The Ordinary Doula Podcast

E57: Perfecting Your Flange Fit for Breastfeeding

• Angie Rosier • Episode 57

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Ever wondered how a small piece of plastic could be the key to a comfortable and efficient pumping experience? Join us on The Ordinary Doula Podcast as we navigate the often overlooked, yet critical, world of flange fitting. With insights drawn from my 20 years in the doula field, I promise you'll leave this episode with the know-how to measure and select the perfect flange size, tailored just for your unique breast anatomy.

Breastfeeding should be empowering, not painful or frustrating. By understanding the importance of nipple size, shape, and elasticity, you can ensure a smoother and more enjoyable pumping experience. Whether you’re about to welcome your little one or are already in the throes of new parenthood, these practical advice and tips, combined with guidance from lactation consultants, will equip you with the confidence to manage your breastfeeding journey seamlessly. Don't miss out on this episode if you want to set the stage for a positive and rewarding breastfeeding experience.

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Show Credits

Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker

Speaker 1:

Welcome to the Ordinary Doula Podcast with Angie Rozier, hosted by Birth Learning, where we help prepare folks for labor and birth with expertise coming from 20 years of experience in a busy doula practice, helping thousands of people prepare for labor, providing essential knowledge and tools for positive and empowering birth experiences.

Speaker 2:

Hello and welcome to the Ordinary Dealer Podcast. My name is Angie Rozier, I'm your host and I am looking forward to this time to spend with you sharing a little bit of little tidbits here and there that can hopefully help you with your labor, birth or breastfeeding experience. So today I want to talk about flange fitting. So flanges are a piece of a pump that fits onto the mom. They are generally plastic, like a firm plastic, and they are part of the pump. It looks like a little like the end of a trumpet, if you will. Is what a flange looks like.

Speaker 2:

If you aren't familiar with that, there are lots of different pumps on the market and all of them will have a component where the breast goes into the pump. They have to right. So that's the flange part. Some of them it's the pump is, if you. Depending on what type of pump you have, the flange is kind of a freestanding piece. Some of them the flange is inside of a cup when the pump mechanism is closer to the body, sometimes down a tube. The motor, you know, is on a tube, and we'll talk about types of pump in another podcast, but this one is about the flange fitting.

Speaker 2:

So nipples, as you can imagine, come in a variety of sizes and shapes, diameters, lengths, elasticity. There's a lot of components about nipples that people need to be aware of when they are choosing a flange the appropriate flange size for them and maybe you are you know, maybe you're familiar with all the different types of nipples and breasts there are, but it's a wide variety, so it could be worthwhile and you can do this on your own. You can have somebody help you if you are at a hospital that has lactation consultants, or you can meet with a lactation consultant before you have a baby or after you have a baby. Both are great. Beforehand, you get prenatal preparation customized to you and your situation can help kind of put together, put to bed some of those rests and concerns in the early days. Maybe you wait till you have baby in your arms and you kind of know what you're working with more to get help from a lactation specialist, but you can talk to them about measuring for flange, the appropriate flange fit. So I'll just give this little caveat. In a perfect breastfeeding world, we don't really even need to touch a pump for three to four weeks. That's perfect, though, and then there's reality, and sometimes we do need to use a pump long before two, three, four weeks. So this is where flange fittings can come in handy. So what we're looking for is the flange fitting.

Speaker 2:

Flanges come in different sizes and they're millimeters they have numbers on them. And the different sizes and they're millimeters they have numbers on them and the sizing system is based on millimeters. So the size you need is based on the size of nipple that you have, Not areola, not that darkened part around the nipple, but the actual nipple itself. So there are little measuring tools A lactation consultant would have them are little measuring tools. A lactation consultant would have them. Lots of people buy their own. Some pump sets come with them, but they range. The measuring tools range from about 10 millimeters to about 30, 34 millimeters across. So 34 millimeters, that's, you know we're definitely over an inch there, and then 10, we're just, you know, a fraction of an inch. So there's obviously different sizes of nipples. So these are little circular measuring tools and you find one that goes over your nipple well, like that's not super tight or super loose, but that's just kind of the perfect fit.

Speaker 2:

And perhaps you have a nipple that the diameter is 18 millimeters is what goes, you know, fits on the nipple the best. What you want to do with that is add one to three millimeters and sometimes that's even four and five sometimes, so that's a little ambiguous and then you add those millimeters and that would tell you your flange size. For instance, if you measured at 18 millimeters, you might want to get a 21 millimeter flange size. If you measured at 22 millimeters, you might want to get a 24 millimeter flange size.

Speaker 2:

Different pumps come with different flange sizes. If you were just to order an ordinary pump, spectra is one of my favorite pumps and they come with two flange sizes. Theirs are 21 and 24. Some pumps come with a 24 and a 27 or 24 and a 28. And those are kind of big. We're finding a lot of people don't need that big of a flange, so you can order for a lot of brands. They have a variety of flange sizes available.

Speaker 2:

So find out beyond just what comes with your pump, which one works best for you. So do that by measuring and then add one to three or four millimeters to the nipple diameter and that will tell you what flange you could use. And it's not a bad idea to have a couple of options around that size, because things can change. So let me tell you what we're looking for when we fit a flange. Now we kind of know, let's say, we're going to use an 18 millimeter flange and you have to test it with the pump on, like the actual component of suction working. So when we put a flange, then the flange ideally that the flange is a left like a fluted opening that that tapers down into a tube that goes into the pump. That's where the milk drips into, right, where we collect the milk. So what we're looking for is in that tube.

Speaker 2:

The nipple should go into that little tube of the flange and it should have some air space all the way around it, Not tons, not tons of air space, but some. So it shouldn't be touching the sides of the flange. If it's touching the sides of the flange, we need a larger flange. If it's got tons of air space around it, like you could run circles around that nipple in the tube, you could run circles around that nipple in the in the tube. You need, um, uh, you're going to need a bigger, a smaller flange, excuse me. So we want just enough air space around it that there is space. And then, once the pumping mechanism turns on, this is how we test flange size.

Speaker 2:

The the pump is going to tug or pull right, it's going to pull that nipple um, in a suction effort. It is going to tug or pull right, it's going to pull that nipple in a suction effort it's going to. When that flange is flush with the breast, it creates a seal and then the vacuum pull of the pump pulls milk out and ideally we want the base of the nipple, where the nipples flush with the areola and starts to rise, that remains at the base of the tube. So you've got, the flange is flat against the breast and that nipple should kind of remain at the base of the tube. We don't want the the areola behind the base of the nipple being sucked deep into the pump.

Speaker 2:

Now, this is also incredibly variable as well, and this actually can change over the course of a pumping session and over the course of a breastfeeding experience. So the elasticity of the nipple has a lot to do with how far that comes in. Some people have incredibly elastic nipples that are just going to suck far down into the flange, the tube of the flange, regardless of the size. And if that's you, you may want to consider getting a low silicone insert, and we'll talk about those in a moment. But ideally the base of the nipple stays put at the base or the beginning of the tube. So that's kind of what we're looking for. So that's how you do a flange fitting and, like I said, that may change over the course of pumping in one session or over the course of pumping over weeks, months, years, however long it is that you're going to be pumping and or breastfeeding.

Speaker 2:

So another thing, another product you can consider is there are silicone inserts, um, that come in packages and they're smaller than the flange but they go into the neck of the flange and they oftentimes come in packs of four. So they might have a variety of sizes, like they might have 16, 17, 18, 19, and 20 millimeter, you know, depending on what's in that package. Or they might come in a package of 19, 20, 21, 22 millimeter, so they can help you when there's changing that happens over the course of pumping. Those can be a part that you just kind of slip in. And I do like the action of the silicone, the contact point of the silicone on the skin. Yes, it's backed by hard plastic generally, but that silicone can have a little better contact point, not quite like skin or baby's mouth, but the contact point can be just a little bit better and more human touch like than a hard plastic flange. So silicone inserts are a product that I really like when my clients use that. So that's a little bit about. Maybe you didn't want to know all that about nipples but now you do. But kind of see what size and you can ask a lactation consultant to help you with this.

Speaker 2:

The benefits of having an appropriately fitted flange is comfort. Like you're some people. Pumping is very uncomfortable for them, if that you know. If it's too large of a flange or too small of a flange, they can cause discomfort for different reasons. We don't want the whole nipple and areola being sucked all the way to the end of the pump. That's incredibly uncomfortable and also it can impact milk supply. We have pretty effective, comfortable and effective, efficient milk supply when we have a well-fitting flange.

Speaker 2:

So maybe you're a mom who has to rely on a lot of pumping, maybe your baby's in the NICU or for whatever reason you're choosing to pump and breastfeed. Make sure your flange fits well and sometimes reassess A couple of weeks down the road, kind of reassess and see where things are. Other people may use some nipple butter, coconut oil. They might want to lubricate the nipple before using the pump and the flange. That can also increase comfort and reduce friction as we are using pumps. So that's a little bit about flange fitting. Hopefully you can find a flange that works best, fits best for you, for your situation, that will help you most comfortably get the most amount of milk while you are doing the awesome, important job of pumping. Thank you for being with me here today on the Ordinary Dealer Podcast. Again, my name is Angie Rozier. Hopefully you can do something today that inspires you, something that makes you and others feel wonderful. Have a great day and I'll see you here next time.

Speaker 1:

Thank you for listening to the Ordinary Doula podcast with Angie Rozier, hosted by Birth Learning. Episode credits will be in the show notes Tune in next time as we continue to explore the many aspects of giving birth.