Glossary
A
Abscess
Thankfully it’s rare, but an abscess can present as a small pus-filled lump that doesn’t move when you massage it. It can be really sore, hot and painful, and it can come with the flu-like symptoms of mastitis. If you have one of these, see your doctor. They may do an ultrasound or put a needle in to check what’s in there or try to remove it. Don’t stop nursing or pumping, as you need to keep removing milk from your breast. If it’s too painful to pump or nurse as usual, then try a lower setting on your pump or expressing just with your hands.
Alveoli
These are the little glands in your breast that create breast milk. They are hollow on the inside and have milk-making cells on the outside. They group together in little grape-like clusters called lobules. There are about 15-20 spaced out (not evenly necessarily) around your breast. Your milk gets stored in the hollow space within your alveoli and then they travel down towards your nipple along tubes, or milk ducts.
Areola
The areola is the darkened area around your nipple. During pregnancy your areola and nipple can become darker and larger. The little bumps around your areola are called Montgomery Glands, which also can become more visible as your body prepares for lactation.
B
Bleb
a.k.a milk blister. A bleb is a little, hard, white clump of solid milk, stuck over or near your nipple pore. Usually you can loosen it by soaking your breast in warm water or gently hand expressing some milk out. But sometimes skin can grow over the bleb, which means you might need to see your doctor to remove it. A bleb can be super painful and the pain can feel like it’s really sharp and running through your breast. If you keep getting blebs, it’s worth going to see a lactation consultant who can help you figure out what might be causing it. Common culprits are tight bras, pumping or nursing only in one spot, and wrong-flange sizes or pump setup.
→ How to: Find an IBCLC
Blocked duct
Blocked ducts can occur if you’re not able to effectively remove milk from your breast from expressing or nursing. You can get inflammation which can feel like a lump, and it can block milk flow along your duct. If you keep nursing or pumping as usual, and use ice or anti-inflammatories, you may be able to resolve it. If your lump doesn’t resolve, or starts to get painful or hot or red, or you start to have flu-like symptoms, then see your lactation care provider or doctor. If you keep getting blocked ducts, it’s worth going to see a lactation consultant who can help you figure out what might be causing it. Common culprits are tight bras, pumping or nursing only in one spot, and wrong-flange sizes or pump setup.
→ How to: Find an IBCLC
Breast compressions
Also known as compressions. You can use breast compressions as a way to increase milk flow when you nurse or pump. Shape your hand like a C and gently press back into your breast rhythmically with pumping or nursing. When we say gentle, we mean it. Harder compressions do not equal more milk and you don’t want to bruise or damage your breast.
Breast shell (or collector)
A breast shell or milk collector is a small, curved cup that is worn inside a bra to help collect milk from letdown.
They can be worn during a pumping session on the opposite breast (if you're single pumping), or under your bra instead of absorbent breast pads.
Breastshield
Also known as the breast pump flange, this is the cone that you put your breast into on your pump. It can be hard plastic or hardish but thinner silicone. It has a hole at the end for your nipple to pass through and for milk to flow through into the pump bottle. Most pumps come with a standard size (around 23 to 24mm), which may not be the right size for you. We made Milkdrop cushions to attach to your breastshield or flange to make it more comfy on your nipple and areola.
→ Read: Flange Size 101
C
CDC / Center for Disease Control and Prevention
The CDC is housed in the United States Department of Health and Human Services. It became a household name during the pandemic, but COVID-19 advice is not anywhere near all that they do. They are a great source of truth and evidence-based guidelines for practical questions you might have like how to clean your pump, how to store your milk or how to travel while breastfeeding.
Closed system / loop pump
A “closed system” pump means that the pump is designed so that your milk flows straight from your breast, through your flange to your bottle. In a closed system, your milk is prevented from coming into contact with the air-filled tubes that run from the pump/battery pack to the parts that touch your breast. It’s the opposite of an open-system pump. Hospitals like to use closed system pumps because it means that they can just provide you with parts for your breast, but not have to clean and sterilize the tubes that connect to the pump because they haven’t been contaminated. If your pump isn’t closed system, you need to take a bit more care cleaning the tubing.
Colostrum
The thick, sticky, clear to yellow, “first” milk that your body starts to make in the last couple of months of pregnancy. You tend not to make high volumes of colostrum, but you don’t need to – it is full of protein, vitamin A and immunoglobulins which protect your baby from disease and help them grow in the early first few days after birth.
→ How to: Collect colostrum
Compressions
Also known as breast compressions. You can use breast compressions as a way to increase milk flow when you nurse or pump. Shape your hand like a C and gently press back into your breast rhythmically with pumping or nursing. When we say gentle, we mean it. Harder compressions do not equal more milk and you don’t want to bruise or damage your breast.
D
DMER / Dysphoric Milk Ejection Reflex
Almost 10% of us experience a rush of anxiety, agitation, or even pain with their letdown. It typically lasts a few minutes, but is a good idea to speak with an IBCLC for help.
→ How to: Find an IBCLC
Not sure what a 'letdown' is? Scroll down 😊
Double electric
A double electric pump just means that you have two sets of flanges and bottles, and that the whole pump is operated with a button (electric pump), rather than your hands (manual pump). Double pumping can save you time because you’re pumping both breasts at once, and there is some evidence that double pumping can increase your milk flow. Just keep experimenting to see what works for you.
Dyad
You might hear your health provider talk about you as a “dyad”. This is just a word to describe you and your baby as one unit together.
E
Engorgement
If you aren’t able to “remove” milk from your breast often or effectively enough then your breast can become swollen to the point that your milk flow is blocked. Your breast can be hot, your skin tight or even shiny and it can be very painful.
It can happen in the first few days and weeks after birth as you learn to nurse or pump effectively and is beyond the typical swelling you have around Day 2 to 4 after birth and typical “fullness” you feel when you need to pump or nurse.
If you have engorged breasts, keep trying to nurse and pump as normal. For the pain and swelling, you can try a shower or a bath, or soaking breasts in a pan of lukewarm water (yes it sounds strange, but it can work) to allow a little bit of excess milk to flow out. If you start to have flu-like symptoms and redness, see your health provider.
→ How to: Find an IBCLC
What about cabbage leaves, cold gel packs, herbal compresses or massage Unfortunately reviews of studies on engorgement treatment have found that although some of these treatments could be promising, there’s not enough evidence to draw any conclusions about their effects.
EBF / Exclusively breastfed
This is a term used to describe a baby who is receiving only breast milk as their food. It historically was more of a clinical or policy term, defined by The World Health Organization, but unfortunately the word ‘exclusive’ ended up being used more widely, and can make you feel really down or judged if you’re trying to feed your baby only breast milk but struggling. Don’t let it get to you, you’re doing just fine.
EE / Exclusive Expressing
This is a term you might see in the forums. This is when you are feeding only breast milk to your baby via breast pumping. You may do this if you’re unable to feed directly at the breast or would prefer not to. The “exclusive” part of the term can leave you feeling a bit judged if you are pumping and also feeding a bit at the breast or supplementing with formula. Try not to let the definition get you down, the community of EPers tend to be quite welcoming and will want to support you.
EP / Exclusive Pumping
This is a term you might see in the forums, and is essentially the same as EE above! This is when you are feeding only breast milk to your baby via breast pumping. You may do this if you’re unable to feed directly at the breast or would prefer not to. The “exclusive” part of the term can leave you feeling a bit judged if you are pumping and also feeding a bit at the breast or supplementing with formula. Try not to let the definition get you down, the community of EPers tend to be quite welcoming and will want to support you.
Expression phase (or mode)
This is a mode on most pumps that is designed to mimic the pattern of sucking that a baby tends to transition to once they’ve latched and stimulated your nipple, and have slowed down to suck and swallow milk. It’s a slower phase than the stimulation phase, and you may find that at this point you might increase the suction a little to make it stronger (only if comfortable). As usual, the key to pumping is trial and error, to find out what works for you.
F
FTT / Failure to Thrive
Ooof. This is a hard one to hear. It’s a clinical term that describes a baby whose growth is lower than medical professionals advise and needs some medical attention. It’s not meant to be a judgment on your ability to look after your baby, but if your baby has been described by this term it can feel like a kick in the guts. Thankfully, it just means that you’re going to get some extra help to feed your baby.
→ How to: Find an IBCLC
Flange
Also known as the breastshield, this is the cone that you put your breast into on your pump. It can be hard plastic or hardish but thinner silicone. It has a hole at the end for your nipple to pass through and for milk to flow through into the pump bottle. Most pumps come with a standard size (around 23 to 24mm), which may not be the right size for you. We made Milkdrop cushions to attach to your breastshield or flange to make it more comfy on your nipple and areola.
→ How to: Find your flange Size 101
Foremilk
This is the milk that you express at the beginning of your feed. There’s an idea out there that suggests that your foremilk is watery and your hindmilk is creamy, and therefore your hindmilk is better for your baby.
Like with most things in the human body, it’s probably not that simple. This idea came from a study in the 1960s, when they looked at fat content from one woman expressed with a breast pump. She had higher fat content in the second half of her pump, than in the first half of her pump. This may have been true from her, but this idea doesn’t translate to every person every time.
More recent research is suggesting that fat content is correlated more with how quickly your baby or your pump can remove milk from your breast. Watch this space for more research.
G
Galactagogue
This term sounds like it’s medical or scientific, but it’s not. It’s just a word that refers to medications, herbs, foods or drinks that are believed to increase milk production. It doesn’t mean that they do increase milk production.
→ How to: Pump more milk
Some people swear by them, and they're worth a try (if they don't have other risk factors for you) but unfortunately a couple of systematic reviews of galactagogue studies found that there simply aren’t enough studies, or the studies that do exist are limited by small sample sizes, poor eligibility criteria and randomisation and can’t be validated.
As a result the Academy of Breastfeeding Medicine has published a protocol saying that they cannot recommend any specific galactagogue. In addition to this, there are galactagogues that can do harm, so you should speak with your doctor about whether you should take them or not.
→ How to: Pump more milk
H
Hindmilk
This is the milk that you express at the end of your feed. There’s an idea out there that suggests that your foremilk is watery and your hindmilk is creamy, and therefore your hindmilk is better for your baby. Like with most things in the human body, it’s probably not that simple. This idea came from a study in the 1960s, when they looked at fat content from one woman expressed with a breast pump. She had higher fat content in the second half of her pump, than in the first half of her pump. This may have been true from her, but this idea doesn’t translate to every person every time. More recent research is suggesting that fat content is correlated more with how quickly your baby or your pump can remove milk from your breast. Watch this space for more research.
Hospital grade
This is a term used to describe pumps that are suitable for hospital settings. What does that mean? They tend to be closed-system so that multiple people can use them, and they tend to have a higher suction level (mmHg) so that you can double-pump. Some hospital grade pumps are only available to hospitals to buy, or for you to rent.
Hospital strength
This is a term used to describe pumps that have a high level of suction. There’s no particular standard for “hospital strength”, but they tend to have bigger, stronger and more durable motors that could be used by lots of people over years in the hospital. If you use a hospital strength pump, you would expect to be able to double-pump and feel like there was enough suction to do the job.
L
LC / Lactation Consultant
An LC is someone who is trained to help you with feeding your baby. This can include anything from latching to helping with your milk supply or pain nursing or pumping and more.
An LC can be anyone who is helping you with lactation, but the highest trained LCs are International Board Certified Lactation Consultants (IBCLCs) who have a health background before taking extra training in lactation and being assessed by the International Board of Lactation Consultant Examiners.
There are other qualifications too which include Certified Lactation Counsellor (CLC) and Certified Lactation Educator (CLE). They have training and must pass an exam, but don’t require a health background. Some LCs are more familiar with pumps and pumping than others, so be sure to check.
→ How to: Find an IBCLC
Lactogenesis
This refers to the stages that your body goes through to start to produce milk. The word comes from Lacto, meaning milk, and Genesis, meaning creation. There are three stages, which start when you are still pregnant and your cells are making colostrum (the first milk), through to a transitional phase to when you are making mature milk.
Lactose
Lactose is a sugar (carbohydrate) that is present in breastmilk. Because it’s a large molecule it needs to be broken down, and uses an enzyme called lactase to do this. Sometimes a baby might have trouble breaking down the lactose because they’ve had a lot of milk at once or for some other reason. If your baby seems like they have wind, green, foamy or frothy stools or pain digesting, it’s not necessary to stop eating dairy yourself, just seek help from your IBCLC or doctor.
→ How to: Find an IBCLC
Letdown
Also known as “Milk Ejection Reflex”.
Thankfully, a “letdown” is not about your feelings of disappointment when your workplace gives you less parental leave than you hoped for.
It’s actually about the milk ejection reflex you have in response to oxytocin that is released when your baby feeds, you see or hear your baby, or your nipple is stretched. Your myoepithelial cells contract and push milk out along your ducts to your nipple.
A letdown can feel like a small tingle or a sudden rush or wave - it is stronger for some people than others.
During a pumping session, you may be able to see your milk start to flow faster when your letdown comes - anywhere from the first seconds to first minutes of pumping. You may even have multiple letdowns in a session.
Some people (almost 10% of us) experience a rush of anxiety, agitation, or even pain with their letdown called Dysphoric MER (DMER). It typically lasts a few minutes, but is a good idea to speak with an IBCLC for help.
→ Shop products: Milkdrop Lactation Massager
→ Read about: How to increase milk flow during pumping
LBW / Low Birth Weight
A clinical term usually defined as when your baby is born under 2.5kg or 5 pounds 8 ounces. This is where you will need (and hopefully be given) lots of help to establish and keep breastfeeding going.
→ How to: Find an IBCLC
M
Massage Mode
Sometimes also referred to as Massage Mode.
This is a mode on most pumps that is designed to mimic the pattern of sucking that a baby tends to make at the start of a feed. It’s a series of short, light, fast sucks to draw the nipple into the pump and stimulate milk flow.
Some people find the stimulation phase is helpful when pumping and others don’t, and start straight away on the expression mode.
As usual, the key to pumping is trial and error, to find out what works for you.
Mastitis
This is a condition where your breast is inflamed and sore. Often your breast will also be tender, red and hot around one area. You can also have flu-like symptoms with mastitis and should see your lactation care provider or doctor.
Treatment for mastitis has recently changed, and involves cooling, anti-inflammatories, no change (if you can) to your feeding/pumping and light lymphatic drainage massage. So no massagers, no extra pumping, and no heat.
Causes of mastitis can vary, but watch out for tight bras or not being able to “effectively remove” milk from your breast, whether with your baby or your pump.
→ Shop products: Milkdrop Cool Packs
→ How to: Find an IBCLC
→ Read more: Symptoms of mastitis
Membrane
The membranes are parts of your pump, usually covering the valve, that are made of small, thin and flexible plastic or silicone.
Because they’re so thin and flexible, they wear down over time and need to be replaced every 1 to 2 months. If you’re finding that your pump feels a little weak, check your membranes, they’re usually the culprit!
Milk ducts
This is the small tube that transports milk from your alveoli (grape-like lobules that make milk) down through your breast to your nipple. They are spaced out (although not always evenly) around your breast.
MER / Milk Ejection Reflex
Also known as “Letdown”.
Thankfully, a “letdown” is not about your feelings of disappointment when your workplace gives you less parental leave than you hoped for. It’s actually about the milk ejection reflex you have in response to oxytocin that is released when your baby feeds, you see or hear your baby, or your nipple is stretched. Your myoepithelial cells contract and push milk out along your ducts to your nipple.
A letdown can feel like a small tingle or a sudden rush or wave - it is stronger for some people than others.
During a pumping session, you may be able to see your milk start to flow faster when your letdown comes - anywhere from the first seconds to first minutes of pumping. You may even have multiple letdowns in a session.
Some people (almost 10% of us) experience a rush of anxiety, agitation, or even pain with their letdown called Dysphoric MER (DMER). It typically lasts a few minutes, but is a good idea to speak with an IBCLC for help.
→ Shop products: Milkdrop Lactation Massager
→ Read about: How to increase milk flow during pumping
Milk removal
You are ‘removing’ milk any time you feed, pump or hand express. Lactation care providers often talk about effective milk removal or effective milk transfer when they are talking at how well you are able to draw milk out from your breast. Milk removal is important in maintaining milk production (have less milk in your breast is a signal to your brain to produce more) and reduce the risk of engorgement, blocked ducts and mastitis.
→ How to: Pump more milk
Mixed feeding
Mixed feeding refers to a feeding method where an infant receives both breast milk and formula. This can involve feeding the baby breast milk directly or from a bottle, feeding the baby formula from a bottle, or feeding the baby both breast milk and formula in the same day. Mixed feeding may be chosen by parents for a variety of reasons, such as supplementing breast milk with formula due to low milk supply or introducing solid foods to the baby's diet.
mmHg
This is the unit of measurement (millimeters of mercury) that engineers use to describe suction (or vacuum).
Most pumps have suction between about 200 to 400 mmHg.
While you need a minimum suction to get your pump working and stimulating your nipple, more suction is not necessarily better, and more suction does not necessarily get you more milk. Actually, putting the suction up too high is one of the causes of nipple pain or damage.
If you plan to double pump though, you will need to look for pumps with a higher mmHg, because you will be connecting two flanges at once.
Montgomery Glands
Montgomery glands are the little lumps (or tubercules) you can see around your areola.
They usually become darker during pregnancy, and they secrete an oily fluid that both lubricates and protects your nipple from bacteria. If you’re in the shower in late pregnancy or after, you might notice water beading off your nipple from that oily fluid.
Some people also secrete milk from their Montgomery Glands. Weirdly, these glands are named after a man. But to be fair, he (William Featherstone Montgomery) did contribute quite the chunk of scientific research on the anatomy of the lactation breast, back in the 1840s.
Myoepithelial Cells
These are the cells that enclose your alveoli (grape-like lobules that make milk) and your milk ducts, that contract when your body produces oxytocin.
N
Nipple shield
A nipple shield is a thin, flexible silicone shield that fits over the nipple and areola during breastfeeding.
It is designed to help protect sore or damaged nipples and to provide a more comfortable latch for the baby.
Nipple shields can be helpful in certain situations, such as when a baby is having difficulty latching onto the breast, or when a mother has sore or cracked nipples.
However, it is important to use nipple shields with help from healthcare provider or lactation consultant, as they can interfere with the baby's ability to latch onto the breast and can reduce milk production if not used quite right.
→ How to: Find an IBCLC
O
Open system (or loop) pump
An open system pump is a type of pump where your milk comes into contact with the tubing that runs to your pump/battery pack. It’s the opposite of a closed-system pump.
Open system pumps tend to be cheaper, smaller and more for personal use. If you have one of these, you’ll need to wash your pump tubing after every use.
P
Pace feeding
This is a way you can give bottled milk to your baby, that slows down how fast the milk flows into their mouth.
Usually you hold your baby semi-upright, and when they show hunger cues, tickle your baby’s lip with the bottle nipple to cause them to open their mouth and latch on. Then, hold the bottle horizontally and allow your baby to start sucking without milk, and slowly tip the bottle up slightly to fill the nipple with a little bit of milk. After they’ve done a few continuous swallows (20-30 seconds), then tip the milk back into the bottle and give them a break. Repeat this until they show signs of satisfaction.
Try to resist feeding them the whole bottle just because it’s there!
PP / Post partum
Another term you might see in the forums. PP standard for post-partum, the period of recovery and adjustment right after childbirth. Some say it lasts 6 weeks (some say forever!)
PPD / Pumps per day
This is a term you might see on the forums! Remember, when you're in the early stage of lactation you could be pumping 10x per day, and then later it might be 1x as you wean.
S
Stimulation Phase (or Mode)
Sometimes also referred to as Massage Mode.
This is a mode on most pumps that is designed to mimic the pattern of sucking that a baby tends to make at the start of a feed. It’s a series of short, light, fast sucks to draw the nipple into the pump and stimulate milk flow.
Some people find the stimulation phase is helpful when pumping and others don’t, and start straight away on the expression mode.
As usual, the key to pumping is trial and error, to find out what works for you.
Suction
When it comes to your breast pump, the ‘suction level’ is the strength of the suck that you feel at your breast. The higher the suction, the more your nipple will be drawn into the pump.
If you’re into physics, suction is actually the feeling of negative pressure, or vacuum, which you feel when the pump removes the air from around your breast.
Supplementer
An “at-breast supplementer” is a little piece of equipment that can help you to feed your expressed milk or formula to your baby at the breast.
There are a few different designs out there, but they are usually just a bottle of milk that you can tape or sit in your bra connected to thin plastic tubing that you can place next to your nipple.
Your baby can practice latching, and you can encourage them with milk flow through the tubing.
T
Thrush
Thrush is fungal infection caused by an overgrowth of the Candida fungus. Your nipples might look red, shiny, and sometimes cracked, accompanied by white patches or lesions on the nipple or areola. It can cause persistent, sharp, or shooting pain between pumping sessions, and might also feel itchy or burning. Candida likes warm, moist environments, which is a great reason to change your breast pads, and only keep nipple protectors (e.g. collector cups or silverettes) on for only a little while. It could be linked to broken nipple skin, or previous infection or vaginal thrush, or recent antibiotic use. If you think you might have thrush, it's a good time to see your IBCLC or doctor. They may give you antifungal creams to try to help. You can also double check your hand washing and pump cleaning practices too. One thing to watch out though - thrush is often misdiagnosed when the issue is actually vasospasm. Make sure you speak with your IBCLC and doctor about this too, as antifungal creams won't help there.
Triple Feeding
This is when you are feeding at the breast, then feeding from a bottle, then pumping. You might do this in the early days of establishing your milk supply. It’s not a sustainable practice, as people typically do this every two hours. If you are recommended to start doing this, or have read about it somewhere, make sure you understand how long for and check with your LC first.
→ How to: Find an IBCLC
→ How to: Pump more milk
V
Vasospasm
If you are having vasospasm in your nipples after pumping or feeding you would notice sudden shooting spasm-y pain together with possible discolouration that might be white or a blueish hue. This can occur when blood vessels in the nipples constrict, resulting in reduced blood flow and oxygen supply to the area. It can be caused by bad breast pump fit, having the suction up too high, poor circulation (you may already notice that you have cold fingers or toes / poor circulation or family history of Raynaud’s phenomenon), and exposure to cold temperatures. Find an IBCLC to help you, but in the meantime you can try checking your pump fit, making sure the suction is only up as high as is comfortable, warming your flanges (DYK that Milkdrop cushions can be warmed?), warming your breast before and during pumping with heat packs, and keeping your body warm in a warm room or with a warm drink. Watch out with vasospasm, it often is misdiagnosed as thrush (or candida), so speak to your IBCLC or doctor about this.
Valve
The valves on your breast pump are the small, flexible parts that allow your milk out, but don’t let air in. They’re super important for making sure your pump is air-tight around your breast and able to build up enough suction to draw out your milk.
Don’t believe us? Tear a spare one, attach it to your pump and see how little suction you get! You need to replace valves whenever they’re damaged, or every 6 weeks or so.
W
Wearable pump
A wearable breast pump is a type of breast pump that is designed to be worn discreetly under clothing, allowing a person to pump milk hands-free while going about their daily activities. Wearable pumps typically consist of a bra or bra insert with built-in breast cups that suction onto the breasts, a motor unit that powers the pump, and tubes that connect the breast cups to the motor unit. Some wearable pumps have done away with wires altogether, and have the motor attached to the top of the breast cup.