Laurie,
You wrote "I have heard it discussed that the baby's mouth should be the
determining factor in choosing a size, and I have heard it discussed
that the mother's nipple size should determine what size to use (stating
a large nipple cannot fit inside a small shield). What criteria do all
of you use? Do you actually measure or do you just
*eyeball* it and guesstimate?"

Kay Hoover (who is not on Lactnet) has started measuring every mom's
nipples when she sees them on home visits. She says, "We just don't know
the normal range of nipple sizes yet, because nobody's collecting the
data!"

Kay asks the mother to measure the diameter at the base of the nipple
with a ruler and also the length from the base to the face. She says
this method is working well, at least as a starting point.

Someone told me that Medela is making a nipple sizing tool-a card with
different size holes in it. If they are, this would be a great boon to
LCs. It would have to be disposable, but then we'd all be able to learn
more about the normal range of nipple sizes, and also whether size
changes as the breast changes. How do nipples on engorged breasts
compare with their pre- and post-engorgement size?


Chris Mulford, RN, IBCLC
LLL Leader Reserve
working for WIC in South Jersey (Eastern USA)
Co-coordinator, Women & Work Task Force, WABA

PLEASE NOTE new email address.


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