I have found that the pump with the soft flange works best for mothers with
very large nipples.  I had a case last year that was referred to me by a
local LLLLeader because the baby would just not latch on.  When I arrived
at the clients home I found the largest nipples I have ever seen (and I
have seen many, many nipples in my 11 years as a LC and 5 years as a
LLLL)-probably close to an inch in diameter.  We were able to get the baby
latched on by kind of pinching the nipple and sliding it into the baby's
open mouth then quickly getting out of the way.  What a happy baby she was
to be nursing.  The visit took about 10 minutes and I almost felt guilty
getting paid, but it was a long trip for me and the mom was happy to pay.
SO when she called me months later about a pump so she could return to work
we tried a bunch of different one until I finally sent her a spare flange
to try.  It worked well and she bought the pump and has been happily
pumping and nursing since.

I don't think I should mention brand names here but if anyone needs this
information, email me privately and I will respond.

Barbara Leshin-Zucker, IBCLC
Highland Mills, NY
Breastfeeding Coordinator, Morrisania WIC-Bronx, NY