Extra small nipples = pumping hell! So frustrated!!!!!

[@llli*avesnovuelan]

Short story: wondering what to do when the 21mm flanges are still too big. Read on for more detail.

Everywhere I look there is talk of women needing bigger breast shields when pumping. I have the opposite problem. I downsized to the 21s and still have lots of extra space around the nipple and end up with a lot of areola in the tunnel. I called Medela and they sent me an insert for the 24s that the lady thought might help, but it is no better than the 21s. Pumping is becoming a nightmare and I am not sure what to do. Here are my issues:

1. Breast/nipple pain. I am always at least a little uncomfortable, varying from mild tenderness to excruciating pain. It is worst in between pumping/nursing. I think I have vasospasm to begin with and I suspect the flange fit is worsening the problem. I started using an OTC version of Dr. Neuman's APNO and I also use a lot of coconut oil. These help but only a little.

2. Trouble with positioning. I can't use any sort of hands-free setup or my nipples go way off-center and the milk stops flowing.

3. Need both hands. After the initial let-down the milk will stop flowing. I get about 1 oz from each breast and then nothing. My breasts still feel full. The only solution I have found so far is to switch to just one side at a time, hold the flange in one hand and massage the breast with the other. I get a lot more this way but it takes a long time. I am concerned with how long my pumping breaks are getting to be since I also have to scald the milk after each session due to lipase.

These problems are getting worse the longer I am back at work. I am only just barely keeping up with her intake and if this gets any worse and I can't make enough I don't know what I will do. We barely have any extra in the freezer.

Suggestions? The lady I spoke to at Medela said I should see a LC but I don't really have time for that

[@llli*isabelofmtl]

For sure make the time to see an IBCLC, someone knowledgeable about pumping.

I've read some moms do better with hand expressing. And of course, you know stressing about is not helping your pump output right? I know that's annoying to say, but it's true. Worrying about how long you're taking, how much is coming out... Etc. Not helping! Normal, natural, but not helping.

You do things like watch videos of your DD on your phone, smell an item of your clothing, etc?

[@llli*avesnovuelan]

Anyone else? I talked to an IBCLC friend of mine and she had me troubleshoot my pump, but I am sure it is the flange size that is a problem. My output is ok as long as I take the time to do a lot of breast massage. I would like to be able to pump hands free but I can live without it. It is really the discomfort that is my primary concern.

[@llli*xiaoshira]

Hi - I have a similar issue. As far as I know, these are the smallest they make, in 19mm:
http://www.amazon.com/One-Piece-Brea...la+flange+19mm

Do you have a "simple wishes" bra? I tried the medela bra and hated it, but have much better luck on simple wishes, which you can make REALLY tight. I put it on over my head rather than using the zipper. I have a PISA, I have to use the highest setting and I use compressions while in the simple wishes bra.

I also take lecithin to make the milk come out easier.

Finally, this might sound like a weird tip, but I have both a PISA and a Swing, and SOMETIMES the Swing actually works better to get stuff out, even though the suction feels weaker. You'd have to use the 21mm flange on the Swing though.

Good luck. I feel your pain here - it really sucks being smaller than the smallest product out there. I feel like I'm in 6th grade looking for something to stuff my bra.

[@llli*avesnovuelan]

The funny thing is I have D cups - but tiny nipples. I had no idea they were so much smaller than average. I will have to order those. 19 has got to be better than my current 21. I might need a different pumping bra also. The Medela is plenty tight but it is like the holes are in the wrong place so my nipples always end up squished to one side of the tunnel.

[@llli*xiaoshira]

Medela was tight on me too - in fact TOO tight - but not at all effective. The Simple wishes bra is better! And in your situation with big boobs/small nipples I think the various ways you can adjust the simple wishes bra would work well for you. Good luck!

[@llli*lllmeg]

Have you looked into Pumpin Pals flanges to see if they might help?

Also, have you tried adding hand expressing to your pumping routine to see if that helps? I assume breast compressions would just make it even harder to keep the nipple centered.

Have you considered if the issue is less the flanges and more something wrong with the pump? Is this a new pump? What setting do you pump on? I agree with xiaoshira about less suction sometimes being better. I have seen it several times that pumping at too high a setting is counterproductive. Have you ever tried a different pump?

[@llli*sonogirl]

I can also vouch for the Simple Wishes bra. It is completely adjustable. It has a panel you can zip in and out of the center, plus a Velcro adjustable back panel. You really can customize that bra to fit pretty much any chest, in my opinion!

My nipples are very widely set, and it is the only product on the market that holds the flanges where they need to be for me to pump. Actually, they keep me centered better than when I was pumping and holding the flanges myself.

[@llli*avesnovuelan]

I have to do a lot of breast compressions to keep the milk flowing. But I end up breaking the seal really easily so I have to switch to one side at a time so I can hold the flange in one hand and compress with the other. It is annoying and takes forever.

Baby and I are being treated for thrush now too, so maybe that will help with the discomfort.

I turn the pump to 3. Any higher and it hurts, lower and I get even less milk out. I can't really afford to go but another pump. I am going to try the 19mm flanges and if that doesn't work I will see an IBCLC.

Thanks all of you for the support as always!

[@llli*avesnovuelan]

Maybe once my hubby starts getting paid I will try the simple wishes bra.