I, too have seen moms willing to pump long-term for non-nursing infants
(usually preterm or mom's with very flat nipples -- like the mom in the
recent post.)  However, its always struck me as not very fun, and most of
them communicate this.   (What metaphore am I going to reach for here:
breastfeeding celibacy or some tacky vibrator allusion...)  While proud of
their effort, it's a tedious effort for these mothers to use a machine
rather than a baby at breast.  I hate to keep harping on the usefulness of
silicone nipple shields in such cases, but to me, nursing through a "nipple
condom" is better than the alternative.  The issue with flat nipples is that
the baby can't sense a teat and can't get the signal to start the
suck-swallow-breathe cycle without some rear-of-the-mouth stimulation.  The
nipple extender merely starts the reflexive responses and once the milk
flows the baby says AHA!

I had a call yest from the mom of the baby I recently posted about who had
never been to breast in 6 weeks (I just saw another one the other day whose
mother is all chewed up with chronic mastitis and nipple abrasions from
incorrect use of a pump)  Baby # 1  (also being tx for reflux) spent another
2 weeks nursing through a shield.  Mom called me every day or so anxious
over all the negative comments she was getting from other support people
about how dangerous this was.  I kept telling her to forget about it and
just remember that previously baby was not nursing at all.  Baby cont. to
gain well, and when she called yest. it was to tell me that baby hadn't
nursed thru the shield for 4 days, and mom was able to stop pumping 3 days
ago.  Everyone is delighted, and she
s ready to get rid of the pump today.  Pumps and shields are TOOLS.  The
GOAL is breastfeeding with no props. Our MISSION is to help the mother reach
the goal with whatever tools will do the job.

BTW, always remember to use the newborn small shields -- the others have too
much teat cavity for a weak baby to fill.  If the mom's nipple diameter is
too large, just stretch the bottom to fit.  I wish the pump co. would make
another size wider at base but still a short, slender teat cavity.  Mom's
with huge nipples have another kind of fit prob. which a shield may not fix
anyway.

Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html