One of  my standard practices if a client is pumping is to check her pump
and her pumping technique -- esp. if there are any milk supply problems.
Very often there is a problem with the hardware.  I check the pressure on
the pump with a pressure gage (because some rental depots don't routinely do
that) and check the fit between the flange diameter and mom's nipples. I
never assume that stressed moms have assembled the pump correctly or that
they know when it's working well or not.  What have they got to compare the
experience to?

 I saw a mom today who rented a pump several days ago when pedi discovered
baby was still down 10% from birth weight on Day 14.  She's been pumping
away wtih no results -- in fact her supply is awful.  My assessment suggests
that the latch problem is related to large diameter nipples and she's got
the wrong size pump flange.  The standard size won't accommodate her
nipples. The minute we put larger size flanges on her breast she said "Oh
that's the first uterine cramp I've felt in a week." Last week I worked with
a mom who had rented a pump that had a defective gasket and wasn't getting
any pressure.  She wasted 3 days pumping fruitlessly on the pump and her
milk supply really took a hit.  When I did the intake, I was really
surprised her supply was so poor after her report of pumping q 3hourly for 3
days until I checked the pump pressure and realized she had a dud kit.

 The LC must be well versed in equipment related to lactation and should
assess for correct use of that equipment during consulation even if the
equipment was acquired elsewhere (maybe ESPECIALLY if acquired elsewhere).

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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