I just realized I left out a key word -- the mom of twins I saw who used 36 mm shields had BREASTS that were NOT much bigger than 36 mm.  I left out the NOT.  Tiny breasts in huge shields.  I never understood HOW that worked for her, but it did.  I watched her do it and it really didn't make sense that she released more milk with those shields than smaller shields, but that is exactly what happened.  

Her little breasts made tons of milk for her twins and they were able to go completely to feeding at the breast.  I would never in a million years have picked out 36 mm breast shields for her.  And I've seen very larger nipples that are plastered to the sides where moms claim it doesn't hurt at all.  Go figure.  So, now I just ask how it feels and suggest other sizes but never promise that the other size will work.  I usually give my estimates of what will work about a 90% chance of working.  The other 10% are surprises.

Best, Susan Burger

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