The Ultimate Buyer's Guide for Purchasing Flange Too Big

Last updated 29/07/

Yulin Machinery supply professional and honest service.

Let&#;s talk flange sizing &#; it is something that could make or break your expressing journey.

Keep in mind, if you think you need bigger, you probably don't...

Firstly, let me tell you about my personal experience with using the wrong sizes

I was told to start expressing by an IBCLC for my daughter when she was 3 days old. My milk hadn&#;t started increasing yet and it looked like she had lost too much weight. I was initially told that I needed 27mm flanges. A week later at a follow-up appointment, I was told I needed 30mm flanges because I still wasn't expressing much (10mls max per session). Having very little expressing knowledge I believed them (this was despite working in NICU for 8 years and 2 years as a midwife before giving birth - it certainly wasn't something we learned much about).

Using the 30mm flanges hurt and I kept going back to the 24mm flanges because they were slightly more comfortable. I would also get more out (only about 10mls more and no more than 30mls total each session).

Around 6 weeks post birth, I saw a different IBCLC who wanted to help me increase my supply and suggested I try a different brand of breast pump while I waited for my Spectra to arrive. She suggested that I try 36mm flanges. In between all this, another IBCLC had agreed that 30mm flanges seemed to be correct. So, 3 IBCLCs had said I needed 30 or 36mm flanges.

I tried the 36mm flanges but quickly went back to the 24mm&#;s &#; they were definitely more comfortable, and I got more with them. Although it was painful to express, I pushed through, wanting to give my daughter whatever breast milk I could get.

About 2 weeks before I ordered my Spectra I tried a friend's electric pump (a brand that you can buy off the shelves in Big W or Target) which had &#;comfort massaging inserts'. I got the most I had ever got &#; 40mls! When another friend told me about the Spectra I ordered it with their &#;massaging inserts&#;.

I also joined an Exclusive Expressing / Pumping Facebook group on her recommendation. After a week or so I posted my story, desperately wanting to increase my supply. The main thing I was told was to increase the number of sessions I was doing (I was only doing 6/day whereas the minimum should 8). But someone in there also recommended checking my flange size. I didn&#;t pay too much notice to that suggestion as I was now using the Spectra 24mm&#;s with the inserts (which took them down to a 22mm) and it was somewhat comfortable, and I was seeing an increase.

Over the next 8mths of exclusive expressing I saw numerous posts about flange sizing. And I came to realise I could have probably been using 17mm or smaller, unfortunately those 3 IBCLC&#;s who had told me I was a 30-36mm were wrong. Maybe if I had been using the correct size each session would not have taken me 45mins just to get enough...

&#;Your flange should fit your nipple like a shoe&#;

Professional experience with flange sizing

In March I started selling Spectra breast pumps as an authorized stockist. Flange sizing quickly became a &#;passion&#; (some might say obsession!). I realized that so many new mothers were being told the same thing as me &#; you need a 27, 30, or 36mm flange.

I started stocking Maymom flanges around the same time as the Spectra breast pumps and I did a survey on the Exclusive Expressing group to work out what volume of stock I should be ordering. Most said they were between a 19 and 27mm flange, so that is mainly what I stocked. Over time I realised I was selling more 19mm&#;s than anything else and I was getting numerous requests for 17's and 15&#;s.

In , a fellow IBCLC from the USA, who I know went through similar expressing journey to me (she is in the Exclusive Expressing group), did a similar survey to me just recently and interestingly the vast majority said they were a 17, 19 or 21mm - below is a summary of her survey.

Results of the informal Facebook survey done by a fellow IBCLC. This is a screenshot taken from a presentation I did for a Breastfeeding conference in - hopefully I can prevent some from giving out the wrong advice!

I have also seen numerous clients who have been told to use flanges that are too big for them with damage (usually around the areola or base of the nipple) and poor output. The vast majority of the time they say that using smaller flanges (ie ones that fit properly) is more comfortable and help them yield more milk.

In late August I started allowing customers in Perth to come test out different sizes in person. Up to then, I was 'eyeballing' sizes, using the guide of 'measure the diameter of the nipple (before expressing) and add 4mm'.

I was surprised to see that most people found sizes that were even smaller than I originally thought more comfortable and productive.

Over the last 4 years, I estimate I have seen over mothers either in person or via video and I have learned a lot about sizing.

I am not really someone to brag about myself, but I often hear 'you were recommended in xyz group' or 'my LC told me to contact you for sizing', etc, and I get quite a few follow up messages along the lines of &#;this size is so much more comfortable&#; and/or &#;I&#;m getting so much more with this smaller size flange&#;, so I am pretty confident in my recommendations now. Recently, a colleague even called me the nipple whisperer, because of my ability to help with flange sizing!

Here is what I have found:

Signs that your flange is TOO BIG:

• Your nipple swells up while expressing (this is often why people think they need bigger - the nipple should not swell up that much)

• Your breast loses contact with the flange while expressing

• Milk leaks out the bottom of the flange (note that no flange is designed to suction onto the breast and be handsfree)

• It takes more than a minute to get a letdown (this one might be subjective - there might be other reasons that you have a slow letdown, but in most cases, milk flows almost instantly with the correct size)

• Your breasts still feel full after expressing

• It feels 'tight' but there is still room between the nipple and the sides of the flange

&#;

Sign your flange is TOO SMALL:

• The nipple does not move freely in the first minute

• The nipple does not fit into the hole at all

These are the only reason to size up, in my experience

What are NOT reasons to size up:

• The 'nipple' is rubbing - I've found that many mistake their areola for their nipple. The nipple is the part that sticks out from the breast. Even if the nipple does not stick out usually, you can usually see a difference in the skin type and the feeling - touch your breasts and learn your anatomy!

• The nipple is swelling up and you need to accommodate that

• It feels too tight - this can be caused by too much areola being pulled into the flange

"But I was using a [flange size] and it was 'too tight' or it was 'swelling up' - why would I go down a size?"

This is something I hear ALL THE TIME!

When you are using a size that is too big your breast tissue (usually the areola, sometimes the actual breast) gets pulled into the funnel - this makes everything swell up. The tissue is literally swelling to meet the diameter of the flange you are using. At some point, the tissue can no longer swell and so it feels like you are using the right size. However, very little of the areola should be entering the flange - so there would be no to very little swelling at all.

It actually seems that the less areola that gets pulled in, the better, even if this means that the nipple is rubbing on the side - as long as it is moving freely.

Something interesting I have realised recently is that sometimes just 1-2mm size big can cause the most pain and least output - often people buy a size, then a size bigger because of these issues, then perhaps another size bigger, then contact me for assistance. They are surprised when I size them smaller than the first size they bought - they say 'but the 17mm (for example) was more so much more painful than the 19mm, but it still doesn't feel right, so I thought I needed bigger...'. Nope, because BIGGER IS NOT ALWAYS BETTER!

I just doubled my output and my breasts finally feel empty for the first time since she was born...I honestly can't believe it...I got 40mls at 3.45pm [with 24mm flanges]....Then at 7.40pm 100mls with the 17mm. Unbelievable! And no lumps after for once

This quote is from a recent client who was amazed that she needed smaller (17mm) as her lactation consultant told her to get 28mm flanges (Spectra do 28mm, Medela and Maymom do 27mm). Of course, not everyone may get these results.

Visual guide of flanges that are too big, too small, and just right - note, however, that the only way to know what size you need might be to try out different sizes

I no longer recommend measuring nipples, either before or after expressing - I have had too many incidences where people have measured and about flanges only to find they are incorrect, or come to me saying they needed 'xx' size only to find they need a size or 2 smaller.

I no longer stock any flanges bigger than 27mm - in the 2 years I have been sizing mothers in person and via video, I have not seen anyone need bigger than 27mm. I have only seen about 5 each need 27mm or 24mm, a handful need 21mm, and probably 90% need less than 19mm (the most common sizes seem to be 13mm-18mm). Yes, just 1mm can make a difference

So then why did my IBCLC/midwife tell me that I needed much bigger? Because unfortunately, they do not know how to size properly. And I am saying this not to confuse you or to criticize other health professionals &#; please keep in mind that breast pump flange sizing is not a part of the midwifery training or even the lactation consultant training. I had to learn this information from a Facebook group and then trial and error of helping others with sizing....

From what I have heard, the original makers of breast pumps decided that 24mm was correct based on the baby's mouth size on the breast when feeding - this is why term babies should use 24mm nipple shields...But that was 60 years ago

Like I said above, there may be exceptions to rules and it might take some trial and error. Using the analogy of it fitting like a shoe - you wouldn't walk into a shoe shop and just buy whatever takes your fancy in the size you think you are, or based on measurements, you would try it on, walk around the shop, and make sure it feels comfortable. The same goes for your flange. And just like shoe fittings, you could get home, use the flange for a bit and realise it is still not quite right. (Keep in mind that sometimes there might not be a perfect fit though.)

If you need help with flange sizing you are welcome to see me in person (in Perth) or send me a video of you using your current size - there is no charge for this. Or you can try my flange lending service - found under 'Shop Now' at the top of the page. Send me a text or if you need more assistance - or

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:

For more information, please visit Flange Too Big.

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 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:

Has good pics and a video.

You can buy a flange fitting kit here too.

Free download with .

Visual image for measuring

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.

For more Surface Wellhead Equipment Typesinformation, please contact us. We will provide professional answers.