David,
As you and your wife have discovered, parenthood is often a choice between
ideals and survival!  I think we LC's understand that and support the parents
in their choices.  You bring up some interesting points...
        Dads need to develop their own unique relationship with the baby.
Babies can learn to be soothed several different ways, as long as they are not
hungry, then they only want food.  If baby is handed back to mom at the first
peep, this does not develop.  I have found that some 'outdoor' time with just
dad and baby is helpful - dad can show baby the wider world, or at least the
knick-knacks in the house.  Taking baths together in the tub is another nice
baby-dad ritual.  The take home message is that dad has to be a little brave,
and try to soothe baby without running right back to mom's breast.
        Pacifiers:  at issue is what oral motor skills the infant has, and the
effect of different stimuli on learning to integrate all those responses that
we lump into sucking.  Orthodontic pacifiers tend to reward pursed lips (to
keep them in the mouth) and tongue retraction.  Skinny pacifiers reward a
narrow gape, etc.  Once baby's oral motor skills are well integrated, and baby
 understands the connection between eating and getting a full tummy, they are
less problematic.  There is a recent study showing increased otitis in
toddlers using pacifiers (in a Scandinavian nursery/day care), and studies
have indicated that pacifier use reduced the duration of bf.  There are also
situations when pacifiers are therapeutic - such as in premies being gavage
fed.  It is up to the health care professional to offer information, and the
parents to make the decision that is best for their family.
        As for the breastpump companies marketing like abm companies, I agree
that one of them at least was doing this, specifically at the ILCA conference.
 I stood up at the board meeting and complained that we could find ourselves
compromised if we accept these goods and services, so I certainly agree with
you.  The only freebies I accept from my rep are occasional samples of new
products to use as demos in my practice.
        Sorry so longwinded...this pushed some buttons.
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]