My first experience with a mom who had been sexually abused occured during a pump rental call about 10 years ago. I went through all the normal questions of why do you want to use the pump. Fortunatelly, this mother was quiet open about the fact that she had a sexual abuse history and gave me quite an education. She knew the importance of human milk for her baby but the thought of putting the baby to breast was too much for her to handle. We worked out a pumping schedule and she was able to provide her milk for her baby for about 8 months. Thanks to her educating me I am more comfortable with the situation and hopefully can support moms better. When a new mom tells me that she will pump and feed from the bottle, I do say (very gently) *You know, I have met other women who feel the way that you do and sometimes there is a history of sexual abuse. Has that ever happened to you?* BEFORE you ask this question you have to be prepared for the answer. How do you feel about this issue? What are you going to do if you are the first person this mom has ever admitted it to? (This has happened to me several times) What are the local resources--counciling, support groups? How do you document the history-- who do you tell? You can't bring up the subject and then leave her hanging!!! Another case that comes to mind: A mom kept coming to our clinic asking us to check her left breast over a period of months, she had many somatic complaints about that breast but there never appeared to be a physical problem. It wasn't until she referred to it as *The BAD breast* that I had a clue that there might be a sexual abuse history. She did and related the story to me. She hadn't even told her husband. We dried up the left breast (because she felt sick everytime she nursed on it) and she began counciling that week. Our HMO has a new policy of asking mom's about domestic abuse during pregnancy and after delivery. A lot of the nurses feel really uncomfortable even asking. I imagine that a lot of people would feel the same asking about sexual abuse. Both subjects need to be approached in the right atmosphere and with a great deal of care and concern. The subject came up at the ICLA conference this year and the responce was overwhelming. A group met to support each other and talk after the session. There are courses on sexual abuse and domestic violence support. We need not become *experts* on the subject unless that is our choice. However we do need to be aware of the resources in our communities. I think it behooves us all to become educated and help support these women who are indeed, surviviors. IMHO Marie