Ep 216: What You Need to Know About Pumping with Dr. Dianna Dixon from Pump with Purpose

Listen and Subscribe On...

Powered by RedCircle

When Dianna had her first baby she felt like no one explained anything about pumping. Hospital staff didn’t tell her about her options, sizing and fit, or even how to do it. Most people will wind up using a breast pump at some point so everyone should know this information.

Dianna’s own journey led her to found Pump with Purpose, a global lactation private practice for people who want to include pumping in their journey, either exclusively or in addition to nursing. They help the breastfeeding community with common concerns like increasing supply, finding the right pump and flange, and getting onto a schedule. She is so passionate about her work and it comes through in the conversation.

In this Episode, You’ll Learn About:

  • How to decide which breast pump is right for you
  • Which factors to consider when deciding what size flange to use
  • Why you need a pumping bra and what makes it different from a nursing bra
  • How people get on a pumping schedule
  • How to increase milk supply
  • What some of the most common issues are that people have with breastmilk collection
  • What “pumping self-care” means

Links Mentioned in the Episode

Come Join Me On Instagram

I want this podcast to be more than a one sided conversation. Join me on Instagram where we can connect outside of the show! Through my posts, videos, and stories, you'll get even more helpful tips to ensure you have a beautiful pregnancy and birth. You can find me on Instagram @drnicolerankins. I'll see you there!

Share with Friends



Dr.Nicole (00:00): In this episode, you're going to get advice about pumping from Diana Dixon with Pump With Purpose. Welcome to the All about pregnancy and birth po. I'm Dr. Nicole Calloway, Rankins, a board certified OBGYN, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy in birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(00:51): Hello there. Welcome to another episode of the podcast. This is episode number 216. Whether you are a new listener or a returning listener, I'm so glad that you're spending some of your time with me today. In today's episode, we have Dr. Diana Dixon from Pump With Purpose. Dr. Dixon is a Doctor of Public administration, a certified lactation counselor, and a certified breastfeeding specialist. And her company, pump With Purpose is a global lactation private practice servicing the breastfeeding community across the world. And she started it due to a recognized lack of resources and assistance in lactation for people that want to include pumping in their journey, either exclusively or in addition to nursing. They help folks to increase breast milk supply with the right pump flange products and schedule and pump a purpose, wants to be an additional resource on your breastfeeding journey to assist with incorporating, pumping in a way that works for you and your family.

(01:58): So we have a great and really informative conversation about choosing a breast pump, choosing the correct flange size, creating a pumping schedule, how to increase your milk supply, mistakes that she sees people commonly make with pumping, and then something called pumping self care, which I really, really loved. Diana is so serious about her work and so passionate about her work. It really comes through in our conversation, and again, I know you're really going to find it enjoyable and find it super useful. Now, before we get into the episode, I have a special announcement to make. I want to invite you to join the All about pregnancy and birth Inner Circle community. This is a community that I have created in support of my goals of making a big, loving, supportive place for those who are having a baby. So this is a free Facebook group.

(02:57): It's called the All About and Birth Inner Circle Community. And I would love for you to join the community if you are thinking about getting pregnant, trying to get pregnant. If you are currently pregnant, if you are a birth worker, a doula, a lactation consultant, a pelvic physical therapist, if you are a healthcare worker who works in a pregnancy and birth related space like you're an OBGYN a midwife, a labor and delivery nurse, a postpartum nurse, a pediatrician, or a baby nurse, I would love for you to join this community. Again, I'm looking to create a place of like-minded folks to just create that warm, supportive place online that is missing these days. Quite frankly, we say so often, see people fighting and divided and this that and the other regarding things in our country, and I just want to create a space that is open, that is accepting.

(03:56): Now, I know it's not going to be perfect, and I know that there will be disagreements and things that come up. That's the nature of being humans. But we're going to do this in a way that is not tearing people down. That's not ugly, that's not mean. That recognizes and supports our humanity in the ways that we are all connected and is empathetic and just a great, lovely place to be. So come join the Inner Circle community. It is at Doctor, no, sorry, let me get this right. It is at facebook.com/groups/dr.NicoleRankins. And we will put that link in the show notes. And then also if you just go to Facebook and search for all about pregnancy and birth or all about pregnancy or even search my name in Facebook groups, you should be able to find it. All right? So I cannot wait to see you inside the Inner Circle community. All right, let's get into the conversation with Dr. Dixon. Dr. Dixon, thank you so much for agreeing to come onto the podcast. I'm so excited to have you.

Dr.Dixon (05:10): Thank you so much for having me today.

Dr.Nicole (05:12): Yeah. So why don't you start off by telling us a bit about yourself and your work and your family if you'd like. I

Dr.Dixon (05:17): Would love to. So I am Dr. Diana Dixon. I am a Doctor of public administration, a certified lactation counselor, and a certified breastfeeding specialist. I am the c e O of Pump. With purpose, I can be found on 10 social media platforms. So very excited about I am a Global, well, we are a global lactation private practice, seeing 2000 appointments to date in less than two years. Wow. Very, very proud of that. Built from the ground up, from just so excited. So I see clients on every single continent. To date, excepting, I'm just waiting for someone. Okay. Be over there doing need some help in summer. Right. But I'm so proud of that. So I am a mom of two. I'm a wife and mom of two little boys that are five and three and a half now. So Pumper purpose was started. I, I've always helped people to pump.

(06:13): My breastfeeding journey started from my son. He was born and had a great pregnancy, but when they went to break my water, they discovered that my son had pooped in the SIA meconium. And then when we reached an emergency C-section, he had meconium aspiration. So his lungs collapsed at birth. God, he had to be resuscitated immediately taken off to the nicu. Okay. Left on the table wide open. My husband whisk away with our newest little one in tears, and I'm just sitting there vulnerable, taken off to the recovery room. My mom just saw emergency room staff just being just full 20 people Sure. Coming in. So she bulldozed her way. My mom and I need to see what's going on. So I was okay. Luckily, everything went well with my little old, now oldest. But at the end of the day, no one taught me anything.

(07:10): And some of it, I've now on this side of it, I'll talk about this side of it. I look back and I didn't do some things as well, but I didn't know to do anything. I didn't know I could start hand expressing or just stimulating my nipples at birth if I'm separated from baby while I'm recovering from a C-section. Right, right. I could take into the room, there are pumps. There were pumps in every single room. No one taught me how to use it. They just gave it to me, put it there with the kit. No one said anything. They didn't tell me how often to pump, what to do, how to collect my milk. I am just left with a sun in the nicu, separated from he did come. So I'm walking in a different area to go to see him. Right. To say I'm pumping all the things and fast forward, I could have done a lot of things so differently.

(08:01): Got it. So I was put to the test. So I started pumping. I didn't know some of the things that I know now, and I went on to have an amazing journey. My first journey was nine months until I got pregnant with my second son playing. I pumped and I had 3000 ounces saved up of breast milk to get done from nine months to 12 months, right on my breast milk. So I had our second son. He was born clean. I did another C-section playing this time, but he was born clean as a whistle. My whole journey stressed about, oh my goodness, oh my goodness, this is going to happen again. Right. Happened. But I planned this time, I knew exactly what I needed to do. I pumped this journey three over three years, providing breast milk for my toddler and my infant and as well saving, rotating my freezer stash for over three years.

(08:56): So Pump with Purpose was came about in 2021 due to my worry about my weaning journey. I was like, I thought I wanted to wean. I put in, I was coming up on my two year mark, was my first goal for myself, but I wasn't ready. Okay. Why am I putting these timeframes on my life? So everyone's like, you need to write a book. You need to write a book. And I'm like, I do. If I ever write one day, someone else will help me to do that with a ghost. I'm just putting that out there. It's been on my heart. But I talk, I love to talk. I love to tell my story. I love to help other people realize that there are so many options when it comes to breastfeeding. So yes, I started the practice and all the certifications, everything did not start until that happened.

(09:42): And from there, I pumped for another three years. Built an amazing platform on so many platforms because our global mission is to normalize, pumping and let the world know that we pump with purpose. So I just really want to let women know that you can do what works best for you. Right. Pumping can be viable, sustainable, long-term solution. We don't have to put societal pressures on ourselves so much that we can't see the glory in the journey. Sure, sure. I wouldn't have had this platform today if I wouldn't have went through what I went through. Trauma produces purpose. So everything my brand has been strategically designed to help people see me in a different way. The pumping in a different way. So excited to be

Dr.Nicole (10:29): Here. I love it. Love it, love it, love it. I can tell you're very passionate about your work. Yes. You're also very serious about your work. Sometimes you see people pop up on social media and they're like, well, I did this thing. So now I'm an expert. And I kind of have some problems with that. Yes, you may be an expert in your particular experience or journey, but there is something to people who put in some work and study and get prepared. And it sounds like that's what you did. And I think that's great. I'm curious, what did you do before you started this?

Dr.Dixon (11:06): I helped underserved communities in a regulation standpoint. Okay. Definitely high profile, high America standards. But my background is in risk management, which in a way, pumping is like risk management. You

Dr.Nicole (11:21): Don't

Dr.Dixon (11:21): Do what you're supposed to do. You not have milk and preparing with the plan order. So it was a pivot for me. I became a mom and I realized there was so much more to life than that so many times. We were forced to face so many different decisions. It was a journey to this place is something that just evolved as I be. It just became more of, I want to know, I want to help. I want to be, I want women to see that they can do what they want to do.

Dr.Nicole (11:54): Absolutely. Love it, love it, love it. And then did you ever both feed at the breast and pump, or did you always pump? And if so, can you share why? Yes.

Dr.Dixon (12:04): We call, well, in the EP world, excuse the pumping by force or by choice. Okay. Journey by force. Second. Journey by choice. So for, okay. I did try to nurse, it's something half of my clients actually, nurse, believe it or not, I just help them to add pumping to their journey in a way that works

Dr.Nicole (12:20): Best. And that's what I figured. Yeah.

Dr.Dixon (12:22): Yeah. So I refer out everything that's dealing with, I'm very vocal on what we do, not assist with no lash assessments or anything like that, anything dealing with nursing. But for the first journey, it was by force. Whereas I wanted to give my child breast milk. My son, my first son was tongue tied and lip tied severely. So he was not able to nurse and effectively, so of course I was pumping well. So I'm like, if it's just tongue time, lip time for me just about nursing, I, I'm ok. Right. When I started researching and learning all the other things and implications that can happen later, we did proceed with this procedure at six weeks. I did try to reintroduce him to the breast and it was not, it did not go well. I remember, sorry. At three months I just kept trying and trying. My husband's like, why are you doing this to yourself? Right. I'm supposed to nurse, I'm supposed that undue societal pressure Yes. Was on me. And I put my son at the breast for the last time that day and he laughed at me when I tell you

Dr.Nicole (13:24): No, he didn't.

Dr.Dixon (13:25): No. Like C plate.

Dr.Nicole (13:27): Oh no, no. I did not see. Listen, he

Dr.Dixon (13:29): Called me out and never tried again.

Dr.Nicole (13:32): Okay. So

Dr.Dixon (13:33): My second journey, the second son was also lib tied and tongue tied and buckle tied. I attempted, but by then I knew it wasn't for me. But again, societal pressure Sure. Makes you think that you need to do this in order to be successful. You need to do this to say that you can help with breastfeeding. So I tried, it didn't work. When we got it sometime lip tie done this time we did his assessment afterwards with the bottle and I was okay with that. Okay. It never was introduced to the breast pass the hospital. Okay.

Dr.Nicole (14:05): Okay. And

Dr.Dixon (14:05): I did it by choice. I knew I didn't. But then the back of your mind, you're like, do I still want to do it? So, sure. And in my community asked, she said, if you had another child, would you do it again? I would try to nurse, no, it's not for me. Right. I'm on this side of things where nothing from society and their pressure can impact my decisions when it comes to choices I would make when it comes to breastfeeding.

Dr.Nicole (14:31): Gotcha. I may, and you could also even change your mind in the moment. None of us has to be stuck to any one thing. Correct. Yeah, exactly. So let's start off with talking about breast pumps because they're so many of them. There's so many new ones from when I was doing this a long time ago. My children are 15 and 13. Yes. So what are your top two or three pieces of advice when it comes to choosing a breast pump?

Dr.Dixon (14:59): Okay, so let's start by, one thing I didn't mention is I have well over 300 products in here, including 60 plus breast pumps. The very clear people think that I have been gifted breast pumps by brands, but I do not accept them in for, I don't accept money for reviews of them. Gotcha. That makes sense. Get them, because some before this, probably 20 ish to 25, even before I started Pump with Purpose, I had also tried, I was that person, I need to try every pump. I need to make sure not knowing what purpose was going to come later. So people think, oh, she was just gifted all. No, I have spent thousands and the first number is not one on breast pumps out of my own pocket. Out of my own pocket. But I do have over 60 plus breast pumps and another 250 plus pumping products in here that their families pull up. It's different when you have not just an educated experience, but a lived experience and a learned experience. Sure, sure. So I able, when they pull up, I know how it feels. I know what they, what's too strong. If they're like, I'm using an eight on this pump. I know what an eight feels like, I can't. Gotcha. Not just, oh, that's a pump. And I read that it was a good pump and everybody on social media tells me they love this

Dr.Nicole (16:08): Pump.

Dr.Dixon (16:08): I have so many experiences with pumps that I use that women choose. So when it comes to the pump, what to consider? Yeah, they're different kinds. You have your hospital grade, so there's a D hospital grade. The ones found in the hospitals, it's hospital grade. Then you have your hospital strength pumps that are your personal pumps. But I call 'em workhorse pumps that they can be customized 60 plus ways. So there's so many setting options on them. Then you have what I call small motor pumps where they fit in the palm of your hand. Then I have what's called wearable pumps. Wearable pumps go into the bra, no tubing. So that's the four. That's how I delineate the pumps. I am for someone establishing their supply from birth. I only recommend hospital grade or your workhorse pumps that can be highly customizable. Gotcha. That is true.

(16:56): That's the number one option for me. My community know will know when they hear this. That's my secret sauce. It has to be customizable. I need to be able to make that pump go faster, slower, stronger, weaker. When I decide to do so. So many pumps on the market, they control when it oh, two minutes and that's it. Or as soon as it, or as you go up in suction strength, it slows down. What about if you don't like it slower? All of those things. So I am big on customizable. I want pumps. I don't like co conven pumps that are considered to be convenient. Some of them yes. People. I get it. There's a different, you need them on different parts of your journey, but as you're home, as you're recovering, you want something that is, because a lot of times these smaller pumps are more aggressive to a person that may cause nipple pain trauma.

(17:50): So is damaged later because these motors are like this big, kind of like a car. If you got a teeny little car versus a big old, the motors are different that they're smoother for some women. So I'm big on having a pump that is customizable, that's able to respond well to what your body likes. That's the biggest thing. People just think, I'm going to say this in love, press the button, turn on the pump, put it on, and then all this milk's going to come out. Right. Gotcha. They don't realize the making sure that it aligns with your body and what you like based on your body. So I'm big on, okay, there's different pumping research out that to be able to individualize the pump choice based on someone's preferences. So I like to figure out what you want. There are wall pumps, right? Do you want to be chained to a wall all day?

(18:42): Right. Right. There are pumps that you can walk around with but still can be a workhorse pump. Hint, hint. I don't recommend, unless something is really going on, that underlying condition or something is going on those pumps that chain you to the wall because it's going to make your journey harder when you feel like you can't get up and move around. So I am big on, or what is your budget? I have pumps in here. Not saying I recommended it from like $35 to $2,000. Not saying you need a $2,000 pump, but I'm just going to say that these 20 $40 pumps may not provide, they're not built to be used long term. People are don't blowing through three or four pumps in the first year. Right. Because they're using these pumps exclusively. Because a lot of times these pumps may not have been meant to be used exclusively on a journey.

Dr.Nicole (19:30): Gotcha. Gotcha. And I would say with insurance also, I mean your insurance is probably going to pay for at least one breast pump. You probably want to get something as, I don't want to say as expensive, but if you can get something that's going to be better, then go for something. Correct. That's going to be a little bit, yeah.

Dr.Dixon (19:47): Yes. The insurance pumps. So if you have insurance as an option, I help clients go through the list of insurance pumps. I walk them through what they would like, what they may not like. But two can choose wrong when it comes to insurance pumps. Cause let me tell you what people do. They go to the internet and they say, what is the best breast pump?

Dr.Nicole (20:03): Right.

Dr.Dixon (20:04): Seo. People don't realize that people are light bulbs. Like SEO is an amazing tool that whoever pays highest right to be at the top of the ranking may not be the best breast pump for you. Right. And really trying to, or some people say, my friend used this breast pump and this worked well for this person. Why is it not working well for me? Cause it's based on your body. Someone may prefer some of the settings on that breast pump when pumps don't allow customization. That pump is saying that a hundred percent of the people that use that pump only need those settings. Do you know how inac, that's so inaccurate. Gotcha. You may need to customize to make your body comfortable. Let's not even bring in the factor of sensory or what's strong. Somewhat have different pain tolerances. So maybe you do need a stronger suction pump. Maybe you don't. Some of my clients, they have very high, they tell me I have a high pain tolerance, so I know I can't go giving them this gentle little pump. Sure. Cause they want to feel like nothing is happening. Does that need

Dr.Nicole (21:10): Yeah, sure. Absolutely. So obvious. So definitely this is something I hadn't even thought about. You can't have a one size fits all. Definitely. Definitely. Definitely. Think about you want something that you have the option to customize and maybe you might need some help customizing the settings, but you want to start with something where you can get customized.

Dr.Dixon (21:29): Find out where your body Yeah. People think I just say that to them just to say, oh, I want you to know once my clients finally pull up and we go through it, some of them already have amazing pumps. A lot of them, they just don't know how to use them based on their body. But people are like, can I you make it work. I'm like, we can do a plan A and a plan B. Plan A is if you have something that I know will work that's going to work, I just have to teach you to use it. Right. Some we can try to make it work and then if not, once we fix the flanges, then we can go over to giving you an option. Gotcha. Cause sometimes some people invest more money, they want to make sure that what they've invested in before they Sure,

Dr.Nicole (22:05): Sure,

Dr.Dixon (22:06): Sure. Is not going to work.

Dr.Nicole (22:07): Gotcha. And speaking of flanges, how do people pick the right flange size?

Dr.Dixon (22:13): So flanges, I, let me tell you what, I don't like the cookie cutter stuff. People think I measure my nipple. My nipple is a 15. They think they automatically, they look at the internet, go up all these different sizes. I have people ranging depending on what their nipple, nipple elasticity needs in order to be successful. Some women, their nipple is what's called elastic, that it stretches and swells to the back of the flange. Okay. And you may need to consider that when choosing flanges. Gotcha, gotcha. You're also women and I'm, I'm pleased if you're listening to this on the sound of my voice. If you hear flat on verted nipples, and that is you so many, once I, so many women are creating nipples that they never had. Okay. Because they're putting their nipple in flanges that are so big for their body because people don't know how to measure them based flat on verted nipples where your nipple may not poke out from your Sure.

(23:08): So people just create this extra nipple and then the pain, the, so just being able to realize that you need to know what your nipple is, where your nipple begins and where ends and your areola begins. Okay. That's critical. Knowing the size, but also flange type people just think I'm a number and that's it due to just advancements. There's so many flanges on the market. People. Okay. Will have spent FI a hundred dollars on flanges, because I'm going to say it in love, the exploitation of the pumping community in such a vulnerable timeframe of you, you're trying to feed your baby. Some people, I don't care. I just want to, they said it's the best. I'm going to get it right. But then they don't consider what their breast or their nipples need in order to be successful. Right. Do you need SI silicone? Do you need hard plastic? I'll give you some secret sauce. There's only two types of flanges. Silicone hard plastic. What do you need? There're different types of flanges where directional, some of them point down, some of them don't. Some of them all silicone, some mimic a baby nursing. There are just so many flanges on the market. This whole bag back here, it's just full of flanges. Okay. I have at least 30 plus flanges in here because it is not a one size fits all

Dr.Nicole (24:26): Approach. Sure. Okay. That makes perfect sense. Makes perfect sense. And I presume you have some resources maybe on your website or social media that can help, because I feel like that's a visual thing showing people how to

Dr.Dixon (24:38): Correct. So in my on social media, I talk about what to be looking for, but as far as what someone needs to do, because what I also do is honor my flange fittings. So sometimes, let me tell you, people do, oh, you're this number. Good luck. Bye. See you later. I honor all of them where when the products that we talk through come in, if they work or you need some troubleshooting, then I troubleshoot at no additional cost to figure out what your body needs to make sure that all of my clients are successful. Because it's not one size fits all on what is happening. If that means

Dr.Nicole (25:13): Gotcha. Gotcha. Yep. That makes sense. That makes sense. Okay. So let's talk about, I mean we maybe talked about this al already, mistakes that you see when people pump. It sounds like one may be choosing the wrong pump. Another may be choosing the wrong flange size. Is there anything else that you see people Correct. Making mistakes on? So

Dr.Dixon (25:33): Everything about pump or purpose is based on four things. I trademarked it as the pumping equation, pump flange product schedule.

Dr.Nicole (25:39): Okay. That's

Dr.Dixon (25:40): It. That's it. Everyone that pulls up, that's all we talk about. Okay. Flange product schedule, pump is the breast pump. Flanges pumping products, that's a big thing. People are like we talking about pumping products. Yeah.

Dr.Nicole (25:53): Everyone

Dr.Dixon (25:54): That's pumping needs, and I did say need, they need a pumping bra. Okay. You need some. You cannot be out here holding your flanges thinking, first of all, just the comfortability of it. Yes. Being able to know if you need a hand massage. Yes. So pumping bra is so important. Anything that accompanies your journey, sometimes people need mass warming, massages or some people like heat and they don't like massage. Some people like massage don't like heat. So figuring out what products you need. Also, if you have

Dr.Nicole (26:24): Some, oh, sorry. I'm sorry. Is it pumping bra different than like a regular nursing bra?

Dr.Dixon (26:28): Yes. Let me tell you secret, all nursing bras do not allow for pumping without a hack. But all pumping bras allow for nursing. See that inclusive nature of pumping, all pumping bras allow, just depending on, they either have a slide to open up for nursing or they have a clip that can come down. Some different ones are now 30 plus pump, probably 40 plus pumping bras in here by now. Some are more sports brass. So thick bra, thin bras, sports bra, canmy bra, Vicki bra with a dv. Feel like you have no bra on at all. There's a plethora of bras on the market that I can match people into. But if you know you like sports bras, you should not, let me tell you, you should not have to jeopardize your looks. So the one thing about me and motherhood, I don't want people to sacrifice what looks good.

(27:16): Some of these frumpy, ugly brass, you're not going to feel beautiful. Right. There's so many amazing, beautiful brass. Right? Some people love sports brass. They don't want to a bra with the clip on the back. So there's so many sports bras on the market. There are just so many things. The nursing hack, I'm not a fan of. It tilts your bra up or your F flanges up in the air. So you keep having, I keep telling me, you keep pulling them down, don't you? Yeah. Because the nursing hack is, yes, I do believe that people always try to make things work, but sometimes it's worth getting something else that will work better for your journey. That makes sense. Sense. Also, not just with some people want to put, I'm say this in love, so if you hear this I'm saying in love, they want to put holes in force so they got a bra and they spit hole in it. Right? Yeah. Don't

Dr.Nicole (28:04): Do that.

Dr.Dixon (28:05): Yes. There's so many things that you know want to have proper support. You don't want to have, you got to take off your bra, especially if you're back at work. You got to take off your bra in order to put a bra with a hole in it. And it makes people think pumping as so complex and complicated and it doesn't have to be. Gotcha.

Dr.Nicole (28:25): Gotcha.

Dr.Dixon (28:25): So yes. Gotcha. Products are so important. And then schedule. Yeah. So

Dr.Nicole (28:29): How get on the schedule. Yes.

Dr.Dixon (28:33): I praise as the 240 minute rule. This is my general advice. So you're actually going to get a rule here that in order to establish supplies the 240 minute rule trademarked by pump with purpose, it is every three hours for 30 minutes for the first 12 weeks with the right pump flash products and schedule. I want to give a huge disclaimer here that is for pumping only. There are women that decide they want to pump from birth or their journey has taken them into a way that pumping is now their exclusive pumping. Your exclusive pumping before the 12 first 12 weeks. That is every three hours for 30 minutes for the first 12 weeks is as up to 240 minutes. So I want people in order to establish supply, it used to be 10 minutes, 15 minutes. I'm going to tell you I am team oversupply.

(29:19): I am team freezer. I'm not saying that I need people with two deep freezers full of milk. Sure, sure. But if you wantage, it is a way to help you to get it. Okay. I feel like it's, for my personal opinion, it's easier to decrease than it is to increase. Gotcha. Pumping has a window that the limiting signal weaning when they're not pumping enough or if they have underlying conditions that are present that they're not aware of yet, they don't realize that their body needs more stimulation in order to be successful. So when people are able to increase their milk supply, it's because they're appropriately getting in the right tools and then using a schedule that works well. So if someone is under the sound of my voice that's nursing, you say, well what am I supposed to do with nursing? And I'm going to give you this.

(30:06): The point of pumping is not to continuously chase behind baby. When you nurse, you don't want to take away, please hear me clearly. You don't want to take away milk from the baby in order to pump and have to give it back to your baby in a bottle. That's not the purpose of pumping. The purpose of pumping, in my opinion, barring any underlying conditions, is to have something for a rainy day. You want to have a date night or you want to go on a trip for a couple days or weekend away. Right. You're sitting here week before trying to tell your body you need all this milk to be away when you signal for the last eight weeks that you didn't need any of that milk got. It's a way to have something on average not, I always ask people, how much do you want? And few people, when you added in strategically where you're not chasing behind baby, it's just going for a rainy day or saving something for a day, or you

Dr.Nicole (30:59): Never know when you go back to work or all those kinds of things, go

Dr.Dixon (31:02): Back to work. You have a dip. Your cycle comes on you and that can impact you. You have something where you're not stressing and people are going to every 30 minutes, I'm not 30 minutes every two hours. Or they are power pumping for an hour long session in

Dr.Nicole (31:17): Order to make. That's a lot.

Dr.Dixon (31:18): It's a lot. And it's so stressful. That could be avoided with strategic ways of when to pump. That's not taken away from your baby. But to add it in a way that you can just put something away, that's my ideal scenario for my nursing clients.

Dr.Nicole (31:34): Gotcha. Gotcha. Love it. Love it. So then what about increasing milk supply? What do you suggest for people? Because a lot of people struggle with milk supply.

Dr.Dixon (31:44): Correct? It is, again, the secret sauce of it all. It's the pumping equation. Pump flange, Protestant schedule. This new way people say eat more, drink more, pump more sleep, more stress less. That's what they keep telling us. I ate Oreos and I increase my milk supply. I drink body armor or coconut water, coconut milk, and increased my milk supply. I pumped every two hours a power pumps and I increased my milk supply. They have all these trends that hit social media that they're trying to do. And I go back to pump flange products and schedule that is it. I've helped people double, triple, quadruple, can topple their milk supply with documented. And I've social proof of that. I'm not just telling you that. Sure, sure.

Dr.Nicole (32:28): Based on

Dr.Dixon (32:30): Claims, products and schedule. No herbal supplements.

Dr.Nicole (32:34): Okay. Okay. When

Dr.Dixon (32:35): You want to have that conversation.

Dr.Nicole (32:38): Okay. All right.

Dr.Dixon (32:40): Then no herbal supplements. Right. People don't realize that milk supply is made from your blood. It's not just about the food. Be eating, drink can fuel it, but it's made from my blood. So many people are chasing, I'm going to buy this supplement and that supplement. Don't realize that you need to go have a conversation potentially with your doctor to figure out what is going on. Or you have all these issues. I'm saying this in love during pregnancy, and then do someone just, they got the baby here so they don't realize some of those same concerns go forward into your lactation journey.

Dr.Nicole (33:13): Yeah. Yeah. One that always I think comes up fairly frequently is PCOS. If you have pco o s and trouble getting pregnant, you very well may have trouble breastfeeding. Okay. Yeah.

Dr.Dixon (33:24): But if you make sure your levels, they maintain or you don't just say, I had the baby, I've had that. And then don't make sure that the appropriate insulin levels and all the things or things are checked with it really can make sure that you have success. I have people with everything breast surgery, PCOS. Right. Igc, insufficient glandular tissue. I have people with every, some thi people think that will not cause, that will think that causes you to not make enough milk and they make enough milk.

Dr.Nicole (33:55): Okay.

Dr.Dixon (33:56): Because if you get it with the stimulation, right. Pump, not saying everyone, but there are ways that people with documented underlying concerns can still make milk and make enough milk for their baby. But it comes with knowing it's there. Working with someone that introduces the products to you earlier. Sure. Cause lemme tell you the, what happens a lot of times at the very beginning, the first two weeks when you're just focused on nursing doctors tell you don't pump for four to eight to six to 12 weeks. Right. But you got to engorge. If you don't pump that milk out, you lose it.

Dr.Nicole (34:31): Yeah.

Dr.Dixon (34:32): If you don't use it, you lose it. Right. Right. And that's when I ask people, Hey, think back to the first couple of weeks where you and I got research coming this week on my social media platforms that if you don't, the first two weeks are so critical, if you feel like something else is going on to potentially make sure that you are effectively removing milk. Does that mean hand expression? That could mean a milk collector. That could mean a manual pump or that could mean an electric breast pump. Sure. I'm not saying what way, but if you want to save some of that milk and tell your body you don't want it to reabsorb back in, that is the way to do so is to get it out of the breast. Because what your baby takes in at two weeks, I promise you's different than when they take in at two months.

Dr.Nicole (35:17): Yeah, absolutely. Yes. They're going to be a bigger baby then. For sure. Yes, for sure. For sure. And I think maybe we talked about mistakes. We talked about milk supply. What about what are the issues that people typically have when they pump? And maybe we've touched on them. No, maybe it's the that the schedule or maybe it's the pain. What are the things that you see people come to you with? I'm

Dr.Dixon (35:44): Not even the pumping is what I call pumping life hacks. Right. Okay. The biggest thing with people with pumping, especially either or with clients and nursing, they need to pump to go back to work or they want to pump or just in general, all the stuff that goes on. You got bottles, you got different bottle drinking, you got all this extra

Dr.Nicole (36:08): Yes.

Dr.Dixon (36:08): To wash. And that is so detrimental to people's journey when they don't realize that there are ways to make things easier.

Dr.Nicole (36:16): Yeah. So please, what suggestions do you have?

Dr.Dixon (36:20): My pumping life hacks are when possible pumping and bottle feeding at the same time. Okay. So what that can look like is if your baby, I tell clients, cause I'm like, how I am going to keep up by the time I get the baby fed and change and then it's time to pump, then I got to turn around and do the same cycle. Right. I was able, and I encouraged when possible it takes you a while to find your way through. Sure. So I'm saying you have to do this. Sure. But one way is to pump and feed at the same time where if your baby is eating, you are pumping, you paste bottle feed in your lap, put the bottle, add different ways to show that. But pumping and feeding, bottle feeding at the same time. Okay. You can make sure that you don't feel like you have to do two separate things.

(37:01): Right. So pump and feed from the same bottle when possible. So there's so many bottles on, okay. That have bottle converters look like this. They're different ones. This one is for a me dealer or Dr. Brown's bottle. But they're different ones for LANs and off. They're a bunch of converters. Right. So you would take that, put it on your pump, put your bottle on, and now you can pump and feed into the same bottle, which will dramatically cut your wash time in half. Okay. And if we going to go some more secret sauce, you buy two days worth. So you're not stressing about I got to wash up all this stuff too. Yes. The same day. Yes. In order to give it to my baby tomorrow. Yes. If you have two days worth, then it can wash and then be ready for the next day. These are just little nuances that make people's lives easier.

Dr.Nicole (37:48): I forgot about all those washing all those guys taco go bottles and things. Yes. Cause most of it, you can't really put, I mean, maybe these days are different, but back then you, you're not supposed to put it in the dishwasher. You know, got to hand wash all the stuff. So I

Dr.Dixon (38:01): Did hand wash on part of old school here, but I did hand wash. But you can put in, I mean, most of them they say you can put it in the dishwash.

Dr.Nicole (38:10): Okay. Okay.

Dr.Dixon (38:12): So then the third one is pumping and feeding bottle. Feeding one bottle head. So what that looked like for me was sometimes we're stressed out like, oh my gosh, my baby's going to wake up and I need to get this milk out. Right now breast milk is good out i'll per CDC for four hours. I promise you most of the time your infant will be eating before four hours. Right. Sleep, you can put it in the fridge. But I fed one bottle head. So when I pumped at four, that was my bottle for seven. When I pumped at seven, that was my bottle for 10. So then I always had a bottle on ready. So just in case baby got hungry, went through a gross spur and needed a bottle at two and a half hours. Sure. Okay. They were always one on ready for me.

(38:49): Once I did these Pumping life hacks for me, they really change the trajectory of how long I could pump. How pumping does not seem as inconvenient. Right, right. Or buying extra parts. So I have a set up I four. I had kept four parts in rotation, so all my morning pumps was with one. I washed them and then all my night pumps. So when I go to bed, everyone's like, I got to get up. And I got no, I just had a stuff already hooked up and I just pumped to the next session. Got already

Dr.Nicole (39:21): Ready to go. Got it, got it, got it

Dr.Dixon (39:22): Left. Okay. So much. And that's how I was able to do so more long term.

Dr.Nicole (39:27): Okay. I love it. I love it. And I know you talked about that three hours, the two 40 rule for the first 12 weeks. Obviously that's going to change as your baby gets older. Yeah. You're not going to have to get up during the night every three hours. Yeah.

Dr.Dixon (39:40): Yes. That's for the first 12 weeks. Some women, if something else is going on, some of them may have to keep some of that doing some type of more regular pumping. But the secret goal to exclusive pumping is most of us want to pump less and make the same amount if not more. So as we drop pumps, I help people to strategically drop them and they don't lose if very little, if any milk. That's the goal where you can drop pumps and because you can see everything, but you can drop pumps and hopefully not see, so when people drop pumps, they're like, I lost 10 ounces. Something's wrong.

Dr.Nicole (40:20): Okay. You

Dr.Dixon (40:21): Know? Got it. Something's not right with your tools. When I hear these huge dips and then you can't get it back because your tools are wrong, your body needs certain things to be successful to make the milk again. But then you're in tools that are too big for your body or your flanges, your nipples are stretching and swelling, looking like a miniature being a sausage. Your nipples are changing. Colors turning purple. Right. You turning white.

Dr.Nicole (40:44): Yeah. Nope. That shouldn't have to be that way. It doesn't.

Dr.Dixon (40:46): Yeah, it doesn't. If we armed that, we can get the right tools from the beginning. My prenatal clients, I cannot say enough how much their journey is set differently by learning the things that they need to do to be successful people. If you hear nothing else for me, know that in general, breastfeeding, but in pumping with all the devices and products create a huge level of confusion. And people think that, say it in love that everyone just like, it's cute to show all these pumps on your page. Right? Oh, it gets all these views. When you look at that page, you rarely see pumps because people will make an inference that some people are like, I see this pump on your page. That means you recommend it. No, I do reviews on pumps, but I don't throw things across people's screen. Because if you have to spend money or get an insurance pump, you want to choose correctly the first. Sure.

Dr.Nicole (41:39): Absolutely. Absolutely. Now, the final thing I want to talk about is I had, and I had never heard this before, what do you mean when you say pumping self-care?

Dr.Dixon (41:53): Find your voice so you can find your peace. That is my motto that my community knows.

Dr.Nicole (41:59): Right.

Dr.Dixon (41:59): Pumping self-care looks completely different from everyone. Okay. Your village, your people that are in your corner, they want us to be successful. I promise you that if you're hearing my voice right now, they want you to be successful, but they have to know what you want first.

Dr.Nicole (42:18): Okay.

Dr.Dixon (42:19): What I'll say is people kept telling me what self-care looks like. Oh, your hus, your significant other. It's supposed to wash all your parts. That's not self-care for me. Okay. People put define, oh, someone's they got a and they do this. That's not self-care for me.

Dr.Nicole (42:35): Okay.

Dr.Dixon (42:36): You have to find your voice so you can find your piece. If that is at home, if that is at work, sometimes self-care means to be able to block that calendar off and know you can get your pump sessions done every day. Self-care can mean specific and others. For me it's basement Fridays. My community knows basement Fridays, my husband takes my kids. Now they're older now that the basement and I get a night to myself. I don't have to listen for anybody. Right. Don't worry about anybody waking up for me.

Dr.Nicole (43:07): Okay.

Dr.Dixon (43:07): Please understand. Stop applying other people's definition on what self-care looks like. But you have to know what it is for you so you can communicate to others what you need. It's already a less, some people self-care looks like washing all your pump parts for you. If they tell you significant other, you need that. I'm thinking. Right. They will do. So if you show them what needs to be done and they will do it. Right. Sometimes it looks like when I was nine months, we hired cleaners to come and they still come in once a month to help deep clean the household. Cause I don't have the time to do so. Right. Or the deep cleaning. Sure. Self care for me, some taking stuff off my plate, right. Is selfcare for me. Doesn't mean I need to go get my nails in my hair and all that stuff that doesn't. People are like, are you get no self-care can look like celebrating your journey in the way that works best for you. So can look like a trip, can look like a pumping moon. I don't know where, whatever,

Dr.Nicole (44:09): It's, you just

Dr.Dixon (44:10): Cut these things, but you have to be able to communicate to your loved ones what that looks like. That can mean someone not even taking your baby out of the house. That could mean coming over, letting you pump in peace. Take the baby upstairs, take the baby to the basement. I just want to normalize that. We have to find what works best for us and communicate that

Dr.Nicole (44:36): To others. Absolutely. 1000%. I

Dr.Dixon (44:39): Want people to really, really hope that resonates with someone today.

Dr.Nicole (44:44): Yeah. That's a life lesson for sure. Yeah, for sure. Sure. We

Dr.Dixon (44:48): Can be everything to everyone. And some people take the S off your chest. We cannot be everything to everyone where we lose ourselves. Absolutely. I also want to point out that who you are today may not be the person you were before you had children.

Dr.Nicole (45:04): It honestly it. They're not. You become a new person when you have children. Yeah,

Dr.Dixon (45:09): Correct. But it's still a beautiful person, even if that person's different.

Dr.Nicole (45:14): Absolutely.

Dr.Dixon (45:15): Absolutely. Not the same person. I don't want to be her though. Right. But I've accepted that this new me looks completely different with different goals, with different aspirations on what success looks like for me. So I hope that resonates with someone today that's listening to this.

Dr.Nicole (45:33): Sure. Absolutely. Absolutely. So as we wrap up, I ask all of my guests this. What is the most frustrating part of your work?

Dr.Dixon (45:42): First thing that comes to mind, and I'm going to say this in love, there are times that peer to peer telling someone your lived experience can help. But also knowing that some people need more professional care. So my biggest thing is I will never deny the influencers. They're great at normalizing, pumping, they're great. At least seeing somebody pumping these days is amazing. I'm just saying. Right.

Dr.Nicole (46:12): Right.

Dr.Dixon (46:12): They put their journey out there for us to see, and people follow it and they love it, but sometimes we try to replicate other people's journey.

(46:21): We try to live through their experiences and try to put and do it for ourselves. And it doesn't always work the same. So my biggest thing is trying to dispel some of the myths or telling people maybe it's time to bring in the doctor. Maybe it's time to talk with your OB or your pcp. You may not have, you're not going to have two deep freezers and 90 ounces a day. Everyone's not going to have that. Right. Most people are not going to have that. True. But I don't shame people that do have it or want it, but I also don't shame or make people feel like they need to have it. But if you do have it and that is what you want for your goals, then that's okay too. So I'm big on making sure we do what's best for you.

Dr.Nicole (47:08): Yes, absolutely. Absolute.

Dr.Dixon (47:09): That's my biggest thing of, I just want people to not live just in social media, to do every single thing or on Google all the time. Sometimes we have to find someone that we can have a dialogue with. Because some people don't realize you could say one little thing and it's the gateway to why you're going through everything you're

Dr.Nicole (47:28): Going. Right. Right. Absolutely. Because

Dr.Dixon (47:30): Absolutely they're not trained to hear and see and have the ability to see so many people to understand all the nuances that can come into

Dr.Nicole (47:39): Play. So the ability to use their knowledge, their expertise and experience, and then apply it to help you through your unique situation really. Yeah. So then on the flip side, what's the most rewarding part of your work?

Dr.Dixon (47:54): Let me tell you, meeting so many amazing people. So my community knows, I say I want to change the world one pumping family at a time and then I mean that.

Dr.Nicole (48:06): Right? Right.

Dr.Dixon (48:07): I'm big on helping the pumping community to reach its goals. And the most rewarding thing is having people to trust me. I create a safe space and place for pumping. I have an app on myself on all Google Apple devices. I'm evolutionary. I want to change the world and how they view pumping.

Dr.Nicole (48:26): Okay.

Dr.Dixon (48:27): Alright. And so my most rewarding work is for people to trust me enough from their journey to be a part of it. I have so many resources. If you're on my Instagram, I go live twice a week. I do question boxes on the weekends because a day in lactation can be a week with your supply.

Dr.Nicole (48:45): That's the true,

Dr.Dixon (48:46): Yes. It can take you literally, if you don't have the resource to say, who can I talk to? Half of the time people don't need, lemme be real. Many people, they don't answer dms, they don't talk, they don't. And you're searching. You always have a place here. Even if it's a this, I'm not the best person here. It's a better person for you. I know my people. I know, I know my avatar, but don't ever hesitate to ask for help. So the people that do they know, I create a safe space and place for them to get what they need. Because some of it can be life changing, some of it is also life-threatening. You have things going on with your body. There are people that if you don't get the care for mastitis or knowing when to go or having that, people have to end up getting their brush drained off. Sure. So much.

Dr.Nicole (49:34): Yeah.

Dr.Dixon (49:35): Without somewhere to at least point you to where to go. I may not be the person for everything, but I make sure I find a resource in order to help you.

Dr.Nicole (49:44): Yeah, that's wonderful. That's wonderful and really important. So then what would be your favorite piece of advice that you would give to someone about pumping

Dr.Dixon (49:54): Everything you say? The first thing that pops in mind, I say it. Do what is best for you. That's always my ma motto. I never demean or second make people second. There could be people that say something and I know that something is wrong. And I will say, cause HIPAA and all the things, sure I can say certain things, sure. But I don't want you to get through with the end of your journey and have all these regrets. So I say, if you're happy with what you're doing, do what is best for you. Don't let me or anybody else in social media or your family, your friends, make you second guess your journey. Make you doubt your motherhood journey because it's yours. It's only yours and no one else's. I made my journey and I'm proud. Right. Two journeys, I'm proud. Right. I'm never going to let somebody make me second guess what I've been called to do.

Dr.Nicole (50:45): Right.

Dr.Dixon (50:46): And I just encourage you, some people they don't under, they always want to know why they're going through things. Some of it is not to understand right now. That's some of it can be two to three years later, i e me. That's created a platform. A platform that if I wouldn't have gone through what I went through. So some of it is not for you. Some of it is for you to help others later with in a way that works best for you.

Dr.Nicole (51:10): Absolutely. Absolutely. So where can people find you? What are the social media links, website, all that great, great stuff? Yes.

Dr.Dixon (51:17): I'm at www, everything is www.pumpwithpurpose.com. Okay. Instagram everything. I'm pumped with purpose, so,

Dr.Nicole (51:25): Okay. Everywhere. Stay

Dr.Dixon (51:26): Everywhere. Twitter.

Dr.Nicole (51:27): Okay. TikTok, are you on TikTok

Dr.Dixon (51:29): Everywhere? TikTok Peanut Lemonade, I got on there. I'm wherever the pumping community

Dr.Nicole (51:34): Is. Okay. All right. I love it. Love it, love it. Yes.

Dr.Dixon (51:37): But Instagram, but I will say Instagram is where I do most and all of my nurturing because I can't be committed everywhere.

Dr.Nicole (51:44): Absolutely. Yeah. We, again, that's honoring your own self and what works best for you. We can't do all the things. I'm the same. I'm on Instagram as well. Correct.

Dr.Dixon (51:52): So if you really want to find me in a way that's in a nurturing space, is Instagram all

Dr.Nicole (51:58): Okay? Okay, perfect. Well, thank you so much for agreeing to come onto the podcast. This was a very, very helpful conversation. I so appreciate your time. Thank you

Dr.Dixon (52:07): For having me.

Dr.Nicole (52:14): So wasn't that a great episode? I just love how passionate she is about her work. How honest, how open, how supportive. I just love to connect with folks who are really just so committed to helping people and I appreciate her input and conversation today. All right. Now every conversation where I have a guest expert on, I do something called Dr. Nicole's notes, which are my top takeaways from the conversation. So here are my Dr. Nicole's notes from my conversation with Dr. Dixon from Pump with purpose number one. I know, I think in my experience, most women, most people are going to introduce pumping at some. Okay. Just because you go back to work or the convenience or to let your partner feed the baby some, most people will introduce pumping. So go ahead and familiarize yourself with it from the start. I wish I would've learned more about this while I was pregnant about how to introduce pumping.

(53:11): You don't want to be figuring out how to do things while you're flying the plane, so to speak. So definitely look into getting yourself familiar with pumping before you have to do it. All right. Okay. Number two, I love how we talked about creating your own journey. You are capable, you are strong enough to create your own journey that is in your life. That is with your pregnancy and birth experience. That is with parenthood, that is with breastfeeding. Now, you definitely want to get help from other sources, right? So as you're going through this journey, like you're going through your pregnancy, you're preparing for your birth breastfeeding, being a parent, of course you learn from others and you get help from others. But as Dennis Morton says, I don't know if any of you do Peloton, but I am a Peloton junkie, so to speak. I mostly do yoga and the tread.

(54:11): And Dennis does yoga and one of the things that he says all the time is when in all his classes is I make suggestions. You make decisions. So we here as experts are giving you our suggestions and input based on our training, our knowledge, our expertise, our experience. But ultimately, you are the one who is capable and should be making decisions about your life and your journey with breastfeeding and your journey with all of these things, okay? Don't let other people make decisions for you. All right? And then the final thing that I want to say, and this is something that I've been talking a lot more about just because I've seen it feels like more people entering into the online education space or in influencer space who are just kind of setting up shop without necessarily having any real background or training. Make sure you are getting your information from a trustworthy source.

(55:12): Okay? Now, if you are here, then you probably already know that, or you prob probably already value that because you know that I'm a doctor, I'm well trained. I've been doing this a long time. I have a ton of experience. I've helped bring over a thousand babies into this world. I am currently still practicing and practicing in a hospital environment, okay? So that's why I focus on talking about hospital birth because that is what I know. That is what I talk about. You're not going to hear me talking about home birth, you're not going to hear me talking about birth center birth. You're not even necessarily going to hear me a lot talking about midwifery care in the sense that I can't speak in depth about it because it's just not something that I know. And I want you to be sure that you are getting information about a topic from trustworthy sources, from people who know what they're doing, know what they're talking about, are not showing up with this sort of, this is the only way to do things.

(56:13): This is how you have to do things if you're doing things a different way than you are doing things wrong. What you want is information from people who are giving you information. They're telling you where getting it from, okay? They're telling you what it's based upon and then saying, Hey, here's the information. Make the decisions for yourself. Anything that is sort of, here's what you have to do. Again, that is a problem. Anyone who's telling you or not telling you how they're basing their decisions, that is a problem. And that's not to say that experience alone doesn't matter. We all start somewhere. When I just started out, I wasn't the same as I am now. We all start somewhere, but people just have to be honest and forthcoming about that, okay? So get your information from sources that are worthy of your trust and creating a trustworthy community is what we are doing inside of the all about pregnancy and birth Inner Circle community on Facebook.

(57:11): It's completely free to join, and this will be a place that is just a big, loving, supportive community for those who are having a baby. I would love for you to join if you are trying to get pregnant, currently pregnant, if you're a birth worker, if you're a healthcare worker in a pregnancy and birth related field. If you want to be in a supportive place, if you want to support others, if you believe in people's humanity, if you believe in empathy, if you believe in coming from a place of love and connection and creating that just warm, supportive community, then I would so love to have you. Now, again, I am not like fairies and rainbows for everything. I know that there are going to be places where people have disagreements, but we're going to do so in ways that are kind, in ways that are not mean, in ways that are not ugly or rude.

(58:10): That is just not the community that I want to create. We have too much of that already in our world. So in the Inner Circle community, we are aiming to do things a bit different, do things a lot different actually. So come join us. It's all about pregnancy and birth. Inner Circle community on Facebook or it, you can get it at facebook.com/groups/dr Nicole Rankins, and you can find it there. All right, so that is it for this episode. Do me a solid share. This podcast with a friend sharing is caring, and I'm on a mission to reach and serve as many people as possible, and I would appreciate your help in doing that. You can also subscribe to the podcast wherever you're listening to me right now. Leave a review on Apple Podcast, and in addition to connecting with us in all about pregnancy and birth Inner Circle community, the other place where you can connect with me is Instagram. I'm on Instagram at Dr. Nicole Rankins. Shoot me a DM there and say hello. I'd love to hear from you. So that's it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.