We believe that a few of these companies offer a smaller sized pad for women who are smaller! A company like Avent -- and, I believe a few others -- have developed an angled neck that allows for most breast sizes to express properly. Often times, it is the angle more than the size of the device. Also, the position you can sit in, which also addressed through this. We’re sure that through Lactation Consultants, there is an option for customizable pads that will conform specifically to your breast, as well. Be sure to maintain adequate pressure on the pump when it is attached to avoid slippage or leaking.