Multicolor Milk Minute Logo.PNG

our latest episode:

Ep. 9: Breast Pump Flange Sizing

Share this episode with a friend šŸ‘‡

Listen to this episodeĀ here orĀ subscribe & listen on Apple Podcasts


Some quick notes before we begin today, our episodes sometimes contains strong language. So if that’s a problem for you with your children, just pop some headphones in. Yeah, please do. And also please note that we are midwives first and not audio technicians and our audio does get better with time, much like a fine wine.

So stick around through these early episodes when we’re messy, but really enthusiastic. And I promise we do sound more professional toward the end. Yes, especially when we hit our stride somewhere after we hired our audio engineer around episode 25. All right. Thank you for listening.

 This is Maureen Farrell and Heather ONeal. And this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus we laugh a little or a lot along the way.

So join us for another episode. Hello folks. Today, we’re going to talk about fitting yourself for a flange in our nice little pod snack. Yeah. So some people might be like, what the hell are you talking about? If you’re pumping, the flange is the part that actually goes over your nipple and areola and onto your breast.

And those come in different sizes. Did you know that? Bet you didn’t. And if you did, I bet you had the wrong size and here’s, let’s start here. For those of you that have already been pumping for a while, if you are experiencing pinching, nipple cracks, especially around the base of your nipple decreased output when you’re pumping and, or deep breast pain, you could be using the wrong size.

And especially if you have different size nipples, because not all nipples are the same size. Yeah. A lot of people actually need two different flange sizes. And I recommend people Sharpie with them left and right. Because like they don’t always say the size on them and that’s super frustrating. The good news for everybody is that a lot of these companies now that make these parts are making a lot more sizes because it just used to be like four of them.

It used to be the standard was like 24. Like boob size number 1, 2, 3, or 4. Which one are you? Which, which box can we put you in today? So like for example, if you’re at the hospital and they give you a pumping kit, which is covered by your insurance, if you have insurance at the hospital, it’s usually only going to come with two sizes.

It’ll either be the 24 millimeter or the 28 millimeter. So I recommend that pregnant patients actually go ahead and measure both nipples to make sure that you have the right sizes. And if you have a size that’s outside of that 24 or 28, don’t panic. It just means that if you plan on being a pumping mom, which you don’t have to be a pumping parent.

Yeah. Yeah. Let’s just interrupt quick. Not everybody needs a breast pump. Not everybody needs to pump breast milk. Not everybody has to do this, but a lot of people do. A lot of people do which is also fine. Some people prefer to exclusively pump. This is not a judgment situation. This is really just about making sure that if you’re going to do it, you’re doing it in such a way that you don’t hurt yourself.

Right. And ideally you want your little nip naps to like get sucked through that tube on the flange without touching anything. But you don’t want so much space that like your whole fricking areola is also getting vacuumed down into that tube. Right. Because that’s what causes the deep vasospasms. And I know that cause I had them because they’re like lightning zapper shocks to your boobs.

Yes. And honestly, I am the worst patient in the world because I’m an IBCLC. And I took my test for my IBCLC certification while I was breastfeeding. And as I was studying, I was realizing, oh, you know what? I’ve been pumping with the wrong size this whole time, the whole time. And that’s what was causing the pain.

So please measure both nipples. If you have two different sizes, not a big deal. These flanges are sold separately and they’re not that expensive and it’s better to just have them on hand. A lot of people will also mention, what if your nipple gets more swollen as you pump? So when do you measure before or after pumping?

It will swell a little bit, but it shouldn’t swell to the size of like a well, I guess it depends on what the baseline is for you. Yeah. So, so usually what we say is like measure your nipple in the third trimester because you go through all these breast changes in pregnancy and sometimes your nipples and your areola change significantly.

So usually by the third trimester, like a lot of those changes have happened. Your nipples look and feel different. And correct me if I’m wrong cause it’s been a long time since I did this, Heather, we’re measuring in millimeters? Yeah. We’re measuring the diameter of just the nipple, not the areola.

Just the part that sticks out from the areola. The diameter is straight across in millimeters, and you can use a ruler. You can use a tape measure or whatever. Yeah, like a sewing tape measure is really nice, slightly flexible, right? Or a kid’s craft ruler, I believe is what I used. Measure both of them and measure them before pumping.

So that’s how you’re going to be able to tell. And like, depending on where your nipples are on your breasts, this might need to be like a team effort with your partner. I mean, to be like, Hey, like, can you read the number while I hold this on my nipple? Exactly. And also some people don’t have nipples that stand very far away from the areola.

So I’ve had a lot of questions from people about how in the heck do I measure this? I can’t even tell the difference between my nipple and my areola. So my answer to that is always identify the base. So, you know, not everybody’s is going to stand out in a significant way, which is also fine. And it has nothing to do with the success of breastfeeding.

Just identify the base of where that nipple is going to be and measure there. And that should do it, but also know that at any point in time, regardless of how accurate your measurement was, if it’s uncomfortable for you, you might have to go up a size or down a size. And that’s fine. There’s no magic like measurement here, guidelines. That’s what we go by.

Yeah. And these are usually pretty cheap parts, but like, if you’re really stressing money about what you’re buying for baby and yourself, like definitely accurate nipple measurement for this is really key. Yeah. And you don’t actually have to use the brand of flange that goes with your pump.

So if one flange is uncomfortable for you, but you really feel like you have the right size, try a different flange from a different brand. You never know. I mean, you’re putting soft tissue in hard plastic. Yeah. It doesn’t like, you know, I’m just going to put it out there. It’s sucks. It doesn’t feel good.

No one fucking likes it. Pumping really sucks. But having like the correctly fit flanges is not only going to increase your comfort, but it’s also going to increase your output. Yes. It’s going to increase like the efficiency of how you’re pumping. Yeah. And that little, tiny tweak of getting the right flange size can make all the difference in the world.

And I also want to say if you’ve had a baby and that baby and you are separated for any length of time, like you have the baby might have to go to the NICU or something and you have to pump, then please be sure that whoever is with you monitoring the situation that is you postpartum, make sure they are noticing how that flange is fitting on your breast, because some of you might have gone under general anesthesia. You know, some of you might need to pump, but might not physically be capable of doing it yourself.

So please let the person know who’s helping you to pay attention, because if that nipple is not lined up correctly in the center of that flange and it’s turned on for a 20-minute setting, you could end up with a very significant nipple injury right out of the gate. Oh yeah. Right on top of having a NICU baby. So if you’re a partner listening to this, that’s you, that’s your job is to make sure that nipple is centered in the flange and you are holding it on there while she recovers.

Yeah. You want to hold it so that, that whole flange is pretty flush against all of the breast tissue that it’s touching because that’s a vacuum system. And if that flange comes off a little bit, then you’re just, it’s, it’s just not going to work and that’s wasted time. And, you know, I’ve definitely seen people post-op or they have all these fluids, you know, maybe they have an IV like in a really uncomfortable place, they can’t even bend their arm at the elbow. And that just makes it really hard then to hold your hand up by your nipples.

Mm. And, you know, it’s exhausting. And especially if you’d had a labor where you had to push for a really long time where you used your arms to hold your legs, it’s like you ran a marathon. And then the last thing you want to do is to sit up straight at attention and hold your flanges on. Hold your nipples for 20 minutes. Right? So along the same lines, if you have a pumping bra where the flanges go inside the slits in the bra, in the front, that’s great. But also please make sure they are centered and stay centered.

Oh, hey, pod snack tip there. If you don’t have a pumping bra, but you do have a cheap sports bra you don’t care about you can literally just cut small holes and then if you have the kind of pump or the flange completely removed from the pump, which by the way, when you’re buying pumps, like that is essential because some of them don’t remove fully. But then you can take the flange off, put it inside your bra and push the tube of the flange out and then hook it back up to your pump.

And then voila, you have like a $2 pumping bra. Yay. Yay. I never did that. And you know what? I ended up with? Carpal tunnel. Oh, yeah. From, from cranking my wrist at an angle to hold the flanges on. And that was super painful and annoying because it’s not like I got to stop pumping because my wrist hurt. Dude we need to get like a chiropractor who works with lactating parents on this podcast.

Yeah. Put that on the list as well. Yeah, some of you might have the flanges that actually do sit in your bra and the milk receptacle is in your bra as well. There’s different brands of these. Like hands free pump, like discreet pumps or whatever. Yes. So the same rules kind of apply there, you know, just make sure that it’s not uncomfortable and make sure you’re sizing it correctly.

And by the way, most of these pumping brands have their size chart on their website. So, I mean, all of them should, that’s the main thing with choosing which one is right for you. Go to their website, look at their specific sizing chart and make sure you have the right one. And those, just quick note about those receptacles that sit inside your bra.

Some of you might find that it does decrease the supply because the suction isn’t as great when you’re using that, especially if it’s an attachment to your pump. So if it is the pump itself, that’s a different story. But if you’re using it as an attachment, like a Freemie, for example, some people love them, but sometimes the suction is decreased because of the length of the hose and just the receptacle being so large.

So if that’s the case and you’re starting out with something like that, you might want to think about moving to a more traditional flange first, and then once your milk is well established, moving to something like the Freemie. Yeah. I’ve also had clients who have trouble because they were wearing too tight of a bra with the Freemie, or I don’t know the Willow or whatever the other ones are in it.

And it was kind of like squishing their boobs back, which decreases blood flow and movement and like, you just can’t get as much milk out when your breasts are compressed like that. Now, like breast compression where you’re compressing, like from the top and bottom to help get milk out is one thing, but like pushing it straight back into your chest wall that does not help.

Yeah, actually, that’s what you do when you’re trying to stop the flow. Right? So, so if you’re using one of those pumps, especially like this is something a lot of people use at work when their bosses don’t give them adequate pumping breaks, which I have a lot of opinions about. And we’ll talk about another time.

So just think about that. Like you might even have to just pack another bra. And as always, if you are done with your pumping session and you still feel like you have lumps or hard areas in your breast, don’t ever be afraid to touch your own breast with your hand and manually express. Yep. Feel yourself up girls.

What did people do before electric breast pumps? They hand expressed. Also they had crazy little weird like glass suction things with, have you fucking seen those? They’re like the little, okay, so, all right. All right. In podcast, land out there, breast friends. You remember those little squeezy horns you had on your bike?

Yeah, they kind of look just like that, but then in the middle they had this little like glass bubble and you’d like, squeeze the rubber ball. Right. And put it on your breast and let go. And it would like suck out the milk into that little glass bubble. Antique breast pumps are fucking crazy. I need one now.

Yeah. Sitting on this birth stool. There are also, oh man, dude Heather, some of them are wild. Also lots of babies died because of how fucking nasty they were, where they had ones where the milk actually went through the tubes. Oh, all the way down to the receptacle. Yeah. Bad septic news there. We’ll go over a whole cleaning episode another time.

And I don’t know, maybe we’ll have to go into like historical lactation practices. That sounds fun. It does. We might need pictures for that. Might have to do video. I don’t know. The point is you don’t have to pump and your baby will probably be ok if you don’t. Back on topic people, but if you do, don’t hurt yourself. Size it correctly, starting in pregnancy, or if you’re already postpartum do it now.

Never too late to double-check. I mean, everybody out there is always looking to increase their supply as we know. So, you know, if you’re if you’re one of those people, that’s wondering if you’ve got the right size, it’s really low intervention, get a ruler and measure. And let us know.

Yeah, let us know if you measure and you’re like, holy fuck my nipple’s a totally different size than this flange I’ve been using and then like, let us know if that happens. Let us know if you change sizes and you see a difference in anything that’s happening. We really love to share feedback with all of you guys so you guys can just hear like real stories about how this works.

Happy pumping.

Thanks for listening to another episode of the Breast Friends Podcast. If you want to help our podcast grow, please like, subscribe, and share with a friend. To support our mission of accessible lactation information, you can find us on Patreon and become our Breast Friend, Lactivist, or a Dairy Queen. Dairy queen, what?

Each level of membership comes with its own personalized member rewards. Yeah, like behind the scenes video, personalized Q and A, merchandise, I might send you a mug or a t-shirt. Love the merch. This podcast was edited by Heather ONeal with music by Bella Zucker. For questions, comments, or sponsorship opportunities, please email us at


Get behind the scenes access and exclusive perks when you support us on Patreon!