Nursing Pad
As natural as breastfeeding is, it seems that dealing with leakage can be anything but. Childbirth education or closer relations may have helped mom understand that leakage can and actually happens. But still, she has many unknowns. Will she leak at all? Will she need high absorbency? Will a particular choice be comfortable for her? How often will she have to change her nursing pads? How often should she change them? Are they safe? To help a mom make her selection you may offer a brief overview of what's available along with advantages and disadvantages. A few "touchy-feely" samples are not a bad idea either, so that mom is not misled in any way. Through asking questions and perhaps a bit of experimentation, most moms seem to find a class or brand that works for them and that they prefer.
Absorbent pads
This class of nursing pads collects leaks into some type of absorbent material, requiring mom to switch them out before they reach their capacity. Advantages are that they are commonly available and that there are plenty of choices. Disadvantages are that moms complain of shifting, the feeling of wetness on their skin, and inconvenient exchanges. Furthermore, they can be fairly bulky and/or obvious under clothing. Many of these disadvantages can be minimized by helping mom select a pad of the proper absorbency, thickness, and shape based on her individual needs.
Washable: Choices include cotton, hemp, flannel, colored, contoured and not. It really is a matter of taste, and sometimes availability. The most commonly available material is cotton. Often there is a contour for a better fit and look under clothing. When available, color selections that are closer to that of moms skin also tend to be less noticeable under lighter colored clothing. Washable pads can be very trim, and some even have a decorative lace overlay, so they are pretty and relatively discreet. A disadvantage, obviously, is that mom will be spending more time on laundry. When out of the house, pad exchanges may be a bit inconvenient, since there is a need to store the wet pads until they can be placed in the laundry. Another disadvantage of a washable pad is that the individual absorbency may not be equal to some of their disposable counterparts. Mom generally needs to buy a dozen or two since they will be in and out of the laundry. So, washables can add up to a more significant up front investment, but tend to be cheaper than disposables in the end. In terms of care, the use of fabric softeners should be avoided, since they can impede absorbency.
Disposables: These one-time use pads are generally cotton based, some with a more absorbent core or construction in layers. Considerations are mom's level of leakage, lifestyle and the fit of the pad within her wardrobe. Thickness can vary by brand and is sometimes linked to absorbency tailoring (i.e. Light, medium and heavy). Variations include contours, tape backing to hold the pad in place and plastic backing to prevent soak through. Theoretically, pads with non-breathable plastic linings may actually impede the healing of injured nipples or make nipple infections more likely. Some moms feel disposables have greater capacity and that they wick moisture away better than washable pads. Pad exchange is simple so long as a garbage can is nearby. Disposable pads carry the disadvantage of being pretty pricey over the long run. Furthermore, they are generally thicker and more obvious than their washable counterparts. With disposables new moms can count on weekly trips to the store, but definitely less laundry!
Non-Absorbent Pads
The concept of the non-absorbent pad is to prevent, instead of collect, the leak – that is to keep the milk in the breast until feeding time. Pads in this category maintain a gentle, steady pressure on the nipple so that the ducts do not release milk. This is not to be confused with binding or other techniques used to slow milk supply during the weaning process.
Currently, LilyPadz® are the only type of non-absorbent pads on the market, although another product was studied and marketed for some time. LilyPadz, are simply contoured silicone pads with a lining that adheres to the breast. This unique class of pads breaks many of the boundaries set by absorbent pads. Being completely nonabsorbent, pad exchanges are not the norm in this class, and mom can even swim in them. They require washing once per day and dry in minutes so there is no need for spare pairs like other re-usable pads. Without a need to collect milk they are very thin and offer a discreet appearance under clothing. These pads offer a unique lining that adheres to the breast, offering the ability to wear a nursing pad without a bra -so sleeping braless is an option. A disadvantage is that in times of milk supply changes the user may require some additional pressure to suppress the leak completely until equilibration.
Individual studies of the two types of devices suggest that there is no detrimental effect on milk supply, nor any increase in other breastfeeding complications. Both devices are breathable, an important feature for the health of the breast. Clinical research indicates that prolonged exposure to wet nursing pads, or even an environment that doesn't breathe causes skin irritation and skin maceration, sometimes resulting in common breast infections. A distinct advantage to this class of nursing pads is that they may even help reduce thrush and mastitis by keeping the nipple area dry.
Shells
Although not technically a nursing pad, shells can be used to collect breast milk leakage. They are a molded device, in one or two parts, of harder plastic composition and contoured in a hollow shape so as to keep pressure off the nipple and leave it open to air. For this reason, shells are often recommended to women with sore or inverted nipples. Breast milk leakage is held in the lip around the lower edge of the shell and simply emptied, although some contain an adsorbent material in the hollow area to better hold leakage. Holes in the upper outer portion of the shell allow them to breathe without spilling milk unless mom bends over too far. The advantage here is for special needs, there is not a need to buy multiple pairs of shells, but they tend to be bulky and rigid to wear.