# Breast pump shield/flange fit issues



## srneda78 (Jun 4, 2008)

I am having issues with comfort when pumping. My nipples and skin appear to be incredibly sensitive and constantly crack. My doctor thought I had nipple thrush, but I am being treated for thrush (diflucan -- almost done with a 3 week course), but it's not getting better.

As far as the fit of the flanges, I am having trouble. I have large, flat breasts (44H). But my nipple is only about 21-22mm, which would likely be the "standard" flange fit I would think. When I pump, my nipples swell to a bit larger. My LC recommended getting a really large flange (36 mm, the largest that Ameda sells) when I was using my old pump (a Lansinoh double electric) and that was okay (even though my nipples are a lot smaller than that).

At this point, though, I am exclusively pumping (many issues -- don't want to go there right now). So I rented a Medela Symphony. The actual comfort of the pump is better, but I cannot get a comfortable fit with the flanges. I have the standard (24 mm), 30 mm and 36 mm. All of them are uncomfortable on the tender areola tissue surrounding my nipple. I have a red ring around my nipple from pulling of the pump. I am starting to wonder if I need a smaller flange to keep the areola tissue out. The medela website says that the flange shouldn't pull in much areola tissue. It's like I can't get the right fit with the Medela flanges. I am afraid the small 21mm flange would be too small if my nipples swell when pumping. But the 24mm flange still pulls some areola tissue in.

Has anyone else had this problem? My breast are starting to hurt and I'm not even using half the suction power this pump has.


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## DWAXSMOM (Aug 28, 2005)

First, can you see a LC? This sounds like something that should be looked at. Second, more suction does not mean more milk. You shoudl start suction on low setting and then go up just until you feel uncomfortable and then back down until you are comfortable again. High suction can cause trauma and inhibit a letdown. Many times people diagnosed with thrush actually have something else going on. Iwould definitely get in touch with a LC. You can find one at http://www.ilca.org. They have a LC locator on the site that uses your zip code.


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## jecombs (Mar 6, 2008)

Try putting a little olive oil on the flange/sheild area of the pump. It will help reduce the friction. It's okay if a little gets into the BM (or at least that's what my LC said).


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## srneda78 (Jun 4, 2008)

I talked to my LC and she said it still sounds like thrush. I told her I have been taking a full course of diflucan and the shooting breast pain and back pain is gone. But the red part around my nipple is still here and hurts. She said to try gentian violet and that will tell me within a day or two if it thrush I'm still dealing with (since it will start getting better very soon after starting treatment). If it doesn't respond to the gentian violet, she said to have my milk cultured to see if it's something else. She said the diflucan may have taken care of the internal pain, but not the nipple itself. I called about ten different pharmacies before finding the gentian violet, so I'm hoping it helps.

I do put olive oil around the flanges. It does help a bit. My LC said to try the 27 mm flanges as well. DH is going to pick those up for me on his lunch hour. Hopefully those will do the trick. Crossing my fingers.


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## colleengun (Mar 27, 2008)

this may be way off but i had Reynaud's phenomenon with dd1 and the symptoms were pretty similar. I was unable to breast feed or pump without a ton of pain. It is commonly misdiagnosed as thrush. Is there a color change that you have noticed? this was what finally, after months, gave it away. here is a link for kellymom that describes it better. If you want more info feel free to get in touch.
i also use the soft fit sheild and feel they are more comfortable than any other. though this might not be true if you are already sore. good luck


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