Co-written by Pippeta and Sally Rickard (IBCLC)
Breastfeeding and pumping can be a rewarding journey, but it also comes with its own challenges. In our experience one area that mothers who choose to pump find challenging is identifying the correct flange size for their breast pump.
The flange, or breast shield, is a critical component of your pump, influencing both comfort and milk expression. Although the significance of proper flange sizing is widely acknowledged, research on this subject is still developing, and many mothers face challenges in finding reliable information. In this blog, we’ll discuss why flange sizing matters, potential issues related to incorrect fitting, and some professional tips on how to approach finding the best fit.
Why Flange Sizing Matters
Finding the right flange size is essential for ensuring both comfort and effective milk expression. Here are a few reasons why paying attention to flange size can be beneficial:
- Flange Sizing and Milk Removal: Studies have indicated that the correct flange size is crucial for effective milk removal. Improper flange size can lead to poor milk extraction, which might contribute to issues like engorgement and clogged ducts. For example, one study found that appropriate flange size positively impacts milk flow and reduces discomfort during pumping.
- Comfort and Efficiency: Studies also emphasise that correct flange size affects both comfort and pumping efficiency. For instance, research underscores that women using the appropriately sized flanges experience less pain and achieve better milk output, which can indirectly reduce the risk of complications related to inadequate milk drainage. Reducing, the Risk of Complications.
- Blocked Ducts and Mastitis: Research highlights that incomplete milk removal can lead to milk stasis, which is a risk factor for blocked ducts and mastitis. The Study noted that maintaining effective milk removal is important for preventing these complications. While this review doesn’t focus solely on flange size, it supports the broader idea that proper pumping techniques and equipment are integral to preventing such issues.
Challenges with Incorrect Flange Sizing
Mothers sometimes encounter discomfort or other issues due to incorrect flange sizing. Here are a few challenges that can arise:
- Discomfort or Pain: Some mothers may experience nipple pain or soreness if the flange is too small or too large. For instance, a flange that’s too small might compress the nipple, while one that’s too large might pull in too much of the areola, potentially reducing milk flow.
- Unnecessary Purchases: Discomfort during pumping can lead to the assumption that the pump itself is the problem, sometimes resulting in unnecessary additional purchases.
- Limited Guidance: With limited research and guidance available, finding the right flange size often involves a trial-and-error approach, which can be frustrating and sometimes costly.
To provide some guidance on flange sizing, we’ve consulted with International Board Certified Lactation Consultant (IBCLC) Sally Rickard. Sally is the founder of baby-thrive.com providing breastfeeding support via home visits in the London area.
Baby Thrive's experts offer personalised advice on how to approach flange sizing, drawing from professional experience to help mothers navigate this aspect of pumping.
“Every day I visit families with new babies to support them with face-to-face breastfeeding. Almost every family has questions about how to use pumping to share the work and experience of breastfeeding with a partner or supporter.”
I find wearable pumps like the Pippeta pumps to be most popular as they are so convenient to use.
Pump fitting, from my professional experience
Lactation consultants know that the best pumping experience comes when your nipple fits against the sides of the pump flange but without any areola getting dragged into the pump. The flesh of your breast at the base of your nipple should be held back by the flange.
If your areola is getting dragged into the pump, several things can happen:
- Oedema can form compressing the ducts & limiting milk flow.
- Your skin may become sore due to friction.
With wearable pumps such as Pippeta, you can’t see your nipple inside the pump so many of my clients find it helpful to pump for a few minutes then remove the pump & check if their nipple & breast is misshapen.
My method with my clients
- Measure using a nipple ruler (this is a rough guide only)
- Try together a few different sizes to see what’s most comfortable & effective.
- The size which actually suits best can vary quite widely from the results of the measure! This depends on many factors including how taught your skin is and how your body reacts to the pump.
- Some people have to review the size they need as their pumping journey develops.
I have what I jokingly call my “petting zoo” of pumps and a “library” of specialist flanges for my clients to try. We spend time together looking at pumps, understanding the assembly, cleaning, settings and fitting.
Flange Options Included with Your Pippeta Pump
When you purchase a Pippeta Hands-Free Breast Pump, you’ll receive three flange inserts in sizes 19mm, 21mm, and 24mm, included with every pump. This allows you to start with a variety of sizes to find the most comfortable fit for your needs. For even more customisation, we also offer additional flange sizes—17mm and 27mm—available for purchase on our website. This ensures that you have the flexibility to find the ideal fit for your unique breastfeeding journey.
Conclusion
Investing time in finding the correct flange size can potentially enhance your breastfeeding experience, leading to more comfortable and efficient milk expression. While research on this topic is still evolving, working with a lactation expert and experimenting with different sizes can help you find what works best for you.
For more information on breast pump flange sizes and additional breastfeeding tips, reach out to our IBCLC team or a local professional for personalised support.
*The information on the Pippeta website, including articles, images, and other content, is provided for general informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. We recommend consulting with a qualified healthcare provider for any medical concerns or questions regarding you or your baby’s health. Do not delay or ignore professional medical advice based on the information you find on this site.
Sources: Sakalidis VS, Ivarsson L, Haynes AG, Jäger L, Schärer-Hernández NG, Mitoulas LR, Prime DK. Breast shield design impacts milk removal dynamics during pumping: A randomized controlled non-inferiority trial. Acta Obstet Gynecol Scand. 2020 Nov;99(11):1561-1567. doi: 10.1111/aogs.13897. Epub 2020 Jun 5. PMID: 32401335; PMCID: PMC7687096.
Abou-Dakn M, Richardt A, Schaefer-Graf U, Wöckel A. Inflammatory Breast Diseases during Lactation: Milk Stasis, Puerperal Mastitis, Abscesses of the Breast, and Malignant Tumors - Current and Evidence-Based Strategies for Diagnosis and Therapy. Breast Care (Basel). 2010 Mar;5(1):33-37. doi: 10.1159/000272223. Epub 2010 Feb 16. PMID: 22619640; PMCID: PMC3357165.