Over the past few years, more mamas are aware that we need to think about breastshield sizing when using a breast pump. This is great - so many women struggle on using the wrong size shield, and the pain and poor milk output it causes can be easily resolved by making sure you use the right size.
(If you need to get started on shield sizing, then go use our measuring tool at pumpable.co/measure).
BUT - your breastshield size isn’t the only thing that makes breast pumping successful. Measuring your nipple is a good start, but that’s just that - a starting point. Before you check your breastshield size (more info on that below), have a look at these other factors that are just as, if not more important :)
You may need to be more hands-on than you think. Have you ever noticed that baby tends to squeeze or twiddle while breastfeeding? This is actually a natural way to stimulate milkflow, and while it’s not the most comfortable thing, practicing hands-on pumping techniques can improve milk output.
Breast massage and compression to stimulate milkflow
Breast massage and compression stimulate milk ducts and encourage milkflow while you’re breastfeeding or pumping. It is also the best way to get that fatty hind milk out and into your baby, so they are not just drinking foremilk. To massage your breasts, begin at the top of your breast and press gently in a circular movement with your index and middle fingers. Slowly work your way down toward the nipple - don’t massage under the breastshield flange when pumping. Repeat starting at different areas around your breasts - don’t forget the armpits as milk ducts can start up there too :)
To do breast compressions, gently cup your breast forming a C shape with your index finger and thumb. Apply gentle pressure and then release. You can hold the pressure, or press-and-release with the suction cycle of your pump.
There’s a fantastic video this method in-action, along with tips and tricks for hands-on pumping, on our blog post about breast massage while pumping.
Make sure you’re positioning your breastshield correctly
When you pump, do you center the breastshield over your nipple and then begin pumping? This is actually just part of what you need to do to fit your breastshield correctly: It’s hard to get proper suction and seal by just by placing the shield over your breast. You need to grab your breast and push the nipple into the center of the flange and as far down the shield as possible prior to turning the pump on.
Make sure there aren’t any air pockets or gaps left between the breast and breastshield when your nipple retracts. This technique creates a seal behind the nipple which is important for maintaining suction throughout your pumping session. You may need to pause pumping and readjust again during your pumping session as milk empties from your breasts.
Do you have a pumping routine? Your pumping routine can absolutely impact your pumping experience, including how much milk output you’re getting. It’s important to pump consistently at the same times each day, and space out your pumping sessions so that you’re not going too long between pumping/feeding sessions. This trains your body to respond to a pump, and also helps ensure your body knows you need milk at the times you pump, so it can produce it ready for you. It’s also important to make sure you’re pumping long enough, until your breasts are empty.
Keep pumping until milkflow has stopped, and continue pumping for a couple minutes longer if you want to build or maintain your supply. This ensures your breasts are emptied and signals your body to make more milk! If your breasts aren’t emptied, your body will think you’ve made too much milk and regulate itself. The amount of time it takes to empty your breasts will vary, but it’s important not to stop pumping simply because a certain amount of time has passed. Breastmilk production is all up to supply and demand, so if you’re not pumping long enough, or often enough, your supply could take a hit - no change in breastshield size can fix this :(
What pumping feels like
Like many things, you’ll kinda have to get used to pumping. It’s not the most comfortable or relaxing experience. When you first start pumping you may experience soreness as your nipples get used to the tugging sensation while pumping. Pumping mamas have written us sharing what pumping feels like to them - you can read about what pumping feels like in this blog post. Pumping isn’t particularly comfortable, even for the pumping veterans - but it shouldn’t cause pain or injury. Nipple pain is quite typical in the first few weeks after baby is born, while your nipples and breasts are getting used to lactating and being suckled on. Hormonal changes can also lead to pain and soreness. These symptoms aren’t necessarily because of pumping, and they will improve as your hormones adjust and your body gets used to breastfeeding and expressing. A stinging/ pressure sensation isn't always a sign of a problem. A stinging / presure sensation during letdown is common throughout many womens’ breastfeeding journey which they do get used to, regardless of how they’re pumping. Pay attention to whether you’re experiencing this feeling just at the beginning of a pumping session, or continually throughout (you may need to assess your breastshield size and pumping technique if you’re feeling stinging at every suction cycle, for example).
Marking on your tissue after pumping also does not necessarily mean anything. It could be suction marks on your skin from the suction seal of the pump, or your body’s response to swelling and stretching of your nipples and areola during feeding and pumping. Your breastshield size may have no impact on this, and this is not necessarily a reason to check for shield sizing.
Using lubrication to make pumping more comfortable
Soreness after or during pumping isn’t necessarily an indication of improper breastshield sizing. Lubrication while pumping can really help with soreness as it protects and nourishes your nipples and areola during and after pumping, which many mamas find helpful. Your breasts and nipples could be sore from moving and rubbing, or simply the suction against the skin could be irritating them till they get used to it. Apply a bit of coconut oil or olive oil to your nipples before pumping, as they are easy to find and safe for your baby should any find its way to your baby’s milk. Make sure you don’t use something like lotion with fragrance or soaps as this will get into your breastmilk :)
Where your prolactin levels are will affect how well your body has a let down and therefore responds to pumping. Soon after you give birth to your baby, levels of prolactin (the milk-producing hormone) are at their highest. This is why some new mothers might experience an oversupply in those early weeks - regardless of whether they pump in the early days or not. With higher levels of prolactin you’re most likely to respond to a breast pump during these earlier days. Levels of prolactin slowly decrease as time goes on and your supply regulates. Pumping extra milk will be harder in time, and you may find you’re not responding to the breast pump as well as you were in the early weeks. This happens even for mums who are exclusively expressing every three hours - their output slowly decreases and emptying takes longer as time goes on. If you wait until later on to pump, it can take a lot more effort to stimulate letdown, get a satisfactory output and to drain your breast. You may need to train your body to respond to a pump before checking breastshield size. Night weaning will also impact prolactin levels. Prolactin is highest at night time, so if you stop feeding or pumping at night, you’ll end up producing less prolactin overall - and this can impact your milk output and ease of letdowns right away, and much more quickly over time in general. The longer you maintain middle of the night pumps and feeds, the easier your breastfeeding and pumping journey is in the long term for ease of letdown and good output.
Your breast pump
The breast pump you’re using might impact your milk output, especially later on as your prolactin levels decrease. You may find it harder to respond to a breast pump that doesn’t have massage mode or independent variable cycle speeds from your suction control as your baby gets older, and adjusting your breastshield size won’t fix that. Some pumps also have gentler suction that others, but variable and independent cycle speed control is more inclined to help you pump successfully than strong suction levels. If you’re planning on pumping long term, or starting to pump later on, consider a breast pump with massage mode and variable cycle speeds.
You will need to replace your breast pump accessories regularly
If you’re experiencing a decrease in breastmilk output, it may be that you need to replace your parts much more often than you think you would, or currently are. Breast pump accessories need to be replaced regularly as moving parts like valves and backflow protectors will wear down over time. If you sterilise or clean in boiling water, you may need to replace these parts more often - even your breastshields, as they can get warped just enough to cause issue with suction. Take a look at our blog on when to replace breast pump parts.
What size breastshield do I need?
Nipple pain that doesn’t improve after a few weeks could be an indication you might benefit from a different breastshield size. It’s important to understand that many women do actually use breastshields that don’t look “best” throughout their pumping journey without any difficulty - although if you’re having trouble draining your breasts even when addressing your pumping technique, it’s worth considering if another breastshield size may help you better :)
You can check your breastshield size by measuring your nipple diameter at the base after your pumping session. You can download and print out our free nipple ruler to make this much easier. We have found that a snug fit using the nipple ruler is what works best for most mums, as when pumping your nipple tends to elongate and thin out with the suction, being smaller than you actually measure anyway.
Remember that there is no perfect looking breastshield size. Everyone’s looks different, and a fitting that ‘looks good’ may not actually be what is most comfortable or what gets you the best milk output. You may have more elasticity in your nipples than others, so you might consider a silicone shield to prevent your nipple moving forward in the shield as much.
Need more help?
Head over to our Fitting Room for a free pumping technique and breastshield sizing consultation, or just message us your questions :) We're here to help.