I have found this discussion of nipple shield use fascinating, but have a 
practical question.  How do those of you in private practice, "try out" 
equipment?  For example, if a 24 mm shield was used and found to be an inappropriate 
size, so you go to a 20mm, let's say, do you charge mom for both shields?  And 
what about pump flanges?  It often takes use to come up with correct sizing as 
mom's nipples can change when suction applied, baby or pump. 

Barbara Latterner, BSN, RN, IBCLC


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