Choosing the Correct Flange Size

By Laura Silvas, RN IBCLC

Whether you are pumping to increase your supply, pumping for your infant in NICU, working away from baby following maternity leave, or an exclusive pumper, knowing how to select the correct flange size can be confusing.

Additionally, many pumping brands offer multiple sizes, inserts to help with the comfort of your pumping sessions, and various pump setups, which only add to the confusion. This article intends to set out some guidelines to ensure you select the right flange size.

Measuring

You'll first need to measure your nipple to know where to start. To get an accurate idea, you will need to measure the diameter of your nipple; be careful not to measure your areola. You can do this either with a simple ruler or a circle ruler.  I use this one at my office::

After obtaining your measurement, then add 2-4 mm. This allows for expansion of the nipple while pumping. For example: if you measure 15 mm for your nipple, I would recommend a 17 or 19 mm. 

Then, compare your measurements to the sizes offered by your pump brand. If you're not finding a compatible size, I recommend looking into flange inserts such as Maymom or Momcozy. Some brands even produce their own inserts, such as Dr. Brown's and Willow. Inserts are a great option as you are able to use them on multiple pumps such as your wall plug and hands free pump. 

Sisters, not twins. You may find that your breast and nipple sizes differ from the other. Everyone's anatomy is different, hence why there are so many products! Depending on the type of breast pump you have ordered, the company may or may not offer multiple flange sizes, and they may or may not be included with the purchase of your pump.

Typically, I encourage moms to wait until the third trimester to measure their nipple sizes and order the pump because the size of their nipples may increase. If you measure your nipples too early on and have already ordered/received your pump, simply remeasure your nipples, and then reach out to that company to see if they offer that flange size. You can also check with local suppliers or online. Many pumps standardly provide a 21 and 24 mm, sometimes a 27 mm. Frequently, I see many moms need closer to a 17-19 mm.

Ordering/Picking a Pump:

When deciding on a breast pump, I always recommend checking with your insurance, as many companies will cover the entire cost or a portion of the cost of your pump. You can call your insurance or have your health care provider's office reach out for you to do this. Another great option is Aeroflow Breastpumps. I highly rate these pumps and used them with both of my children. Some breast pump companies, including Aeroflow Breastpumps, conveniently reach out to your insurance company to verify your coverage.

Research different pumps to fit your needs. There are so many great options out there. So much so that it may seem overwhelming. Reach out to family and friends for their suggestions, and, of course, a Lactation Consult can also help you measure and pick which pump and flange size may suit you best. We have a great comparison list also for wall pumps and hands free options to help you see some of our favorites!

Pumping

While pumping, the nipple should freely move in and out of the flange. With a proper size flange, it should feel comfortable while pumping. Don’t forget to utilize lubrication. Organic nipple butter, or even coconut oil is very helpful.  If a large portion of your areola is being pulled into the flange when you are pumping, it is too big. The flanges should be comfortable, with a gentle pull noted. Your flange size shield should mimic the feel of your infant's latch. This means that if the flange isn't sized correctly, it's just like a bad latch. Improper sizing can lead to multiple issues, including pain with pumping and nipple trauma. Due to the breast not being emptied properly, you may also encounter problems with repetitive clogged ducts, mastitis, and a decrease in your output.

The strength of your suction also makes a big difference in your pumping sessions. As mentioned previously, it should mimic the suck of your infant with a nice gentle pull. Often, mothers increase the suction strength, assuming it means more milk will be produced due to a stronger pull. However, if turned up too high, the vacuum may be too strong and collapse or minimize the ducts.

Conclusion

Your pump will play a big part in adequately keeping up your supply and demand. Having the correct size makes all the difference to both output and comfort. If you need assistance with your flange size or deciding where to look, contact us here at Leva. We are happy to help you! We applaud you, Mama!