Flange Size Matters : How to make more milk!

I recently took an amazing continuing education course on flange fitting and feeding gear to improve my knowledge and expertise on these to help better support my clients. The course was taught by the well respected IBCLC Jeanette Mesite Frem of Babies in Common. I like to think of her as the Fairy Godmother of Pumping! Check it out, she has classes, free Flange FITS guide and more for parents to be.

There were some huge revelations made that I'd like to share with you cool parents who like to learn from me. I decide to put this into a blog form rather than a TikTok to help fully explain how to find proper flange fit for breast pumping efficiency for maximum milk output.

So, as I always knew, having the incorrect flange size can lead to less output, cause pain with pumping and overall be inefficient and ineffective to creating a sufficient milk supply.

What I didn't know was the how do we fix this for everyone? I was doing it on a case by case basis. But I realized there are some general facts about pumps and flange fitting that all parents should know, even without a private consult. Pumping education should be included in breastfeeding classes and it typically is not.

Here are 5 tips on getting a proper flange fit & increasing milk output:

1. Measure your nipples

2. Lube up

3. Check your flange type hard vs. silicone

4. Wearable vs. Stationary or Limited movement pumps

5. Check for comfort

Buy a flange fitting kit or book a lactation consult to use theirs.

How to measure your nipples:

Using a measurement tool in front of a mirror or snapping a pic with the timer on your phone will help you see best.

Measure each nipple individually since you may not get the same measurement on the left and right sides of your chest.

There are two ways to measure your nipple - a ruler and a circular guide.

Flat or inverted nipples can do this too. Be sure to hand stimulate your nipples a bit.

Use a ruler or measuring tape to find the diameter of your nipple (the horizontal width across it starting from the 1 mark) in millimeters (1 cm = 10mm). Measure the nipple alone, do not include the areola, which is the outer edge around your nipple. If you are measuring 1.5 = 15mm / 1.7 = 17mm / 2 = 20mm and so on.

Using the circles on your silicone measuring tool:

1. Place the nipple into the smallest hole you can comfortably fit into without forcing it. 

2. Your nipple should fit completely inside the circle.

3. Make sure you can see your entire nipple inside the circle and right where it meets the areolar tissue.

4. The number in millimeters indicates your nipple diameter.

A printable one would look like this...I have my own available to download for free here:

This is me using a lanyard to show you how to measure your nipple, but do use a proper ruler, I couldn't find mine anywhere this day! I will re-upload this picture when I find it

Some feel comfortable sizing one up or down one from their measurement. I recommend trying that if you have the means. Some change sizes throughout their breastfeeding journey.

Finding the right fit for you may mean you need to order flanges that were not included with your pump. Most pumps come with size 24mm and 27mm flanges. I have no idea (other than capitalism, making parents pay for more things) why pump companies do this, when they know breasts and nipples come in all shapes and sizes as well as breast tissue elasticity.

They might want to do a survey of folks to see what the average size is, cause it definitely ain't 24mm. Most people will need to change their flange size from the one the pump came with.

There are also inserts that can be placed inside your pump flange. More on why/how to use those below. You would measure your nipples the same way for inserts.

More Free Meausring Tools:

https://www.legendairymilk.com/blogs/news/silicone-nipple-ruler-instructional-guide

Has good pics and a video.

https://lactationhub.com/flange-size-measuring-tool-us-only/

You can buy a flange fitting kit here too.

https://pumpables.co/pages/measure

Free download with email.

http://www.maymom.com/nippleruler/nippleruler.pdf

Visual image for measuring

https://www.costco.com/wcsstore/CostcoUSBCCatalogAssetStore/Attachment/15w1220-costco-jewelry-ring-size-chart.pdf

Hack - you can also use a ring measuring tool!

Lube up:

Anytime you are pumping, it would be beneficial to use some type of lubrication in your flanges to reduce friction. Put it around the cone and in the tunnel.

This will also help with soreness, dry or cracked nipples due to constant and/or new stimulation.

You can use it after pumping or feeding as well. Any edible oil is OK but the optimal choices would be Coconut oil or Olive oil. More on coconut oil here.

Hard Vs. Silicone

We aren't talking about implants here lol. But yes, you can breastfeed with those!

I'm speaking about flange types. Most pumps come with hard flanges but more are coming out on the market with these soft gummy like silicone flange said to be massaging or massage padding. While it might seem logical to use something softer and seemingly more comfortable, silicone doesn't pull milk out as well as hard flanges. If you have to chose, consider opting for a hard flange with good lubrication.

Wearable Vs. Stationary

I know those wearable pumps are so tempting and help with multitasking. However, they are not best to use as your main pump if you are pumping exclusively or doing a lot of pumping. They also are not good for increasing supply.

Consider the reason for using your pump. This will help determine what type you need. More on pumps here.

Bodies don't all respond the same way or to the same kind of pump. You might need to try a few to see what works best for you. Hospital grade like a Spectra or Medela is going to be best for most people, especially going back to work. You can rent these instead of buying one if needed. Most people have insurance that grants you a free pump thanks to the Affordable Care Act from the Obama years.

Single or double, I like double because you can do both at the same time instead of alternating, which is super efficient.

Wearables are great for power pumping, occasional pumping and travel pumping. Wearable pumps don't always have the option to get new flanges. If this is the case, try flange inserts instead. They fit inside the tunnel of the pump and make the hole smaller.

Don't forget about hand pumps! These precious little gems might seem strange, outdated or hard to use. However, you'd be surprised by the number of people who try one and say they get the most milk out with a manual hand pump. They are inexpensive, handy (keep in car, bag or desk) and provide great stimulation.

How does it feel?

Measuring only tells us a piece of the story.

Several factors go into finding the proper flange fit. It’s important to assess how the flange looks, feels and whether you are pumping an adequate amount of milk.

Average milk output is about 2-4oz total one or both breasts. This is every 2-3 hr if you are exclusively pumping or about 1-2oz if also nursing your baby at the breast.

A higher vacuum suction does NOT mean more milk. Lowering the suction vacuum might help if you are having pain or your nipple is pulling significantly through the flange tunnel. 

Correct sizing can help give you more milk when pumping and should be comfortable during and after pumping. 

This how you gonna feel when you find the right fit:

Finally:

You've now got the tools you need to be off to a great start on pumping.

I offer virtual consults and in person for flange fitting. You can be anywhere for virtual. San Diego at my clinic for in person.

Visits for Black parents are FREE. Book here and choose the BIPOC virtual or clinic option.

All others pay cash or use insurance to book here.