While definitive research on flange sizing has yet to be conducted, an
article in Clinical Lactation might be of interest on this topic. See:
Higgins, A.F. (2022). Flange sizing recommendations for frequent breast
pump use. Clinical Lactation, 13(3), 159-169.

This study is interesting but the authors are funded by Medela.
Sakalidis VS, Ivarsson L, Haynes AG, Jäger L, Schärer-Hernández NG,
Mitoulas LR, Prime DK. Breast shield design impacts milk removal dynamics
during pumping: A randomized controlled non-inferiority trial. Acta Obstet
Gynecol Scand. 2020 Nov;99(11):1561-1567.

Because nipples can swell during pumping, some mothers may need different
size flanges during the first part of a pumping session and at the end of a
pumping session. Some mothers also need a different size flange as
lactation progresses and breast shape changes over time.

Marsha Walker, RN, IBCLC
Weston, MA

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