I was recently recounting to another nurse my first "official"
consultation which occurred several years ago.  The mother had attended
my childbirth and breastfeeding classes and was determined to
breastfeed.  Her baby was born with a cleft palate and a receded chin
(Pierre-Robin was ruled out.).

After prolonged attempts at getting the infant to breast, calls to two
more experienced LCs, and repeated attempts with feeding methods I had
only read about, I sent the father to the breastfeeding store for a
Haberman feeder.  I distinctly recall reading the instructions in front
of the mother and spilling a good deal of ABM while learning to make it
work.

To make a long story somewhat shorter, the mother pumped and fed breast
milk from the Haberman for 5 months.  She used a hospital grade electric
pump with double set-up.

About 2 1/2 years later, the mother had a second child who latched and
sucked beautifully.  However, breastfeeding was painful.  I assessed the
latch repeatedly during her hospital stay and again at her postpartum
visit.  I did repeated oral assessments.  The mother consulted at one
other experienced and respected IBCLC.  I met her in a local store when
her second child was 8 or 9 months old.  She was still nursing, but said
breastfeeding had never become comfortable.

Mom did tend to oversupply.  I believe the second child's chin also
receded slightly.  We discussed all usual causes of breast pain.  The
Breastfeeding Answer Book discusses pain related to distended ducts from
oversupply, but says it usually goes away in a few months.

The nurse to whom I related this story asked if long term pumping could
cause breast damage which would result in painful feedings for next
baby.  I didn't know.  What do you all think?

Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA where I have been suffering from acute Lactnet
withdrawal while preparing my talk for the resident physicians  (It was
for a good cause, however, and I think it went OK.)