About the question about the breast shield inserts--

I don't think they are necessary, as more moms don't
use them than do.  However, most of the time they come
free with the pump, and if the mom thinks she might
feel more comfortable using them, then she could try
them and see.
They are meant for women with smaller nipples.

Just for an added note, if this mom is using a medela
product, they do offer a smaller breast shield.

Rachael

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