So when CAN I use my Haakaa? 

So when CAN you use the Haakaa*?

In my last post, I wrote about some of the issues that I see from clients of mine who are repeatedly using the Haakaa in a way that causes them problems. I probably should have predicted it, but this has led to a lot of people totally flipping out about using one at all, and presuming that using one is going to unequivocally give them a low weight gain, coughing and gagging, breast refusing baby. Oops. I had figured that there were enough articles that discussed how to use them and how wonderfully handy they can be, when used correctly, that it wasn’t necessary for me to write my own version… But apparently that’s actually not the case! So here I am!

I spoke to a mama today with a 15 day old baby, and I recommended she use the Haakaa. A few days ago, I spoke to a mama with a 7 week old baby, and I also recommended she try one out. Then there was the mama with a 3 month old, a 6 month old, and a 2.5 year old, and all with different situations, I recommended this as a tool that may help. 

I’ll break down each of these scenarios with these mamas I mentioned above, as I think each shows a different perfect way to use this tool.
Mama 1 with her 15 day old baby:
Lots of milk and likes having a freezer stash.
This mama is doing great (she had a prenatal consult and began breastfeeding informed and empowered! Yay!) and has a great amount of milk. Her baby was at birth weight by day 8, things are going well. During the morning feeds when her supply is highest, her breasts feel very full with a lot of pressure. She tells me that her breasts are her alarm clock, and then she really just sits there waiting until her boy shows the first signs of waking, so that she can quickly feed him and relieve this discomfort. These last few days, however, he will only ever take one side. She continues to offer both sides during every feed, but for the three morning feeds, for the last week, he won’t take it.
She tells me that she has started pumping her unused breast at these times, and has actually realised that she loves being in a situation where she has a little expressed milk available.  She tells me that having a small freezer stash seems to alleviate her anxiety a little, and that she loves knowing that her husband would have the option of giving some milk if there was a time in future that she wanted to go out for more than an hour. 
Here, I suggest the Haakaa.  I’d usually tell her to hand express just to the point of feeling comfortable, but she wants to continue to have a small freezer stash. We obviously talk about a lot of things, but I let her know that the pumping that she is doing is stimulating her supply further, and her baby is already beginning to really struggle with the force of her letdown, so I don’t want a pump in the mix (sure, the Haakaa is a kind of pump, I suppose, but it does not stimulate the breast in the same way). I suggest that she use the Haakaa just for that first morning feed where her breast is really uncomfortably full. If that discomfort isn’t there for the other ones, then don’t do it. I tell her that I’d like her to use it only once a day, not any more. I tell her to do this for one week, then check in  about how things are going. If she feels her supply is continuing to dramatically increase and her baby finds feeding more and more difficult, then stop the Haakaa completely. If things are going well, she can continue to do this.
(At the same time, we work at getting her into a laid-back position to feed, we do a little bit of extra work with the bubba to help him to be able to cope with that letdown a little easier, and I teach about paced bottle feeding and other options for if/when she decides to do that.)
Mama 2 with her 7 week old baby:
This mama was trying to boost her supply and hates pumping.
This mama has a total aversion to pumping. This is her second baby, after a traumatic feeding experience with her first, and she comes to me having worked incredibly hard to boost her supply for weeks now. She is doing as much as she can while totally avoiding pumping. She is occasionally trying to hand express after feeds when she has the emotional and physical energy, but she now is having symptoms of carpal tunnel syndrome, and is feeling really very lost and defeated.
Here, among many many other things and a lot of emotional support, I suggest the Haakaa. The most important thing is that the baby gets as much milk as they can directly from the breast, so I don’t want her to put it on a breast before her baby has been there first. Feed from Side A, then swap bubba to Side B and put the Haakaa on Side A. This means that her first breast (A) may begin to release some milk when her baby elicits a letdown from the other breast (does that make sense?!). This might not work for her, but when she is actually causing herself pain during hand expressing, and when she can’t consider pumping, this is another alternative to consider — and it has helped a couple of clients of mine in the past where they really really really really really hate the idea of pumping. Oh, also, If the baby finishes on Side B and you want to put them on Side A again, no problems! Know that this will continue to be really stimulating for the breasts, and the milk he gets at that point will be coming slower but be much higher fat. If that happens, then I’d put the Haakaa on Side B… So the general theme here is that you want your baby to be the first one to be at your breasts — but after that, go for it.
Mama 3 with her 3 month old:
Oversupply and block feeding.
Here, the mama came to me with a very high oversupply. She has a Haakaa already, and I suggest using it as part of our block feeding plan. The plan is that she continues to feed her baby on demand, but she feeds only from the one breast for a particular period of time (we determined this together, based on a long conversation — it’s not a one-size-fits-all situation). ie. If baby is hungry at 9am, she can feed with her right breast. If baby is hungry again at 11, she feeds again with her right breast, until x number of hours have passed. This means that the other unused breast remains filled with milk, sending the signal to the brain that all that milk wasn’t needed, so settle down already! (Disclaimer — Don’t do block feeding without professional support!)
Here, I tell the mama that she can use the Haakaa on her unused full breast if she gets to the point that it is causing her a lot of discomfort. I tell her that she needs to remain very vigilant though, and use it only for the time it takes for her to sing the ABCs. Then take it off, and assess if her breast is feeling a bit better and if she feels relief — don’t leave it on for any longer than is necessary. She may not need to do this at all, or may only need it for two of the feeds during the first day, but again, it’s a viable, handy option.
Mama 4 with a 6 month old:
Clogged milk duct / plugged duct
This mama has a clogged milk duct and has been doing alllll the things. Heat before and during feeding, massage before and during, using the vibration of an electric toothbrush to attempt to break it up, dangle-feeding on all fours, frequent feeding and expressing… all of it.
I suggest the Haakaa. Here, you fill it with warm water and epsom salts. The epsom salts have a property that helps to draw things out of the skin, and using the Haakaa in the normal way but with this epsom-salty-water in it too, it can help to draw out the clog. For this mama, it worked a treat. It’s not a guarantee, but it does get some really good results, and it’s something to add to the list of things that can absolutely work.
Mama 5 with a 2.5 year old:
Going away for a three-day trip
This mama tells me she rarely feeds in the day now, though she breastfeeds to sleep, and also once in the morning. She tells me she never feels full, never leaks, feels her supply is pretty low and wants to know if she should worry about her breasts while she’s away. This mama has never pumped, doesn’t own one, and would love to avoid using one.
I suggest the Haakaa. Here, she can fold it up very small and put it in her luggage, and it’s a good pump-back-up. She may not feel she needs it at all, but it would really suck (pun intended!) to be away for a fun weekend and spend your time feeling really uncomfortable and worried about your breasts the whole time. Here, she can attach it to her breasts and squeeze the base rhythmically a few times to elicit a letdown, if needed.
* * *

So there you have it, a bunch of situations where I feel that this can be a useful tool!

(*I use ‘Haakaa’ here as a noun describing something that is more technically known as a ‘silicone hand pump’. I realise I’ve been using it in the same way that some use ‘Kleenex’ or ‘Hoover’ in the U.S., or how we use ‘Band-Aid’ and ‘Esky’ in Australia… I may just have to write another post about that whole concept too…)

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