Dear Judy, I was reading your articles and wanted to ask you a question that you might know about: how do I know what size flange came with my breastpump? Also, how do I know what size I need? I’m not having discomfort and I get plenty of milk, but I noticed that some of the tissue at the very beginning of my breast, where the nipple and breast meet, gets pulled into the pump. I think I have small nipples and wasn’t sure how to figure out this stuff about the flange fit. — Amy
If you have a Medela pump, it came with 24 mm flanges. If you have an Ameda pump, it came with 25 mm flanges. Most moms need somewhere between 21 and 28 mm. If your nipple is touching the sides at all, you probably want to go up a size. Be sure it is your nipple touching and not your breast tissue. If your breast tissue is touching, then you may want to go down a size (may be too large).
Your nipples will typically swell when you have a let down, so even if they are small to start, they may get larger when expressing milk. Look at how they fit during let down. You want to make sure that your nipple is not hitting the sides of the flanges while you are expressing milk. This can cause discomfort and low milk output. You also want to make sure that your breast tissue (beyond just your nipple) is not getting pulled into the flange as this might mean that your flanges are too large.
For more information on getting the correct fitting flange, please download this article.