When it comes to pumping, whether you're an occasional pumper or pumping exclusively, the fit of your flange is crucial for ensuring comfort and efficiency. The flange, which is the part of the breast pump that fits over your nipple, plays a significant role in the effectiveness of milk expression. Using a flange that is too small can prevent the nipple from moving freely causing discomfort, potentially leading to issues such as blocked ducts or decreased milk supply. On the other hand, a flange that is too large may not effectively stimulate milk flow, resulting in inefficient pumping sessions, and discomfort.
We see so much education and advertisement on different types of pumps but often so little about the part of the pump that so greatly impacts your pumping experience. Often times, you are simply sent a pump with a standard size and left to figure things out on your own, with little more than a vague wish for success. Your birthing class and hospital experience typically do little to provide the necessary education on this aspect of breastfeeding. Understanding the importance of a proper fit is crucial, as it can make a significant difference in the overall comfort and effectiveness of the pumping experience.
Earlier this year, I made the proactive decision to pursue further education in this area. While I already possessed a solid foundational understanding, I acknowledged the value in refining and expanding my knowledge to ensure that my clients receive nothing but the best care and support. I still remember my first pumping experience before becoming an IBCLC. No hospital advice, only knowing to use the flange that came with my pump, and thinking to myself the first time I pumped "I cant do this. This is too painful." I want to ensure other moms don't have to share in my experience of trying to figure things out on their own.
So, how do you know what size to use?
How do you measure?
Do you add to the number you measured?
Is pumping painful?
Should I use lubrication?
First, start off measuring with a ruler, measuring tape, or flange measurement tool in millimeters (mm). You want to place the tool directly underneath your nipple and measure the diameter of the nipple only. Be sure to do this for both breast, as it's not uncommon to need different flange sizes. Once you get your measurement, there is NO need to add 2 to 4 mm as some resources and social media suggest. Stick with your measured number as your starting point. The ideal fit will allow the nipple to glide along the sides of the flange without extra space around the nipple and cause no pain. I recommend using lubrication to allow the nipple to glide more easily in the flange.
Some women may ultimately decide to size up or down 1-2mm from their starting size. Experimenting with different sizes and observing how your nipple moves within the flange can help you find the most comfortable and effective fit. The goal is the MOST comfort with the BEST milk output. A measurement alone is not the only deciding factor. Some women will do better with soft silicone inserts, many others will do best with hard shell flanges. Some will produce great with a traditional shape, others may need to try an alternative shape. Some will do best with lubrication such as coconut oil, organic nipple butter, or an organic pumping spray, some will prefer not using it.
IT IS NOT A ONE SIZE FITS ALL, despite pump companies sending the same size to everyone.
Time isn't something that mothers have the much of to spare, but I highly encourage taking the couple minutes to measure your starting size and see how you respond and feel. It may surprise you what a difference it can make, even if things feel "okay" now.
Remember, a proper flange fit is not only about comfort but also about optimizing milk expression. Don't hesitate to seek guidance from a lactation consultant if you are experiencing any issues with flange fit. By ensuring the right fit, you can enhance your pumping experience and support your breastfeeding journey.
-Haley Willson RN, BSN, IBCLC
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