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Archive for the ‘Breast Pumps’ Category

Barbara Wilson Clay, BSEd, IBCLC kindly offered to explain this widely used term “nipple confusion”…..

Occasionally a baby will have difficulty breastfeeding normally. The reasons for this may include:

• The infant is small, or born before the due date
• A difficult or complicated birth
• The infant or mother is ill, or recovering from illness
• Structural abnormality of the baby’s face or mouth
• Structural abnormality of the breast or nipple

When poorly feeding infants are offered a bottle, they then may appear to reject the breast. This is not nipple confusion, but an indication that the infant needs help to breastfeed successfully. In these cases, the baby’s refusal to breastfeed stems from inability rather than preference.

The term nipple confusion most appropriately refers to an otherwise normal infant who has had too many bottles before breastfeeding has been well established.

Sometimes nipple confusion occurs in an older baby, previously nursing well, whose mother has returned to work or school. If the mother’s milk supply is low due to lack of stimulation during separations, the baby may begin to prefer the quick, easy flow of the bottle. The key to reversing this situation is to re-stimulate the mother’s milk supply. Mothers also can gently re-focus on the breastfeeding relationship by nursing more often when at home with the baby and cutting back on the number of optional bottles.

Another type of nipple confusion refers to a baby who refuses to accept a bottle! Breastfed babies love to breastfeed. In such situations, offer the bottle in a low-key manner. Keep practice sessions playful. Reassure the baby often, and stop whenever baby seems stressed. By continuing to offer tastes from the bottle, baby will soon get the idea. Some babies will not accept a bottle from the mother, but will accept a bottle from a father or a babysitter.

Some older babies prefer to drink pumped milk from a cup, or mixed with solids from a spoon. They may never need to use a bottle.

Pointers: If Your Baby Seems Nipple Confused:

• Increase skin-to-skin contact to calm baby
• Use of a nipple shield can help coax these infants back to the breast.
• Use of a feeding tube device such as the SNS can provide an increased milk flow allowing supplementation at breast
• Protect breastmilk supply by increased breastfeeding/pumping

Using a breastpump can seem like a bit of a minefield, especially when you are considering going back to work and have several other things on your mind as well. Expressing breastmilk for your baby during the day is a sizeable commitment and will require lots of forward planning and a fair bit of kit. Once organized however, expressing can easily slot into your day and need not be too much of a mission. The tips below are the 6 most important issues to consider:

1. Invest in as good a breastpump as you can afford.
The best and quickest pumps are double pumps with variations of speed and suction (sometimes called 2-phase expression). Also make sure that the pump is fairly quiet if you will be using it in the workplace.

2. Make sure that you have a suitable place to store your milk at work.
Often there will be a fridge at work (make sure that the milk is stored at the back and not in the door), but if not, invest in an ice pack which will keep your milk cool for up to 8 hours.

3. Invest in a hands-free expressing bra.
This will free you up for tasks such as talking on the phone, writing emails, eating your lunch, etc. They also seem to have a positive effect on your milk yield.

4. You will need a suitable carry-bag with a mini-ice pack inside for transporting your milk safely and hygienically.
Make sure you are very organized and chill the ice packs overnight before work so they are ready to go in the morning.

5. Remember that breast pumps are different to your baby and your breasts may take a while to get used to them.
It is better to begin expressing one or two weeks before you go back to work so that you are already familiar with the drill by the time you get to the office.

6. Take regular breaks to express at set times
Remember to eat a healthy and balanced diet and drink plenty of water.

Express As Much Milk As Possible

If you are using a breastpump to remove (express) milk for your baby, it is very important that you have correctly-fitted breastshields. The breastshield is the part of the pump collection kit that fits directly over your nipple and forms a seal around the areola (the darkened part of your breast).  The breastpump works by creating a vacuum, which gently draws your nipple into the tunnel of the breastshield–just like your baby would draw it into the mouth with sucking.  A correctly-fitted breastshield will help make your pumping comfortable, and allow the pump to remove as much of your milk as possible with each milk expression.

Medela Breastshields – 5 Different Sizes

Medela PersonalFit™ breastshields are available in four sizes:  Medium (24 mm), which is the size in Medela’s breastpump kits; Small (21 mm), Large (27 mm), Extra Large (30 mm), and XX Large (36mm).  Medela’s breastpump kits make it easy to use a larger or smaller breastshield, because all sizes are designed to fit into the same connector on the collection kit.  Many women appear to benefit from a size other than the standard 24 mm breastshield.  In one study, many mums were fitted with either a Large or Extra Large breastshield within the first days after birth, and even more mums eventually used these larger sizes in order to pump comfortably and effectively. It is almost impossible to tell which size breastshield is the best fit without watching the nipple movement during pumping.  The following tips will help you determine whether a different size breastshield would be right for you.  Then, you can discuss your observations with your nurse or lactation specialist.

Choosing the Correct Size Breastshield – Signs to Look For

To determine whether you think you might need a Large or Extra Large breastshield, look at your nipple as it is drawn into the tunnel of the shield during pumping.  It should move freely and easily, and should not rub against the sides of the tunnel.  If the breastshield fits tightly, your nipple will rub against the sides of the tunnel with each vacuum movement of the pump.  After several pumpings, you may notice that the outside of the nipple (rather than the nipple tip) is tender or sore.  You may also see a little ring of skin flecks in the tunnel of the breastshield after you pump.  While a little circle of milk in the tunnel is normal, a ring of skin flecks probably indicates that the tunnel is too small, and that you would be more comfortable with a larger breastshield.  When your nipple moves freely in the tunnel of the breastshield, you will also note a gentle pulling movement in the areola each time the pump cycles.  If you do not see any movement in the areola with the pump vacuum, the breastshield is probably too small.

What Happens When You Use the Wrong Size Breastshield?

A tight breastshield can affect breast emptying and lead to problems with milk supply.  During pumping, your milk flows out of the breast due to a combination of the pump’s vacuum and your milk ejection (or let-down) reflex. However, a tightly-fitting breastshield does not allow good breast emptying–even with the best breast pump and a strong milk ejection reflex–because it squeezes the small ducts inside the nipple that carry your milk out of the breast.  Ordinarily, these ducts increase in size when you feel milk ejection so that the milk can flow out of the breasts quickly and easily.  However, if the ducts are squeezed by a tightly-fitting breastshield, some milk stays behind in the breast.  Eventually, this incomplete milk removal can lead to plugged ducts, mastitis, and problems with low milk volume.  You may note breast engorgement that seems to last a long time–or little “knots” or hardened areas in the breast that do not seem to empty with milk expression.

Choose A Medela Personalfit Breastshield

If you have either or both of these symptoms–nipple tenderness around the outside surface of the nipple or problems with breast emptying– your pumping will probably be improved with a larger size breastshield.  You will want to correct this problem as soon as possible after your baby’s birth before the nipple tenderness and back up of milk in the breasts affect your milk supply.  For more information or to purchase Medela’s PersonalFit breastshields, contact your lactation specialist.

By Paula P. Meier, RN, DNSc, FAAN

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Express Yourself Mums is delighted to launch our new website offering you an easier and clear shopping experience. Breastfeeding and expressing is still very much our speciality, however new product ranges include developmental baby toys, nursing and breastfeeding bras, slings and weaning products. If you need advice on any of our products do contact us and we will be happy to help. Enjoy your visit. We are currently offering Ameda Elite and Medela Lactina and Medela Symphony hospital grade breast pumps for hire and rental.