I've been trying to stay away from this -- personal experience.
If the mother is very, very lucky she will find herself a skilled LC and
a supportive LLL Group and read Jack's book. The Avent pump works well
on mothers with big nipples. Very comfortable. (Sorry for brand name,
but I think it is necessary to say -- and I don't sell them.) This
problem seems to get worse in successive pregnancies -- I didn't notice
it with #1 and #2, and #3 and #4 were manageable. Following babies were
all big, and #5 and #6 were FTT before we figured out the problem, and I
had traumatized nipples at that point. With #7, we were prepared, so it
took about a month of pumping and cup-feeding. I preferred cup feeding
because it was fast and I missed the cuddling during pumping. I put the
baby on the breast very often, for relatively short periods of time,
before and after pumping and cup-feeding and several times between
scheduled supplements (6 X 2 oz. at the peak, but that was a short time)
-- and all night. I also took fenugreek and domperidone, and started it
early with my doctor's blessing because of my earlier experience. If you
could see her now, you would know how successful it was. As a mother, I
was ecstatic that she got nothing but breastmilk, was on the breast
about 15 to 20 times a day, including most of the night, that I didn't
have sore nipples and that I knew she was getting enough to eat, and had
more bms than the two previous ever did.

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html