About Trash the Pump and Dump
IABLE

About Trash the Pump and Dump

In many healthcare situations, lactating parents are incorrectly instructed to pump and discard their milk, or stop breastfeeding entirely. Most commonly, these scenarios involve administration of medications, radiology and nuclear medicine procedures, and surgery involving anesthesia.

The goal of the Trash the Pump and Dump App is to 1. Explain the true situations when pump and dumping is recommended. (Note, there are very few!) 2. Bust myths regarding contraindications to breastfeeding/providing human milk.

If you are uncertain about a situation, please advise PUMPING AND SAVING!  Most often dumping milk is NOT necessary, and the expressed milk can be given to the child later.

Instructions for installing Trash the Pump and Dump are here.

Our editors and authors are found below. The authors have disclosed no financial relationships with ineligible companies. For more information about the app, please click here.

Trash the Pump and Dump includes general information about medication use during lactation that is intended for educational purposes only and is not medical advice. This information is not a substitute for individualized medical care from a personal health care provider. Please contact your physician or healthcare provider or arrange for a visit with a qualified healthcare provider for medical care if you have any questions or concerns regarding your medical conditions or medications. Information on Trash the Pump and Dump is not intended to be and should not be considered the practice of any healthcare profession that requires a license, certification, or other credentials. Your use or access of this website does not create a provider-patient relationship, privileged relationship, or any relationship with IABLE that would result in any duties or responsibilities on the part of IABLE, TPD, or affiliated authors or staff.

Editors

Anne Eglash - MD, IBCLC, FABM

Anne Eglash MD, IBCLC, FABM, is a clinical professor with the University of Wisconsin School of Medicine and Public Health, in the Department of Family and Community Medicine. In addition to practicing family medicine, she has been a board-certified lactation consultant since 1994.

Dr. Eglash is a cofounder of the Academy of Breastfeeding Medicine, the Medical Director and cofounder of the Mothers’ Milk Bank of the Western Great Lakes, and the Medical Director of the University of Wisconsin Breastfeeding Medicine Clinic. She has published many peer- reviewed articles on breastfeeding medicine.

She co-hosts and produces a breastfeeding medicine podcast series, called The Breastfeeding Medicine Podcast, available free on iTunes and IABLE website.

Dr. Eglash is founder and president of IABLE, a nonprofit organization dedicated to the creation of breastfeeding-friendly medical systems and communities.

Disclosures
No conflicts of interest.

Nithya Natrajan - MD, CLC, FAAFP

Nithya Natrajan, MD, FAAFP, CLC is a Board Certified Family Medicine Physician and Certified Lactation Counselor with additional clinical experience in women’s health, infertility, and hormone management.

Through Blossoming Mamas: 4th Trimester Care, she provides physician-led virtual care to patients throughout South Carolina and Georgia. Her services include perinatal support, breastfeeding medicine, lactation counseling, and infertility & pregnancy loss support. Through her practice, Dr. Natrajan strives to nurture and empower new parents during the 4th trimester and beyond as their family grows.

In addition to her clinical work, Dr. Natrajan is on the inaugural board of the Center for 4th Trimester Care, a Medical Content Expert and writer for the Institute for the Advancement of Breastfeeding & Lactation Education, a moderator for Dr. MILK (an online lactation support community for physicians), and co-hosts Masala Chai with Dr. Aunties (a YouTube Channel focused on 4th trimester care and parenting).

Authors

Allison Reiter - MD, FACOG

Allison Reiter, MD, FACOG is a Board Certified Obstetrician and Gynecologist. Dr. Reiter works as a full scope OBGYN physician with Kaiser Permanente Medical Group in Northern Virginia. Dr. Reiter is passionate about improving postpartum care for women through continued study in breastfeeding medicine as well as perinatal mood and anxiety disorders.

April Castillo - MD, MPH, IBCLC

April Castillo, MD, MPH, IBCLC is a Preventive Medicine Physician currently engaged in breastfeeding medicine research and clinical practice at Stony Brook University Hospital. She is continuing her research career with a mentored LINCATS-K research career development award, studying the effect of antenatal colostrum collection on lactogenesis. Her clinical work includes breastfeeding and fourth-trimester support including peripartum mood and anxiety disorders, nutrition, induction of lactation and re-lactation support. She works closely with Stony Brook’s WIC program and has a strong interest in improving health equity and decreasing disparities, particularly in maternal and infant health.

In addition to her clinical work, Dr. Castillo is a moderator for Dr. MILK (an online lactation support community for physicians), a regular guest on The Momversations Project of the Women’s Theater Festival, a blogger about early childhood nutrition @cabbagepatchdocs, and a mother of three. She is also completing longitudinal research on the mRNA COVID-19 vaccines and breastfeeding.

Bethany Potere - MD, MSc

Bethany Potere, MD, MSc is a board certified anesthesiologist and critical care intensivist at Tufts Medical Center in Boston, Massachusetts. Dr. Potere’s interests include supporting lactating mothers in the perioperative space in order to maintain breastfeeding as well as supporting women in medicine to meet their own breastfeeding goals. Additionally, she is a mother of three and has contributed to COVID-19 vaccine databases looking at effects on breast milk supply after intrapartum and postpartum vaccination against COVID-19.

Edna Prieto - MD, IBCLC

Edna Prieto, MD, IBCLC is a Board Certified Family Medicine physician and International Board Certified Lactation Consultant (IBCLC) in California’s Bay Area. Dr. Prieto pivoted away from primary care in 2021 to focus on Breastfeeding and Lactation Medicine and is currently a fellow in the Lessons in Lactation Advanced Curriculum (LILAC) Fellowship. She is also co-chair of the Alameda County Breastfeeding Coalition, an active member of the coalition’s Latina Chicana Lactation Taskforce (LatCh), and moderator for Dr. MILK (Mothers Interested in Lactation Knowledge), an online community via Facebook, providing peer-to-peer support for female-identifying physicians.

Dr. Prieto is passionate about increasing access to lactation support for her community, as well as helping to improve lactation knowledge and education among medical professionals. She is currently hard at work building her practice, while learning about gardening and finding any reason to enjoy ice cream with her husband and two kiddos.

Heidi Szugye - DO, NABBLM-C, IBCLC, FAAP

Heidi Szugye, DO, NABBLM-C, IBCLC, FAAP is the founder and Medical Director of Cleveland Clinic’s Breastfeeding Medicine Clinic and Assistant Professor of Pediatrics at Cleveland Clinic Lerner College of Medicine/Case Western Reserve University School of Medicine. She is triple board-certified in Breastfeeding and Lactation Medicine, General Pediatrics, and Pediatric Hospital Medicine. Her interests and expertise include clinical operations, quality improvement, and research initiatives related to breastfeeding care and trainee education.

Janean Wedeking - DO, IBCLC

Janean Wedeking, DO, IBCLC is a full scope family medicine physician. Born and raised in Iowa, she completed her undergraduate degree at Wartburg College in Waverly, IA her Doctor of Osteopathic Medicine degree at Des Moines University in Des Moines, Iowa and her family medicine residency at the University of Nebraska Medical Center/Offutt Air Force Base in Omaha, Nebraska. Long term, she plans to practice full scope family medicine in rural Iowa with a special interest in maternal/infant care and breastfeeding medicine. She enjoys a sustainable living, staying active, and spending time with family.

Katrina Mitchell - MD, IBCLC

Katrina B. Mitchell, MD, is a board-certified general surgeon, fellowship-trained breast surgical oncologist, and international board certified lactation consultant (IBCLC) whose practice includes the care and surgery of women with breast cancer and benign breast disease. She also treats maternal complications of lactation, and has a special interest in pregnancy and postpartum breast cancer.

She resides in Santa Barbara, California and practices at the Ridley Tree Cancer Center at Sansum Clinic. She enjoys reading, traveling, and spending time with her son at the beach. More information about her clinical and educational interests is available at physicianguidetobreastfeeding.org.

Disclosures
No conflicts of interest.

Lauren Spieler - DO, NABBLM-C, IBCLC

Dr. Spieler is an Osteopathic Physician Board Certified in Family Medicine and Breastfeeding Medicine. She practices both specialties in Santa Rosa, California with the Kaiser Permanente Medical Group. She has a Breastfeeding Medicine clinic at her Santa Rosa Kaiser Permanente location and also serves as Regional AFM Lactation Lead working on projects across Northern California Kaiser Permanente sites to improve Lactation services.

Her own struggles with breastfeeding her first child made clear how little (aka none) breastfeeding education occurred in medical training and how important it is to support families during this time. She is passionate about elevating Postpartum/4th trimester care by providing good information and compassionate ministration.

Dr. Spieler is a mother to 2 humans and way too many plants. She loves to go see live music with her husband and make music mixes.

Natasha Sriraman - MD, MPH, FAAP, FABM

Dr. Sriraman, MD, MPH, FAAP, FABM is a mother, wife, a board-certified academic pediatrician and an Associate Professor of Pediatrics at Eastern Virginia Medical School-Children’s Hospital of the King’s Daughters. She is also Faculty in the Department of EVMS OB-Gyn at the Center for Maternal & Child Health and Advocacy. She is the author of “Return to You: A Postpartum Plan for New Moms.”
She has an MPH from the University of Pittsburgh and has designed curriculum for both public health and breastfeeding training within pediatrics.
She has spoken internationally and is a recognized expert on breastfeeding, postpartum depression. She is tri-lingual and has published about cultural, linguistic and racial differences with respect to breastfeeding and maternal mental health.
She is a strong advocate for moms and babies and has worked with the Governor’s office on having May declared as Maternal Mental Health Month in Virginia; she has also lobbied in Washington for women to have protected time and lactation space in the workplace.
In the AAP, she has served as the Equity, Diversity, Inclusion (EDI) Champion as well as Education Chair for the Section of Breastfeeding. She is currently the Vice-President of the Virginia AAP Chapter and the Honorary Chair of the Postpartum Support Virginia.
In her free time, she likes to run, do yoga, read and spend time on the beach with her husband and 4 babies (3 human, 1 canine).

Penina Gross-Richmond - DO

Penina Gross-Richmond, DO is a PGY-3 at Cleveland Clinic Children’s. After graduation, she plans to pursue primary care and newborn nursery. Her interests include supporting mother-baby dyads in breastfeeding, particularly in the primary care setting, and using osteopathic manipulative medicine for breastfeeding dysfunction.

Petagaye English - DO

Petagaye English is a family medicine physician. She completed her undergraduate degree at Duke University in Durham, NC.  She received her Doctor of Osteopathic Medicine at the Philadelphia College of Osteopathic Medicine in Philadelphia, PA and later completed her family medicine residency at University Hospital in Ohio.  She has a great interest in lactation and currently acts as a moderator for Dr Milk (an online lactation support community for physicians).

Philip Anderson - Pharm.D., FCSHP, FASHP

Philip O. Anderson, Pharm.D., FCSHP, FASHP is a Health Sciences Clinical Professor of Pharmacy at the UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences where he heads the course on drug information.

Dr. Anderson has lectured and published extensively on drug use during breastfeeding including in professional journals and textbooks, including original research on drug excretion into breastmilk. Dr. Anderson founded the LactMed® database, which is a National Library of Medicine database. He continues to write all LactMed® records and to expand the database. He has authored the medication appendix to the popular handbook, The Nursing Mothers’ Companion and the chapter Medications and breastfeeding in the Breastfeeding handbook for physicians, 3rd edition, published by the American College of Obstetricians and Gynecologists & the American Academy of Pediatrics. Dr. Anderson is a member of the Editorial Board and the Pharmacology Editor of Breastfeeding Medicine, and writes a monthly column on medication use during breastfeeding for the journal. He has also been a consultant to the US Food and Drug Administration on the topic of drug labeling with respect to use during lactation.

Dr Anderson has been a consultant to MotherToBaby, San Diego in the UCSD Department of Pediatrics since 1979, and a charter member of its Scientific Advisory Board and Breastmilk Repository Steering Committee. He is also a charter member of the Board of Directors of the San Diego Milk Bank and a consultant on medications in donated breast milk for the Human Milk Banking Association of North America.

Disclosures
No conflicts of interest.

Yvonne LeFort - MD, FRNZCGP, FCFP, FABM, IBCLC

Dr Yvonne LeFort is a Canadian-trained Family Doctor and an IBCLC who has practiced Breastfeeding Medicine in Auckland New Zealand for over 20 years. She is a Fellow of and an elected Board member of the Academy of Breastfeeding Medicine.

She has addressed many topics in Breastfeeding Medicine both nationally and internationally over the years and particularly enjoys providing educational sessions for other doctors.

The use of medications in Breastfeeding continues to be a challenging area for most medical practitioners and she has been eager to participate in this innovative means to present key information to our medical colleagues.

She is married to David and they have two grown breastfed sons who grew up enjoying the hiking and great outdoors of New Zealand.

Reviewers

Abrar Al-Faraj - MD

Dr. Al-Faraj is an Assistant Professor of Neurology at Boston University with a special interest in women’s health with epilepsy. For more information on Dr. Al-Faraj’s work, her profile at Boston University can be found here.