Dear Karen,
I have been also struggling with this question. I do feel that most of 
my clients need to go up in size not down if they are having discomfort 
or lack of milk. But then I have colleagues, who I respect, who say, no 
go down. I am handling this by having several sizes on hand for families 
to try and see what is most comfortable I clean and sterilize them after 
use. My families are doing very well their milk supplies so this appears 
to be working.
I am so curious what others think.
Thank you!

-- 

Barbara Robertson, MA, IBCLC, RLC
The Breastfeeding Center of Ann Arbor
bfcaa.com

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