Let’s chat about pump flanges. You have likely heard that it is possible your pump flange is either too large or too small. If you did a quick internet search, you soon realized there are endless possibilities for sizes and shapes of flanges. And, well, it is quite overwhelming. Your Lactation Consultant (IBCLC) can help you navigate the perfect flange fit and find the right pump setting for you.

Breast pumps come with many pieces and pump settings. The flange is this piece shown above. It is a cone shape that goes against your breast. The tunnel is attached to the flange and and is meant to pull only the nipple in. Your nipple shouldn’t rub on the sides of the tunnel, but the pump also shouldn’t pull in too much areola (the dark circle around your nipple). This can be a delicate balance and the perfect size flange may also change over time as you pump more frequently and your nipples grow in size (don’t worry, they will go back to your normal size once you wean/stop pumping).
The next challenge comes in gauging the proper fit. This is more complicated than measuring your nipple at rest, and often it is best to gauge the right fit during an active pumping session. Your IBCLC will observe you pump to determine if your flange size is fitting appropriately, or if you should go up or down a size. At the same time, they will give tips on pump settings and techniques for more efficiently removing milk.

Signs flange is too small:
- Rubbing at base of nipples
- Pinching or squeezing of nipple
- Blisters on sides or base of nipple
- Blanching at base of nipple
- Decreased milk production
Signs flange is too big:
- Ring on areola, past base of nipple
- Inflammation on areola
- Pain in breast tissue
- Blanching on areola
- Decreased milk production
How pumping feels is as important as how it looks. It is helpful to center your nipple in the middle of the pump flange and only pump to your maximum level of comfort (pumping on a stronger vacuum level does not always equate more milk). Many pumps have a vacuum and cycle feature. Vacuum is how strong the pump pulls. Cycle is how fast or slow the pump pulls. In the beginning, a pump will typically have a massage mode. This mode offers a fast cycle and low vacuum to mimic what a baby does to get milk flowing and stimulate a milk let down. Once milk begins flowing the pump will switch (or you select an option to switch) to an expression phase. This phase is usually at a higher vacuum and slower cycle. The purpose of this phase is to mimic what a baby does when milk begins flowing which results in a longer drawn out suck to remove milk.
Additional tips to make pumping more comfortable include: Use a food grade oil, such as coconut or olive oil, to lubricate the pump pieces before pumping, AND use a hands free pumping bra to to allow you to use hands on pumping during your pumping sessions.
Schedule an appointment with us for help picking out the right pump, flanges, and to maximize your pumping output! Check out our Back To Work Workshop for tips on exclusively pumping and returning to work.
About the author: Julie Oberholzer is an International Board Certified Lactation Consultant (IBCLC) with Nurture Columbus, in Columbus, Ohio. With her background in Public Health and Lactation, she enjoys meeting with parents and new babies, helping them on their feeding journey and supporting them as they find their new normal.