I have to pipe up on this one here since Manhattan is full of pumping moms.  I've spent 
far too much time watching breasts in pump parts.  The Pump in pal breast shields are 
actually sized larger than the Medela breast shields because of the angle.  

I haven't specifically studied this, but my anecdotal observations and comments from 
moms suggest to me the following equivalents:

The regular size Pump in Pal breast shields work well for women who seem to fit conical 
breast shields ranging in size from 24 mm-27 mm and even a fair number of women who 
seem to fit 30 mm Pump in Pal breast shields. 

SOME mothers who are using 30 mm and most mothers who use 36 mm breast shields 
need to use the large Pump in Pal Breast shields.

I have not yet seen a mother who fits the extra large Pump in Pal shields, although I have 
seen some mothers try them and they didn't work well.  This almost guarantees that I 
will see someone in the next week that will need shields that big.

The angle creates a different pattern of pressure and so it doesn't correspond exactly to 
the single ring of pressure on most shields.

Best, Susan Burger

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