Janice,
My armchair analysis thoughts for you---

Sleepy baby issues make this hard, but it may well be that baby did not
stimulate the breasts well at first, or that maybe she wasn't even on
correctly. I've seen moms with large breasts have a nipple-sucking baby
and not complain of any pain at all.  Though she did not have a strong
engorgement phase, that is not necessarily bad!  I think that "filling
up" and leaking at 4 hours is a positive sign.

The problems with pumping may be more anatomical than anything.  I've had
a couple of moms, also on the heavy side and with large, soft breasts,
who just didn't get much milk with a *good* breastpump without concurrent
manual compression. This type of pumping is often not as effective as a
mom in crisis needs and so it can be very frustrating when you need to
build a milk supply and baby isn't cooperating!  It's good to hear that
mom has good breast growth this pregnancy.

I see no reason for mom to panic and worry about pumping at the hospital,
let alone before birth.  The original LC sounded less than impressive,
and so the first place to start is with a better start than she had with
her first baby.  In short--- offer breast often, get help to verify a
good, deep latch and efficient suck (she should feel after-birth pains
during breastfeeding for the first couple of days), and make sure that
baby is nursing at least 8 times a day by day 3.  No supplements without
medical indication. Watch for adequate meconium diapers early on, avoid
pacifiers and rubber nipples. Mom needs a chance to try breastfeeding the
way it was meant to be before we panic, and she needs to be followed
closely for at least the first week.

I like to assume the best until proven otherwise.

Lisa Marasco, BA, IBCLC