Today’s Podcast
Episode 177  Survey says….

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 Episode 177 Survey Responses on Pumps

The topic for todays show.

It all started from an email I received. The same week, there were a few qustions in the All About Breastfeeding Community group about pumps. Between the emails I receive, the questions in the AABC group and the ones I get asked in my private practice, and during breastfeeding classes, here are the most common questions.

• Moms are wanting to know which pumps are the best.
• Which ones they should pick from the list on the insurance company.
• Which ones are the most comfortable?
• How frequently and how long to pump each pumping session?
• Not sure what is a normal experience as far as pain and discomfort?
• If they are using it correctly?

Since I am not using the pumps myself and since I don’t want all my suggestions and advice to come from the pump company reps and literature, I think it is best to go straight to the moms who are using the pumps. On a daily basis, I am asking moms how they feel about the pumps they are using: like, dislike, comfort, etc.

Since I have this great group of women in the Facebook Community Group, I thought going back to this group and asking the questions people were asking me, would be of value. And it was. The only thing I did not count on was the fact that some moms have more than 1 pump. Since this can change the accuracy of the results, I asked the moms to choose one pump and respond to the questions with that one pump in mind.

Confused? Well, let me explain to you why I asked moms to only use one pump for this survey.

A few of the questions have to do about pump useage and comfort. If a mom is switching between using 2 pumps, her responses about things like comfort is somewhat skewed. I know that if you use a pump that is so-so comfort wise if you use twice a day, and your tolerance for so-so can be quite fine for months.

But if you were to use that same pump 4 times a day, your so-so might turn to a description of painful nipples.

Another example, pump motors do not work as efficiently after a certain amount of hours. So, if you use 1 pump 4 times a day, your perception of its effectiveness and how long it lasts is going to be quite different then if you are using 2 pumps and use one twice a day while at work and twice a day the othene while at home,both pumps will last a longer period of time ( not longer pumping hours), bu longer time, which will give you the impression that XYZ pump lasted me a whole year, when in fact if you used it 4 times a day, rather than twice, you would have a very different response.

These are just 2 examples of why I wanted those who were taking the survey, to have 1 pump in mind as they answered the questions.
I am first going to go through the survey and the responses.
As I go along I will share some of my thoughts about the responses

Okay, so let’s get going with the survey.

I would like to first that the 21 moms who took the time to fill out the survey.

Make and Model of your pump

12 are using the Medela Pump In Style
1 is using the Medela Symphony which is a hosspital grade pump.
3 have an Ameda Purely Yours – 2 are using them – 1 got it from the ins company but is not using this one and is using her PIS instead.
2 are using the Spectra 2
1 is using the Philips Avent
1 is using the S1 and S9 plus

Not much of a surprise here. Several years ago when the insurance companies began issuing pumps to moms, it was such a fiasco. They were giving pumps that were cheaper than cheap. These pumps were damaging moms nipples, creating breast pain, and low supply. It was so hard for us Lactation Consultants to try and explain this to moms. After all, they were happy they were getting pumps for free. The way they saw it, they saved themselves $350.00 or more.

The way we saw the whole situation was quite different. When we met with moms who were suffering with pain and low milk supply and they were looking for our help, one of the first changes we suggested was switching to another pump, preferably a hospital grade pump.

Of course this meant them spending money to rent the pump. Since the pump they were using was free, it took some convincing to explain why a different pump would be better. Bottom line I would tell moms that if the pump they were using created such a high level of pain that they reduced the pumping frequency and time caused them a great deal of pain and stress and suffering, what was the point in continuing to use the same pump? When moms continued with the pump that was causing the problem, we noticed a significant drop off in moms pumping and breastfeeding. When they switched to a more comfortable pump, the rates of continuing were high. It is easy to decipher those results. Use a pump that is causing pain and suffering and low supply -less likely to continue. Use a pump that decreased your pain increased your comfort and increased your output – more likely to continue pumping, getting through the rough parts and returning to breastfeeding.

Along with cheap, poorly made pumps being a problem, we also had the problem that some insurance companies were not issuing the pump until after the baby was born. For moms who had a premie or baby in the NICU, this was unacceptable. They could not wait. Unfortunately, They did not want to spend money on a pump when they would be getting one anyday. We had our work cut out in this area also, because it was common to not receive your pump for several weeks. Your breasts do not stay in a holding pattern, waiting to be stimulated and then quickly respond by increasing the volume. The result of this would be – you guessed it. Lack of pumping on moms parts or pumping with an inferior pump = less and less milk volume. By the time they healed or they got their pump, for many, the breastfeeding was lost.

Thank goodness, the insurance companies have gotten their act together and are doing much better. They are issuing higher quality pumps more often and are getting the pumps to moms in a timely fashion. The world of insurance issued pumps is not perfect, but far better than the state it was in a few short years ago.

Where di you get your pump from?

13 from their insurance company
5 purchased it themselves
1 given or loaned it
2 said Other

These answers are very different than 5 years ago when most moms were purchasing pumps themselves or getting them as gifts. There was also a lot of pump sharing. This has been majorily reduced since more are getting ones issued for free from their insurance company.

Other –

Insurance and a friend
Was reimbused from insurance
Rented from a breastfeeding store
want sent the pumps to try by the owner of the company after hearing that I had tried ALL the other brands and still struggling to produce a FULL supply. I was President of FLCA and she wanted to help. I had AMAZING results and ultimately, wanted to share this pump with other moms. I know work for the company.

For those who paid for their pump, I wanted to know how much they paid

2 less than 100
1 between 100 and 150
2 between 250 and 300
3 over 300

There were no surprises here

How did you learn how to use your pump?

15 said they were self taught
3 said the hospital staff
2 famiy or friend

This is also pretty typical. If you are not sure how to use your pump and have noone to show you, many of the pump manufactures have their reps giving demos on you tube. So, just do what all moms do – Google or you tube it!

Confidence that you are using the pump correctly?

20 said yes
1 said No

Confidence that you are using the right size parts/flanges?

10 yes
5 No
6 Not sure

This was interesting. 20 moms said they were confident they were using the pumps correctly however, only 10 said they were confident they were using the right size flanges. 5 said they were not confident and 6 said they were not sure. This is a very common question I have when I am doing a consult. Moms want to discuss the size of their flange and want to be sure it is the correct size.

The first thing I ask them is: Is it totally comfortable? Are you pumping for the recommended time and getting average volume. If the answer is yes, I tel them that while I am happy to watch them pump, they more then likely have the right size. Why mess with a good thing, just because you think you need another size.

Sometimes the flange is actually a good size, but the pump is being misused. The pump is turned on and the mom turns that suction up way high from the get go, rather then gradually. Sometimes moms the flange is good, the suction is fine, but they are p umping for a half hour or more. Sometimes moms are spending way too much effort and kneading their breasts like you would be when you are making bread.
When you do this during pumping, your nipple is probably moving around inside the flange and you are causing internal breast swelling.
I suggest,,,, try hands off breast and just let the pump do its things.

It is always interesting to see a mom pump and to ask her what her pumping habits are.
I have seen some moms doing some pretty cockamaime things with the pump.

The kneading of the breast, the pressing of the flanges so hard into the breast that it leaves compression markes for a while once taken off.
Some are using the hands free bras, which I love, but the bra is too loos and the flanges are not staying put, therefore the pump is cuasing the lowere half of the niple and a lot of beast tissue to get sucked into the flange, while mom is busy multi-tasking and does not realize this until she takes the flanges off and clearly the pump was sucking in the wrong tissue. Some moms fall asleep while pumping and the parts move. Now, If I was a pumping mom – this would definitely behappening to me.

I would be tired and then I would sit down and be lulled into the sound of the whooshing of the pump… that would def put me to sleep
Come on now, don’t get insulted. You gotta have a sense of humore when it comes to this subject.
It helps me get to the bottom of why a good pump with the right size flanges, are still killing the mom.

Why are you using the pump?

EP for baby who is not latching – 1
Temporary pumping because they are in pain with BF -1
Temporary pumping to help increase supply – 3
Replacing breastfeeding during working hours. – 12
Collecting milk to prepare for BTW -4

When pumping, are you pumping both sides at the same time?

Yes – 19
No – 2

Since this survey was anonymous, I don’t know who said they were not pumping both sides at the same time or why they are not.
Some moms have lots of milk and there baby can feed from one side and get full.this allows them to be able to pump the other side and store that milk. Of course, this is fine and incredibly convenient for this mom

If you are mom who is doing one side at a time, purely because you cannot coordinate holding 2 at a time, or you feel like you need your other hand free for taking care of your baby, I encourage you to be creative and find ways to do both at the same time. The number 1 reasons moms quit pumping is because they
say it is inconvenient and just takes too long. So, rather then pump 2 times 15 for 30 minutes, it is in your best interest to pump 1 time for 15 minutes.

This might mean using a hands free bra.
It might mean turning on the pump before you put the second flange against your breast. If you start with it on a low suction, this may be doable. If someone else is around, ask them to turn the suction up a few minutes into the pumping for you. If you can figure out a way to hold he flange against your breast with one arm while you remove your hand to turn the suction up yourself, then go ahead and take off the flange, turn the suction up and put the flange right back on. It will be worth it to save time.

On average how many minutes do you pump each time?

Less than 15 minutes – 7
15 minutes – 3
15-30 minutes – 11
30-45 minutes – 0
more than 45 minutes – 0

I would say that 15 – 20 minutes is a good average time to pump. You are never totally empty. You can have several letdowns during a pumping session. But for lots of moms ( especially if you are sore from pumping), 15 – 20 minutes is best. If you get more milk, but leave it on for 30 and you hate pumping and skip some pumpings because of the pain, then leaving it for 30 minutes does not really help you.

0-10 how would you rate your pump 0 is the worst and 10 is the best experience.

10 – 3
9 – 2
8 – 8
7 – 3
– 2
5 – 2
4 – 1
3 & 2 & 1 – 0

This is pretty much in line with what I hear in the breastfeeding/pumping community 8/10

Would you choose to use this same pump again?

15 said yes
6 said no

How likely are you to recommend this pump to another mom?

70% said that the pump they are current using, would recommend it to another mom

Are you using the flange brand that came with your pump?

Yes – 21

If you are p umping hands free, what are you using to hold the parts in place? – 13 responses

Medela Easy Expression bra – 4
Simple wishes Bra – 5
Rumina brand – 1
Pump Ease brand – 1
Other – 3

More moms are using hands free bra s then ever before. For pumping moms, I think this is one of those luxury items that pays for itself in the end.

Other – 3

Made one themselves
Sports bra with holes cut into it
Bravado Designs Womens Clip and Pump Hands free Nursing Bra Accessory

I am all for moms being creative and making their own!

What would you like us to know about your pumping experience? 20 answered

I have no problems pumping and like to collect and store milk for my baby – 9
I have no problem pumping however, I just don’t like to pump – 3
I have no problem pumping, however I dislike it but do it anyway for my baby – 7
I just have not found a pump that I am comfortable with – 0
I cannot wait to be done pumping – 4
I plan to pump for a specific time and then I am done – 2
I plan on quit pumping when by baby is a year old – 4

This is of no surprise to me at all. Pumping is definitely a labor of love for most mothers. they are doing it because they want their babies to have their milk and they are tryin their best to avoid formula. This is quite admirable as pumping is surely not fun. It is like another job.

I mean, moms are using their breaks at work and their lunch hour to sit and pump for their baby. If there babies arenot directly breastfeeding, they are hooking themselves up to a pumpi 8 times a day. Certainly not what they planned on when they thought of breastfeeding.
Pumping moms need all the help and support we an give them.

Please use this space to explain anything you need to in further detail – 4 responses

Because I knew I could not cover everything in one questionnaire, I gave moms some space to add anything else about their pumping situation that they wanted to me to know, so I asked them 2 questions.

Recommended pumps –

No one in the survey mentioned the Hygea pump, however, I would say that the most popular pumps, the most predictable as far as getting high marks as far as comfort and efficiency are:

Medela Symphony – a hospital grade pump
Medela Pump In Style- double electric pump
Ameda Purely Yours
Spectra
Hygeai

We must also accept the fact that women are just built differently. Some are more sensitive in the nipple/areola juncture and breast tissue then the next mom. Some moms have nipples so small that they find it hard getting a good fit and the same is for the opposite extreme, nipples that are very large. Some moms have had nipple piercings and scar tissue and some have skin tags. All of these issues can have an impact on how they feel about the comfort of their pumps. This is why I speak in terms of averages and do not recommend on specific pump brand over the other. However, as you can see, there are just a few pump manufacturers that seem to rise above all the other pumps that are available. I say, be smart and if you don’t know, go with one of the ones mentioned, knowing that they are the most predictable as far as efficientcy and comfort.

Pump sharing –

I am very happy to see that the number of moms sharing pumps has been greatly reduced. While I know that sharing pumps can be a savings for families, it generally is not in your best interest,
Because many of the pumps could not be fully sterilized. Moms would purchase their own kit and think that they were safe, however, there are other parts of the pumps that can have bacteria growing that one cannot clean and cannot be fixed by just getting your own parts.

Another problem is that pumps do not last forever. After a reasonable amount of use, they become less and less efficient. Since there is no alarm on the pump to let you know it is running out of juice, moms were using pumps at various stages of efficiency. Some were halfway through their shelf life so to speak, some were on there last leg. Moms were buying 350 pumps for 25 bucks, thinking they got a bargain, but if the pump was on its last leg of efficiency, it was only going to work for you for so long.

The biggest problem with this is that moms were pumping less and less and blaming that they were tired, back to work, babies up at night, not enough time to pump & not looking at their pump as a possibility that they were pumping less volume. You know what this meant…. less milk volume and more supplementing with formula. Moms were not wanting to spend money on a good pump, a product that was going to enable them to get enough milk to meet their babies needs and yet, were now spending money on formula, a product they admitted they did not want to give to their baby.

What else did we learn from this survey?

One interesting thing to note is that while moms are having a much easier time learning how to use the pumps then they did years ago – thanks to more moms using pumps and willing to share their knowledge, also thanks to google and you tube for help – one of the same problems still exist now that has always been a problem… is moms feeling confident that they have the right fit, the right size flanges. Remember in this survery, 10 moms said that they were confident they were using the right size, but 5 said they were not confident and 6 said they were not sure. Combined with this being one of the top 5 questions I am asked by moms, I would say that this is an area the pump companies can improve on. Better education and perhaps online videos to help moms feel confident. Also, to moms who are unsure – it may be worth your time and money to visit with an IBCLC who can answer all your pumping questions, including checking for the right size fit. If you want accuracy, seeing is much better than a canned phone response. In my office, I have different flanges and sizes that you can experiment with and a flange trial can be helpful for long term pumping comfort.

This is a good time to take the opportunity to remind all moms that I am a huge fan of hand expressing. I work with enough moms who find this is more comfortable for them and they see better volume results with hand pumping. It is a great skill to learn because there might be times when you are stuck without a pump. Perhaps you forgot to take yours to work that day, or perhaps one of the parts broke, or the motor gives out. Just sayin… it is a good tool to have in your toolbox.

Speaking of tools in your toolbox – It use to be a hard sell to talk moms into using a hands free bra. Many thought it was weird, they didn’t like to be hooked up to that thing, it seemed unnatural. Well, I don’t think being hooked up to a pump is natural either, however, I could appreciate moms and their partners reactions, to seeing them put on this bra, with small holes where your nipples are, to hold the pump accessory in place and to see that hanging from your chest. Okay, I get it. However, once you get over that, you an appreciate the freedom that allows mothers. You can be on the computer, chart at work, hang out on facebook, put your makeup on in the morning, hold a book to read, or frankly,,, just do nothing.

Lori J. Isenstadt, IBCLC
Lori j Isenstadt, IBCLCLori Jill Isenstadt, IBCLC is a huge breastfeeding supporter.  She has spent much  of her adult life working in the maternal health field. Once she became turned on to birth and became a childbirth educator, there was no stopping her love of working with families during their childbearing years.  Lori became a Birth doula and a Postpartum doula and soon became a lactation consultant.  She has been helping moms and babies with breastfeeding for over 25 years.  Lori founded her private practice, All About Breastfeeding where she meets with moms one on one to help solve their breastfeeding challenges.  She is an international speaker, book author and the host of the  popular itunes podcast, All About Breastfeeding, the place where the girls hang out.  You can reach Lori by email at: [email protected] or contact her via her website:  allaboutbreastfeeding.biz/contact

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