Birth, Baby!

The information provided on this podcast is for general information purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment.

Always seek the advice of your qualified health provider with any questions you may have.

Never disregard professional medical advice or delay in seeking it because of something you have heard on this podcast.

Reliance on any information provided here is solely at your own risk.

Welcome, this is Birth, Baby.

Your hosts are Ciarra Morgan and Samantha Kelly.

Ciarra is a birth doula, hypnobirthing educator, and pediatric sleep consultant.

Samantha is a birth doula, childbirth educator, and lactation counselor.

Join us as we guide you through your options for your pregnancy, birth, and postpartum adjuvant.

Today we're chatting with Katie Tims.

Katie is an IBCLC and is here to give us some tips on choosing a breast pump and finding parts that fit.

Katie lives near Dripping Springs with her husband and two daughters, enjoys family time reading and involvement in her church community.

So with her trained expertise, personal breastfeeding experience, and passion for education, she offers customized and flexible lactation care for patients on their infant feeding journey.

And we're so excited to have her here help us understand everything about choosing a breast pump.

Thank you for being here, Katie.

Thank you so much.

I'm so happy to be here today.

So a lot of people, I think, don't realize this, but lactation consultants don't just help with breastfeeding.

They also help with pumping, right?

Yes, I have a lot of moms that use pumps, if they're exclusive pumpers, or if they're mostly breastfeeding, and they wanna use a pump to help supplement or use a bottle from time to time.

And I even have moms that will pump half the time and directly breastfeed half the time.

So there's a wide range of how the pumps are used.

And I'm really happy to help parents navigate how they wanna feed their babies and how they wanna use the pumps.

I think that was something I was kind of surprised and impressed with when we had our first client that we worked with together, Katie, because we had a family and she was really struggling with her baby's latch.

She was super, super premature and he just was like, I'm not having it, I want the bottle.

And so she was pumping a lot and she was still coming up with so many issues.

People think that there's just issues when you're breastfeeding.

There can also be issues, even if you're an exclusive pumper.

So one of the biggest questions we get from parents, we get texts all the time that ask, do you know which pump I should choose?

Because their insurance is asking them which one they want to order.

So can you walk us through what types of pumps are available?

Well, I know whenever I had my first baby over eight years ago, there were only a few options.

Now there are so many, it's almost difficult to keep up with all the new technology.

There's still some really tried and true pumps that I really, really love.

There's the Medella and the Spectra S1 and S2 that plug into the wall.

There's some benefits to having those pumps.

And then there's obviously the downfalls of having those pumps and that they're not very mobile and you're stationary when you're using them.

But they have a really great motor.

Then there are different types of hands-free pumps and so many different brands out there that are available now.

So there's a hands-free pump that you can actually wear in your bra and you can walk around and you can do chores or you can be at work.

You can be in a Zoom meeting and it's not even very noticeable.

They're very quiet.

And those pumps have their place in the lactation world too.

There's a reason that they're invented and why they're so popular.

The motor on them is not always as great, but I'm glad that they're there because it's made a lot of moms, especially back-to-work moms, be able to continue their breastfeeding journey.

There's also just manual pumps where you actually use your hand to express.

And I used to keep one of these in my car whenever I was breastfeeding because it's always there.

If that's the case, if you're keeping one in your car, you want to make sure that you have materials available to clean it and make sure that it's safe.

But I used to always find myself out and about and just completely forgetting that I was breastfeeding.

And then feeling engorged three or four hours in and thinking, oh my gosh, I need a pump.

I need something.

And there were times when I had to stop at a Target or a CVS or something and just buy the hand pump so that I could express and feel some relief.

So, yeah, there's all these different kinds, even some of the like the Spectra S1 and the Spectra S2.

The difference between those.

Yes, I'm so glad you're going to say that because I get that question a lot too.

Yeah, one of them actually plugs into the wall and is stationary, and the other one has the option of being battery powered.

I believe it's the S2 that is battery powered.

It's the S1?

Okay, good.

So the S1 has the option of being battery powered, and the S2 just plugs into the wall.

So I would assume that the one that has the option of being battery powered is maybe a little bit more expensive, but that helps it for travel and on-the-go and taking to work.

So you don't have to be quite a stationery or just buy an outlet.

I remember when I was nursing, I mean, it wasn't that long ago with my son.

I stopped like four and a half years ago or something.

He is five and a half.

And so I, this sounds terrible, but I'm going to say it because other people might think it.

I thought that hand pumps, the not battery powered or not plugged into the wall ones, were just for people who didn't have the money to get one that was electric.

And so I thought that it was a lesser product and something that like, if you have to use it, you do.

I didn't realize at that time that some people only ever use a hand pump.

And I have really weak hands.

I have a disorder that makes it like, it would be impossible for me to sit there and squeeze that that many times to do it.

But we have some clients that are more effective with a hand pump than they are with an electric pump, which is really interesting.

So, you know, 13 and five years ago, I didn't even know that was something that someone would choose over an electric pump.

I love that.

I remember I had both.

I had a hand pump and I would carry that in my like diaper bag, just in case like, my son didn't want to eat, you know, when I needed him to that day, I had a kind of big oversupply with him.

Or if I was like going out and about, I remember I have a very clear memory of going to a Longhorns game one year and sitting in the bathroom, pumping with this little hand pump with all these little college girls around me.

And that was how I lived.

It was great.

But I liked having that mobile.

I probably terrified them.

Oh, I'm sure.

That is birth control, I hope.

But it was nice to have that mobile option of just something I could toss in my purse because the hand pumps are so small.

I think I had like the medulla, just easy peasy.

I could bring a bottle and that would be it.

It was great.

So that was always really nice.

So-

And they're very affordable.

So yeah, so affordable.

It's like 20, 30 bucks, I think.

You can get them at Target.

And you can find them almost anywhere.

Yeah.

With the hand pump, you can also get inserts because the hand pump, if you do just run out to CVS or Walgreens or some place like that to buy one, they're gonna just come with one plan size, but there are inserts that you can buy usually on Amazon and have them overnighted.

And you can actually put it in there to have it fitted to you.

So if anyone out there is gonna be using a hand pump more often than just the here and there use, then that would be a really good option for them to make sure that it's fitted well.

That's so cool.

I didn't know that.

It's called Maymom.

The brand is Maymom.

That fits the medulla pump.

That's awesome.

So of all of these kind of different types of pumps, what would you recommend a parent getting?

And like, does it depend on the person and like what their purpose is?

Yes, absolutely.

So for a first time mom that has never breastfed, then I will definitely recommend one of the ones that I mentioned earlier that has a really good motor, which would be the medulla, like the old school medulla, the big, it comes in the black case and it looks like a square, that medulla, and the Spectra S1 or S2 because they have the best motors.

And so if you're a first time mom and you're only getting one pump and you're getting it through insurance, that's the one that I recommend.

I feel like I often see recommendations on Facebook groups and different mom groups online, and they're all crazy about their hand spray pump and they want everyone to know about it.

And that's great, but for a first time mom that might be in a situation where they're 100% dependent on their pump to protect their supply or build their supply, a plug-in one to the wall or the spectra that allows the battery power option, it has the best motor and so those are the best ones to use.

One that's not as widely known is called the Unimom pump.

And so if you look at a list that your insurance sends you, the Unimom pump might not show up.

It's pretty new, but it has a fantastic motor as well and a lot of different cool features that the other ones don't offer.

For the Unimom pump, you can contact that company directly and they can contact your insurance and get you approved most of the time.

It has different features like it will alternate.

It has two motors, so it can alternate the right and the left breast because some people have better simulation if it's kind of alternated one pump at a time on each breast.

And it has more of a computer screen that just makes it really user friendly.

And I really, really like that pump.

It also has a great motor, but it's just not as widely known because it's new.

As far as the second time mom that did not have issues with supply with their first baby and is comfortable with pumping and is comfortable with breastfeeding and did not experience any type of labor trauma or anything like that in between pregnancies that might cause them to have a lower milk supply, then if they have their previous pump, then I might suggest that for this baby, since you are covered with insurance for each pregnancy, to use that insurance coverage to get a hands-free pump, especially if they're going to be returning to work.

But even moms that are returning to work full-time, I tell them have both of your pumps with you so that if you have a moment to take a full break from work and actually sit down and pump, use the one with the better motor, like the Medella or the Spectra or the Unimom.

But it's always good to have your hands-free pump with you for when you're on a Zoom meeting and you don't have the time to just sit there and only focus on pumping.

Or if you're at home and you have a busy day and you need to be doing laundry and you need to have your hands and you need to be walking around, then it's a good pump to have in those occasions.

But I don't recommend a hands-free pump or your only pump.

So those are always good pumps to get if you wanna buy one out of pocket or if you're a second time mom and you wanna use that through your insurance for your second pump.

Gotcha.

Yeah, I've heard of like nurses and teachers specifically using like the hands-free pump so that they can pump when they're sitting at the desk charting or when they're in their room.

And maybe they're not really able to be completely disconnected and have to have their door open or something.

And I just imagine that that would be really helpful in those situations, but I can definitely see how it would also be necessary to have the other option too for the more effective emptying.

I was at my chiropractor one day.

Yeah, it's not ideal to be in a meeting and pumping.

It's not always as effective, but whenever you're in that situation where it's either don't pump at all or use my hands-free pump while I finish working on this project, it's a great option.

I was at the chiropractor one day and she has back to back to back to back clients.

And if she's going to take time off to pump, it's going to be an hour.

It's not going to be a full appointment because her appointments are an hour.

And I remember one day I heard something and I'm a doula, I should have realized, but I didn't click it first.

And I was like, what's that noise?

And she was, oh, I'm pumping.

And I was like, oh, okay, everything makes sense.

And then a little while later, I noticed that her shirt, like it had leaked a little bit because she had leaned too far or whatever, because that's a very physical job, you know?

And luckily she's a friend of mine too, so we just laughed about it.

But yeah, it was like, it was like this tiny little noise.

I love that.

So what would be a sign for someone that your pump's not working for them?

Like what if they get a pump and, you know, how would they know if that was kind of the right choice for them?

The first indicator that there's an issue with the actual pump motor itself is if there's no suction.

Usually that is not the case.

It's usually not a motor issue, but it can be.

If everything is set up correctly and there's no suction and you've tried everything, then I might go back and see if there's an actual motor issue there.

Most of the time it's user error.

And even though I've worked with so many people with so many pumping moms and I've put pump pieces together so many times, there can always just be one missing part or one piece that isn't connected fully that's keeping the suction from actually coming through.

So if you put the flanges and everything is set up and there is no pulling and there is no suction, that's an indicator that you need to go back and look at every single pump part and make sure that it is connected fully.

And if that's not the case, then you would want to check the motor and make sure that the motor is actually working well.

That's as far as all the pieces working correctly.

If you have the wrong flange size, then that could be a piece that is not giving you the output that you want to see.

So another indicator that your pump is not working for you is if you're not getting good output.

And of course, the amount of output changes depending on where you are postpartum.

But if you just feel like nothing is coming out and you've tried everything and you notice the suction, your nipple is being pulled in and there's nothing coming out, then it might be a flange sizing issue, or it might be a pump that is just like a hands-free pump that is not really up for the task.

Okay, so what is a flange?

You've said that a couple of times.

What is a flange?

How do you know what size flange you need?

That's a great question.

So the flange is the part of the pump that actually touches your breast.

So it's what you fit to your breast that's pulling your nipple in through the tunnel.

That's the flange.

So most breast pumps will come with a standard 24 or 28 size flange.

And in all of the hundreds of moms that I've seen and measured for different pump sizes, I don't think I've ever seen a 28 and I maybe have seen one or two 24s.

Most people are gonna fall under the 15 millimeter to 19, maybe even 21 millimeter category, but I would say the majority of people I see are between a 15 and a 19 and some 21s.

But I know whenever I had my kids, I had either the 24 or the 28 and I just used those.

I didn't pump that much.

I usually pumped once or maybe twice a day and I just used what it came with.

I didn't give it any thought.

I think if I would have been an exclusive pumper, it would have become an issue, but it just never occurred to me that I needed to think about that.

When you're measuring, when you're trying to see if you have the right plan size, the most important thing to look for is pain.

If your plan is causing you damage or it's causing you pain or it's pinching or it's hurting or it's rubbing, then that's not your flange size.

That's the number one thing to go off of.

As far as looking at a correct size fitting flange and what it should look like when you're pumping, you wanna see just your nipple being pulled through the tubing.

So the flange has a wide base that fits around some or a lot of a big portion of your breast, but the actual tubing that your nipple is being pulled through should just be pulling your nipple through, not your areola.

If your areola is being pulled through, that can cause damage, discomfort, pain, low output.

So that's where we kind of know whether or not we have the right flange size or not.

As a starting point, we actually measure the nipple, the diameter of the nipple, and I use a ruler, but you can also just use, I use a nipple ruler.

I have a little device that you can fit, you know, and you might have seen these online or on Instagram that you can fit your nipple in the hole.

I think it's sold by Lactation Hub, and you can measure it that way, but you can also just use a regular tape measure and measure the diameter of, you know, how many millimeters across is your nipple.

And that's a starting point for flange fitting.

I've seen plenty of moms that I've fitted for a flange, and I'm like, I 100% think that you're a 17, and I think that's gonna be the best fit for you.

They go home, they get a 17, or they try one in the office, and it looks good.

And everything, in my mind, I'm like, this should be a good fit, but they're not comfortable, and they're not getting the output that they want.

And so if it's not comfortable, and it's not getting the output that you want, then it's not, still, even though I, it probably should be the right size, is not for that mom.

And so then at that point, you have to kind of play around with different flange sizes.

More often than not, I feel like moms that don't have a lot of knowledge on flange sizing, they will just think, oh, this hurts, it's probably too tight, I'm gonna go up a size.

But in a lot of cases, when they go down a size, they feel a lot more comfort than going up.

But if you're fitted for a flange size and you think you should be about a 17, I would maybe even try buying a 17, a 19 and a 15 and trying all three of them.

Your nipples can also be different sizes.

So you wanna make sure that both of your nipples are fitted for a flange and then try different sizes on each one.

So one size might be a 15 and one might be a 17 or one might be a 15 and a 19.

So it's always good to just have several sizes so that you can have the opportunity to see which one works best, which has the best output and feels the most comfortable or go to a lactation consultant that has the size available to do a pump evaluation with you.

This completely blew my mind when I learned about this after, because again, this is something that I learned after I had my babies and was done pumping or nursing.

And I just figured those were the sizes, 24 and 28 or whatever came in it.

And so I used the smaller one.

I didn't even know that was something that I would need to ask questions about.

And I think that Naomi mentioned the other day, she said something like, it's kind of like if everyone was given a size 11 and 13 of shoe and you just are supposed to pick one.

And you're like, but I'm an eight or I'm a nine or I'm a four, whatever.

That totally blew my mind.

And I think back and I had such awful time with output when I was pumping.

I was like, I wonder if I had had a smaller flange size, if that would have made a difference when I was at work and getting the output that I wanted or needed for my baby.

So that is so extremely helpful.

Another thing that I hear about is that people receive pumps from their friends or neighbors, like a hand-me-down, or like it's a second pump.

They're having one for home that they got from their insurance and then they're like, oh, my friend has one leftover that I'm gonna actually bring to work, so I don't have to bring one back and forth every day.

So is it safe to use a pump that's already been used by someone?

And can you kind of help us navigate that a little bit?

So if the pump has a closed system, then it is safe to use a used pump that's been donated from your friend or that you get used if it has a closed system.

I actually found this website on exclusivepumping.com that lists which ones have a closed system and which ones have an open system.

Basically, if it has a closed system, the milk from the previous person was not able to get into the tubing because there's a backflow protector.

And if you're familiar with the Spectra, it has, you know, it looks like a disk.

It kind of looks like a spaceship that's connected.

It's between the actual tubing and the flange.

And so that's what's keeping it from getting into the tubing.

If it has an open system and it doesn't have that backflow protector, then it could have gotten into the pump equipment and it could still be there.

And there could be some harmful bacteria that might not be great for your baby.

So most pumps actually have a closed system now.

If you send us that link, we'll put it in the show notes too.

Yeah, it's on exclusivepumping.com and I'll send that to you.

But for the most part, that is safe.

But if you do get a used pump from someone, you should go ahead and get new tubing.

And especially any part that touches breast milk, you don't want to reuse that from someone else.

So the flanges especially, usually the back flow protector, the little duck, we call it a duck bill because it looks like a duck bill.

All of those things should probably be replaced and you can get those on Amazon too.

And that's something that people don't think about too is, and I didn't realize this at the beginning of my pumping journey, that you yourself might need to get more of those.

It's like, that's not a lifetime use.

Some of those parts get loose or some of them get liquid in them.

Like I remember every once in a while, my tubing would have little condensation in it.

And I'm like, oh, that's never gonna dry out, you know?

So just because you have a set and it's great and everything fits doesn't mean that you're never gonna have to buy another one because even for your personal use, you might need a second set.

Exactly.

So what would you say is the biggest piece of advice that you have for parents who are pumping for whatever reason?

I think sizing, like Ciarra was saying, is something that a lot of people don't know much about and can kind of make or break your pumping journey.

I did wanna add on the sizing that when you give birth, especially if you're like me and I had a C-section, they pump you full of so many fluids that you're really swollen up all over your body.

My nose was swollen up.

I got home from having my first baby and I was walking around my house and told my husband, my feet are jiggling.

What is happening?

And I weighed myself.

I had an eight pound baby, but I only lost three pounds.

How did this happen?

So your nipples can actually be swollen too because you're retaining fluid all over.

So the size that you might be using, postpartum, like right after you have your baby, that might not be the same size that you're using a few weeks later.

In the hospital, I believe that the smallest size they carry is a 19.

So it might be a good idea to actually get sized before you have your baby and have some flanges on hand that you bring with you to the hospital in case you're separated from your baby for some reason, and you want to make sure that you have a good size fitting flange in the hospital.

So flange sizing can be huge.

Not having the right size flange can cause clogged ducts, blood, mastitis, and just really frustrate the nursing parent.

So I feel like flange sizing is really important.

I feel like the other part of that too is just, if you don't love pumping, I have a lot of patients tell me this when it comes to pumping.

I just don't love it.

And that's okay.

It's totally fine to not love it, but it's also okay to reevaluate your goals as you go through the whole process.

So if you don't love pumping and directly breastfeeding your baby is just not an option for whatever reason, I just hate the mom guilt.

And if you know there's always different plans, you can visit a lactation consultant and you can get to a point where you're like, you know what, I feel like I can do four pumps a day.

And that's where I'm at with my mental health and with everything that's going on with my family right now and taking care of a baby and possibly other children.

I can do four pumps a day.

That's what I can do.

I just encourage all parents to just do that.

Re-evaluate your goals as you go along.

Try pumping out if it is something that you don't love or you're just not really that comfortable with.

There's always different options in how you use pumping and your breastfeeding journey.

And as far as people that are exclusively breastfeeding that don't love pumping, I feel like they see so many things on social media and there's so much technology and marketing out there that when they're not pumping and they're exclusively breastfeeding, they feel that they should be doing some type of additional pumping, although their baby is getting everything that they need from them.

And I tell moms, like, you're doing a great job.

Your baby is getting everything they need from you 100%.

So you're giving, you are at a full supply.

If you are breastfeeding your baby 24 hours a day and they're growing and they're healthy and then you're pumping on top of that, you're putting yourself into oversupply.

So there's just a lot of information out there that kind of make moms feel like they should have a huge deep freezer stash of stored milk on hand all the time.

And so they're breastfeeding, pumping, breastfeeding, pumping, breastfeeding, pumping.

But what you need and what your goals for what you want for storage and how you want to feed your baby should really determine how you're using pumps, not just going off of what you see on the internet and how often or how much you should be using your pump.

I feel that so hard.

And I think that this is so important to say, and so glad you mentioned that because it kind of pinged my brain to say this.

It can become an obsession.

So like my mental health postpartum, I already had some postpartum anxiety and I didn't even recognize that until I became a birth worker.

But I was so obsessed with my stash in the freezer, like it became a numbers game.

I was always comparing how many ounces I got this pump to the next pump.

And I had like a system where I had stacked and dated and I had them ordered a certain way in the, anybody who knows me knows this is like, they're like, oh, this isn't surprising at all.

And I just had to have everything.

I had like a sheet I wrote down on how many ounces I had.

I ended up being able to donate a lot, which was great to somebody who needed it.

But I didn't need to do all of that.

I stressed myself out so much.

And I also had at the same time an aversion to pumping.

It made me nauseous.

Every time I hooked up to a pump, I got this like feeling in my stomach.

And I still would do it just to obsessively add to those numbers in the freezer.

And that is not mentally healthy.

So finding a balance that works for your family is really, really important.

Absolutely.

And just like with all technology, it's great.

It's so useful.

I'm so happy that we have pumps, but there's also the downsides to having the technology.

Like parents that are a little bit more type A and are pumping, they're trying to do a combination of direct breastfeeding and pumping.

They become obsessed with the numbers like you were saying, Ciarra.

And they're like, I know that if I pump and I get four ounces, I can see it.

And then I can see my baby taking it.

But when they're at the breast, I don't know if they're getting four ounces every time.

And so sometimes it can be kind of difficult for moms that are doing a combination to trust their body and to trust their baby that they are getting what they need from direct breastfeeding.

So that's just something for pumping moms to keep in mind that as long as your baby is healthy and growing and all signs point to them being satisfied, then they are more than likely getting what they need from you directly.

Yeah, being a parent is so hard and being a breastfeeding parent is doubly hard, triply hard.

So yeah, I mean, this has all just been so helpful.

So if someone was looking to connect with you for support through their lactation journey, tell us how we can find you.

You can go to www.milkdiva.com and you can book an appointment with me or any of our other fantastic lactation consultants right there on our website.

We also have a fantastic office administrator that if you call the number on our website, she'll be happy to help you navigate through the whole booking process and she's wonderful.

So that's how you can reach me.

We'll put all their socials in the show notes too.

Yes.

Thank you.

We appreciate your time.

Thank you so much.

Thank you for joining us on Birth, Baby!

Thanks again to Longing for Orpheus for our music.

You can look him up on Spotify.

Remember to leave a review, share and follow wherever you get your podcasts.

See you next week.