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 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 support
• Building a private practice from scratch to fill a critical care gap
• The growing need for outpatient lactation support in communities with high birth volume and limited access

Alisa 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 pandemic
• A lack of formal training around pumps for lactation professionals and students
• Real-world observations of pump-related injuries and milk supply issues
• The absence of safety standards or meaningful FDA regulation of pumps

Alisa outlines the clinical signs of pump-related harm:

• Nipple trauma and pain
• Engorgement and localized inflammation
• Desensitization and nerve damage affecting oxytocin release
• Reduced milk output and mental health impacts
• The economic burden of buying multiple ineffective pumps

Assessing and Educating About Pump Use

Alisa walks through her protocol for evaluating pumps and educating parents:

• Conducting visual and tactile nipple assessments
• Observing the flange fit and suction cycle using traditional pumps
• Identifying signs of poor fit, pressure intolerance, or ineffective drainage
• Educating parents on safe suction levels and cycling patterns
• Using pump pressure gauges to test actual PSI and document findings

Alisa discusses how she determines the correct flange size and pressure setting:

• Using a nipple measurement tool and allowing 2–3mm for expansion
• Watching how the nipple behaves during pumping in both modes
• Measuring pain, output, and visual signs like blanching or trauma
• Teaching families to aim for the lowest effective pressure

Alisa 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 latch
• Standardize protocols using structured tools
• Teach observational skills to identify subtle signs of dysfunction
• Normalize using equipment like pressure gauges during clinical care

Margaret and Alisa discuss the ethics of recommending specific brands:

• Why “just pick a pump that fits your goals” may not be sufficient
• How to assess pumps based on safety, suction mode, and cycle adjustability
• Building ethical partnerships with manufacturers to influence safer design
• Educating families on red flags that suggest a pump isn’t working

Alisa shares key tools and resources to improve pump literacy among IBCLCs:

📌 YouTube – Alisa’s video on testing pump pressure

📌 IABLE – Flange sizing and safety resources

📌 Oregon WIC – Printable handouts on safe pumping

📌 New Little Life by Allison Tolman – Pumping gear course

📌 FDA’s Breast Pump Guide – A cautionary example of feature-based, not safety-based, guidance

📌 Babies in Common FITS Guide – Visual flange sizing tool

Alisa encourages aspiring IBCLCs to pursue mentorship and hands-on experience:

• Find a mentor who offers direct clinical exposure
• Build assessment skills through repeated observation
• Understand that lactation support includes feeding mechanics and medical safety

Alisa Williams, RN, IBCLC is the owner of Momentum Lactation in Southern Illinois. She specializes in outpatient lactation care and is a leading voice on breast pump safety and injury prevention.

📧 Email: [email protected]

Have questions or suggestions for future episodes? Reach out to Margaret at [email protected] or connect on social media:

📸 Instagram: @margaretsalty

📘 Facebook: Margaret Salty

🎙 Hosted by: Margaret Salty

🎧 Guest: Alisa Williams, RN, IBCLC

🎵 Music by: The Magnifiers, My Time Traveling Machine

#IBCLC #PumpingSafety #BreastPumps #LactationConsultant #Mentorship #FlangeFit #LactationEducation #ExclusivePumping #PumpInjuryPrevention #LactationTools

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