Nancy asked:
"Do you think that since a mother gets a "two sizes in one" package with the
Hollister product that a sizing tool is unnecessary?"
       Hi, Nancy.
       I do think that if Hollister is willing to keep both sizes in one
package, any sizing tool is really unnecessary.  The mom gets the standard size
with the collection kit.  If only all rental stations would be sure to tell mom,
"Please be aware that there is a larger size flange that you can purchase if
the standard size is uncomfortable", then that would resolve the problem.  I
know that Medela separated the sizes in an effort to make it cheaper for moms
to purchase a different size, but I really liked it better when both were in
the same package.  Not only did this make life easier for those moms who have tw
o different sized nipples, but having the two larger sizes together also
allowed those moms who were comfortable with either to do the type of pumping I've
mentioned previously, where the mom pumps 5 minutes with one size and 5
minutes with the other, to better drain the breast.  And as the saleswoman, I feel
bad if I recommend one of the larger sizes and it turns out the mother really
needs the other larger size, so she has to buy another set.  I know that
because the nipples can expand and look different while pumping than while resting,
it's not really my fault if my original recommendation doesn't turn out to be
correct, but I still feel bad about it.  I've always tried to set moms up with
the cheapest device (pump or otherwise) that will still meet her needs.
However, if Hollister decides to offer only one size flange in a package, or they
somehow decide to offer collection kits without a flange at all--for a cheaper
price--so that mom separately buys the "correct" size flange and doesn't have
to pay for a standard and then buy a larger one as well if that's the size
she really needs, then a device such as Medela's would be helpful.  The thing
that Hollister should stress if you develop such a tool is that it is to be used
as an educated guess for a starting point, but that it can't be a perfect
measurement, breast anatomy being what it is.  It would probably also be a good
idea to include in any instructions that the "hole" in the tool should be large
enough to allow extra space all around the nipple at rest--it should not be a
snug fit.  Those of us on Lactnet probably all know that, but there are an
awful lot of rental stations that offer rental pumps simply for the income they
generate--their personnel don't know the first thing about how the pumps
really ought to be used.  So any tools you devise should come with instructions
that may seem to be obvious, for all those people who have no lactation training
but deal in pumps anyway.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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