On the topic of extra large nipples, I am wondering what size flanges
(breast shields) that your patients were using.  I had a lady last week
that had bilateral mastitis and nipples would not fit into the 36 mm
shield, which is the largest we have.  She could not hand express
because of the pain.  I know one pump company sells the glass shields in
40 mm but they are very expensive.
 (and why are they glass?  one sleepy pumping mother and slippery soapy
shield and she's in trouble).  I don't know if she ended up buying them
or not.  
 M Westra RN, IBCLC
 Miami, FL
 

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