Katie James (00:00)
you have a topic that I have no idea what we're discussing.
Johanna (00:01)
yes.
That is correct. And we have things that we were going to be talking about and this one is a total surprise. It wasn't on our list. So I'm just throwing it at you and we're going to talk about it in exactly the same way we usually do when we have a cuppa and we just, you know, shoot the, am I allowed to say shoot the shit? Yes, I am. My bad.
Katie James (00:28)
Well, you have now, so that means I'm ticking the explicit box.
Johanna (00:33)
You know, I'm Australian. It's very difficult to turn it off. All right. So what we're going to be talking about today is these silicone milk catcher thingies, right? You know those things.
Katie James (00:36)
I'm a Londoner mate, come on. The blue words come out all the time.
Yep, I do. ⁓ okay. Brilliant. Bring it on.
Johanna (00:54)
Yeah. So
right. ⁓ We are going to be talking about pros and cons. ⁓ Maybe like some stories. I mean, I've got a few, I'm presuming you've got a few, some stories for where we've seen people use them in ways that have not been beneficial and then in ways that have been beneficial. And I think also probably
To start with, we should explain what these are because at the moment I see you and you see me and I'm holding up this squidgy silicone thing, but most people are gonna just be listening and maybe not know what I'm talking about. So can you please describe for me what this thing is?
Katie James (01:37)
really hard without name dropping because there was one company, great, I mean hopefully people are watching us on YouTube now because if after the first episode they haven't moved on to YouTube because of all the props and stuff, I think they need to. You should definitely see Jo, she's got it on her face. It's almost like she's going to suffocate herself, like she's got an oxygen mask going on, but she's actually going to run out pretty soon. So one company devised these and now...
Johanna (01:39)
I know. I'm going to attach it to my chin.
Mm-hmm.
Thank you.
Katie James (02:07)
Every other company who make breast pumps, shall we say, more or less have copied this. It's made from silicon and it's often called a silicon pump.
Johanna (02:10)
Yes.
passive pump I've heard it called.
Katie James (02:21)
But basically it exerts some kind of vacuum. So you would squeeze this silicon catcher and so you would flap back. God, Jo's trying to do it I'm trying to explain. So you'd flap it back, squeeze it to create...
Johanna (02:39)
I'm not doing it on my boob,
by the way, for the people that are listening, I'm doing it on my cheek. Just, you know. Okay. Continue. Sorry.
Katie James (02:47)
Flap it back, a like with a sort of a nipple shield. You're going to try and you're going to squeeze the actual bottle container part and attach it to the breast. And what this does is it then will adhere to the nipple areola and it will create a small amount of vacuum. And I've heard, if I remember, you're going to get like a hickey. This is like cupping. It's like acupuncture. We could just get a few of those and stick them all over our backs.
Johanna (03:04)
Just like this on my cheek.
It is like nothing. It is.
Katie James (03:16)
I'm amazing today. I've had a breast pump all over me back. A passive one. However, I've heard that they exert 30 milligrams of mercury. It's minus 30 as well. Like this is where I get really bad with my vacuums and things. So there is a vacuum applied. It is much less than a breast pump. a breast pump. Ooh, gosh, my brain is now like, what's breast pump?
Johanna (03:19)
Exactly. A passive one.
I love that you're numbers.
Katie James (03:45)
Milligrams of mercury
is like 150 to 250, sometimes 300, some of the pumps go up to. So it's a massive difference. However, it's not without any vacuum. How they've been advertised is like a milk catcher. So if you're someone, often the advertising is if you're someone who you're feeding your baby say, on the right-hand side and whilst you're feeding your milk would leak out of the left, then why not collect it and
Johanna (03:51)
Yeah.
Katie James (04:15)
However, in the past, 80s, 90s, 2000s, there were milk catchers. They were made from hard food grade plastic. You would clean them, you put them in your bra and it would not do anything other than kind of just sit there with the help of your bra under your breast and it would collect anything that came out, whether that was five mls, 10 mls, 15. Unlikely to be getting big volumes. Whereas with this,
Johanna (04:16)
Mm-hmm.
Katie James (04:42)
It is putting a certain amount of vacuum on and what we're finding is a lot of women are then getting maybe 30 mls. Some women are getting much greater volumes and they're probably getting bigger volumes than they would have if they just let their breast leak naturally. So there's my waffle.
Johanna (05:01)
For sure.
There's your waffle. Yes, absolutely. People are getting bigger volumes, 100%. ⁓ Now, that was an excellent summary, by the way. Congratulations. ⁓ What I'm curious about is, like you mentioned that the way that they are kind of advertised as meant to be used on one side while you're feeding from the other. ⁓
What I'm interested in from your perspective is where have you seen this use in the way that they want you to use it? Where have you seen that actually cause problems
Katie James (05:46)
Ooh, I've seen it a lot, caused problems for a lot of women. I think, I mean, and you know, I'm a proponent of this. talk a lot about making sure we get off to the right start, making sure that we're making enough milk because, you know, one of the main reasons that women stop breastfeeding is because they're not making enough milk by four weeks alongside double gold position, sore nipples. This is one of the biggest reasons women stop breastfeeding before they want to. So it's a huge problem that
Too many women are not making enough milk because they don't get the right support at the right time. And that's a big proponent of what I talk about because there's a major problem. However, there is a bell curve with everyone in life. And we know that there is some women who are towards the end of the scale who are going to make, regardless of what we do, their genetic makeup, their breast tissue is going to be someone who makes
probably more than they need, maybe enough for twins until their body gets the kind of signals to go, ⁓ we don't have twins. ⁓ you've got, you're just so full all the time. And then we get this feedback inhibitor of prolactin or fill. Phil goes around and goes, wait, stop making too much milk, Chill out, relax. We've only got one Bambino here. Just a little bit more is fine, but that takes...
Johanna (06:50)
Mm-hmm.
Chill out, bro.
Katie James (07:11)
a while for that to settle down. And if we get a woman who, you know, quite cleverly thinks, well, I've got all this milk, it's going to waste, I might as well catch it and save it in my freezer. I could keep it for six months. Who wouldn't think what a bloody good idea. What a great invention. I'm going to stick that on. Also, gosh, I can squeeze it and it sticks to my boob and I can just walk around. I don't need a bra.
Johanna (07:12)
Mm-hmm.
Mm-hmm.
Katie James (07:38)
It just hangs out with me while I'm feeding. However, you start doing this and we give that little bit extra vacuum and you are taking out say 40, 50 mls extra than you would have. Say your breast would have leaked 10 mls and you take 40 mls.
Johanna (07:52)
Mm-hmm.
And
little interjection, this is often people who are before that point, they are only feeding on one side as well. Right.
Katie James (08:05)
Yes, good point because they've got, you know, a good capacity in each breast. So they might have say, let's just do nice round numbers, a hundred mls in each breast. That baby drinks 95 mls at a feed. It's a lucky baby. And they don't need to go to the other breast. So that other breast would have eventually settled itself down because it wouldn't have had the signal from the baby at each feed to keep making more milk. And what happens?
Johanna (08:21)
It's mainly a black thing
And we have to leave
milk in the breast for that to start to happen. And if milk is moving, if a little bit even, if being pulled out, then that feedback inhibitor is not going to start to kick in.
Katie James (08:48)
And so then we end up with oversupply big time for some potentially for some women. And what does oversupply lead to Joh
Johanna (08:51)
Mm-hmm.
⁓ Katie, oversupply. ⁓ oversupply leads to, ⁓ well, firstly, it means in my practice, I see women coming to me because they've got babies that are really, really uncomfortable for every feed. They never get that cozy, nurturing feed experience. It's all just about like attempting to coordinate the swallowing and the breathing. And that all gets really difficult. So you've got coughing and choking and.
And just really stressed out babies that are taking in so much gas and end up with a lot of cramping and unhappy babies. ⁓ Also from the mums, we end up with scenarios where you've got inflammation and clogged ducts and potential mastitis and then potential abscess and all of that kind of business too. So we end up in a scenario where the mums and the babies for different reasons are both really having a rough time.
time.
Katie James (09:58)
Absolutely. And I think it's really important to mention the babies because often we focus on oversupply that's just more of a, a marker for risk factor for inflammation and inflammatory spectrum issues. So things like mastitis blockages, but you're right. It's the babies. And also then in terms of the psychological wellbeing of mom.
Johanna (10:11)
Mm-hmm. Mm-hmm. Mm-hmm.
Katie James (10:21)
And how they are bonding and connecting with that baby who feels like they come under the guise of a in quotes, fussy baby, a high needs baby, a baby who won't settle this baby who's probably pooping a ton more than others. So in terms of having that time to settle after a feed, you've got babies who are more upset, more irritable. They're pooping more. They're probably gassy.
Johanna (10:29)
Mm-hmm.
Katie James (10:48)
And there isn't as much downtime. So this is then becomes this vicious cycle. and I find that often oversupply can even be masked as I don't have enough milk because they have a baby who is probably getting full up on a lot of, Ooh, here we go. Four hind milk or high lactose milk or low fat milk, high sugar milk. Exactly. think that's another podcast because we I'm still hearing this debate of should we
Johanna (11:07)
Mm-hmm.
That's right. say high sugar. They take, you know, low sugar.
A hundred
Katie James (11:18)
allowed, allowed to say four and high milk. What's
Johanna (11:18)
percent.
Katie James (11:22)
the difference between them? Is the difference? That's another podcast. Thank you. Yeah, I think that actually is a good 10 minutes of discussion. High lactose or high sugar. And you can, what was my whole point? I don't even know. You've got irritable babies.
Johanna (11:24)
I'll put that in the list. We'll come there later. It is. is. is.
that gets digested
very quickly. They get hungry again very quickly. So you've got these babies that are feeding really frequently, but also don't seem to be super satisfied and are also really fussy at the breast. And all of these things can also be a sign of people that are struggling to get enough milk. So actually a lot of the signs, weirdly, if you're not quite sure what you're looking for, the signs from the baby's behavior are actually quite similar a lot of the time.
So that's where you were going with that, right? So I knew, I knew.
Katie James (12:10)
totally where I was going, it's
because we see it and we get referrals all the time, or we get a self-referral from a mum who will say, I don't think my baby's getting enough. However, the scales, and the scales might not always show the difference actually, the scales might show static weight gain. So you've got scales that might show static weight gain, slow weight gain.
⁓ you've got a baby who's feeding really frequently and on paper, just those few points would make you think, not enough milk, but actually you can have this mom who's got a copious milk flow, but this baby who's unsettled. ⁓ and because they're having this high sugar milk, there's not as much fatty, creamy stuff. They're not gaining weight as well. And also if you think about the amount of movement and activity going on and amount of rest.
Johanna (12:57)
of them. ⁓
Katie James (13:05)
You know, we need to rest and digest as well, both mom and baby. That would also impact in terms of how we, how we metabolize what we're eating, how we cope with it, how we gain weight as a small part. But I think it's a really important thing to ⁓ discuss those similarities.
Johanna (13:28)
Yeah. Yeah. And I think as well, I mean, one of the things that I've seen cause an issue is that these, these mums really struggle with the fact that now their breast is really only being used as a food source and that's it. And they've heard so much about how breastfeeding is much more than just about the milk and that it should be able to help calm a baby down that the baby can.
you all of the things, right? Like temperature regulate that their heartbeat and their breath and everything can just kind of settle and they can go to sleep if they are struggling with that. All of these kinds of things, it helps them do a poo. And then suddenly now they're in a scenario where every time their baby gets close to their nipple, they're already pouring milk out. And I know that we have scenarios, you know, the ideal situation where you've got ⁓ a very,
a woman with a milk supply that is very much in line with what her baby needs. The ideal scenario is that you've got like one breast maybe that is ⁓ fuller and is ready to pour milk out and the other one that's a little bit more empty. And if you've got the baby that is really, really sleepy and fussy and maybe you offer the high, the breast that's got a lot of milk, but the baby didn't want that. And they come off and they go to the emptier side so that they can just chill out.
have a couple of swallows maybe and just go to sleep. And the people that have got the oversupply, they don't have that as an option. It's like every time I offer my breast to the baby, the baby struggles and the mums really, really struggle with not being able to have that aspect of the mothering that they really, really crave as well.
Katie James (15:18)
Absolutely. And that's, that's a huge component in terms of, you enjoying the feeding? It's not just necessarily about pain. It's about how we react with our babies because you know, we don't even need to say it, but, yet we do. Breastfeeding is way more than food. A food source can come from elsewhere, but the connection.
the signal, the communication that happens between mom and baby is what actually happens first and what is vital for our kind of survival. If we look at all mammals, that's what it is. Communication, bonding, settling, reading is our baby healthy. and food is kind of secondary almost to that because of the immunization and everything else. And when it is just purely this food source that is being
flown at them and you've got a baby who's very unsettled, it makes the whole experience really challenging. And I also think it can be quite challenging the reaction from outside because we know that with the medicalization of birth, we know that with the poor care and education that we are being able to give in terms of time, training of our staff, et cetera, et cetera.
We know that low milk supply is a predominantly high problem. And so most mums in mothers' groups have either struggled with low supply. They're not able to breastfeed. They're mixed feeding, or they struggled and got through it. And the very small component is going to be this mom who's got more milk than she can cope with. And that can be quite alienating in itself.
Johanna (17:03)
Yeah, absolutely. There's a woman that I'm helping at the moment who a hundred percent is in this situation and she is really, like really, really having a rough time. she is, I think about 10, 11 weeks postpartum now. She still has never fed her baby out of the house because of her extreme oversupply that her baby every time is coming on and is then just being covered in milk and her baby is so distressed.
and the other side is just flowing out and she just can't control it. But when I'm working with her, she's in a lot of stress about it. But so much of that also is the shame of the fact that she thinks that this is a bad thing that she wants to fix, that she should be feeling eternally grateful for being in that situation as well. So.
You know, Katie, like my history is of low supply and it took me a long time to be able to work with women with an oversupply to be able to see that it was a really significant issue. And that has been a whole journey of humility for me to see that actually, yeah, these women and these babies are also really having a rough time. So.
So yeah, I mean, I see it, we both work with it and we see the stigma that comes with that situation as well, for sure. Yeah.
Katie James (18:34)
And I think that that's why this is so important in terms of this has started from the silicon, silicon pump, but it is for me, oversupply can happen without the silicon pump making it worse or causing it. That can be a very small percentage of women who have that anyway. And there are tips and techniques and tricks that we can learn and we can support these women with sometimes harder than others.
Johanna (18:40)
This started from this thing. Yeah.
Katie James (19:01)
But again, never ever separating that psychological component and just having that kind of zoomed out viewpoint of, yeah, actually this is a really tough kind of environment to navigate because most other moms out there have struggled with the opposite. And that's a really lonely place to be for some women. And I think it's really good that we talk about that here.
Johanna (19:23)
Mm-hmm, agreed.
Katie James (19:26)
Okay, so points on the silicon pumps in quotes, ⁓ milk collectors. Let's clarify what a milk collector should be and how they should be used and what one of those should be useful and who should not be using it.
Johanna (19:43)
Good, good. So these are, I do think that these tools, I mean, we've only talked about the problem that they cause, right? They are also occasionally useful. And I do think it's not the kind of thing that I would say, like the moment that your best friend gets pregnant and that you go and buy one for them, right? And I think that that was happening for a while.
Katie James (19:54)
Very.
Please don't put these... actually
don't put pumps! Just don't put a bloody pump on a baby shower list. Or buy one. Don't.
Johanna (20:12)
No, exactly. The
points where I do see it being useful is when people are at a point where they can see that ⁓ they have managed to get into a rhythm, which usually happens like after I say like six and a half, seven weeks, heading towards about 10 weeks, we start to see this predictability of
of a rhythm, whether or not people are trying to make that happen, they can try or they like, it's not going to work until that point. ⁓ If they do nothing, that is going to start to happen anyway. And what I start to see is that we have points where people can predict that these maybe early morning feeds are going to be one side only. And then maybe the first feed of the day, maybe all of the feeds up to lunchtime, the baby is happy with like just
one side and then the other side is full waiting for the next feed. And then maybe after lunch, they are back to doing when the supply starts to go down as it does for everybody, as the day goes on, they're starting to do two sides. I'm so interested into your reaction when I talk about this, because we haven't had this discussion, but I'm just going to keep talking. So after lunch, they're going to start to do both sides per feed because supply has gone down.
And what I say is that these people potentially are in a scenario where they think, Hmm, I am leaking a little bit and it's not very dramatic though. And I really would like to go to yoga on Thursday evenings, or I am thinking that I am going to have to go back to work in a chunk of time. ⁓ So actually if I ended up with like just a really low grade.
oversupply, maybe just a little bit more than what I wanted. And I'm past six weeks. So things are a lot more stable than that would not be the worst thing in the world. So now we have a scenario where maybe one feed per day, maybe that really early morning feed, maybe the one at breakfast time. They're using one of these, they're pulling out 30, 40, maybe mil, putting it in the fridge next day, doing the same thing, adding it on top.
until they get to 150, 120, put it in the freezer, use it whenever they want to. And that's it. In that kind of scenario to me, like super handy tool to end up with a little bit of a stash as your kind of insurance backup makes you feel that you have some options. What do you think about that, Katie?
Katie James (22:59)
pretty much agree. I, I, what I also like is I completely, I completely agree with how you would use it. That's how I would use it as well. It's about that little bit extra and see what you get and also being mindful that for some women they'll use it and get drops because it's not enough vacuum. But what I do like is that it's quite, uninvasive. So as a pumping
Johanna (23:16)
100%, we didn't say that. Thank you for singing. Yes.
Katie James (23:27)
kind of regime of getting your head around, I'm going back to work or, then all the paraphernalia, that can be quite a nice option, particularly in terms of, if we think about how milk flows, oxytocin, sometimes when you go from lovely, warm baby, gorgeousness and oxytocin flowing and love and cuddles to putting a whole pump machine on, that should have been our theme tune.
Johanna (23:49)
Well...
Katie James (23:56)
⁓ Welcome to the Latch Revolution! ⁓ Guess what this is?
Johanna (24:00)
Can we change so that
I'll have one of these on my face?
Katie James (24:07)
That's just the babies when they're not feeling well.
Johanna (24:08)
I want
the sound effect of it. Hold on. no, it didn't work anyway.
Katie James (24:13)
I think we got that,
that release. It's like when the nipple shield comes off. ⁓ So I think that's, that's a good, it could be a good use. can be a good introduction, almost like a going from feeding to slight pumping to then pumping, because I think how we react with oxytocin can go both ways. So I've seen, and you probably have, and you've heard about it, is women who have had to
pump for a baby who's in the NICU for a long period of time. And actually they start having a letdown when they hear the noise from other women's pumps, not other women's babies, ⁓ because they've got so used to it. Also, there's the opposite of women who've had to pump a long time and that noise almost sends goosebumps of dread through them. And so these can be quite a nice introduction, particularly if there is a mom.
Johanna (24:50)
Yeah? Mm-hmm.
Katie James (25:08)
who maybe had to use it with a first baby and it's like, I just do not want a pump anywhere near me. Like don't put it, I can't bear it. This feels like a much softer alternative. You can almost forget about it.
Johanna (25:20)
Mm-hmm. Mm-hmm. And there are also, there are also these like smaller ones as well. Like this is the one that you like sticks out, right? And you can get these smaller ones that actually fit inside your bra as well. That usually I'm playing with when we're chatting, but I was playing with while I was getting, getting set up and then I lost it somewhere around the house. So I don't have it to show you at the moment.
Katie James (25:22)
So I like them with that.
I
reckon your dog's got that.
Johanna (25:47)
Not at the moment. Much smaller, much, much smaller. Yeah. So for me, it's like, again, it's kind of, you know, we've got grades, right? And so I think like, if this for some people is still too much, but they want to have like a gain a little bit of an in-between or if this was working great, and now their baby is bigger.
Katie James (25:48)
Yeah, but what's the vacuum on those little ones? Yeah.
Johanna (26:10)
And is really interested in it and is pulling it off and kicking it and stuff like that. Then also we have this other smaller option that's available as well that I think is a handier option than this one. Yep.
Katie James (26:14)
yeah.
So have we covered? We've talked about the dangers. We've talked about, so as a general blanket rule with these, would you be saying, would you be saying, and I'm just going to see just to check that we got this message, take it home, wait until about six weeks to know what's happening with your supply.
Johanna (26:26)
Do you think we've talked about these things enough?
Mmm.
Didn't we?
That's an excellent take home message. Let's go with that.
I like when you were like...
Katie James (26:55)
Basically
don't mess with your supply before around six weeks. Just see what happens if you don't need to interfere.
Johanna (26:59)
Leave it. Yes. ⁓
I think that...
The reason I was laughing was you were like, so what is our blanket take home advice? And I thought our entire first episode was about the fact that there is no blanket advice. Everything is nuance, you know? ⁓ but yeah, I think. Unless you have got a scenario that it would make sense for you to be using it, which is going to be outside of the norm. And there are people of course that are definitely outside of the norm.
If you want to use it for whatever reason, and you know what the risk factors are, then you go for it. And then you're to have to deal with whatever comes along the way. Right. ⁓ but I would say, yes, my dream scenario is that people would wait until after six and a half to seven weeks, because six weeks is the big, big, big growth spurt where babies start to get really tricky for a couple of days.
And I don't want people to start to use something else at that time. And then they start to think, it's because I have changed everything that I'm doing with my feeding and my milk supply must be all over the place. So I want that to be over. And then you can start to play around a little bit.
Katie James (28:18)
⁓
So we'll say seven weeks. And I want to put in that if you need, and you're on the opposite end of the scale and you need to be boosting your milk supply, hell no, don't start with one of these. No way. Not the other end of the pump scale. Double pump, hospital grade, correct flange size. Like that's a whole thing in itself, but do not think that
Johanna (28:26)
Let's go seven.
⁓ This is not gonna do it.
Yeah.
That's the thing.
This is not a pump.
Katie James (28:53)
30 milligrams.
Johanna (28:53)
This is not a pump.
Katie James (28:56)
Do not think that 30 milligrams of mercury. Basically, let's just go minus 30 vacuum compared to 250 is going to be enough. It ain't. Do not waste your time because making enough milk is time sensitive. So yes, both end of the scales.
Johanna (29:02)
things.
Mm-mm.
Excellent.
Excellent take home message. Well done. You're welcome. I think we're done too.
Katie James (29:19)
Thanks. Great. I think we're done here. That's a wrap. I will see you next week with
lots of red marks on one cheek. I cannot wait.
