Our Favorite Things: Pumping Edition!

Let’s face it, pumping can really suck! We wanted to share just a couple of our favorite products and tips to help make it suck a bit less so you can enjoy your baby a bit more…

Now, we are assuming you have the basics like a double-electric pump. Pop over to this blog to see what we think about which breast pumps are best.

HAAKAA STYLE PUMP

This soft silicone “milk catcher” can be wonderful in two scenarios in particular: 1) if you are breastfeeding your baby and find you are leaking on the side baby is not feeding from. Pop the Haakaa on and collect all that otherwise lost milk! This can be really helpful for increasing your stash a few ounces at a time without having to add additional pumping sessions. or 2) if you find yourself leaking a lot in the shower, just out of the shower, or you are struggling with oversupply and need to take the pressure off without doing a full pump.

FREEZE-IT-FLAT

If you are an exclusive pumper you will learn quickly that optimizing storage of breastmilk bags is imperative. Storing milk bags flat can help you save LOTS of freezer space and keep your stash nice and organized. Even if you aren’t an exclusive pumper, you’ll want to keep any excess milk neatly organized and labeled so you know what you have and when it needs to be used. If you have loads of freezer space, you can use the cookie sheet method to freeze several bags of milk flat all at once. But many folks don’t have that kind of space. That’s where Freeze-It-Flats come in super handy. Just place one (or two if you have the double size) bag(s) of milk between the device and place in your freezer. You’ll get perfectly flat bags that can easily be stacked or grouped together in gallon ziplock bags for easy storage. (There are imitation versions available on Amazon, but we’ve used both and prefer the original from Mammaway.)

HANDS FREE PUMPING BRA

A hands-free pumping bra is absolutely essential for exclusive pumpers, people who are pumping frequently because they are away from their baby for work. But even for parents who are primarily breastfeeding, a hands-free pumping bra can make the chore of pumping a lot easier and even more effective. The obvious benefit of using a hands-free pumping bra is you are able to carry on with other tasks like work, baby care, or fixing yourself a snack. You can also use a hands-free pumping bra to get the most out of your pumping session by using your hands to do breast massage during the pump. This can help move milk more effectively, especially if you find (like many pumpers) you aren’t able to express as much milk with the pump as your baby is able to remove through direct feeding.

We have two favorites in this category! The Simple Wishes bra is our favorite for pumping on the go, when you are away from your baby, and when you have a bit of privacy to be able to pump. We recommend wearing a normal nursing bra or tank and then putting this on one over top just during your pumping session(s). It’s not the best to wear throughout the day, although you could if you wanted to.

The Sublime Nursing/Pumping Bra from Kindred Bravely is our go-to for people who are doing a combination of nursing and pumping and for folks who need easy access to hands-free pumping on the go. With this bra you have the option to nurse or use the internal slits to hold your pump flanges. This bra is comfortable for all-day wear so you won’t have to carry an additional pumping bra with you on the go. We find it a bit less snug and secure when holding your pump flanges and that can affect output, so when you are able to bring a separate pumping bra we still prefer the Simple Wishes solution.

PUMP BAG PACKING LIST

If you are preparing to go back to work outside the home or will be away from your baby for an extended time, it’s helpful to have a pumping bag stocked with everything you will need for the day. Here’s what we suggest:

• Double Electric Pump (for on-the-go we love the Spectra S1 or S9 if you need maximum portability)

• Hands-free pumping bra

• Quick Clean Wipes if you need to clean on-the-go

• Enough bottles for the day (with lids!) and a few storage bags for extra. (You can pump directly into the bottles you will send to child care with your baby the next day to save a step. Store any excess milk in bags.)

• Nursing cover (this can come in handy if you don’t have a private space to pump.)

• Extension cord and/or car adaptor if your pump needs to be plugged in (the S1 and S9 do not need to be plugged in, a big advantage for pumping on the go!)

• Extra pump parts and bottle lids just in case

• Snacks for you! Making milk takes a lot of work!

• Frozen water bottles. Use them as cooler packs to keep your milk cold and as they melt you will have fresh cool water to drink and stay hydrated. Win win!

• Separate cooler bag for bottles/pump parts. This is an optional tip for those who are pumping for a healthy, full-term baby who doesn’t require special sanitation protocols. You can keep your bottles and pump parts in a cooler bag or in the refrigerator between pumping sessions.

YOU GOT THIS!

We know it can feel overwhelming to figuring out this nursing/pumping/everything ELSE stuff out. Lots of parents have come before you and we are right here with you every step of the way. Lean on your postpartum doula for help with all sorts of practical advice so we can lighten your load and make this transition a little less chaotic.

---

GOT MILK?

If you are dealing with an oversupply and would like to donate milk, we are happy to help connect you to individuals and organizations in need of donor milk.

Our co-owner, Christine, is an experienced gestational carrier and milk donor and has provided thousands of ounces of milks to local families informally and to Wake-Med’s Mother’s Milk Bank.

Contact us to learn more about giving or receiving donor milk.

What You Need to Know About the CDC Placenta Encapsulation Paper

The CDC has published notes from a case study that associated an infant's late-onset bacterial infection to its mother's placenta capsules. 

 

Here are the facts:

The infant's mother was screened for group B Streptococcus agalactiae (GBS) bacteremia at 37 weeks, as is the standard protocol with most medical practices. She was not positive for GBS at that point in time. 

The infant showed signs of infection shortly after birth, tested positive for GBS, and was treated and discharged following treatment.

5 days later, the infant was admitted to a second hospital and was again positive for GBS. A second treatment protocol was followed. The mother's breastmilk was tested and no bacteria was found. Other tests were conducted and none revealed a source for the bacteria.

Seeking a source of the infection, doctors tested the placenta capsules the mother had been ingesting and the capsules tested positive for GBS.

The infant's diagnosis was "late-onset GBS disease attributable to high maternal colonization secondary to consumption of GBS-infected placental tissue." (source) 

No standards exist to regulate placenta encapsulation, and not all placenta encapsulators have adequate training or processes to avoid contamination by bacteria or another infectious disease. 

This paper is a case study of one infant, not a large study looking at placenta encapsulation in general. 

 

Here's what we know about how the mother's placenta was handled

The mother hired a placenta company to pick up her placenta from the hospital. Placenta capsules were returned to her three days later.

Because the mother's placenta left her possession, there's a lot we don't know about how it was handled, whether it was stored properly, and if there was any contamination.

Company A states the placenta [was] "cleaned, sliced, and dehydrated at 115°F–160°F then ground and placed into about 115–200 gelatin capsules, and stored at room temperature." (source)

 

Here's Our Take

PLACENTA ENCAPSULATION IS NOT WITHOUT RISK. We know this. This fact is what guides our extremely rigorous process and the safety protocols we adhere to at Doulas of Asheville. We do everything we can to mitigate every potential risk we are aware of.

We never transport client placentas. Our clients receive their own personal cooler and transport kit with clear instructions for safe storage of their placenta from its birth to getting it home. There is no doubt that your placenta was stored properly and that it is indeed yours because you have maintained possession of it and it is processed in your own home. 

Doulas of Asheville only offers the traditional method of placenta encapsulation that stems from Chinese Medicine. This means we clean and drain the placenta and then steam it for 8-12 minutes prior to dehydrating it at 165°F. We know that bacteria can grow rapidly when meat is left in the "danger zone" of 40°F and 140°F. The placenta in the Oregon case was not steamed prior to being dehydrated at temperatures too low to kill bacteria. 

The safety precautions we take in the preparation of your home, handling of your placenta, and sanitation of our equipment exceeds industry standards. We follow OSHA protocols for preventing transmission of bloodborne diseases, we use disposable/one-time-use equipment and supplies wherever possible, we sanitize all reusable equipment with a bleach bath according to bloodborne pathogens protocols.

At Doulas of Asheville, placenta services are provided by Postpartum Placenta Specialists that have been through in-person, hands-on training, extensive book study, a comprehensive certification process, and have access to ongoing mentoring by leaders in the industry.

Is Placenta Encapsulation Safe?

We can only answer that question according to our process and protocols. We stand by our process as the safest placenta encapsulation service in western North Carolina. We take every precaution to safely store and handle each placenta, we never have any client's placenta in our personal possession, we never work on more than one placenta at time, we always steam prior to dehydrating at 165°F, we advise our clients to store their capsules in the refrigerator for two weeks and then move to the freezer for longer-term storage. 

If there is an active intra- or postpartum infection in baby or mother, we do not encapsulate. We would not have encapsulated this mother's placenta. (Note: having a positive screen for GBS colonization does not mean mother or baby will have a GBS infection.)

Again, placenta encapsulation is not without risk. People who choose to ingest their placenta have decided that the potential benefits outweigh the potential risks - especially when they hire a professional placenta encapsulation service like ours that safely handles their one and only placenta. 

What should you look for in a placenta encapsulator?

We've compiled this list of questions to ask your placenta encapsulator as you decide who to entrust with this very important task. As the CDC paper points out, there are no universal regulations or oversight of placenta encapsulation at this time. There are multiple training and certifying organizations that maintain their own sets of quality standards. All Doulas of Asheville Postpartum Placenta Specialists are trained by ProDoula's Placenta Prep program and engage in ongoing professional development and mentoring. 

We recommend hiring a professional that has been through a rigorous in-person training, is certified in handling bloodborne pathogens, follows federal and state food handling guidelines, and does not ever maintain possession of other people's placentas or process more than one placenta at a time. The unfortunate and unpleasant truth is that this does happen. There are "placenta specialists" that learned how to encapsulate placentas from a blog, YouTube video, or other individual (who may or may not have had adequate training themselves). There are specialists who have possession of multiple clients' placentas in their homes or separate work spaces at the same time. There are times that specialists process placentas back-to-back. That should never happen. It does not ever happen with Doulas of Asheville's Postpartum Placenta Specialists. 

We are proud of our process and are happy to continue to offer this service to the many families who choose to have their placenta encapsulated in the Asheville area. 

If you have any questions about this case study, our process, or placenta encapsulation in general we're always here to chat.