I just had an experience this week which I am sharing just to increase
options...

A mom with size B to C breasts came in to say the Left breast was pumping
fine with the Lactina and the usual kit but the right one didn't give any
milk at all, even though she was sure she had milk in it.

Baby in NICU, breasts felt full, able to hand express from both equally
well, though right breast was more full and firm. 

Well, we tried the normal shielc, the insert, then I thought, well let's
try the large one - out of desperation, as I knew there was milk there -
well, the large sheild did the trick - almost the entire breast went into
it, as she did not have large breasts, but the milk started flowing well. 
She came back two days later with more questions about pumping and diet,
but reported the large shield was working even now when her breast was no
longer so full...

????

Oh well, learn something new every day.  Perhaps more women COULD use the
larger one, then the Medela company could make them out of plastic and they
would't be so expensive...

Jeanette Panchula, BSW, RN, IBCLC, LLLL
Puerto Rico
[log in to unmask]