Protecting Parents from Pump Harm: Evidence-Based Guidance for IBCLCs. A discussion with Alisa Williams.

Episode Summary:In this episode of Behind the Latch, Margaret Salty interviews Alisa Williams, RN, IBCLC, about her groundbreaking paper, Are You Knowledgeable About Breast Pump Safety and Assessment? Knowledge and Skills for Clinical Practice, published in Clinical Lactation (2024). They explore the overlooked risks of pump misuse, why lactation professionals must become more informed, and how to better support families through safe and effective pumping education.Williams, A. (2024). Are you knowledgeable about breast pump safety and assessment? Knowledge and skills for clinical practice. Clinical Lactation, 15(2), 77–90. Alisa’s Journey into Lactation ConsultingAlisa shares the story of how she left hospital nursing to start her private practice, Momentum Lactation, after witnessing the lack of follow-up care for families postpartum. She now runs a thriving lactation clinic in Southern Illinois serving over 400 families a year.Key insights include:The emotional toll of watching families leave the hospital without adequate lactation supportBuilding a private practice from scratch to fill a critical care gapThe growing need for outpatient lactation support in communities with high birth volume and limited accessWhy She Wrote the Paper on Pump SafetyAlisa explains the urgent need to better understand how pumps function and how misuse can cause harm.Discussion highlights:The explosion of exclusive pumping during the COVID-19 pandemicA lack of formal training around pumps for lactation professionals and studentsReal-world observations of pump-related injuries and milk supply issuesThe absence of safety standards or meaningful FDA regulation of pumpsCommon Problems Caused by Breast PumpsAlisa outlines the clinical signs of pump-related harm:Nipple trauma and painEngorgement and localized inflammationDesensitization and nerve damage affecting oxytocin releaseReduced milk output and mental health impactsThe economic burden of buying multiple ineffective pumpsAssessing and Educating About Pump UseAlisa walks through her protocol for evaluating pumps and educating parents:Conducting visual and tactile nipple assessmentsObserving the flange fit and suction cycle using traditional pumpsIdentifying signs of poor fit, pressure intolerance, or ineffective drainageEducating parents on safe suction levels and cycling patternsUsing pump pressure gauges to test actual PSI and document findingsWhy Flange Fitting and Pump Settings MatterAlisa discusses how she determines the correct flange size and pressure setting:Using a nipple measurement tool and allowing 2–3mm for expansionWatching how the nipple behaves during pumping in both modesMeasuring pain, output, and visual signs like blanching or traumaTeaching families to aim for the lowest effective pressureEducating the Next Generation of IBCLCsAlisa shares how her detailed pump safety tool and hands-on process can be used in lactation education. Margaret discusses plans to integrate it into her Pathway 2 program.Key recommendations:Train students to assess pumps just like a latchStandardize protocols using structured toolsTeach observational skills to identify subtle signs of dysfunctionNormalize using equipment like pressure gauges during clinical careEthical Considerations in Recommending PumpsMargaret and Alisa discuss the ethics of recommending specific...

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