Just one additional comment: I have had, and have seen in others, significant tenosynovitis at the base of the thumbs from the repetitive activity of hand expression of breast milk. This responded to rest and to a change in technique. (Of course the best treatment for me was to rearrange my schedule so that I could nurse instead of express....:-) ) -- Anne Montgomery, M.D. [log in to unmask] St.Peter Hospital Family Practice Residency Olympia, WA