Pumping with an ill-fitting flange can do quite the number on our nipple and areolar tissue! Some parents may experience painful pumping, sore nipples, nipple damage, clogged ducts, mastitis, and even decreased milk supply from using a flange that is too large or too small.
Determining your optimal flange size is a critical component in maximizing both comfort and milk output with a breast pump. However flanges are not one size fits all, or even one size fits most.
Most breast pump manufacturers include a pair of 24 mm breast shields (aka flanges) in their pumping kit but I have found the majority of the parents I work with need something smaller than the standard size. And in some cases each breast needs a different size shield.
Click here to download our free nipple caliper to get an approximate idea of your flange size. While measuring your nipple size will give you a ballpark, individual nipple tissue and elasticity are going to vary. We need to see the nipple in action, how it looks and feels.
Ideally you don't want much, if any, areolar tissue getting pulled in to the flange tunnel. Tissue crowding in the flange, elasticity, or dense breast tissue being sucked in can also cut off or choke the milk release. Constant inadequate milk removal will decrease supply over time.
This is one reason flange sizing is so critical!
Try measuring your nipples before pumping and add 1-3 mm for flange size as a starting point to account for nipple swelling.
If you’ve been using a flange that is too large and are now trying to transition to a smaller size but you’re experiencing discomfort or decreased milk output, I find the switch method can be helpful. This entails starting with your new size and about halfway through, switching back to the larger (wrong) size for the rest of the session. This usually only happens for a few days before the correct size can be comfortably used for the entire session.
If you’re currently experiencing nipple discomfort or pain, a lubricant such as our Pumping Spray can help your nipples move freely and reduce friction. Just one spray in the flange tunnel can prevent abrasions and provide a more comfortable pumping experience.