Flange Size Matters: A Comparative Pilot Study of the Flange FITSTM Guide Versus Traditional Sizing Methods.
Lisa A Anders, Jeanette Mesite Frem, Thomas P McCoy
PMID 39614713WHAT IT FOUND
Parents using flange sizes matched to nipple tip yielded more milk and reported more comfort than manufacturer-sized flanges.
Fitting should be individualized; smaller sizes are not automatically better without measurement and trial.
Key findings
01Average milk yield was 138.2 g with standard-fit flanges and 153.2 g with smaller-fit flanges; the reported mean difference was −15.0 g (95% CI −25.0 to −5.0, p=0.004).
02Average comfort was 3.3 with standard-fit flanges and 4.5 with smaller-fit flanges on a 1-to-5 scale; the reported mean difference was −1.2 (95% CI −1.6 to −0.91, p<0.001).
03All participants completed both one-week flange periods without injury.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 36 healthy U.S. parents who were exclusively feeding their own human milk and owned a double-electric pump completed the study, so the results may not apply to other parents or feeding situations. Each flange size was used for only one week, and there was no washout period between sizing, so long-term comfort, milk supply, and injury risk were not assessed. Participants used their own pumps, and pump settings such as vacuum strength and cycle speed were not recorded, so differences in milk yield could be related to pump response rather than flange size alone. Comfort was self-reported, and the exact time since the previous milk removal was not recorded, which could affect yield and comfort ratings. The study tested only hard plastic conical flanges in odd-numbered sizes, so results may not apply to other flange materials, shapes, or sizes.
Declared interests
One author owns a private lactation practice and educational provider that has received payment for courses about flange fitting methods and the Flange FITS Guide. Funding came from an internal University of North Carolina Greensboro award. Maymom LLC donated supplies but was not involved in conceptualization, data collection, analysis, or dissemination.
The easy way to misread this
Do not conclude that smaller flanges are always better for all parents. This pilot used a short follow-up, tested an individualized fitting process, and did not record pump settings or assess long-term comfort, milk supply, or injury risk.