E87: Flange Fitting Fundamentals

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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

Episode Transcript

Speaker 1 (00:10):
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice Helping thousands of
people prepare for labor,providing essential knowledge

(00:37):
and tools for positive andempowering birth experiences.

Speaker 2 (00:47):
Hello and welcome to the Ordinary Doula podcast.
We talk about just the ordinarythings surrounding childbirth,
labor, delivery, postpartum andbreastfeeding.
My name is Angie Rozier, I'myour host and I'm happy to be
with you here today.
So for today's topic I want totalk about flanges.
So flange, so a well-fittedflange, let's put it that way.

(01:09):
So a flange is the part of thebreast pump that actually covers
and goes over the areola andthe nipple.
Right, it's the part that'stouching the breast.
That's called a flange.
In a lot of cases it looks kindof like the end of a trumpet,
if you will.
In some hands-free pumps youcan't even see it.
It's kind of all encompassedbut that's the part that's
actually touching the body,that's pumping.

(01:30):
And actually funny thing aboutpumps they don't pump, they pull
.
Pumps don't have the ability toactually like grasp and pump
the breast, but they provide asuction and a mechanism, a
moving mechanism that pulls milkout of the nipple.
They don't actually pump it.
So kind of interesting pumpsdon't pump, they suck.

(01:52):
So flanges are.
It's important to get awell-fitted flange.
So a lot of pumps come with alittle flange measuring tool.
It could be a little foam pad.
It could be a little paper cutout with different measurements
on it and what that tool isdesigned to do is measure the
diameter of the nipple, so notthe areola.

(02:14):
Areolas come in a variety ofsizes, but just the nipple right
, so the part that protrudesaway from from the areola in the
center of the areola.
So take this and you can havesomebody help you if you want.
If you want to work with anibclc, I suggest that could be
great as well.
But um a lot.
Some of the tool kits that comefor measuring have one of every

(02:36):
size, from like 10 millimetersto 30 millimeters.
Some just have, you know, a fewof them in there and don't give
you super accurate.
But what you want to do is justplace that over the nipple.
You can also use a millimetermeasuring Ruler and just go
straight across from one side tothe nipple to the other, or you
can use these round ones.
So it's important to have theappropriately fitted flange for

(03:01):
both comfort, protection of thebreast tissue and for maximum
supply.
Now pumps historically just camewith one Flange size.
As we look at the history ofpumps, they became much more
available to the public in theflange sizes.
We look at the history of pumps.
They became much more availableto the public in the 1990s, a
lot more in the 2000s, way morein the 2010s, so this is kind of

(03:21):
new to our society.
Your mom and or grandmaprobably didn't use a pump very
much, and today most people areusing pumps to some extent.
So you may not have a reallygreat or trusted resource
because they just it wasn'tavailable then Back very, very
long ago.
This is kind of a new piece oftechnology in our parenting

(03:42):
worlds here.
So most pumps came with 24millimeter flanges for a long
long time and like awesome, onesize fits all.
Turns out that's not the caseat all.
One size does not fit all.
One size fits all.
Turns out that's not the caseat all.
One size does not fit all.
Some pumps one of my favoritepumps, which is a Spectra come
with huge flanges that are fartoo big for almost everyone.

(04:03):
They'll come with a 24millimeter and a 28 millimeter
flange.
What I find most people areprobably in the range of like 16
, 17, 18 millimeters, andthere's an easy fix around that.
So after you measure andrealize what size it is, some of
the guidelines a lot of theguidelines that are out right
now, say to add two to fourmillimeters for your flange size
.
So if you measure the nippleand it's 16 millimeters, you'd

(04:25):
add two to four millimeters tothat for your flange size.
So you'd get an 18, 19 or 20.
Recent studies have actuallyshown that you want to get the
exact same flange size as thenipple.
So if you measure 16 on thenipple, 16 millimeters get a 16
millimeter flange, and 16 ispretty common size.
If you measure 12, get a 12.

(04:46):
If you measure 22, get a 22.
And depending on your pump, youmay not have flanges that come
in all sizes for your pump.
Like I said, one of my favoritepumps, the Spectre, comes with
24s and 28s.
Most people don't need that, soyou can get separate components
.
Whether it's an off-brand or anactual brand of your pump.
You can get separate componentsthat will accommodate the

(05:09):
actual size that you need.
You also can get siliconeflange inserts and these are
just and they come in every sizeEasy to get on Amazon.
You can buy them online prettyeasily.
They usually come in a set offour.
Sometimes they come in like allodd numbers, like maybe 13, 15,
17, 19, or even numbers.
They'll come in a littlepackage of four of them or

(05:30):
you'll get a couple differentsizes, and a couple different
sizes is okay.
Okay, because things kind ofcan change as well and we'll
talk about what we're lookingfor in flange fitting.
So get the same size as thediameter measurement of the
nipple, and those siliconeinserts are pretty universal to
any pump that you're going tohave.
Some pumps come with severaldifferent silicone flange
inserts so you can kind of seewhat fits best and then use what

(05:53):
is going to work best for you.
So what we are looking for whenthe pump mechanism is on, the
motor is going, we look for thenipple to stay at the base of
the nipple, to stay at the baseof the tube.
So the flange is right on thebreast and then it starts to go
down a tube.
Now some pumps you can't seethat Some pumps, um, especially

(06:14):
some of our portal pumps youcan't really look in and see
what the nipple's doing.
But after, when the pumpmechanism is on, we want that
nipple to kind of stay put.
We don't want a whole lot ofareola traveling down that tube.
Now some people have quiteelastic breasts or nipples, and
they do.
They'll get a lot of traveldown, um, you'd want to just
size down on your flanges.

(06:36):
So if you're, if you got whatyou thought was an appropriate
size flange, yet you have a lotof areola traveling down that to
get a little bit smaller andsee how that helps.
Some people may find somefriction, like it's
uncomfortable to pump with aflange.
It's not the right size.
You can lubricate either thebreast or the pump itself with

(06:56):
like nipple cream or nipplebutter to help reduce that.
Though, when you have anappropriately fitted flange, the
comfort will be the best andproduction will be the best as
well.
I've worked with clients in thehospital or private clients who
have a huge like change inproduction when they use a
flange that's appropriatelyfitted to them.
One mom said yeah, my milksupply just about doubled

(07:19):
because we were compressing thebreast where we needed to rather
than in parts that were notgonna be helpful Also helps with
comfort.
So make sure your flange isfitted appropriately and maybe
have a couple options, becauseover the course of a pumping
session or over the course ofyour pumping journey whether you
just pump a little bit or a lotthat elasticity can change in

(07:42):
the nipple.
So you might have increasedelasticity over time and maybe
you want to downsize on a flangethat way as well.
So there are tons of productsout there as far as pumps.
Go kind of do some research andsee what you need, consider
your lifestyle, see what youneed and consider what flange
size would be best for you.

(08:04):
A lot of people if I work withthem and they've pumped for
other babies they're just blownaway by the fact that that it
makes a big difference to changeand use something that's going
to work for you.
And, as always, you can consultwith a lactation consultant in
your area that will be helpfulto fit flanges and work with you

(08:25):
and see what pumps are going tobe the best for you.
Having a good fitted flangealso can increase your letdown,
which helps obviously withsupply and minimize any clogged
ducts and minimize risk tomastitis.
Um, so yeah, nipples change overtime.
Realize that kind of.

(08:46):
Do a little experimenting,change up or down, um, if you
need that.
Um, sometimes there aresilicone or hard plastic.
Um flanges silicone seems.
I think.
In my experience silicone whenI work with clients, is a little
more pliable.
It's kind of it's a littlecloser to the baby's skin than
the hard plastic of a pump.
It might kind of match theshape of the breast a little bit

(09:08):
better and know that eachbreast may differ.
You may have a different flangesize on the left than you do on
the right and you candefinitely accommodate with that
and get different fl flangesfor each side and then sometimes
just check it right.
If output drops or if you'regetting pain or anything, just
check and make sure your flangesizes are still okay.

(09:29):
You can also adjust the suctionsetting um see if that helps
increase supply or decrease painif you start getting that.
But yeah, it's important to getthe right sized flange and as
we learn more aboutbreastfeeding and pumping,
that's one of the things thatwe've learned in recent years.
Hopefully this has been helpful.

(09:50):
I wish you the very best in yourpumping journey.
Whether it's you're anexclusive pumper or sometimes
pumper or a never pumper.
Hopefully your breastfeedingjourney has what you hope from
it.
It can be a little bit of achallenge sometimes, but get the
help that you need.
There's a lot of support outthere to be had.
Thanks for being with me on theOrdinary Dilla podcast today.

(10:11):
Hope you have a great day and,as always, make sure you make a
human connection today, one thatwill help you and help someone
else.
See you next time.

Speaker 1 (10:35):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes.
No-transcript.