Usually the first advice for pain or discomfort pumping is that your flange size is wrong. 

-- Alex 

Chances are it is good advice, although like most things it is probably a combination of factors, and best to speak with a professional like a lactation consultant. 

Most pumps, like Medela, Spectra or Avent have a standard size of around 24 to 25mm diameter, measured across your nipple, but there's not much data published about how many women that standard size is appropriate for. 

If you suspect you might need something smaller or larger, usually because you're in discomfort or pain, barely collecting milk, or your nipple is touching the end of the pump, you need to figure out what diameter your nipple is. 

The problem is, have you ever tried to measure your nipple? 

When I tried to do it, I started asking myself questions I never thought I would.

When should I measure my nipple diameter? Should I do it before or after pumping (when it's swollen)? Where does the nipple end and the areola begin? How should I measure it? With callipers? Where do I find callipers?

And then wait. Holy moly, am I abnormal for not being 24mm wide? 

I imagine this would be even more confusing and foreign if you were trying to figure out before birth, when your nipples haven't changed that much yet. 

So what should you do?

Most breast pump companies know this is an issue, and are doing their best to help. Here are instructions from:

  • Medela: https://www.medela.com.au/breastfeeding/mums-journey/breast-shield-sizes
  • Spectra: https://spectra-baby.com.au/measuring-nipple-correct-flange-size/

Clinicians and other organisations are also trying to help. There are handy sizing charts you can print, and poke your nipple through. Sure, it's a weird thing to do, but no weirder than the act of pumping itself when you think about it. 

Once you've selected your size, order that flange (and maybe one either side if you've got cash to spare) or borrow from a friend, and see if it helps with pain and discomfort. 

A lactation consultant would be a good person to call in at this point, if not earlier. Especially if you're confused, having trouble or plan to be pumping a lot. As I mentioned earlier, chances are that pain on pumping is down to a combination of factors, unique to you. 

What did I do? 

I tried all this advice, but still had issues, because the advice I was getting was conflicting. I had sought help from a lactation consultant who told me I needed a bigger size, but the maternal child health nurse help line told me to try a smaller one. It turns out I needed a smaller one, but I didn't figure this out until I had already damaged my nipples. I was so rubbed raw around the areola that I had discolouration when the skin eventually healed. 

This was actually what spurred me to try to "design out" the problem of having to select the right flange size in the first place. 

As well as being a mum, I happen to be an engineer, and so I worked with some colleagues, and my husband who is a General Practice doctor, on designing an ultra-soft silicone cushion that would stretch onto the funnel of most breast pump heads, and protect the nipple from being rubbed along the side of the hard funnel, and the areola from being sucked in too far.

Soft cushion for a better fit

We made the cushion with really soft, jelly-like silicone, which feels much nicer against the nipples, especially when they're already sore or tender from feeding or pumping.

Our research has found that on top of it making pumping more comfortable, that nipple swelling and redness all but disappeared. We think this is because the soft silicone melds against the nipple, preventing the areola from being over-sucked into the pump flange. 

Because Milkdrop it fits any flange size (other than 30mm+), we offer it as a simple solution to the flange size nipple measuring problem. 

Try a cushion

We would be delighted to have you try one of our cushions. We have a 30-day trial and friendly refunds. Our mission is to change the way pumping feels for you. 

Find out more about us here

Read our pilot study here

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