Re: Re: Medela's Contact Nipple Shields

[Guest guest]

Amen to everything you said!!

Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.com

See breastfeeding articles at www.fertilefoods.com---

Subject: Re: Medela's Contact Nipple ShieldsTo: Date: Monday, December 28, 2009, 5:43 PM

An infant does not need to fit a flange tunnel/base into it's oral cavity. The flange tunnel opening and space is more related to the degree of tissue elasticity of the user, not necessarily the nipple size although there can be some relation, and certainly not the size of the infant's oral cavity at all.Nipple shields are sized more to the infant's oral cavity, and somewhat to the nipple size. I work with hundreds of pumping mothers a year covering a nursery. I cannot determine appropriate flange size until I observe the mother pumping, and for 10 or more minutes or so. Even Medela now describes those plastic 'nipple flange sizers' as obsolete and not useful. You can't look at a woman's breast and accurately determine how her tissue will respond to pumping, it must be observed. And nipples swell significantly during pumping. I rarely use the 36mm flanges, often use the 30mm, and sometimes use the 27 although I find that somewhere

around 75% of the mothers I provide a 27 end up with a 30mm flange. Less then one quarter of the patients I work with use the standard 24mm flanges the entire time. Even Medela's own literature, and inservice providers explain most moms will need a different size flange. Which makes me wonder why not provide the larger size and let us down size 25% of the time....but it doesn't take a rocket scientist to see the answer to that proposal.>> It looks like Medela doesn't make a 30mm nipple shield? Seems like> the largest one is the standard 24mm.> > http://www.medelabr eastfeedingus. com/products/ breastfeeding- devices> > Why would they have BreastShields that are 27, 30, 36 and even the> 40mm glass ones but not make larger nipple shields?> > Thanks,> Chris>