Breast Pumps, Nipple Shields, Hooter Hiders…Oh, My!

As a childbirth educator, I frequently receive letters, pamphlets, postcards and, yes, the occasional free sample of products targeted toward the expectant and new mother.  One particularly popular category of said products includes those revolving around breastfeeding.

As breastfeeding (thankfully) continues to re-gain momentum in our culture, so do the products which are developed for and marketed to breastfeeding mothers.

But what about these products?  Which ones are necessary?  Which ones are helpful?  A luxury?  Superfluous?  Unnecessary?  Ultimately unhelpful to the breastfeeding process?

As is with life in general, the answers to the above questions represent a slippery slope–the grade of that slope largely dependent upon the dynamics going on between each mother-baby duo.

Here is a non-exhaustive list of the types of breastfeeding-related products out there:

clothing:
-nursing bras, shirts, tank tops, gowns, pajamas, etc.
over-clothing accouterments meant to cover up the nursing mom and baby:
– Hooter Hiders, Baby Bond drapes, screens, slings, wraps, cloths, blankets, etc.
sore nipple treatment products:
– ointments, creams, gel pads, nipple shields and shells
leaking breasts:
– breast pads, nipple shells/covers
breastfeeding aids:
– nipple shields, nipple shells, tube feeding systems, syringes, cups,
breast pumps:
-one- and two-flanged, manual, automatic, hospital grade, hands-free pumps…

With all this equipment out there, how does a woman choose which of these items is important to have on hand upon baby’s arrival, and which products represent little more than a marketing ploy aimed at capturing the dollars of vulnerable, new parents?  Which items ultimately have an influence on how we collectively view breastfeeding in our culture, which ones truly support the breastfeeding process, and which ones complicate it?

As documented and/or suggested in several recent studies (one being Kathleen Buckley’s A Double-Edged Sword:  Lactation Consultants’ Perceptions of the Impact of Breast Pumps on the Practice of Breastfeeding, as appeared in the Spring 2009 issue of The Journal of Perinatal Education a large percentage of American women view breast pumps as a necessary item on the to-get list prior to baby’s arrival.  The implicated assumption being: in order to achieve breastfeeding success, one must employ the use of a mechanical pump at some point, rather than encouraging the baby to perform the sole job of drawing milk from the breast on his or her own.

Of course, complicating this issue is the higher and higher percentage of women returning to work within a month or two of their baby’s births.  Whether by choice or by lack of adequate maternity leave, more women are trying to keep up with the practice of breastfeeding they so desire, all the while tending to their uncompromising duties at work (“work,” in this case, meaning financially reimbursed duties outside the home).

But here’s a seemingly little known secret:  in most cases, whether returning to work or not, long-term breastfeeding success usually depends on less accouterments than more.  And early introduction of tools like breast pumps (before, say, three weeks postpartum) and nipple shields?  They actually decrease a woman’s likelihood of achieving long term breast feeding.  (By long term, I mean, say, longer than a few months.)

Breast pumps, specifically, have some potential drawbacks:
Unless a woman has an extraordinarily abundant milk letdown reflex, it is difficult to express a whole heck of a lot of milk via a breast pump.  Believe me.  I know.  I struggled for months at trying to get a breast pump to work for me, just to build up that little reserve of breast milk in the freezer for the occasional date night out or, way back when, a shift at work that kept me away from the baby beyond nursing time.

And because breastfeeding is a supply and demand system, the more you rely on the pump to generate milk for your baby, the less milk is being drawn from the breast.  Less milk “demand” equals less milk production.  Within a relatively short period of time (the body responds to a change in the supply-demand system within 24-48 hours) the woman begins to notice a decline in her milk supply.  Add to that, the visual image of how much milk is showing up in the bottle after any one pumping session (again, much less milk will come out into the bottle via the pump than would otherwise end up in the baby’s tummy via baby-to-breast feeding) and the woman starts to doubt her ability to feed her child.

Can breast pumps save the nursing trajectory for some moms and babies?  Sure.  There are a variety of scenarios in which breast pumps can undoubtedly be useful and helpful.  But that degree of assistance only goes as far as the knowledge of how to keep a woman’s milk supply up while also relying on the breast pump (basically, by adding in some extra stimulation of the breasts–a couple extra nursing sessions with the baby, or extra pumping sessions beyond the frequency of the baby’s normal nursing pattern).

And how about other items like nipple shields, an increasingly popular tool distributed by more and more lactation consultants?

nipple_shield

Are these tools the magic bullet they are so often made out to be?  Or is this a case of mistaken identity or, worse yet, blind acceptance of half truths fed to us by medical supply company salespeople working on commission?   In many cases, are products like nipple shields a divergence away from addressing, and treating, whatever the true problem is in a challenged breastfeeding situation?  Here is an excellent article that addresses these questions.

Whether it be in the realm of pregnancy, labor and delivery or breastfeeding, I see us as a general population more and more often taking the band-aid approach versus addressing issues, problems and concerns head-on and dealing with them proactively, succinctly and efficiently.  Going back to the nipple shield example:  if a baby and mother are having difficulty with breastfeeding due to a poor latch (the most common cause of breastfeeding woes) it’s easy to hand over a nipple shield which, when used carelessly, encourages the baby to latch on to the teat of the shield only and draw milk via isolated suction rather than suction plus significant jaw and tongue motion.  (watch this video clip and this for the proper manner in which a baby ought to latch on to the breast)

While nipple shields can temporarily help women with the most severe cases of inverted nipples:

invertednipple

or flat nipples:

flatnipple

there is not a strong indication for the frequent or regular use of nipple shields in most other situations.  The risks, however, are plentiful, as described in the article referenced above.

Of less severity, are some of the other products mentioned:  special nursing clothes, drapes, etc. meant to hide mom and baby as much as possible from public view while breastfeeding.  Here, I realize, I’m opening up an enormous can of worms but…what the heck, the can is already open, right?

How many folks, when preparing to purchase one of the dozen different nursing cover-ups, stops to think about why they feel compelled to add one of these things to their collection of baby stuff?  If it’s purely a matter of mother’s modesty than, have at it.  But if it’s a concern over what other people think about the act of a woman feeding her child, well…couldn’t one argue that the mass production and marketing of breastfeeding cover-ups onl furthers our culture’s still often distorted and prudishness views regarding breastfeeding?

So, if you’ve made it to the end of this post, you’re likely looking for a conclusion (or a couple Ibuprofen, or a stiff drink, or…an enormous sock to cram in my proverbial mouth).  My conclusion would be this:  think carefully about the products you buy in regards to feeding your child.  Think even more carefully about the products you recommend to an expectant, new and/or nursing mother.  Consider who will ultimately win at the end of that purchase:  The mother?  The baby?  The company who has happily sold another well-marketed product?

10 Comments

Filed under Balancing career and motherhood, breastfeeding, Childbirth Issues, family, From One Mother to Another, General Health, Kids, Living, Mommy and Motherhood, pregnancy

10 responses to “Breast Pumps, Nipple Shields, Hooter Hiders…Oh, My!

  1. Lisa

    Great post, Kimmelin! I received a Hooter Hider as a shower gift from people at work, but I was totally uninterested in it as a product and exchanged it for a nursing bra. They come in some really cute colors/patterns that appeal to lots of women, but I have no desire to drape myself in what essentially amounts to a big apron every time I feed my child (if he ever comes out, that is…tomorrow makes week 41 of pregnancy for me). If someone’s concerned with discretion, I think the HH is the wrong way to go.

  2. After receiving your email suggesting a video on our site, I went to view your book which ultimately led me to your blog. Have you ever walked the isles of a Home Depot and seen how many hammers have been designed by various companies to hit a nail? Why shouldn’t women be offered a number of different products to help with such an important experience as breastfeeding? Every woman is different and may or may not need a product to achieve breastfeeding success. I believe women are intelligent enough to figure out what products suit their needs. My idea for a breastfeeding cover that covers mom but not her baby was born from a random idea while nursing at 2 am. Our family was not in need of money or another job for mommy (we have 4 children, I am an SLP and yoga instructor). However, I decided to pursue this venture for several reasons with a top one being a desire to help other women be successful and comfortable nursing in public. And our products do just that as described by moms in countless emails, letters, and conversations. Let these products be available, let companies continue to be creative with what they offer… women deserve options. What if the one product you find silly helps just one mom breastfeed one child? Isn’t it worth it?

  3. A great post! I am training as a Lactation Consultant right now and some of the cases we see are caused by nipple shields :-( We had a mum on friday last week who was told to use one for her inverted nipples…her nipples were not inverted at all, if anything they were a little large for her baby!!

  4. Lisa,

    First of all: YES, that baby will come out…don’t dispair…even when those remaining days/weeks feel like an eternity! :)

    As you found, not every product is right for every mom…it requires a discerning mind, as Melissa Reder points out, to choose what is right for each mom/baby/family.

    Helen, great to hear you’re underway in your LC training…and that you’re already recognizing some of the pitfalls of a tool that can, on occasion, be helpful but often complicates the picture. You’re point about the woman’s nipples being everted vs. inverted is an excellent point: in order to address an issue or problem, a correct assessment is key.

    Melissa: I don’t think I ever used the term “silly” for any of the products mentioned above. I do believe that in many/most/ of the examples I provided above, these products are initially designed/produced with great intentions in mind…as seems to be the case with your Baby Bond line of products. (Nipple shields, in fact, have been around for centuries…going back to the 1500’s when they were made of wood, metal and archaic rubber materials.) The trend of women helping women is an ancient one and always respectable.

    What I was speaking to, regarding nursing clothing/accessories, has more to do with our collective societal feelings and impressions about nursing. Think, for instance, about mothers in various countries in Africa, northern Europe and parts of South America: because the act of breastfeeding is not, and never has been taboo in many of those locales, women don’t feel compelled to cover up while nursing in part or in whole. There is no concern over receiving dirty looks or unsavory comments about when and where she feeds her child because, culturually, THAT would be unacceptable. Therefore, in cultures like that, products like those mentioned in this post are irrelevant.

    So in our country, and others with similar mindsets when it comes to breastfeeding, the short term resolution is: offer creative products like yours to provide women some feeling of modesty in what might be a less-than welcoming atmosphere when it’s time to nurse her baby: an undeniable improvement and benefit over choosing to not BF at all. Nonetheless, the larger problem still remains: the woman who would be a potential customer of yours is driven to purchase such a product due to her discomfort while nursing in public–a socioculturally-based problem.

    Hope this clarifies.

    Thanks for the comments, ladies.

  5. Heather

    Just wanted to throw my 2 cents in for the defense of breast pumps. Like you said, “There are a variety of scenarios in which breast pumps can undoubtedly be useful and helpful.” One of those scenarios is low-milk supply caused by breast surgeries (implants, reductions, reconstructions, etc). It’s common for ladies who’ve had these procedures to experience problems producing enough milk. Hospital grade breast pumps are a fabulous way for helping these women increase their milk supply. Sometimes it’s the only way when herbs and medications designed to increase supply don’t work.

    Breast pumps also allow mom to express extra milk and store it so she can spend quality time with her partner. Mom and Dad need some time alone once in a while to maintain a healthy relationship. While I don’t want to open up a can of worms on bottle feeding, pumping and the occasional bottle also allows other family members (including Dad, who might feel left out) to bond with the baby and the baby still gets the benefits of mama’s milk.

    There’s more to say, but I’ll keep it to myself. In all, I see way more benefits to pumping than drawbacks. It doesn’t matter whether it comes directly from the breast or is pumped and stored, baby still receives the best possible nutrition in mother’s milk. And that’s what’s most important.

  6. Heather,

    You definitely bring up some good points here, many of which I agree with. As I said in the post, for women who are headed back to work and desperately want to continue breastfeeding… breast pumps can be life savers! (Although, truthfully, hand expression can work just as effectively, if not more so, but not many women are taught how to do this properly).

    And for generating some milk in anticipation of dad feeding the baby or enjoying a child-free date night w/ partner? Absolutely. Couldn’t agree more. (Although, it’s still best to hold off on pumping…even for these excellent reasons…until AT LEAST three weeks after birth.)

    But for the women who assume they need to bring the breastpump with them to the hospital…for those who start pumping on day 1 after birth because “they weren’t making enough milk,” this represents nothing more than sorrowful misinformation. And while the body is undergoing the 3-4 day postparum process of converting colostrum to milk, adding the stimulation of a breast pump into the mix can, truthfully, mess things up (if nothing else, over stimulate the breasts, causing horrifically painful engorgement that takes longer to resolve than it would have w/o the pump).

    The point here: any of these breastfeeding aids–especially the technical ones like pumps, shields, tube feeders, etc.–really need to be used with thorough guidance from a well-trained resource who understands the implication on the breast milk supply and demand system that said aids can have. I know it’s hard to believe, but, when used improperly or without great awareness, breast pumps CAN and DO decrease a woman’s milk supply in many cases.

    Thanks for your input…

  7. trusted breast pumps

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  8. Great eyeopener for us moms that there are cases like this. I’m using a breast pump for my daughter to give her the nourishment that she needs everyday. It is now know that breast pumps are necessity and not for luxury use.

    It has been great to know regarding this post and I could share this to my friends.

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