Lactation consultant blog offering breastfeeding tips and advice for the nursing mother written by Tanya Roberts, retired IBCLC lactation consultant and owner of Lactation Connection & Amamante Nursingwear.
When it is time to replace a Spectra Backflow Ptotector or Valves?
1. Reduced Suction
If you’re noticing a reduction in suction while pumping, this is a sign it is time to replace your Spectra Backflow protector and Spectra duckbill valves. Valves may need replacing more often than the backflow protector, but not less often so a good rule of thumb is if your backflow protector needs to be replaced, replace your valves at the same time. Thes two Spectra parts are the most critical when it comes to suction and worn out valves and backflow membranes are the most common reason for reduced suction
What about no suction when I’m pumping?
A sudden loss of suction while pumping is most often because the backflow protector is not assembled correctly or duckbill valve or is not attached correctly to the breastshield, or has fallen off. What if the backflow protectors still moving when your pump is on?
If the backflow protectors are still moving back and forth with the sucking motion of the pump, then chances are the suction issue is because of the membranes. When they lose suction,it’s usually because they have worn down and it’s time to replace them. Check to make sure your membranes are still properly assembled to your kit, and remember that to properly maintain the pump.
How often does Spectra recommend replacing Backflow Protectors?Backflow protectors should be replaced regularly, as often as every two to three months. Any time your breast pump has been stored, duckbill valves and backflow protectors should be replaced as well as any brittle or crimped tubing.
2. Backflow Protectors are Flopping Around
If your backflow protectors are moving eratically or hitting the casing, this usually means the duckbill valves need to be replaced.
3. Moisture in the Backflow Protector
While condensation is common on the breast shield side of your backflow protector, moisture on the side where the tubing is attached is a problem that can then create moisture in the tubing. If your parts are completely dry prior to assembly, but you notice moisture in the tubing during and after pumping, it’s most likely an issue with the backflow protector. Improper assembly of the backflow protector or a broken or worn out backflow protector will allow condensation to built up while pumping. Once moisture enters the tubing, there’s no way to safely clean, dry, and sterilize it. You also risk getting moisture into the pump motor itself, which can cause damage to your pump motor and grow mold. This is why backflow protectors need to be replaced regularly. Working mothers or moms who pump exclusively shoud always have extra Spectra valves and Spectra backflow protectors on-hand for for when you need them. Your milk supply will thank you!
4. Valves Don't Snap Back into Place
Spectra breast pump valves and backflow protector membranes for that matter are made of a flexible silicone material which stretches and releases each time your breast pump cycles. This creates the suction you feel and that draws out your breastmilk. After regular use, the elasticity of these parts break down. When the valve wears down, it makes your breast pump less efficient because the motor has to work harder to create the same amount of suction.
5. Valves Fall Off
If your valves fall off, the most common cause is that the elasticity has been compromised and it is time to change your valves. If you purchased new valves, but they fall off your breast shield anyway, this may be because of the changes heat has made to the breast shield during sterilization. If this happens, you will need to replace the breast shield as well.
6. Torn Valves
If you notice a decrease in suction or if you’ve noticed your pump doesn't feel as strong as before and you’re getting less milk, take a good look at your valves. If it has been more than a month since you have replaced them or if there is a tear in your valve, it’s time to replace it. Tears most often occur at the tip of the valve.
How often does Spectra recommend replacing breast pump valves?
How often Spectra recommends replacing valves depends on how frequently you pump. If you pump once daily, you may only need to replace valves every two to three months. If you pump frequently such as for working or exclusive pumping, every four weeks is recommended.
Spectra breast pumps include the most commonly fitted flange size, 24mm breastshields. Although this is the most common size, many women will fit better in other sizes. A properly sized breast shield aka breast flange is important to ensure the best performance of your pump and the most milk output. An improperly fitted breast shield can hinder milk supply and cause discomfort. To determine the shield size you need, pump for five minutes using the standard size provided with your breast pump. Your nipple will expand while milk is being expressed, therefore it is important to measure after five minutes of pumping so that the size you select will provide adequate room. After five minutes, measure the diameter of the nipples at the base with a tape measure that uses millimeters. Click the link to access a printable tape measure.
Ensuring the proper fitment is essential for protecting milk supply especially in moms who use their pump frequently for working or exclusive pumping. An ideal fit compresses the milk sinuses properly ensuring good milk transfer, less pain and fewer clogged milk ducts.
When purchasing new breast shields, you should also replace your duckbill valves. Duckbill valves and breast shields that are not sterilized together may not fit well causing the duckbill valves to be loose on the breast shield. Normally, Spectra valves should be replaced every 6 weeks for moms pumping 15 times per week. Backflow protectors do not need to be replaced as often but at minimum, Spectra Backflow Protectors should be replaced every 2-3 months.
It has come to my attention that some day care fascilities are using crock pots to warm baby bottles. While most are using one crock pot for formula bottle and another for breast milk, this is NOT a healthy practice. Just to name one reason, if a mother has a yeast infection this can be passed along to another baby bottle sitting in the same water bath. Yeast infections cannot be killed by sterilizing or boiling, let alone by warming. Only an anti-fungal can kill yeast.
We encourage working mothers who use day care to find out what the practices are for storing and warming breast milk. Most day cares are requiring labling of bottles, so that should be something you look for when interviewing a day care fascility. If they use a water bath to warm bottles such as a crock pot, you will want to bring in your own bottle warmer for them to use. If this is not allowed, look for another day care as you don't want your baby's bottle to be contaminated.
Most quality baby bottle warmers cost around $40. To get the most bang for your buck, you may want to opt for the Motif Bottle Warmer. It warms up to two bottles so it is a good option for day care purchases and it has temperature setting to warm baby food and even sterilize bottles. The 104 degree setting is perfect for the baby bottle to be warmed to that temperature and as it cools during the feeding, it is around the 98.6 that your breast milk is at body temperature. The Motif Dual Bottle Warmer has a 158 degree farenheit setting for baby food and 212 degrees to sterilize. At under $40, this bottle warmer is a great multi-use purchase.
Originally, the Montgomery glands on the nipples were all you needed to keep your nipples lubricated for breastfeeding. But due to the chemicals in our clothes from the manufacturing and laundry and on our skin from soaps and lotions, our skin including nipples may need a little help. Of course soreness from a poor latch or a small breast pump flange may contribute to the need for nipple creams while breastfeeding.
With the growing number of choices to soothe sore nipples, moms are opting for anything from coconut oil to nipple butter. Coconut oil in solid form is an effective nipple cream, but it is unstable in warmer temperatures so does not travel well. The slightest warming can turn the solid cononut oil into a messy liquid in a very short time.
When choosing a breast cream, you want to make sure it is something that does not need to be removed. It needs to be safe for the baby as well as mom. Removing the nipple cream is not recommended because rubbing with a cloth often breaks down the natural keratin layer on the skin that helps protect the nipples.
A very popular option for moms who need to soothe dry or sore nipples is the Motherlove Nipple Cream. Ingredients are certified organic and do not have to be washed off prior to nursing. Ingredients include extra virgin olive oil, beeswax, shea butter, marshmallow root and calendula flower. Most creams come in a tube or tub, so it is important that hands are washed each and every time to ensure that bacteria is not introduced into the milk ducts. And no double dipping the same finger into the tub, please! This will keep your nipples, ducts and glands free from bacteria.
New on the scene is something that is long overdue, a nipple mist. Spectra Nipple Mist takes the problem of having to wash your hands when you are holding the baby out of the equation because your hands never touch the product or the nipple. You simply spray on and the healing mist soothes the nipples. Ingredients include Persea Gratissima (Avocado) Oil, Olea Europaea (Olive) Fruit Oil, Sambucus Nigra Fruit Extract, Tocopheryl Acetate, Retinyl Palmitate, Cholecalciferol.
These creams and sprays can be used to keep nipples supple for nursing and pumping! Here's to Happy Breasts! Tanya
A common situation moms encounter is how to get out of the cycle of supplementing artificial infant formula when breastfeeding has been disrupted. Disruptions can occur for medical reasons or just from advice or practices than lower milk supply. Why is not the focus of this article, but rather how can a mom get back to breastfeeding?
First things first. Calculate how much breast milk your baby needs to grow and thrive. An easy calculation for babies under six months of age is weight x 2.5. For example for an infant weighing 9.5 lbs, you will multiply 9.5 x 2.5 and you will get a total of 23.5oz per day. Take this per day total and devide by the number of normal feeding in a day which will be 8. (Note that it is normal for an infant to feed 11-12 times per day when going through a growth spurt at age 3 weeks or 6 weeks, but for purposes of milk supply, divide by 8.) For example, 23.5 divided by 8 = 2.94oz per bottle so we will round up to 3 oz.
Assess your milk supply. Feeling full or feeling let down or not feeling it does not give a true picture of breast milk supply. Calculate how much you are producing in the following way. Wait three hours after the first feeding of the morning. Then, using a good quality double electric breast pump like the Hygeia EnJoye, Ameda Finesse or Spectra S1 or S2, double pump for a full 15 minutes. How much did you produce? Let's say you produced 2oz and you need 3 for your baby's weight intake...
Only supplement the difference. Let me say that again...ONLY supplement the difference. If you infant still acts hungry after the additional supplement, put them back to the breast. If you over-supplement you sabotage your milk supply and it will be a never-ending battle to catch up. Stick to your goal. Here is where things can go off the rail. If your baby is feeding eight times per day, but still acts hungry even after you put them back to the breast, look at the wet and dirty diapers to confirm that they are getting the nourishment they need. An infant 6 days to 6 weeks old will have 6-8 wet diapers and 3-4 dirty diapers each day. After 6 weeks, dirty diapers decrease to sometimes as few as one every 3-5 days. As long as the wet diapers are still consistent, they are getting fluids. Keep the following schedule for 5-7 days: Nurse Supplement (only the difference needed) Pump 10 min of double pumping Repeat 8x times per day
Re-assess your milk supply! Using the previous method of pumping instead of nursing the second feeding of the day, calculate how much you are now making. Let's say you are now making 2 1/3oz...
Reduce the supplement! As per the example above, the infant needs 3 oz and you are now producing 2 1/3 oz so you will now only supplement 2/3oz.
Repeat until you have full milk supply! As long as your baby is having the appropriate number of wet and dirty diapers, you can continue this method until your milk supply has been restored. As a reminder, an infant from 6 days to 6 months, should produce 6-8 wet diapers per day and either 3-4 dirty diapers per day or at minimum one every 3-5 days if the infant is older than 8 weeks.
Need to speed up the process? In order to speed up the process, taking a supplement such as Nature's Herbs or Nature's Way Fenugreek or Motherlove More Milk Plus is an excellent way to increase milk supply more quickly. If taking Fenugreek, make sure you are taking an appropriate dosage for lactation and for your weight. This is more than it says on the bottle. For 600-626mg Fenugreek, the dosage for an average woman is 3 capsules 3x daily. For a plus size mom, she will need 5 capsules 3 times daily. If you are taking too much, your stools will be loose. A maple odor to your urine is normal. Motherlove More Milk Plus is formulated specifically for lactation so the appropriate dosage will be on the bottle.
Don't have time to pump? If pumping after every nursing is too taxing or not an option, using a supplemental feeding tube so that your baby suckles while being supplemented is an option. Lactation Aid feeding tubes are economical and can be used for this purpose on a short term basis.
Take heart! Any breast milk you give your baby is beneficial. Even if there is a medical reason you cannot acheive full milk supply, your baby benefits from being at the breast and receiving breast milk. You want what is best for your baby or you would not be researching this so don't beat yourself up over this.
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.
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.
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, Ameda Finesse or the Hygeia EnJoye 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 Lansinoh, Ameda or Hygeia 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.
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.
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!