What Happens if Your Pump Flanges are Too Small?
A few years ago, seeing someone using flanges that were too small was fairly rare.
The launch of the Willow Pump has dramatically changed parents’ understanding of the need to size pump flanges as this pump has much more severe consequences with poor flange sizing. This is a fantastic thing that has increased many people’s ability to pump comfortably by getting properly fitted flanges.
It has, however, given rise to an increasing number of parents using flanges that are too small.
Signs of flanges that are too small:
Bruising at the base of the nipple
Cracks at the base of the nipple
Skin breakdown from excessive friction
Trouble removing milk
Often, but not always (elasticity is a factor here), the damage will be isolated to the nipple as the areola can’t be pulled into the flange at all.
If the flange is too small, the nipple doesn’t fit entirely in the flange and can’t move and expand properly.
The style of flange plays a large role in how the damage manifests with softer silicone flanges less likely to damage the tissue and cause issues with poor removal when too small. When the flanges are hard plastic with a solid ring at the base of the nipple, we often see more extensive damage.
Nipples Come In All Shapes and Sizes
Some are easier to measure than others. Some require different fits to achieve comfortable and effective sizing. None fare well in a flange that is too small!
The shape of the nipple can also lend itself to the use of a flange that is too small. Nipples with a clearly defined base are less likely to be measured incorrectly, and therefore, less likely to be sized improperly. Some nipples are a bit trickier to measure as the base of the nipple is harder to identify, and measuring at the wrong point can result in flanges that are too small. In some cases, the base of the nipple is not actually the widest part and sizing is done based on a separate, wider part of the nipple.
This nipple has a clearly defined base that lends itself to easily being measured accurately.
This nipple is easy to measure inaccurately, as the nipple and areola are taped together. Depending on skin tones there may be little color differentiation here to make identification easier.
The widest part of this nipple is not the base of the nipple, and this shape of nipple is easily mismeasured and prone to being sized too small.
Flanges that are sized too small can actually be complicated to identify
The challenge here is that flanges that are too small versus too large often require a lot of assessments to determine the source as swelling can make a large flange look too small, and the signs of poor flange fit overlap quite a bit.
A common source of this sizing concern is flange sizing estimates done without measuring the nipple. This is often done by visualizing the nipple in a 24 mm flange from the side view to estimate the size. The issue here is this method is flawed when it comes to getting an accurate assessment of the nipple and is prone to mis-sizing even when done by someone with experience.
Why is the visualization method flawed?
Height of the nipple is what is being measured, and this is not the biggest measurements for about 30% of people
Varying flange brands have different plastic thicknesses and angles making this an unreliable comparative measurement
Slightly skewed angles of photographs give different perceptions of the nipple size
The base of the nipple cannot be accurately visualized with this method which makes the comparative measurement flawed
The damage to the nipple that is frequently found from poorly sized flanges isn’t always visible.
So, why is this method so popular in so many breastfeeding Facebook support groups?
It’s easily done by untrained moderators, and these groups are using affiliate links so they profit from utilizing this method. They use disclaimers saying the method isn’t accurate but continue the practice to the detriment of breastfeeding parents who are desperately seeking support. This practice may have started with the best of intentions, but the data supports it as flawed and jeopardizing the breastfeeding parent’s comfort and ability to continue breastfeeding. No trained and ethically practicing breastfeeding supporter should be engaged in this practice, and parents should be wary of those who allow this to continue.
So, what should you do if you think your flanges might be too small?
The same thing you do whenever you are having trouble with your flanges!
You can either do a DIY nipple measurement or seek professional sizing support from a trained lactation consultant.
If you are doing the DIY Approach:
This circular ruler measures by millimeters and helps identify the base of the nipple by finding the size that fits snugly without being forced.
Digital calipers can help take the guesswork out of measuring - be sure to measure height and width of the nipple.
This free downloadable ruler makes measuring height and width together quickly possible.
This free downloadable ruler helps you confirm your DIY Sizing and visualize how a size fits with your nipples.
Measure your nipples to see if the flange size you are using is within your typical size range:
2-4 mm for a standard flange and 0-2 mm for Willow.
If you are outside of that range, we need to adjust your sizing.
If you are inside of that range and still having trouble, that is a sure sign you need to skip the DIY approach and get professional support.
If you want to skip the hassle of the DIY approach, professional sizing support is available at a low cost from the convenience of your nearest smart device. Learn more about how professional sizing support works here. The greatest advantage of professional sizing is that once we have your measurement, determining what sizes to try is done based off of substantial training and experience, no guesswork involved! This results in faster identification of the perfect flange size for you!
