So tell me the truth.....do my flanges look too big?

When it comes to breast pumps, I don't hesitate to recommend my favorite styles. Whether a new mom is looking for a classic, plug-into-the-wall-outlet style pump ( I heart Spectra!) or a trendy, wearable one (Hello, Elvie!), there are lots of great options to fit every budget. I find that many new, first-time moms I meet are surprised when I ask if they have already purchased their breast pump. "Well, I wanted to make sure I thought breastfeeding was gonna work out first" or "Oh, I wasn't planning to worry about that 'til closer to when I go back to work" are two responses I hear often. Whether mom is planning to exclusively breastfeed, combo feed, or pump and bottle feed, I always educate my clients on the importance of purchasing a high-quality, double-electric breast pump and all the situations that necessitate owning one. Experienced breastfeeders out there are nodding their heads right now, thinking about how many times they used their breast pumps to boost supply, relieve engorgement, or empty their breasts when baby refused to latch all-of-a-sudden. OK...I won't go off on a tangent right now about how breast pumps are medical devices that are almost always COVERED BY HEALTH INSURANCE for new moms. I'll save that conversation for another day. Today, let's talk about how to determine your FLANGE SIZE.

I find that most women assume they should just rotate through using the flanges that come with their new pump. Well, here's why that doesn't always work. Most double-electric breast pumps come with a motorized pump, tubing, bottles, valves, and one or two sets of flanges (that's the cone-shaped part that goes over your breast. Take this out-of-the-box Spectra S2. It comes with one set of 24mm flanges and one set of 28mm flanges.

What most women don't know is that these two sizes are NOT their only option. In my personal experience, I would estimate that about 50% of the time I assess a client's flange size, I find it is smaller than 24mm. On some occasions, it is larger than 28mm. Take it from someone who pumped with the wrong flange size for years......finding the right flange size is critical to empty your breasts effectively with a pump. I don't care if your pump cost $25 or $600. If you are using the wrong flange size, you are at risk for one or more of the following problems:

Incomplete emptying of your breasts
Blocked milk ducts and mastitis (Eeeek!)
Dwindling or low milk supply
Chronic nipple pain, cracks, bruising, or blisters
Damage to milk ducts
Decision to stop breastfeeding before you reached your goal

So how do you determine your flange size? The best solution is to have an Internationally Board Certified Lactation Consultant (IBCLC) assess your breasts prior to using a breast pump. This is one of the biggest reasons I offer prenatal consults for expectant families. While mom's flange size can (and typically does) change during the course of breastfeeding, it is critical that she knows how to tell whether her pump flanges are a good fit. Lactation Consultants typically use a measuring device or kit to measure the diameter of mom's nipples. They may be two different sizes! If mom has already delivered and has her pump on hand, I usually observe her pumping to assess for a few other factors as well (one of these is nipple elasticity.......which we will talk about in another blog entry!!!). I use a flange sizing guide (like the one shown below) to assess nipple diameter.

So how can you determine whether your flanges fit without a sizing guide or an LC? The simplest method is to observe your nipple as it is being pulled into the flange when pumping. It should be freely pulled into the center of the neck (straight part) of the flange. Pumping should not be painful. There should be no pinching...just a strong "pulling" sensation. Is your nipple touching the sides of the flange neck? That flange is likely too small, which could cause nipple damage, skin tears, and pain. On the other hand, is your areola being pulled into the flange? That flange is probably too large. This could result in damage to your milk ducts and a painful "pins-and-needles" feeling when your milk lets down.

If you find yourself reading this, shaking your head and saying "yeah....all of this!", please contact me or an IBCLC in your area for help! A wise person once said "Pumpin' ain't easy, baby" (or something like that). Don't wait until there is a problem......ask me today! Your milk supply and breast health is soooooo worth it!!!