The Ordinary Doula Podcast

E87: Flange Fitting Fundamentals

• Angie Rosier • Episode 87

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A well-fitted breast pump flange is crucial for comfort, breast tissue protection, and maximum milk supply. The flange—the part of the pump that covers the areola and nipple—should be sized to match your exact nipple diameter measurement, not 2-4mm larger as previously recommended.

• Pumps don't actually pump milk; they create suction that pulls milk from the nipple
• Most pumps come with standard 24-28mm flanges, but many women need much smaller sizes (16-18mm range)
• Measure your nipple diameter (not areola) using the measuring tools that come with your pump
• Get flanges that match your exact nipple measurement for best results
• Silicone inserts can help adjust flange size and are more comfortable than hard plastic
• During pumping, your nipple should stay at the base of the tunnel without excessive areola movement
• Each breast may need different sized flanges
• A properly fitted flange can increase milk output, improve comfort, and reduce risk of clogged ducts
• Nipple elasticity may change over time, requiring flange size adjustments

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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 Doula podcast. We talk about just the ordinary things surrounding childbirth, labor, delivery, postpartum and breastfeeding. My name is Angie Rozier, I'm your host and I'm happy to be with you here today. So for today's topic I want to talk about flanges. So flange, so a well-fitted flange, let's put it that way. So a flange is the part of the breast pump that actually covers and goes over the areola and the nipple. Right, it's the part that's touching the breast. That's called a flange. In a lot of cases it looks kind of like the end of a trumpet, if you will. In some hands-free pumps you can't even see it. It's kind of all encompassed but that's the part that's actually touching the body, that's pumping. And actually funny thing about pumps they don't pump, they pull. Pumps don't have the ability to actually like grasp and pump the breast, but they provide a suction and a mechanism, a moving mechanism that pulls milk out of the nipple. They don't actually pump it. So kind of interesting pumps don't pump, they suck. So flanges are.

Speaker 2:

It's important to get a well-fitted flange. So a lot of pumps come with a little flange measuring tool. It could be a little foam pad. It could be a little paper cut out with different measurements on it and what that tool is designed to do is measure the diameter of the nipple, so not the areola. Areolas come in a variety of sizes, but just the nipple right, so the part that protrudes away from from the areola in the center of the areola. So take this and you can have somebody help you if you want. If you want to work with an ibclc, I suggest that could be great as well. But um a lot. Some of the tool kits that come for measuring have one of every size, from like 10 millimeters to 30 millimeters. Some just have, you know, a few of them in there and don't give you super accurate. But what you want to do is just place that over the nipple. You can also use a millimeter measuring Ruler and just go straight across from one side to the nipple to the other, or you can use these round ones. So it's important to have the appropriately fitted flange for both comfort, protection of the breast tissue and for maximum supply.

Speaker 2:

Now pumps historically just came with one Flange size. As we look at the history of pumps, they became much more available to the public in the flange sizes. We look at the history of pumps. They became much more available to the public in the 1990s, a lot more in the 2000s, way more in the 2010s, so this is kind of new to our society. Your mom and or grandma probably didn't use a pump very much, and today most people are using pumps to some extent. So you may not have a really great or trusted resource because they just it wasn't available then Back very, very long ago. This is kind of a new piece of technology in our parenting worlds here. So most pumps came with 24 millimeter flanges for a long long time and like awesome, one size fits all. Turns out that's not the case at all. One size does not fit all. One size fits all. Turns out that's not the case at all. One size does not fit all.

Speaker 2:

Some pumps one of my favorite pumps, which is a Spectra come with huge flanges that are far too big for almost everyone. They'll come with a 24 millimeter and a 28 millimeter flange. What I find most people are probably in the range of like 16, 17, 18 millimeters, and there's an easy fix around that. So after you measure and realize what size it is, some of the guidelines a lot of the guidelines that are out right now, say to add two to four millimeters for your flange size. So if you measure the nipple and it's 16 millimeters, you'd add two to four millimeters to that for your flange size. So you'd get an 18, 19 or 20. Recent studies have actually shown that you want to get the exact same flange size as the nipple. So if you measure 16 on the nipple, 16 millimeters get a 16 millimeter flange, and 16 is pretty common size. If you measure 12, get a 12. If you measure 22, get a 22.

Speaker 2:

And depending on your pump, you may not have flanges that come in all sizes for your pump. Like I said, one of my favorite pumps, the Spectre, comes with 24s and 28s. Most people don't need that, so you can get separate components. Whether it's an off-brand or an actual brand of your pump. You can get separate components that will accommodate the actual size that you need. You also can get silicone flange inserts and these are just and they come in every size Easy to get on Amazon. You can buy them online pretty easily. They usually come in a set of four. Sometimes they come in like all odd numbers, like maybe 13, 15, 17, 19, or even numbers. They'll come in a little package of four of them or you'll get a couple different sizes, and a couple different sizes is okay. Okay, because things kind of can change as well and we'll talk about what we're looking for in flange fitting. So get the same size as the diameter measurement of the nipple, and those silicone inserts are pretty universal to any pump that you're going to have.

Speaker 2:

Some pumps come with several different silicone flange inserts so you can kind of see what fits best and then use what is going to work best for you. So what we are looking for when the pump mechanism is on, the motor is going, we look for the nipple to stay at the base of the nipple, to stay at the base of the tube. So the flange is right on the breast and then it starts to go down a tube. Now some pumps you can't see that Some pumps, um, especially some of our portal pumps you can't really look in and see what the nipple's doing. But after, when the pump mechanism is on, we want that nipple to kind of stay put. We don't want a whole lot of areola traveling down that tube. Now some people have quite elastic breasts or nipples, and they do. They'll get a lot of travel down, um, you'd want to just size down on your flanges. So if you're, if you got what you thought was an appropriate size flange, yet you have a lot of areola traveling down that to get a little bit smaller and see how that helps.

Speaker 2:

Some people may find some friction, like it's uncomfortable to pump with a flange. It's not the right size. You can lubricate either the breast or the pump itself with like nipple cream or nipple butter to help reduce that. Though, when you have an appropriately fitted flange, the comfort will be the best and production will be the best as well. I've worked with clients in the hospital or private clients who have a huge like change in production when they use a flange that's appropriately fitted to them. One mom said yeah, my milk supply just about doubled because we were compressing the breast where we needed to rather than in parts that were not gonna be helpful Also helps with comfort.

Speaker 2:

So make sure your flange is fitted appropriately and maybe have a couple options, because over the course of a pumping session or over the course of your pumping journey whether you just pump a little bit or a lot that elasticity can change in the nipple. So you might have increased elasticity over time and maybe you want to downsize on a flange that way as well. So there are tons of products out there as far as pumps. Go kind of do some research and see what you need, consider your lifestyle, see what you need and consider what flange size would be best for you. A lot of people if I work with them and they've pumped for other babies they're just blown away by the fact that that it makes a big difference to change and use something that's going to work for you. And, as always, you can consult with a lactation consultant in your area that will be helpful to fit flanges and work with you and see what pumps are going to be the best for you. Having a good fitted flange also can increase your letdown, which helps obviously with supply and minimize any clogged ducts and minimize risk to mastitis.

Speaker 2:

Um, so yeah, nipples change over time. Realize that kind of. Do a little experimenting, change up or down, um, if you need that. Um, sometimes there are silicone or hard plastic. Um flanges silicone seems. I think. In my experience silicone when I work with clients, is a little more pliable. It's kind of it's a little closer to the baby's skin than the hard plastic of a pump. It might kind of match the shape of the breast a little bit better and know that each breast may differ. You may have a different flange size on the left than you do on the right and you can definitely accommodate with that and get different fl flanges for each side and then sometimes just check it right. If output drops or if you're getting pain or anything, just check and make sure your flange sizes are still okay. You can also adjust the suction setting um see if that helps increase supply or decrease pain if you start getting that. But yeah, it's important to get the right sized flange and as we learn more about breastfeeding and pumping, that's one of the things that we've learned in recent years. Hopefully this has been helpful.

Speaker 2:

I wish you the very best in your pumping journey. Whether it's you're an exclusive pumper or sometimes pumper or a never pumper. Hopefully your breastfeeding journey has what you hope from it. It can be a little bit of a challenge sometimes, but get the help that you need. There's a lot of support out there to be had. Thanks for being with me on the Ordinary Dilla podcast today. Hope you have a great day and, as always, make sure you make a human connection today, one that will help you and help someone else. See you 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. No-transcript.