Hacks for Willow Pump Gen 3 Pain
Before going any further with this post, I want to say a huge THANK YOU to the admin and mod team in our pumping support group on Facebook, and Shondra Mattos, IBCLC, at Mattos Lactation, for all of their help investigating this matter. This is one of the most complicated, painful pump situations I have come across, and it took a lot of time and effort from all parties involved to generate and test theories to determine the root cause and come up with possible solutions.
Back in February/March of 2021, there was an uptick in pain for Generation 3 Willow Pump users. At first, it was assumed this pain was due to sizing, but further investigation and assessment presented this pain as an unanticipated effect of the changes to the Willow Gen 3 overall, and exacerbated by changes that seemed to occur at the same time the Gen 3 pumps were updated.
This pain was centered on the base of the nipple and areola with radiating pain frequently occurring that radiated back into the breast tissue. What really stood out is the fact that these users were experiencing pain within short periods of time with Willow usage, who then, took some period of time away from the Willow to resolve it despite a lack of damage or swelling, and the pain quickly resumed with returning to the Willow Pump. Despite reporting pain with that sounded consistent with sizing, such as pinching, it was determined that sizing was not the issue we were seeing.
Pain Diagrams from users were essential to identifying what we were seeing
Typically, this pain was centered on the base of the nipple with the outer sides of the nipple being most common. Pain was radiating back into the breast following what we know to be the path of the nerves running to the nipple.
Once we started using this pain diagram to identify the trends in the pain, what we saw emerging was a pattern of pain that indicated the Willow Pump was likely causing inflammation and irritation of nerves that innervate the breast and terminate in the nipple. These nerves are responsible for the milk-ejection reflex, and inflammation of these nerves is consistent with impaired MER reported by many users with lingering impairment when pumping with another pump despite this not having been a previously seen issue.
So, what about the Willow Gen 3 led to this concern?
View these videos below of the stimulation mode for the Willow Pump Gen 2 and Gen 3 to see the difference in how their suction patterns function.
The Willow Gen 1 and 2 were known for having strong suction, with the nipple being held tightly under constant suction and with a small variation in suction leading to a pulsing sensation. Willow Gen 3 promoted a more gentle suction pattern that used lower constant suction with a wider variation in suction closer to what we see with a standard pump, just not releasing to 0 mmHg, which releases the suction on the nipple entirely.
The best way to think of how this impacts the nipple tissue is to think of the range of suction like the height of a bounce on a trampoline. The higher the range, the higher the bounce. Some people are not impacted by this larger range of motion, but for others, this is causing the nerves to become overstimulated and triggering pain due to the excessive motion in their tissue. There is also a much more noticeable vibration with the Gen 3, which we know historically, based on other breast pumps, can trigger pain in some users.
This issue is exacerbated by flanges that may fit the breast tissue at an angle, where despite sizing appropriate for the nipple, there is still a gap around the base of the nipple and areola. This is complicated to assess for the Willow as many of the inserts are not visibly clear, and we don’t have a great visualization of the breast when pumping with wearable pumps. This is not an issue unique to the Willow, but it’s one we were not really seeing prior to this issue because the strong suction of the Gen 2 held the tissue firmly in place and had limited opportunity for excessive movement of the tissue.
So the big question here is, what options do we have for people experiencing this type of pain to allow them to comfortably use the Willow?
We need options that…
A.) Prevent excessive motion of the breast tissue
and
B.) Limit the impact of the vibration and movement on the tissue.
This leads us to a few different options we can use to try to make the Willow Pump work for those experiencing this issue:
Option 1: Inserts
Freemie inserts may be preferred over Maymom inserts for people experiencing this pain, as the rim of the Maymom may rub the areola with the excess motion being experienced. In some cases, we did see success using Lanolin on the rims of the Freemie inserts to essentially “glue” them to the breast tissue to reduce movement.
Option 2: BeauGen Cushion Hack
Cut the end of a BeauGen cushion and use it to cushion ONLY the areola. This helped absorb some of the vibration and reduced movement in the tissue. This option worked decently well for users with flat or inverted nipples, but more elastic tissue had issues with this hack. There is some risk of the cut BeauGen cushion causing pressure around the nipple tissue.
Option 3: Ameda Flexishield
We have had this option for quite some time, but for users with a 19-21 mm nipple base, the Ameda Flexishield stopped the discomfort by preventing the areola from being bounced or pulled. Two users who had previously used the Gen 2 with the Flexishield felt this option felt most similar to the older pump and produced the best resolution of discomfort for them.
Option 4: Legendairy Hack
Using a Legendairy 24 mm silicone cup flange in the 27 mm Willow flange allowed for use of Freemie inserts up to 21 mm with great success as well as Maymom inserts. Freemie inserts seemed to feel best with this combination due to removing that spot where the Maymom insert could rub. Vibrations were perceived to be less noticeable with this set-up. Overall, this set-up seemed to be most preferred.
Option 5: Evenflo Hack
For people who dislike the texture of the Legendairy or Freemie inserts and prefer the smoother feel of the Maymom inserts, you can use an Evenflo 24.5 mm insert in a 27 mm flange. You do have to trim the bottom ridges of the Evenflo insert carefully to make it fit, but the texture was fairly seamless with the Maymom inserts.
So how do you know if this is the issue you are dealing with?
This is an issue I would consider to one of exclusion. We don’t jump to the conclusion that this is the issue unless we know the sizing is right, your bra fit is right, there are no breast or nipple infections, and there are no concerns with nursing.
Once we have ruled everything else out, we trial these alternative flange set-ups for Willow, see how you respond to them, and take into consideration your breast shape.
*It’s important to note that this should not be considered a flaw in the Gen 3 pump or a reason to avoid the Willow Pump. This is simply an issue related to the updated function of the Gen 3 pump compared to previous generations. With any updates, we are going to see new issues that require new solutions. The Willow Pump utilizes new technology and there are going to be hiccups. This pump is still worth working through all the challenges, for it allows parents to continue breastfeeding and meeting their infant feeding goals in a way no other pump has been able to yet.*
