Flange Fit in the Real World: What NICU Clinicians Teach Us

Flange Fit in the Real World: What NICU Clinicians Teach Us

Flange Fit in the Real World: What NICU Clinicians Teach Us — and How Pumpin’ Pal’s Angled Flanges Align With Their Needs

Flange sizing is one of the most debated topics in lactation today. With new studies emerging—like Anders et al. (2024), which found that smaller flanges may improve comfort and output—the conversation is heating up again.

But in the middle of all the excitement, one group of pumping parents rarely gets centered:
NICU families who rely entirely on mechanical milk expression.

In her recent response letter, NICU IBCLC Mina Ognjanovic-Jasovic raises vital concerns about applying early-stage research to high-risk, exclusively pumping parents. Her message is clear:

NICU pumping is different, and flange recommendations must reflect the intensity, frequency, and emotional load these parents endure.

At Pumpin’ Pal, we couldn’t agree more.

For over 25 years, our angled, rotational flange system was built not to follow trends, but to solve the real-world problems clinicians kept seeing again and again:
nipple trauma, milk flow issues, positioning discomfort, and the need for sustainable pumping over months—not days.

Below, we explore Mina’s key concerns, why they matter, and how Pumpin’ Pal fits into this evolving conversation.

1. NICU Pumping Requires Solutions Built for Endurance — Not Single Session Outcomes

Most outpatient study participants pump around 3 times per day.
NICU parents pump 8–12 times daily, often for months.

This difference affects:

  • Nipple resilience

  • Comfort needs

  • Long-term supply stability

  • Fatigue and burnout

  • Pump-dependent milk production

A flange that works “fine” once or twice may break down under high-frequency use.

Pumpin’ Pal’s angled design was built for endurance:

  • It reduces downward drag on nipple tissue

  • Allows milk ducts to drain more naturally

  • Supports elevated, ergonomic positioning

  • Encourages a more neutral angle for the nipple during suction

These aren’t aesthetic features — they exist because real clinicians saw their patients struggling and needed a better approach for long-term, high-frequency pumping.

2. Pump Variables Matter — That’s Why Pumpin’ Pal Emphasizes Compatibility and Rotation

Mina highlights a major limitation in the research:
participants used different pump models, each with unique suction patterns, speed cycles, and flange geometries.

This affects comfort far more than flange size alone.

Pumpin’ Pal’s flange system was intentionally designed to adapt across pump brands and across nipple angles through:

  • 360° rotation (12 o’clock through 11 o’clock positioning)

  • Compatibility with most major pump models

  • Multiple sizes for adjusting as supply regulates

  • A shape that guides the nipple into a neutral line of pull regardless of pump mechanics

When pump variability is a real-world constant, flexibility isn’t a luxury — it’s a necessity.

3. In a Market Flooded With Products, Families Need Fewer Tools That Do More

Clinicians like Mina are rightly concerned about the explosion of unvalidated flange designs—over 100 options and counting.

NICU parents are already overwhelmed. They don’t need:

  • Constant equipment changes

  • A drawer full of unused sizes

  • Pressure to buy the “latest” trend

  • Confusion about what’s actually working

Pumpin’ Pal offers five clinically grounded sizes that have helped tens of thousands of pump-dependent parents for over two decades.

One system.
Multiple rotations.
A solution that grows with the parent from engorgement → regulation → maintenance.

Our goal has never been “more products”—only better outcomes.

4. Smaller Isn’t Always Better — Especially Early Postpartum

Mina emphasizes a nuanced truth that clinicians know well:

Smaller flanges often work beautifully once supply regulates — but early postpartum, they can actually make pumping harder.

Before regulation, many parents experience:

  • Engorgement

  • Tissue swelling

  • Heightened sensitivity

  • Rapid breast size fluctuations

A too-small flange at this stage can:

  • Reduce milk flow

  • Increase friction

  • Cause nipple compression

  • Create more trauma, not less

Pumpin’ Pal is positioned uniquely here:

  • Parents can start with a larger angled flange when breasts are swollen

  • Then transition to smaller sizes as supply regulates

  • Without changing the system or learning a new technique

This reduces stress and maintains consistency—critical for NICU families already navigating intense emotional terrain.

5. What Patient-Centered Care Looks Like — and Where Pumpin’ Pal Fits

Pumpin’ Pal has always aligned with the model Mina advocates:

  • Individualized fitting

  • Fewer, not more, unnecessary purchases

  • Tools that support comfort first

  • Options that adapt to anatomy, not trends

  • Consistency that helps parents feel grounded, not confused

Our angled design isn’t about chasing hype—it's about honoring:

  • Nipple angle differences

  • Milk duct alignment

  • Pump ergonomics

  • Body positioning

  • Real-world lactation needs

The same things NICU clinicians prioritize daily.

6. Where Research Needs to Go (and Why We Welcome It)

We agree wholeheartedly with Mina’s call for better, more clinically relevant research.

Future studies should feature:

✔ Exclusively pumping participants

Especially those pumping 8–12 times per day.

✔ A standardized pump model

To accurately isolate flange effects.

✔ Long-term outcomes

Nipple health, comfort sustainability, trauma rates, supply maintenance.

Pumpin’ Pal would welcome research examining:

  • Nipple angle alignment

  • Milk duct drainage patterns

  • Rotational optimization

  • Long-term comfort outcomes

  • Impact on high-frequency pumpers

We believe our design principles would hold up—because they weren’t built for a trend, but from decades of clinician observation.

Final Thoughts: Centering Families, Not Flange Trends

Mina’s letter is a powerful reminder that real families—not marketing cycles—must drive flange innovation.

NICU parents, exclusively pumping parents, and high-frequency pumpers deserve tools built for:

  • Longevity

  • Comfort

  • Anatomical variation

  • Emotional wellbeing

  • Pump compatibility

Pumpin’ Pal’s angled, rotational flanges were created exactly for this purpose, long before the market exploded with options.

As the research evolves, we remain committed to:

  • Listening to clinicians

  • Supporting vulnerable populations

  • Improving comfort and milk flow

  • Reducing trauma

  • Simplifying the pumping journey

Because real-world pumping isn’t measured in single sessions — it’s measured in weeks, months, and memories.

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