Hi Norma
What a dilemma for this mom. 
I had a friend with epidermolysis bullosa, a related skin disorder I believe, so I understand what the challenge might be. Has this mom gone onto the ichithyosis.com chat forum to see if anyone has personal experience breastfeeding?
Even very gentle hand expression would possibly cause trauma - wouldn't it? But if she prepared every time by lots of skin to skin with baby, warm compressing, massage and effleurage/ leaning forward and gently shaking breasts maybe she could tolerate some hand expression? +/- applying lanolin as a lubricant to minimize any inadvertent rubbing (though in theory, if hand expression were done right there wouldn't be friction), then maybe boost supply as much as possible with Domperidone?? (if it were compatible with her meds/disease)? 
I'm interested to hear others suggestions. 
Meggie, PHN
Penticton,
B.C. Canada
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