The worst case of tenosynovitis I ever saw was in a patient who was trying
to increase her milk supply using a manual breast pump.  I think that it is
probably a good idea to remind patients who are using manual pumps, to try
to alternate hands and hand positions if they are using the pump frequently.

Overall, I tend to use pumps reluctantly and only when I have to as they are
certainly not without hazzards.   It always seems to me that there is
something rather bovine about those things!!!

From the Great North where we are expecting the year's first snowstorm
tomorrow,

Shirley Gross M.D.,C.M., C.C.F.P.
Director, Edmonton Breastfeeding Clinic