Linda,
Regarding your client with very large breasts -
I have used with success a sling to support the breast(s) made from that
material used for turtle necks.  You can get it at any fabric store and cut a
long piece, sew the two ends together.  Put one end around her neck and one
under the breasts.  There is a good photo of this in the Renfrew book:
"Bestfeeding..."  The woman in the photo is not that large, but I think this
still may help, along with a couple of pillows. The extra large flanges may
or may not help.  I've used the glass ones from the other company, and they
are helpful, but cumbersome to use because they add considerable length to
the breastshield.  Just some thoughts.
Elaine Webber, IBCLC