If you are a nursing/pumping mama, you already know that pumping can be a pain in the butt but do you know for sure if you are using the correct size flanges? Having the right flange size is really important. Using the right size can seriously impact your relationship with your pump… it could mean the difference of a few more ounces of milk and obviously it makes a huge difference in comfort.
I discovered about 8 months into my nursing/pumping journey that I had been using the wrong flange size and I WISH that I had known this much earlier on. One of the biggest reasons that it took me so long to realize that I was using the wrong size is that as a new mom I had no clue how the flange was supposed to fit or how the pump was supposed to feel. This topic wasn’t even touched on (as far as I can remember) in my breastfeeding class that I took before my son was born and unfortunately with breast pumps and their subsequent parts, there’s no “try before you buy” option so I didn’t have anything to compare. Sure, I read the instruction book that came with my pump and there was a diagram in it that showed what a too big and too small flange should look like but do you have any idea how hard it is to judge if your flange fits the way it shows in the picture? (Below is a picture similar to the diagram in my user manual) I mean my pump happened to come with two sizes of flanges and I knew for sure that one size was too big but if the other one was right? It seemed OK! To be honest I didn’t even know that there were additional sizes available that didn’t come with the pump and when I did find out… I assumed that they only came bigger (because that what was always discussed when I heard/saw it brought up) rather than the smaller size that I actually needed.
The other reason that I waited so long is that the flanges that I had were working and I wasn’t exclusively pumping so I figured it wasn’t worth stressing over. I had to pump in the beginning when my son was a newborn to protect my supply because he was so sleepy but after that I pumped primarily to have the option of bottle feeding around family members who were not crazy about my choice to breastfeed or to be able to leave milk for another caregiver if I was out without baby.
Every one’s anatomy is totally different. We all come in different shapes and sizes and it’s unfair to assume that what works for one mom will work for another. The flanges that I was using were OK… I mean, if I’m being completely honest, I’ll still reach for them in a pinch if my other sets are in the dishwasher. However, when I pump using the bigger size I get less milk output and my nipples look reddish purple and slightly swollen after pumping. If I was an exclusive pumper… this would be a much bigger problem. I imagine that my nipples would be sore and that I would likely not have pumped for over a year. I also doubt that I would have wanted to nurse my son directly after pumping with my nipples in that state if I was pumping multiple times a day.
How did I finally figure out I was using the wrong size? Believe it or not, I was watching a live stream on Shari Criso’s page. If you are not familiar with her she is an IBCLC and you can find her Facebook page here. She was doing a breastfeeding Q&A and she was discussing nipple shields. (Bear with me, I know this seems like a different topic, but I promise it’s related!) Shari was explaining that if you are using a shield, it’s important to have it sized correctly. She commented that most people are not a size 20 (which happens to be what I was using). This got me thinking…
I knew for sure that I was using the right size shield because in the hospital when my son was born, I really struggled to get him to latch. The nurses suggested using a shield but it wasn’t until the last day of my hospital stay, when we finally got my son to latch, that a different nurse told me that she thought I had been given a shield two sizes too big by the other nurse. I am forever thankful to this nurse (who I am now lucky enough to call a friend) because without her, I’m really not sure that I would be nursing today. Anyway, the point is, I knew for sure that I was using the right size nipple shield. It had saved my nursing relationship and had never caused me any pain or discomfort.
I commented on Shari’s livestream that I was in fact using a shield that small and that it fit perfectly and she asked what size pumping flange I was using. I was using a 24mm flange! What I didn’t know is that if you are using a shield, the flange should be the same size! A few days later in my breastfeeding support group I brought my flange with me and asked my IBCLC (who is awesome, for the record) if she thought I was using the wrong size. She said that it was a tough call and suggested that it might be worth trying the smaller size just to see.
*Side note: Most flanges aren’t terribly expensive but before you invest in a new set… check with your insurance company! I am so glad that I did because it turns out that my insurance company covers extra parts for my pump for up to three years! Wow!
The only problem was that I was using a Spectra pump which I had recently switched to from my Medela. (More on this in a future post!) Unfortunately, my pump supplier did not have the Spectra flanges in the size that I needed. But lucky for me, the Spectra can be hacked to use Medela parts! You can also use Maymom parts with the Spectra. My insurance company actually ended up sending me both Medela Flanges and Maymom flanges. (Note: smaller sized Spectra flanges are now available on Spectra’s website – at the time they were not!)
Two weeks later (because insurance processing times are SLOW) I had my new smaller flanges in hand and let me tell you what a difference they made! I was literally able to pump a whole ounce or more with the smaller flanges than I had been able to before and not only that, but my nipples were not swollen and tender afterwards. Talk about a positive change! I will note though, that all flanges are not created equal. By that I mean that even if they are same size, they do not all fit the same. I found that the Medela flanges (which are two parts) versus the Maymom ones (one piece) were a better fit and so again, I found it helpful to hack my Spectra pump to be able to use them. (Note: the Maymom flanges come with adapters that allow you to use them with the Spectra pump without “hacking it.” These adapters can also be used with the Medela parts for easier use with the Spectra pump.)
The bottom line? If you aren’t responding well to your pump, there could be a number of reasons why. Before you change the pump you are using consider checking with an IBCLC or at the very least checking this link (Medela) or this link (Spectra) to see if you are using the right flange size. I have included a Maymom image below that could be helpful too! It’s also worth checking Google to see if you can “hack” your pump or try a different compatible flange to see if you prefer it. And lastly, don’t be afraid to check with your insurance to see if they will cover the new parts! The worst that they can say is no and you might benefit in a big way.
Do you have a similar story? Leave me a comment and tell me about it!
** Update** Below is another useful guide from Aeroflow. You can find more info on their website here: https://aeroflowbreastpumps.com/blog/breastpump-flange-size-chart