Breastfeeding Pain: Good Mom Syndrome

You may have heard of good baby syndrome which is when a baby is content and doesn't ask to be fed.  (This can happen with good-natured babies who are content to play while mom tends to other siblings and not get enough feeding in by the end of the day which can lead to slow weight gain.)  But have you heard of Good Mom Syndrome?  This is the new mother who wants the very best for her baby so she is gritting her teeth and accepting the pain of a poor latch.

STOP THE MADNESS!

Normal breastfeeding should not hurt.  A good latch is one that encompasses at least an inch of the areola so that baby is latched on behind the nerve ending.  A poor latch is one where the baby is on the end of the nipple either initially or has slipped down and is causing pain.  I hate to be a lactation nerd, but I here is a diagram of the breast.

It is so important that moms have this information because you can see where the nipple and areola are in relation to the milk (lactiferous) sinuses.  In other words, the farther onto the breast your baby is latches, the less pain you have and more milk is transferred.  In other words, you are a good mother.  You want the best for your baby, but letting your baby cause you pain is not best for you or the baby.

If you already have nipple trauma and correct the latch, there may still be pain for the first 30-60 seconds, but after that it should be comfortable to nurse.  If your baby slips down during the feeding because you are not supporting the breast or the arm with which you are holding your baby tires because you are not supporting your arm with a nursing pillow or armrest, detach the latch.

The proper way to detach a latch to to take your finger and slip it into the baby's mouth past the gums so that the suction is broken.  Turn your finger slightly to release the baby's grip and then take him off.  Start your latch again.  See our breastfeeding latch blog post for proper latch techniques if you need more help with this.

If you have followed proper procedure and still have pain, this is the time to see a lactation consultant, but normal breastfeeding should not hurt.  It should be a comfortable experience for mom and baby.  The sooner your latch is corrected, the better chance you have of meeting your personal breastfeeding goals.

If you need time for one nipple to heal while you are correcting the latch, using a quality breast pump to express and syringe feed the milk to your baby is a good way of transitioning to pain-free nursing.  And as always, the right nipple cream can help healing.  We recommend Breastmilk Bandit Natural Nipple Cream made from organic extra virgin coconut oil.



Happy Nursing!
Tanya

What Moms Can Buy with Your HSA FSA and Flex Spending Account

2015 is drawing to a close.  Many of you have benefits left in your insurance accounts, especially FSA, HSA and FLEX spending accounts.  If you are breastfeeding, breast pumps and breastfeeding suplies qualify as medical expenses.  Here are some suggestions to help you use it before you loose it!

1.  Electric Breast Pump

 If you hate lugging your pump around, having one at home and one at work is such a luxury.   Or if you are struggling with a manual pump, a good electric pump is a necessity, especially one like the Hygeia Enjoye LBI that has a rechargeable battery pack for travel.

2.  Breast Pump Replacement Parts

Most pumps have filters or diaphragms that need to be replaced every few months and valves that need to be replaced every few weeks.  Having extra sets of breast flanges or getting additional sizes to see which one helps with optimal milk output is another way to use your allotment.

3.  Lactation Consulting

If you still need help with your baby's latch, this is a great time to use your funds.  Make sure the person you are using is a board certified lactation consultant.  To find one in your area, see the ILCA website.

The bottom line is whether you have a few dollars or quite a few left in your account, those are your benefits and you should use them.   Parts that need replaced most often on popular breast pumps are the Hygeia filter, Hygeia valve, Ameda valves, Ameda diaphragm, Spectra backflow protector, Spectra Valve, and ARDO valve.  Don't forget stock up before your medical benefits expire on December 31st.

Here is to a happy new year!
Tanya

Nursing Must Haves: Breastfeeding Essentials Basket

Having a basket of necessities near your favorite nursing spot is not only nice, but essential. After all, moms only have two hands.  To get you started, here are 6 recommendations for building a breastfeeding basket of must-haves for yourself or as a gift.

1.  Breastfeeding Book
Let's face it. Moms have questions and a Lactation Consultant is not always available to answer those questions especially at 3 am.  We recommend books endorsed by La Leche League and Lactation Consultants such as The Nursing Mother's Companion by Kathleen Huggins and The Womanly Art of Breastfeeding by Weisinger, West and Pitman. 

2. Water Bottle
Although the amount of water you drink does not translate directly into the amount of milk you make, your body functions better when it is hydrated.  

3.  Nursing Pads
Your breast milk lets down bilaterally, which means especially in the early weeks of breastfeeding, when you are nursing on one side, you are leaking on the other.  When you finish nursing is the optimal time to change into a 100% cotton breathable nursing pad for your breast health.  Pads with water proof linings tend to harbor yeast so instead of waterproof, you need a good absorbent nursing pad.  A good quality pad like the Amamante 100% Cotton Nursing Pads not only keep your clothes dry, they help prevent yeast infections.

4.  Nipple Cream
Purified lanolin has been used effectively for moist wound healing for decades.  Acclaimed author of The Nursing Mother's Companion, Kathleen Huggins states "Purified lanolin creates an air-permeable temporary skin barrier, and has been demonstrated to have anti-inflammatory, antimicrobial, skin-protecting, and barrier repair properties.  The down-side to lanolin is that it is sometimes hard to apply and there is currently no organic option. Many mothers prefer using coconut oil for tender or injured nipples.  Coconut oil is believed to be a natural antimicrobial, anti-fungal and anti-inflammatory substance."  Always use clean hands when applying nipple cream.

5.  Burp Pads
Although breastfed babies get less air when they nurse, you should try to burp between breasts and after feeding.  Burp pads can also be used under the breast to give your breast the extra support it needs when reaching for your water.  Newborn babies cannot hold up the weight of their own heads, so support the breast with your hand or a rolled up burp cloth, so they don't also have to try to hold up the weight of your breast while feeding.

6.  Snacks for Milk Supply
Moms have little time for a shower, let alone to eat healthy all the time.  Snacks packed with milk boosting foods and herbs are a great go-to in your breastfeeding basket.  Choose snacks like Milkmakers Cookies which contain oats, brewers yeast and flax seed.  Most moms see results from these snacks after 5 days of eating one or two per day.  

Best wishes for building a breastfeeding basket for your little bundle!


Happy Nurturing!
Tanya

Getting a Free Breastpump from an Insurance Company: It's Harder Than You Thought

I get this statement all the time as a lactation store owner, " Getting a free breast pump from my insurance company is harder than I thought."  I hear it from moms every day.  Many insurance companies  representatives tell moms to find out who takes my insurance instead of giving them an accurate list.  Or if they do offer a list, the insurance company does not have the pump they wanted in stock or offer that model at all.  Another issue is that when the mom does get her pump, it doesn't come with any extras.  No cooler carrier to take back and forth to work or breast pump replacement parts are provided.   In other words, the insurance companies pare down the pumps to keep costs down leaving moms unprepared when their valves go down the disposal.

Lactation Connection offers the largest selection of breast pump replacement parts around including brands like Ameda, Hygeia, Spectra, Bailey, ARDO to name a few of the more popular brands.  You may want to bookmark these links so you have access once you finally get your insurance pump. You are going to need it!  As for the pump itself, below is a list of the most popular health insurance companies:

UnitedHealth Group

Kaiser Foundation Group 

Anthem Inc. (Formerly Wellpoint Inc. Group)

Aetna Group 

Humana Group 

HCSC Group 

Cigna Health Group 

Highmark Group 

Blue Shield of California Group 

Independence Blue Cross Group 

Centene Corp Group 

HIP Insurance Group 

BCBS of New Jersey Group 

BCBS of Michigan Group 

Guidewell Mutual Holdings Group 

California Physicians’ Service  

Wellcare Group 

Carefirst Inc. Group

Health Net of California, Inc. 

Molina Healthcare Inc. Group 

UHC of California 

Lifetime Healthcare Group 

BCBS of Massachusetts Group 

Metropolitan Group 

Cambia Health Solutions Inc. 

In order to secure a pump through these insurance companies some require a pregnancy notification form to be filled out such as Anthem.  The company you contact below will know whether or not this is necessary.  To reduce your time and headache in getting your pump, go to these companies first and then call your insurance company so you know what forms you need or what questions to ask. The following companies bill all or most of the insurance companies listed above, but remember to bookmark Lactation Connection so you can order an extra double pump kit, valves, diaphragms, filters or tubing as needed.  If your pump uses a duckbill shaped valve, plan on replacing it every 6 weeks.  If your pump uses a filter, plan on replacing it every 8-12 weeks.  Other breast pump parts are replaced as needed for convenience or if they get lost or destroyed; but it is best to have at least one or two of every pump kit part in reserve if you rely on your pump for working or are exclusively pumping.  The companies below offer quality brands like Ameda, Hygeia, Spectra, and ARDO, but may also offer Medela whose insurance pump quality has been called into question as of late and the do not settle for brands like Tomy and Nuk. 

Acelleron Medical Products
Phone Number: 877-932-6327

Aeroflow Healthcare Breast Pumps
Phone Number: 844-867-9890

Byram
Phone Number: 877-773-1972

Edgepark® Medical Supplies 
Phone Number: 800-321-0591

EHCS
Phone Number:  888-344-3434

National Rehab 
Phone Number: 800-451-6510 option 9

Shield Healthcare
Phone Number: 800-765-8775

Sterling Medical
Phone Number: 800-216-5500

If your insurance company allows you to purchase a breast pump and then file for reimbursement, and you can wait 30-60 days for your money; it is always best to pay for your pump instead of getting a "free". Breast pumps like the Hygeia EnJoye LBI are going to include a lithium ion rechargeable battery, a premium cooler bag, universal bottle adapters and other extra parts that the insurance company Hygeia Q will not include. And sometimes you can even get an allotment towards purchasing a higher quality DME pump such as the Hygeia EnDeare,  Ameda Elite or even an Ameda Platinum which is the best pump on the market today, including the Medela Symphony which is inferior in cycles per minute and suction to the Ameda Platinum.  It pays to do what you are doing right now, getting information and getting your ducks in a row.  Lactation Connection is a private pay DME and therefore provides appropriate insurance codes on your receipt for ease in filing for reimbursement, but always check with your insurance company to see if this type of reimbursement is available before purchasing.

And if the brand or model you want is harder to find, call or email the manufacturer for information on DME's they recommend.

Happy Nurturing!

Tanya

Pumping: Increasing Volume of Breastmilk

Our previous post gave information on how to increase your milk supply while pumping,  In addition, there are ways to increase the milk output from the supply mothers already have. 

1.  Massage While Pumping.  Using a hands-free pumping bra or using the pledge of allegiance hold pictured here can give you the freedom to massage your breast while pumping.  This can assist your milk output provided that you are doing it in a relaxed manor and not watching the bottles anxiously.

Mother using pledge of allegiance hold with Ameda Elite Breast Pump.



2. Reposition Breast Flanges.  Instead of just sitting and double pumping for 10-15 minutes, take advantage of the anatomy of your body.  You can engage more milk ducts if you re-position your breast flanges a.k.a. breast shields every 3-5 minutes during your pumping session.

3.  Pump Up the Volume.  Studies on mothers of premature babies show that listening therapy increases their output by 2-3 times. The most effective form of listening therapy includes verbal encouragement plus music.  One way to accomplish this is to have hubby record encouraging words and/or relaxing music.  It doesn't have to be elevator music, just music that is relaxing to you.

Study published in Advances in Neonatal Care, Douglas Keith, April 2012. 



4. Visualize the Prize.  Have a picture of your baby taped to your breast pump bag, on your desk or table by where you are pumping.  This will help milk output much more than staring at the bottles.

5.  Sense of Smell.  Another way to aide with let-down is to have a receiving blanket that has been on the baby or nursing scarf to drape around your neck or even to cover the bottles while you are pumping.

Remember, your expressed milk is liquid love.  You are leaving a part of yourself when you can't be with your baby and you are doing a great job, mama!

Happy Nurturing,
Tanya

Pumping: Increasing Milk Supply

Every Lactation Consultant will tell you breast milk quantity is based on supply and demand, but with today's busy mom taking the baby to bed with you all day to suckle is not an option.  You can increase your milk supply while at work or with your breast pump at home.

First make sure you are already getting the appropriate stimulation for your baby's age.  If your nursling is under 6 months, you should be nursing and/or pumping at least 8 times per day while using a quality double electric pump such as the Hygeia EnJoye or Ameda Purely Yours or Ameda Platinum breast pump for a full 10-15 minutes per session.  If your nursing is 6-12 months, you should be stimulated at least 5 times per day.  For over 12 months at least 2-3 times per day. 

If you are already following the above protocols for sufficient stimulation of the breast, you will need to increase the number of pumping sessions to increase milk supply using a breast pump.  Research indicates that you need an hour of additional stimulation to increase milk supply.  Nature dictates that the average growth spurt where a baby is increasing their nursing sessions lasts about 5 days.  taking these two things into consideration, you should add 3 double pumping sessions of at least 10 minutes for 5 days in a row.  Each breast is stimulated for 30 minutes totaling the 1 hour of stimulation you need. For example, if you are nursing/pumping 8 times a day, you need to increase it to 11-12 times per day.  If you are nursing/pumping 5 times a day, you need to increase it to 8. 

Growth spurts are just that, spurts.  You need to increase your pumping sessions for a full 5 days in a row for this to be effective.  If life interrupts that, you will need to start over and do another 5 days in a row to simulate the growth spurt.

You can also use breastfeeding supplements during this time for additional increase if you prefer.



Happy Pumping!
Tanya

Free Breast Pumps: Insurance Company Breast Pump Review from the Experts

     After the Affordable Care Act took effect more moms are getting a "free" breast pump.  We get a lot of phone calls asking us which pumps on their insurance are best so we thought we would give you a review of the common ones out there.  After all, I personally have over 20 years experience using and selling different breast pumps and have seen breast pump companies come and go so you may benefit from my experience.

1.  Hygeia EnJoye Breast Pump - This is the number one choice for insurance company breast pumps because even the least expensive Q model has higher suction than most pumps at 250 milligrams of mercury and faster speed at 80 cycles per minute on it's highest settings.  Hygeia offer a closed system with a bacteriostatic filter so no bacteria can reach the milk and qualifies it for multi-person use.  So in that regard, you get a quality breast pump for free.  What you don't get.  Insurance companies do not give you the Hygeia EnJoye LBI which is the best model due to its integrated lithium ion battery pack.  You can add a Hygeia External Battery Pack to the Q and Hygeia EPS breast pump models, but this is a AA battery pack and not the lithium ion battery.  As with any insurance company breast pump pump, you either do not get a tote bag, or you get a cheaply made version of the deluxe tote that comes when you buy retail.  Another item that is not included in the insurance pump are the Hygeia bottle adapter rings to allow you to pump into standard size bottles instead of the Hygeia wide mouth bottles, but these are sold separately as well.  Large and X-Large Hygeia flanges are available.

2.  Ameda Purely Yours - This would be the second pump I would recommend because it does what most pumps do which is 220 milligrams of mercury and faster speed at 60 cycles per minute on it's highest settings.  It is a closed system with an Ameda diaphragm for protection against bacteria, but since this is not a filter it does not qualify as a multi-user breast pump.  This is most likely the case because if the bottle of expressed milk fell over, milk could theoretically enter the Ameda tubing.   Ameda Custom Size Flanges are available.

2.  Spectra S2 Breast Pump - New to the marketplace, the Spectra S2 breast pump is a good pump for moms who have never pumped before or who felt more comfortable with their previous breast pump at lower settings.  While it will do the higher 220 milligrams of mercury, it functions better on lower settings because the suction is not a constant pull and release, but more of a succession of short draws much like the peristaltic wave of the baby’s tongue.  The company's slogan is "Our pumps don't suck, they suckle!".  It is also easy to use because you just turn it on, put the massage setting on to get your milk flowing and then change the suction or speed to your liking.   I would recommend this pump for moms who have had nipple abrasion, for those who don’t use their pump on the high setting, and for those looking for something with a more natural feel than the traditional pump.  It offers the very effective Spectra Backflow Protector filtration so it is a closed system and approved for multi-person use.  I love the night light feature on this pump form moms pumping at night.  It offers a the light right where you need them, on the controls at the pump and includes two settings for additional lumination.  Additional flange sizes are available to custom fit every mom.    

3.  Ameda Purely Yours - This would be the third pump I would recommend because it does what most pumps do which is 220 milligrams of mercury and faster speed at 60 cycles per minute on it's highest settings.  It is a closed system with an Ameda diaphragm for protection against bacteria, but since this is not a filter it does not qualify as a multi-user breast pump.  This is most likely the case because if the bottle of expressed milk fell over, milk could theoretically enter the Ameda tubing. This pump is slightly louder than the Spectra and Hygeia pumps, but still a quality efficient breastpump.  Ameda Custom Size Flanges are available.


4.  Medela Pump In Style - This is by no means my first choice for several reasons.  It is not a closed system and can and does harbor bacteria and mold.   While the pump does offer 220 milligrams of mercury in the strength of suction and 60 cycles per minute for speed, the insurance company version does not come in any type of tote that can hold your milk or even your breast pump part.  While good cooler tote bag are available from various companies, they can cost as much or more than a good breast pump.  It is important that the cooler tote you choose is one that keeps the milk cold for a minimum of 10-12 hours which makes them harder to come by.  On the upside, Medela PersonalFit breast shields are available to accommodate various nipple sizes.  And finally, the Medela company does not support the World Health Code or the International Lactation Consultants Association standards. 

5.  First Years Breast Pump - No, no, no.  Just NO! 

If your insurance company has pumps on their list that we have not reviewed here,  please let us know and we will do our best to review it.  What if you want a better pump?  An alternative to getting an insurance pump on a list, check with your insurance company to see if they allow you to purchase from an alternative DME and file for reimbursement.  Or if you have an HRA or HSA credit card, breast pumps qualify as a medical expense.  This way you can get a pump like the Hygeia EnJoye LBI Breast Pump with the deluxe tote, bottle size adapters and the lithium ion rechargeable battery making pumping on the go much easier.

Best wishes in your search for a breast pump,
~Tanya