Someone mentioned that a mom using the (I assume Medela kit) flanges used
only the outer flange and not the insert, and it didn't seem to matter that
the nipple seemed a better fit for the insert. I hope I am remembering this
right. Someone else said she noticed most moms use only the outer shield
too. I have noted this too. Now my question is this: How exactly do you LCs
go about deciding what flange to use? Do you measure anything, or eyeball
it, and if so what are you looking for.?
I must admit that I am not doing anything scientific, and generally suggest
the (Medela) outer shield and suggest to the mom to try it both ways, with
and without the insert. Also sometimes as the breast changes with later
lactation, some moms find using the insert at that point helps extract milk
better. In my hospital we have an "old" Egnell pump, don't know the name but
it is big and chrome like similar to Medela classic. The kit is very rigid
and comes with an insert which I think every mom so far says hurts if she
uses the insert. What does everyone think>?
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA


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