Hi to all of you,

I have a patient, her nipple is 10 millimeters of diameter! (0,3937 in)
Her breasts are really extra-large;
She has to pump - it is very difficult, she gets small yield with 
breastpump, and it might be painful I am afraid of;

Her current reducing inserts is 21 mm (0,8268 in) and one could see a 
two-and-a-half-folds smaller nipple completely lost in the flange.

Have you any idea, any tip? any adapted reducing inserts in any country? 
The fact is she has extra-large breasts and tiny nipples;
I thought of Skype for teaching her manual extraction but I am afraid 
she is not in favor of it.

Breast regards,
Françoise Coudray, IBCLC

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