharp shooting pain in her breast during and in-between feedings.  Yeast is highly contagious so if you are experiencing these symptoms, check your baby for thrush in the mucosa lining of the mouth, not just white patched on the tongue which could be milk.  The baby might also have a bright red diaper rash.  NOTE:  Mom's nipples might not be red nor have a white spot and baby may have absolutely no symptoms and mom can still have a yeast infection if she has the burning, sharp shooting pain.  In either case if yeast is diagnosed, both mom AND baby must be treated simultaneously even if baby is asymptomatic otherwise the pair continue to pass the yeast infection back and forth and curing it becomes extremely difficult.

There are a few ways to diagnose yeast.  Initially the visual and pain cues I described before can lead you to suspect yeast.  Second, you can see your doctor: but if the thrush is not visible, he may have to test for the fungal bacteria which could delay your treatment.  The easiest way to check for a yeast infection on the nipples is to wash your hands and apply Gyne-lotrimin (clotrimazole) or Monistat (miconazole nitrate) to dry nipples after each feeding for 24 hours to see if your pain is starting to diminish.  You will find this with the vaginal yeast treatment in most drug store and heath and beauty section of grocery stores.  Make sure that the one you are purchasing is not just in suppositories, but has a tube that you can use like a breast cream.  If the pain is beginning to diminish (you are not yet cured) within 24-48 hours, it is most likely a yeast infection.

You have a yeast infection on your nipples.  What's next?

1.  After each feeding, air dry or sun dry nipples before applying the clotrimazole or miconazole with clean hands.  You can air-dry nipples by fanning them with your nursing pad, allowing them to dry naturally or use the sun or even a blow dryer on a cool setting if you are in a hurry.  These anti-fungals absorb in the skin within 15 minutes, so there is no need to wash them off before the next feeding.  It is not advisable to wash your nipples with a washrag when you are breastfeeding as you can actually remove the protective keratin layer on your nipples.

2.  Seek treatment for the baby.  Remember that mom and baby must be treated simultaneously even if one or the other does not have symptoms.  There are over the counter treatments for thrush in the baby such as gentian violet, but it quite messy so I recommend calling the pediatrician for oral Nystatin and following the directions.

3.  Change habits to promote healing.  Always use nursing pads to avoid contaminating your bras and only breathable disposable nursing pads.  We do not sell them, but we recommend Lansinoh and Ameda Nursing Pads as they do not harbor yeast.  Some pads have a plastic lining or are made with products that do not promote breath-ability, so stick to these brands to be safe.  You can find Lansinoh in most stores.  Wash hands frequently and sterilize breast pump parts, bottles, nipples, nipple shields, feeding syringes with each use.  Normally due to the anti-fungal properties of breast milk, you only have to sterilize breast pump parts once per day, but better safe than sorry!
In addition eating habits needs to be curved during a yeast infection.  Mom should eliminate wheat, refined sugar, alcohol and honey to promote a healthier intestinal flora instead of feeding the overgrowth of yeast.


4.  Complete treatment.  Give the Nystatin and Gyne-lotrimin or Monistat a full week to 10 days for treatment.  If both mom and baby are now symptom-free, treat for 3 additional days to know out any residual infection and remove any items that may be prone to harboring yeast.

What do I need to discard to avoid re-occurrence of yeast?

- breast cream 
Moms usually will put breast cream on the second nipple with the same finger they used to apply to the first nipple.  So it is essential to use a clean finger to apply the nipple cream.  Wash hands first and then use a different finger to apply to each nipple so you don't cross contaminate.
- washable nursing pads
You cannot kill yeast by washing or boiling.  The only thing that will kill yeast is an anti-fungal so pitch the washable nursing pads you used while you had symptoms!
- breast pump parts
Any breast pump parts that have come into contact with the breast milk must be scratch-free or non-porous.  If you used a bottle brush to clean your parts, pitch everything.  If you washed them carefully, get rid of valve membranes, duckbill valves, bottle nipples and replace any filters or back-flow protectors as well. Store breast pump parts in an air dry bag that promotes air flow and is machine washable.  Using a ziplock bag to store breast pump parts is an incubator for yeast growing on your breast pump parts.
-sterilize your parts frequently
Keep disposable microwave sterilization bags on hand to make it quick and easy to sterilize your breast pump parts frequently.

- feeding supplies
If you used a bottle brush to clean your bottles, pitch everything.  If they were washed with a soft cloth or in the dishwasher, you can just discard bottle nipples and some brands have rubbery sealing discs.  Even baby feeding syringes have a rubber plunger, so if you used one to feed breastmilk or give medicine, discard it and replace.
- breast milk
Any breast milk that you pumped during your yeast infection must be given to the baby during the first week of treatment.  During the three days that you are treating the yeast to avoid recurrence, only feed the baby directly from the breast, freshly expressed breast milk or milk frozen prior to the initiation of the yeast symptoms.

Here is to putting out the fire!
Tanya

Pumpin' Pal - Getting the Most out of an Angled Breast Pump Flange Size

Finding the right breast pump flange size is your first concern when starting to pump, but as you continue to pump exclusively or for working and breastfeeding, investing in a more comfortable flange can help not only your body, but your baby's milk supply.  Pumpin' Pal Super Shields offer a multitude of benefits including:

• Eliminating constriction of milk ducts that can be cause by traditional flanges 
• Promoting better milk flow
• Helping prevent plugged milk ducts and mastitis
• Reducing nipple irritation
• Saving mom from back aches caused by leading forward

While Pumpin' Pal Super Shields are effective in most cases, you will want to know if and how they fit with your breast pump before you invest in these breast flanges.  Pumpin' Pal M-XL work best with breast pump brands that have two piece breast shields such as Medela, Lansinoh and Hygeia.

Pumpin' Pal Small and X-Small include an adapter to work with two piece breast shields.

Again, start with finding your correct breast flange size.  Then work with making pumping the most comfortable experience possible because not only does flange size matter, but tension from pumping in an uncomfortable position can reduce oxytocin and therefore reduce milk supply.

On a coincidental note, getting a discount actually increases oxytocin in most people including nursing mothers, so you never pay MSRP at Lactation Connection!  And check out our breastfeeding coupon code or breastfeeding sale page for another boost of oxytocin...lol!

Here is to more comfortable pumping!
Tanya

UPDATE!  Connectors are now available so that you can easily use Pumpin' Pal with Ameda and Spectra Breast pumps.  The Pumpin' Pal Connector for Ameda and Pumpin' Pal Connector for Spectra can be purchased separately for use with your Pumpin' Pal breast shields.

How to Use a Baby Feeding Syringe for Breastfeeding

It is recommended that breastfed infants are fed exclusive of a bottle for at least 6-8 weeks while learning to breastfeed.  Bottle feeding greatly changes the way the infant sucks and their expectations for immediate gratification while feeding.  Feeding from a bottle provides immediate gratification because bottle drips even when sucking does not occur.  This causes the infant to thrust their tongue to the end of the nipple or to arch their tongue to collapse the nipple on the roof of their mouth to control the flow.There are several methods of supplementing a newborn with breast milk during the early days.  For short term feeding solution, we recommend finger feeding with a syringe.  This method is tried and true and can be learned by both parents and baby in a matter of minutes.

Instructions:

Wash your hands.

Sit with your feet on a stool or anywhere you can raise your knees.

Place the baby in your lap facing you so they are in a reclined with their head above their body.

Draw the breastmilk into the syringe from an open container.  This can be done with one hand once you learn to pull the plunger up with your thumb.

Allow the baby to suck on the index finger of your non-dominant hand.  Your finger should be in far enough that the infant's tongue is attempting to draw it in with a peristaltic wave motion.  If Dad is feeding and has large fingers, he may want to turn his hand and use his pinky finger.

Using your dominant hand, place the syringe full of breast milk in the corner of the baby's mouth.

Wait 30-60 seconds before tapping the plunger so that the baby understands that they need to suck before the milk lets down when they return to the breast.

Tap the plunger every 3 sucks, but not every suck so they establish a breastfeeding pattern of suck, suck swallow.

Remember that a newborn's stomach is the size of a cherry when they are born so during the first few days, the teaspoons of colostrum are all that is necessary.

If there is a reason to syringe feed beyond day 5, refer to the infant feeding chart for ounces needed.  A 10 cc or 10 ml baby feeding syringe is 1/3 of an ounce so it is easy to know that re-filling this syringe 3 times is 1 ounce.

Attempt burping after 1-3 times of re-filling the syringe.  If the baby is spitting up or taking the milk too quickly, burping is a good way to slow the feeding and eliminate excess air.

Syringes are an inexpensive way to supplement a newborn without interfering with breastfeeding.  This lactation aid may be a tool you will want to have in your arsenal in case your baby has latch or suck difficulties such as the ones that can arise from tongue tie.  A sleepy  baby can also become more lively if breast milk is supplemented correctly so they will have enough energy to stay awake at the breast.


Best wishes for a bottle-free start to breastfeeding!
Tanya

Troubleshooting: Breast Pump Replacement Parts for the Hygeia Breast Pump

If your Hygeia Breast Pump is not suctioning the way it used to, the culprit is usually one of two parts, the duckbill valve or the bacteriostatic filter.

The number one cause of low suction is a torn or worn out valve. The tip of the Hygeia duckbill valve must be able to close completely.  If it remains open, the amount of pressure your pump can provide is decreased.  As a rule, if you are pumping three times per day or more, replace duckbill valves every six to eight weeks at minimum.  If you are like most moms and you have multiple valves that you interchange and you notice a decrease in suction and want to determine which part needs to be discarded, switch to single pumping.  To do this, you will remove the tubing from one side and cover the opening with the port cover attached to the bacteriostatic filter.  Place the remaining breatshield still attached to the pump on one breast and test the suction.  If the nipple is being drawn in normally, remove the breast shield from your breast and remove the bottle from the breast shield.  Then remove and replace the duckbill valve to test the next one.  Continue to do this which each valve you have in your stash and discard any valves that are not performing well.  This way you don't use valves that may compromise your milk supply with inferior suction.

It is harder to visually determine when the Hygeia bacteriostatic filter needs to be replaced, but the rule of thumb is that whenever you replace a valve, replace the filter.  At the very least, if you are a working mother or an exclusively pumping mama, replace the filter every 2-3 months whichever comes first.  

Buying replacement parts is a small price to pay when the reward is a healthier milk supply.  Lactation Connection makes this easier with their subscription service.  With the Hygeia Replacement Parts Program, moms can choose to get parts delivered to you every 3 months for 2 shipments, 3 shipment or 4 shipments.  Each shipment arrives with free shipping and an option to add additional items that ship free along with your subscription in case you need more bottles, milk bags or any other breastfeeding supplies.  The subscription service takes the guesswork out of  replacing breast pump parts.  

During the month of March 2018 in honor of our 25th year in business, Lactation Connection has partnered with Hygeia to offer moms some exclusive deals.  We are really excited about the March Hygeia sale!  All Hygeia breast pumps and accessories products are 25% off, all month long with no coupon code needed.  Every order that includes Hygeia products during the month, will receive a free gift of a breastmilk storage guide magnet, samples of milk bags and nursing pads and a coupon for a future Hygeia order.  In addition, every mother who places any order at Lactation Connection during March 2018 has a chance to win a Hygeia Nursing Stool.  It is so simple!  If your order number ends in the number 25, you win and your stool will be shipped with your order.  That is a 1 in 100 chance of winning, so the odds are pretty great!

Best wishes for a healthy milk supply and good luck on winning a nursing stool!

Tanya

Milk Supply: How Do I Know if My Newborn Baby is Getting Enough Breast Milk?

Once your newborn is at least 6 days old, there are some guidelines to help you be sure of your milk supply.  Note that insufficient milk supply is rare.  What is more common are practices that can hinder your milk supply or baby's feeding which I will detail at the end of this post.

To assess good milk transfer, answer the following:

1. Is the baby wetting 6-8 diapers in 24 hours? (Disposable diapers are so absorbent, that it might be hard to tell.  If you are unsure, take a clean diaper in one hand and the removed diaper in the other and you should be able to tell by the slight weight difference.)
   Yes  |  No
2. Is the baby having 3-4 bowel movements in 24 hours that are mustard yellow with curds in them? (These shold be silver dollar size or larger, not just a stain.)
   Yes  |  No
3. Do the breasts feel full before feeding and softer after feeding? 
4. Yes  |  No
5. Do you hear swallowing when the baby is breastfeeding?
   Yes  |  No
6. Is the baby eating at least 8 times in 24 hours?
   Yes  |  No
7. Does the baby seem satisfied after a feeding?
   Yes  |  No
8. After the initial weight drop, has your baby started gaining 3/4 - 1 ounce per day?
   Yes  |  No                                                               
9. If tyou had some nipple soreness, is gone?                                                                                    Yes  |  No

Practices that hinder milk supply include "scheduling".  Making an infant wait for feedings, lowers milk supply and slows weight gain.  Infants may need to eat at 1-3 hours apart during the day, especially between day 10 and three weeks when the first grown spurt occurs.  The only scheduling that should occur is if the infant has not asked to be fed at the 3 hour mark from the beginning of the last feeding, it is time to nurse.  A mininum of eight times a day is normal for a newborn.  The longest stretch you could hope for is one 5 hour stretch.  It is common for newborns to feed up to 12 times per day during a grown spurt.  This practice ensure a healthy milk supply for a growing baby as milk supply follows a demand and supply principle.

Other practices that can hinder milk supply are the use of a nipple shield.  While they have a time and place to assist in latch.  They are not a cure for sore nipples and should not be used unless necessary and discontinued as soon as possible.  When using a nipple shield, a cut out ultra thin silicone nipple shield is best.  Place the cut out at the baby's chin so that the skin to skin can elevate your hormone response which increases milk supply.

Another practice than can reduce milk supply is unresolved engorment.  When the milk first comes in 3-5 days postpartum, softening the breasts with warm moist heat from a compress or disposable diaper doused with hot water and warmed in the microwave is essential before nursing or pumping so that milk is more effectively extracted.  Milk that is not extracted actually reduces milk supply as your body is being signaled that you do not need the milk.  That is why the practice of waiting for an insurance pump is not the best idea.  If your insurance company will not allow you to get a pump until after the birth, go with a private pay DME.  That way, you can order the breast pump on the day of the baby's birth and it will be at your doorstep between 3-5 days when you need it most.  You then have to file for reimbursement with your insurance company, but it beats waiting around for a company to bill your insurance and you may not have your pump when you need it most. 

Here is to a Healthy Milk Supply, Mamas!
Tanya

Breast Shield Size - Do You Need a Small 15 mm or 19 mm Breast Flange?

Recently, we have been researching the effectiveness of small breast flanges for moms who are trying aftermarket brands in 15mm.  Most manufacturer's do not offer flanges that small.  This mom in particular was having difficulty because even a 15mm was too large.  A smaller flange can often be too large if too much of the areola is being pulled in and the milk sinuses are not being compressed properly at the breast shield.
This problem can ofte be solved with a silicone insert or silicone breast shield.  So where a 15mm plastic flange may be too large, a 15-19 mm silicone breast shield such as the x-small and small super shields by Pumpin' Pal will work very well.  The reason is the material.  Silicone helps hold the breast tissue in place whereas the hard plastic flange will allo the tissue to be draw in too far.
If you have tried a silicone shield, and still need to the areola to be held in place more efficiently, rolling the silicone so that it suctions to the breast is often the answer.  See the image below which is from Pumpin' Pal's 2018 Quick Start Instruction Guide.

Not only are the SuperShields angled for a more comfortable pumping position, they are available in x-small 15-19 mm breast shields and small 20-23 mm breast shields in silicone for better adhesion to your breast.

These are now also available for use with popular Spectra breast pump when using the Spectra flange adapter.

Here is to better pumping!

Tanya

Troubleshooting: When to Replace Breast Pump Parts & Accessories

If your breast pump is not suctioning the way it used to, the problem often lies in one of two breast pump parts.  Most breast pumps have a valve plus a diaphragm, filter or backflow protector.  The number one cause of low suction is a dirty, torn or worn out valve.  If you valve is the type that has a valve head and membrane shown here, it is imperative that you remove these parts when cleaning.  The valve membrane will retain a build up that decreases the suction.  Taking the membrane apart from the head is essential to remove this build-up.  If you see that the membrane will no longer close completely with the head or if it has a tear, replace it as soon as possible.

If your breast pump has a duckbill valve (shown below) which in most cases is a clear or white valve, the tip of the duckbill must be able to close completely.  If it remains open, the amount of pressure your pump can provide is decreased.  As a rule, if you are pumping three times per day or more, replace duckbill valves every six to eight weeks at minimum.  This is a small maintenance expense that will reward you in the dividend of a healthier milk supply.

One example of essential breast pump parts that need replacement are the Spectra S2 parts that include the white duckbill valve and the backflow protector.  These two parts are the most commonly replaced parts for Spectra breast pumps and if either of these parts is used for longer that eight weeks, the amount of pressure your breast pump has can be decreased.  The longer you use a breast pump with parts that are not functioning at capacity, the greater the chance of decreasing milk supply.

The most commonly replaced parts for each brand are listed below:

Spectra - duckbill valve, backflow protector
Ameda - duckbill valve, diaphragms

Motif - duckbill valve, diaphragms 
Hygiea - duckbill valve, bacteriostatic filter
ARDO - duckbill valve, membrane pot
PJ's Limerick - micron filter, silicone gasket
Bailey Nurture III - filter

Breast pumps that do not have closed systems such as Medela do not need parts replaced as often, but open system can lead to exposure of bacteria to breast milk so we do not recommend these pumps.

Lactation Connection offers subscription services for replacement parts on our most popular brands so that you don't forget to replace them on a regular basis.  We only sell authentic manufacturers parts for Spectra, Ameda, Hygeia, ARDO, Limerick, Bailey, Rumble Tuff and BelleMa to ensure quality of performance in your breast pump.

Salud! Here is to a healthy milk supply!
Tanya

Get Breastfeeding Help - Lactation Connection Celebrates 25 Years Serving Nursing Mothers since 1993!

Happy New Year!  Lactation Connection has been serving nursing mothers since 1993 so we are celebrating our 27th year in business in 2018.  In honor of this event, we are launching a new program to answer your breastfeeding questions.  You will be able to email me directly and have
25 years of breastfeeding experience tailored to your situation.

Just copy and paste the following into an email and fill out the information so that I can assist you
in the best way possible!

What is your baby’s birth date and birth weight?

What was your baby’s age and weight at last weigh-in?

How often (include specifics on number of times per day and how long)
are you putting the baby to the breast?

How often (include time of day and number of minutes) are you pumping?

How many wet and dirty diapers does your baby have in 24 hours?

What color are the stools?

What specific breast pump do you have?

If you are exclusively pumping, how many ounces are you getting per day?

If you are supplementing, how many ounces and at what age did you start
to supplement?

What breastfeeding concerns do you have?

Are there any health concerns with you or your baby? (ie infant tounge tie,
maternal diabetes, etc.)

Have you taken any herbal supplements or lactation cookies? If so, be specific
on brand and dosage.

Happy Nurturing!
Tanya