I wonder if she is allergic to something in the pump kit, or something 
that she uses to clean it with?  Does she have hives if she hand expresses?
It might be hard to manually express if she has terrible muscle pain, 
but it might be her best option.  I wonder if there is some sort of 
autoimmune process going on?
I'd send her to an allergist/immunologist too.
Catherine Watson Genna, IBCLC  NYC

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