New mom sues medical licensing board

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I doubt that this is solely a breast-feeding issue.

Currier, who lives Brookline, Mass., also has a 22-month-old son, Theo, and has already received special accommodations under the Americans with Disabilities Act for dyslexia and attention deficit hyperactivity disorder.

Currier is feeling added pressure because she already took the test in April, when she was 8 1/2 months pregnant, and failed by a few points.
 
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Obviously they GIVE you 9 hours to take the exam, but almost everyone I've ever spoken to doesn't NEED the full time to take the licensing exam (which is am assuming is either Step 2 or 3). A dyslexic, ADHD person might...which seems a more reasonable explanation than she will experience "medical complications" if she doesn't pump completely during the exam. There are plenty of women who don't pump over a period of 4.5 hrs and they don't experience mastitis or milk duct stasis.

Besides, who needs 1.45 hours to pump (which is what she is asking for) over 4.5 hrs? If you ask me, the baby looks a little scrawny...she should give him some chips and dip while she takes the exam.;)
 
Wow, this woman sounds like such a whiner. Remind me never to get a biopsy done at MGH. And what kind of idiotic person schedules their licensing exam at 8.5 months pregnant???

More about her:
http://www.boston.com/yourlife/heal...6/26/hyperactive_adults_need_help_too?mode=PF

I can't believe she had her undergrad (MIT) hire people to *read* textbooks TO her!

You wouldn't want a firefighter who couldn't climb a burning building in time to rescue you, shouldn't there be minimal mental benchmarks (without accommodations) in medicine??

And after they allowed her to do the exam in TWO days, she wants her break extended from 45 minutes to 60 minutes? Her sense of entitlement is so infuriating... she needs to suck it up like the rest of us and be flexible. I can think of so many more deserving people for that HMS spot and MGH residency.
 
Wow, this woman sounds like such a whiner. Remind me never to get a biopsy done at MGH. And what kind of idiotic person schedules their licensing exam at 8.5 months pregnant???

I dunno, if you were feeling well and knew that you wanted to take it before you delivered, it doesn't seem like a bad idea to take it while 8.5 months pregnant. However, since the match was in March, it would seem to me that she has known for 6 months that she needed to take whatever part of her licensing exam to start residency (which is apparently is already starting late). Is it 3 months you have to wait before retaking an exam you failed?

And after they allowed her to do the exam in TWO days, she wants her break extended from 45 minutes to 60 minutes?

Even worse...she wants an ADDITIONAL 60 minutes each day on top of the 45 minutes...or an hour and 45 minutes during a 4.5 hr period to pump.
 
Classic Ivy League. Yep, I said it. Entitlements trump all common sense. I took my USMLE between 1 and 1/2 drives to get my wife treatment for a medical condition. Such is life. Get over it.

Legal Disclaimer: This post is not meant to disparage any particular individuals who may have attended Ivy League institutions. It's purpose is solely to expose the ridiculous mindset that seems to permeate these institutions, where the nations most priveledged can't seems to achieve the same standards without special accomodations that the rest of us seem to be able to do without. ;)

P.S.: I also had ADHD. So what? If you aren't capable of doing the work, don't do it. Either the test is necessary to establish competency (in which case everyone should need the minimum standard), or it's not and no one should have to take it. Special accomadations don't fit here.
 
Couldn't she pump extra the day or two before and keep bottles in the fridge for her babysitter to give the child? I don't have a kid yet but that's what my friends do when they know they won't have time to pump for most of a day.

She's already getting a lot of time concessions.
 
Couldn't she pump extra the day or two before and keep bottles in the fridge for her babysitter to give the child? I don't have a kid yet but that's what my friends do when they know they won't have time to pump for most of a day.

She's already getting a lot of time concessions.

Of course she could. She's implying that she will have medical complications if she doesn't pump every 2 or 3 hrs. I'm not sure why her boobs are any different than anyone elses...but who's to say?:rolleyes:

This is why the story seems even more dubious, IMHO.
 
They've already laxed a number of other standards to allow her to take the test... but this doesn't address the primary issue. It is clearly unfair to subject her to the test in the first place. This will only be solved when everyone is treated equally and certain people get unreasonable fair and excessive accommodation. The only logical recourse is to give her a 'Pass' on the test.
 
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I agree... there were other nursing moms who took the test with no problems. One would hate to think that she would use nursing her infant as an excuse or a crutch. I'm not judging her, but that's what it looks like. She's come so far, I hope it works out for her. Anyway... the test is 9 hours?!? :( I think the board is very nice to allow her to take the test over two days instead of one but I would probably want to get it over with in one day. :)

I doubt her autheticity not because others have done it before, but because she already has a 22 month old prior to the 4 month old. How was she able to do what she needed to do then but can't now? I somehow doubt that's the real issue here. She's just sad she didn't get her own way.

I also think it could do with her other disabilities which were mentioned above.
 
I also think it could do with her other disabilities which were mentioned above.

I suspect it has more to do with her being one of those people who got where she is by exploiting loopholes in disability things. Oh look, she's got ADHD, better get class notes from other people. And extra time on the MCAT. And 800 other things.

If she's FAILING Step 3 she shouldn't be allowed to practice medicine, much less given special accomodations. Step 3 is supposed to assure a minimal level of competence, not be a grueling weeder test.
 
NOBODY should be given extra time on the USMLE. NOBODY. I could give two $hits if they have ADHD. I don't care if this woman's boobs will spontaneously combust if she doesn't pump milk out of them. It's an exam to get to be a doctor for chrissake, you don't get extra bonus time.

What the f^(# is she gonna do when her pts start coding??

"Excuse me Mr. Johnson, could you go ahead and go back into a sinus rhythm for me for a little while, I have ADHD you see, and it'll take me a while longer to figure out how to get you out of this V-tach."
 
NOBODY should be given extra time on the USMLE. NOBODY. I could give two $hits if they have ADHD. I don't care if this woman's boobs will spontaneously combust if she doesn't pump milk out of them. It's an exam to get to be a doctor for chrissake, you don't get extra bonus time.

Now in their defense, I would find that to be a bit of a distraction if I were sharing a test center.
 
What the f^(# is she gonna do when her pts start coding??

"Excuse me Mr. Johnson, could you go ahead and go back into a sinus rhythm for me for a little while, I have ADHD you see, and it'll take me a while longer to figure out how to get you out of this V-tach."

:laugh::laugh::laugh::laugh:
 
I wonder if she'll go down in history as the first Harvard MudPhud who failed a step.
 
Long-time lurker, I just had to post on this (I'm a huge breastfeeding advocate). While this woman may not be the typical medical student, I think the bigger issue here isn't whether SHE should be allowed extra time, but whether the board should make accomodations for breastfeeding moms. A lot of other places/institutions make accomodations (including no jury duty), why does the NBME think it should be anything different?

Let's not forget that
- she is asking for extra BREAK time, not test time.
- it's not a matter of having enough milk for her baby to eat, it's a matter of her pumping often enough. Her breasts will keep producing milk at the same rate!
- a typical exclusively breastfed 4-month old does nurse every 2-3 hours in the daytime (based on my experience), and she will be in serious pain and risk complications (engorgement, clogged duct, mastitis) indeed if she goes too long before pumping. Some women are very prone to that. She will also most likely start leaking, possibly considerable amounts.
- pumping takes time - at least 20-25 minutes per session (including set-up, pumping, clean up, storing) for the super fast mom with a great letdown reflex, could take much longer depending on the mom, especially in stressful conditions as she would be. A 45-minute break may only be enough for her to pump once, and that is definitely NOT enough.
- because *some* women can and have done it doesn't mean *all* women should. Some women also take no maternity leave, so should that be the standard for all? Maybe she needs to pump more often, maybe she produces more, maybe she is a slow pumper, maybe she's prone to mastitis. I don't see why the NBME would refuse to even consider giving any woman an accomodation for breastfeeding, which is not only her right, but better for her baby's health.

It's easy to focus on this woman's particular circumstances, but let's focus on the big picture too! What if she wasn't receiving other accomodations, and hadn't failed the test before? Would you think it ridiculous for her to ask for extra BREAK time (not TEST time)?
 
So I don't want to necessarily directly defend her, but I have to defend breastfeeding and pumping. How many of you have actually pumped? Think of the real time it takes. You have to go to a private place (inevitably a dirty bathroom, since there is rarely anywhere else to pump), set up all the supplies (have you ever actually seen a battery powered breat pump? it's not a one step operation), start pumping, wait for the let-down, empty your supply, disassemble everything, clean all the individual parts (or else they clog and are too disgusting to use for the next pumping session) and store everything.

At times, it would take me 30 minutes or more for the whole process. And no one can say how many times a particular woman needs to pump or how long it will take to empty her out. At the height of nursing (around the 4 or 5 month mark), I would often have to pump 3 times in an 8 hour period to avoid excruciating pain. Other women can go much longer. It also varies greatly with the age of the child. There is no standard.

Maybe she is prone to mastitis. Who knows. I just don't want everyone jumping to conclusions about what she should or shouldn't do based on what you have been told that your friends do, but you haven't actually experienced yourself.
 
That is not a cute baby... (I'm just saying...)
 
Long-time lurker, I just had to post on this (I'm a huge breastfeeding advocate). While this woman may not be the typical medical student, I think the bigger issue here isn't whether SHE should be allowed extra time, but whether the board should make accomodations for breastfeeding moms. A lot of other places/institutions make accomodations (including no jury duty), why does the NBME think it should be anything different?

Let's not forget that
- she is asking for extra BREAK time, not test time.
- it's not a matter of having enough milk for her baby to eat, it's a matter of her pumping often enough. Her breasts will keep producing milk at the same rate!
- a typical exclusively breastfed 4-month old does nurse every 2-3 hours in the daytime (based on my experience), and she will be in serious pain and risk complications (engorgement, clogged duct, mastitis) indeed if she goes too long before pumping. Some women are very prone to that. She will also most likely start leaking, possibly considerable amounts.
- pumping takes time - at least 20-25 minutes per session (including set-up, pumping, clean up, storing) for the super fast mom with a great letdown reflex, could take much longer depending on the mom, especially in stressful conditions as she would be. A 45-minute break may only be enough for her to pump once, and that is definitely NOT enough.
- because *some* women can and have done it doesn't mean *all* women should. Some women also take no maternity leave, so should that be the standard for all? Maybe she needs to pump more often, maybe she produces more, maybe she is a slow pumper, maybe she's prone to mastitis. I don't see why the NBME would refuse to even consider giving any woman an accomodation for breastfeeding, which is not only her right, but better for her baby's health.

It's easy to focus on this woman's particular circumstances, but let's focus on the big picture too! What if she wasn't receiving other accomodations, and hadn't failed the test before? Would you think it ridiculous for her to ask for extra BREAK time (not TEST time)?

First of all you absolutely do not have a "right" to pump your breasts during the USMLE. I'm pretty sure that is not one of the inalienable rights designated in the constitution. As everyone else said she should not get extra break time. The USMLE is a test of endurance as well as knowledge.

If breast feeding is that important to her then she should postpone the test until she has weened the baby off. The other option would be to ween the child now and take the test like everyone else.

By the way, I am a huge breastfeeding advocate - my wife breastfed our children until they were 1. I'm going into OB and will advocate for breast feeding (to an extent) and think is ridiculous.
 
I'm surprised that, as a future OB/GYN, you think it is acceptable that her choices should be
1) wean her child
2) postpone her test and most likely delay graduation
3) risk mastitis/clogged duct/extreme discomfort.

As you said, you know the benefits of breastfeeding for both mother and child, but you still recommend that she weans her child *just* so that she can take the test in acceptable conditions? That's a pretty big sacrifice. I'm aware it was her choice to have children, but this is a sad choice to have forced upon her. What next? Be a physician OR have children? Take zero maternity leave OR don't have children at all?

I personally only see extra break time as a minor accomodation (testing time would be different, of course), and as I said before, accomodations for breastfeeding are made in many other arenas (in some cases, mandated by state laws). I find it a bit hypocritical that a MEDICAL board wouldn't support breastfeeding.
 
I'm surprised that, as a future OB/GYN, you think it is acceptable that her choices should be
1) wean her child
2) postpone her test and most likely delay graduation
3) risk mastitis/clogged duct/extreme discomfort.

As you said, you know the benefits of breastfeeding for both mother and child, but you still recommend that she weans her child *just* so that she can take the test in acceptable conditions? That's a pretty big sacrifice. I'm aware it was her choice to have children, but this is a sad choice to have forced upon her. What next? Be a physician OR have children? Take zero maternity leave OR don't have children at all?

I personally only see extra break time as a minor accomodation (testing time would be different, of course), and as I said before, accomodations for breastfeeding are made in many other arenas (in some cases, mandated by state laws). I find it a bit hypocritical that a MEDICAL board wouldn't support breastfeeding.

I actually don't really care that much. I'm assuming its step 2 that she is having problems with - its really not that hard of a test. But I don't think the 3 options you listed are that bad. There have been several girls in my school who have taken time off to be with their new babies and will not graduate on time.

I guess she has to decide what her priorities are. Of course, nearly the entire baby boomer generation was raised on formula (which were not as good as the ones they have today) in the US and they turned out OK. Obviously breast feeding is better.
 
Again, I don't think her priorities should force her to choose between weaning or delaying graduation.

Delaying graduation because you want to take time off with your kids is great! Delaying graduation because you can't take a test in reasonable conditions unless you wean your kid is a bit extreme to me. I really cared about breastfeeding with my kids and would certainly not have weaned just so I could take a test; some people don't care about it that much and would wean without second thoughts and that's OK for them.

As for baby boomers, their moms drank and smoked the whole pregnancy too, and they turned out OK... Sure, formula is nowadays well-designed, very nutritious, and a fantastic alternative to breastmilk, but again, weaning just to take a one-day test when very simple accomodations could be made is too much to ask, but that's just me.

Alright, I'm off. Nice talking to you! Good night.
 
Like Kent said right away, I think the real issue behind all of this is "Currier is feeling added pressure because she already took the test in April, when she was 8 1/2 months pregnant, and failed by a few points."

She already failed. She's in big trouble if she fails again, so she could very well be looking for ways to make it less likely that she fails again.
 
She already failed. She's in big trouble if she fails again, so she could very well be looking for ways to make it less likely that she fails again.

I suggest studying more. Its unlikely that extra break time will make the difference in passing or failing; its not like they're gonna allow her to be studying in the bathroom while she's pumping. She's not getting extra exam time.

They're discussing this in the SP forum as well, FYI.
 
Far be it from me to make fun of someone's appearance...

...but she look like Emporer Palpantine's niece or something.

Yeah, and this has nothing to do with her needs to breastfeed and everything with her not wanting to risk a second fail.
 
As a mom who has breastfed two babies I can attest to the fact that pumping is not exactly an easy or timely thing, but I still don't see how she'd need extra time. If she is taking the test in two days and has a 20 minute break each day it would not be a terrible thing for her to set up shop and pump right before the test, do whatever she can in her 20 minute break and then pump immediately afterwards. That allows for 3 pumping sessions in approximately 5.5 hours. I suppose she could allways use a hands free pump and set up in the middle of the test. :smuggrin:

Now, I'm not going to say that this is true of every breastfeeding mom, but I really do have a hard time believing this girl has never stretched a feeding past the 3 hour mark. Once I bought a pump and got to where I felt like it wasn't going to hurt my milk supply, there were plenty of times I was "late" for a feeding, just because its incredibly inconvenient to have to plan everything around breastfeeding. If my baby drank every three hours then I'd only have about 2 1/2 hours between feedings. That doesn't give much time to do anything, especially if your trying to get out of the house.
 
So do lactating women have to wake up several times during the night to pump? I guess they have to feed the baby anyways...

This is why I'm never having kids. I value sleep more than baby.
 
Reading through her ADHD symptoms list made me think I have ADHD :laugh:

But more seriously, I think her dyslexia is for real, so if they're making her take the test without some kinda auditory aid then the 2nd day might be warranted. I honestly don't see why she would need so much extra break time to milk though...45 minutes is still a decent deal of break time. Plus, she can probably milk ahead of time anyway so she wouldn't have to milk as much on exam day.

The fact that she's asking extra time for this makes me doubt that she even has ADHD, since it just makes it look like she uses any excuse to get an edge. Can't believe she got into MIT and HMS (MD-PhD no less) and got a residency (in path no less) at MGH...grr... How exactly did they decide that she's competent if she seems to have so much trouble taking any sort of test?!
 
So do lactating women have to wake up several times during the night to pump? I guess they have to feed the baby anyways...

This is why I'm never having kids. I value sleep more than baby.

A new infant requires night feedings. As the infant gets older (for me it was about 3-4 months) then the night feedings are no longer necessary. Initially the mom might have engorgement during the night due to the change, but the body adjusts.
 
I am all about diversity in the work place rather it be sex, color, health issues, etc.... however I think there should be a HUGE wall if any of the above has an effect on whatever job it is your are doing.


I do not think anything in medical school should be 'adapted' for someone with any problems above. I think we are doing humankind a huge disservice by granting extra times and the such for testing.


If her boob is going to hurt because she could not pump, tough. My freaking back and feet hurt many days on Surgery call when I had to stand for hours. Why did I not get 'extra break time'? I've had to pee so bad before that I am surprised I never wet myself in the OR.....extra break time would have fixed that. Any idea how bad my stomach has cramped when its 10 at night and I still have not had anything to eat all day.... wish I had extra break time. One of my classmates was pregnant as an MSIII. We were call partners in Surgery and later on IM. During surgery, shed vomit between cases... during IM, shed pump between rounds and such. She never asked for anything less, she sucked it up and did better than I did probably...


If you have ADD, lost your arm cause your you abusive father chopped it off, or can't stand long because of the chronic back pain after that car wreck where the drunk driver hit you... tough. Life sometimes sucks, but we should not feel sorry for you and make it easier for you to get by. Come in, suck it up, git r done, and show us up that even someone with a handicap can do well, if not better, than the rest of us. If not, go to the house, medicine isn't for you.


Off my soap box..
 
Again, I don't think her priorities should force her to choose between weaning or delaying graduation.

Delaying graduation because you want to take time off with your kids is great! Delaying graduation because you can't take a test in reasonable conditions unless you wean your kid is a bit extreme to me. I really cared about breastfeeding with my kids and would certainly not have weaned just so I could take a test; some people don't care about it that much and would wean without second thoughts and that's OK for them.

As for baby boomers, their moms drank and smoked the whole pregnancy too, and they turned out OK... Sure, formula is nowadays well-designed, very nutritious, and a fantastic alternative to breastmilk, but again, weaning just to take a one-day test when very simple accomodations could be made is too much to ask, but that's just me.

Alright, I'm off. Nice talking to you! Good night.

Judging from the rest of the facts, I doubt that breastfeeding is her real issue. In fact, I tend to think that if this is a woman who has had to pay people to read to her due to her ADHD as others pointed out, (keeping in mind other people cope with ADHD just fine by exercising, yoga, medication if worse come to worse on their own. I know because I have some very good friends in real life that have admitted to having to cope with this disease for years), and if this is a woman who has also had dyslexia and failed once before, then it is reasonable to assume that there is a good possibility she's not really doing this in the name of breastfeeding mothers and possibly wants the extra time for other reasons.

Besides, she already had a child once before and she coped so how come she can't cope now?
 
Judging from the rest of the facts, I doubt that breastfeeding is her real issue. In fact, I tend to think that if this is a woman who has had to pay people to read to her due to her ADHD as others pointed out, (keeping in mind other people cope with ADHD just fine by exercising, yoga, medication if worse come to worse on their own. I know because I have some very good friends in real life that have admitted to having to cope with this disease for years), and if this is a woman who has also had dyslexia and failed once before, then it is reasonable to assume that there is a good possibility she's not really doing this in the name of breastfeeding mothers and possibly wants the extra time for other reasons.

Besides, she already had a child once before and she coped so how come she can't cope now?

Yeah, this is sort of my hunch, too. If it were just the breastfeeding with nothing else going on, I'd be more likely to buy it. Honestly it's really hard to figure out what she brings to the table when she has to have so much accommodation for everything. Speaking of the ADHD issue, we have lots of posters here who have admitted having it, and they seem to have taken their boards just fine without accommodations. My brother has it and has managed to pass all his board exams without any special help. It sounds to me like she's worried because she failed once. Now if she fails again, she has an excuse, so MGH is less likely to dump her.
 
So I don't want to necessarily directly defend her, but I have to defend breastfeeding and pumping. How many of you have actually pumped? Think of the real time it takes. You have to go to a private place (inevitably a dirty bathroom, since there is rarely anywhere else to pump), set up all the supplies (have you ever actually seen a battery powered breat pump? it's not a one step operation), start pumping, wait for the let-down, empty your supply, disassemble everything, clean all the individual parts (or else they clog and are too disgusting to use for the next pumping session) and store everything.

At times, it would take me 30 minutes or more for the whole process. And no one can say how many times a particular woman needs to pump or how long it will take to empty her out. At the height of nursing (around the 4 or 5 month mark), I would often have to pump 3 times in an 8 hour period to avoid excruciating pain. Other women can go much longer. It also varies greatly with the age of the child. There is no standard.

Maybe she is prone to mastitis. Who knows. I just don't want everyone jumping to conclusions about what she should or shouldn't do based on what you have been told that your friends do, but you haven't actually experienced yourself.


Actually, my wife pumped AND had mastitis twice, and I can tell you (and she would tell you too), that this is utter garbage. We all have advantages and disadvantages. The rules should be the same for everyone, or the idea of a minimum standard of competence flies out the window.
 
Reading through her ADHD symptoms list made me think I have ADHD :laugh:

But more seriously, I think her dyslexia is for real, so if they're making her take the test without some kinda auditory aid then the 2nd day might be warranted. I honestly don't see why she would need so much extra break time to milk though...45 minutes is still a decent deal of break time. Plus, she can probably milk ahead of time anyway so she wouldn't have to milk as much on exam day.

The fact that she's asking extra time for this makes me doubt that she even has ADHD, since it just makes it look like she uses any excuse to get an edge. Can't believe she got into MIT and HMS (MD-PhD no less) and got a residency (in path no less) at MGH...grr... How exactly did they decide that she's competent if she seems to have so much trouble taking any sort of test?!


Apparently reading will no longer be required of physicians, so we should exclude all tests that require it from medical training for people with ADHD or dyslexia. If you can't read a test, there is no way that you meet minimum competency, as I can't think of a specialty that doesn't spend half of its time reading and writing notes (like it or not).
 
Judging from the rest of the facts, I doubt that breastfeeding is her real issue. In fact, I tend to think that if this is a woman who has had to pay people to read to her due to her ADHD as others pointed out, (keeping in mind other people cope with ADHD just fine by exercising, yoga, medication if worse come to worse on their own. I know because I have some very good friends in real life that have admitted to having to cope with this disease for years), and if this is a woman who has also had dyslexia and failed once before, then it is reasonable to assume that there is a good possibility she's not really doing this in the name of breastfeeding mothers and possibly wants the extra time for other reasons.

Besides, she already had a child once before and she coped so how come she can't cope now?

All good points. :thumbup:

I suspect there's more going on here than she readily admits.
 
Apparently reading will no longer be required of physicians, so we should exclude all tests that require it from medical training for people with ADHD or dyslexia.

Patients will be required by the Americans With Disabilities act to bring readers to read their charts for her. Failure to do so will result in a lawsuit. Also, she will receive a "time accomodation" from insurance companies so she can bill for a 25 minute outpatient visit instead of the normal 15.
 
Patients will be required by the Americans With Disabilities act to bring readers to read their charts for her. Failure to do so will result in a lawsuit. Also, she will receive a "time accomodation" from insurance companies so she can bill for a 25 minute outpatient visit instead of the normal 15.

She's gonna be a pathologist so no patient contact. Maybe someone will read Robbin's to her?
 
Patients will be required by the Americans With Disabilities act to bring readers to read their charts for her. Failure to do so will result in a lawsuit. Also, she will receive a "time accomodation" from insurance companies so she can bill for a 25 minute outpatient visit instead of the normal 15.

Hey, finally an excuse to sue the patients :laugh:
 
Says my classmate. Posting at 1am with lecture at 8am.

Yea...it happens...a lot.



What if you have some kind of GI distress the day of the test? Can you get extra break time to go to the bathroom and...empty your contents? Is that request any different from extra break time for breast pumping?
 
I don't see why she needs extra break time.
the pump does all the work - she could use it during the exam.
 
Actually, my wife pumped AND had mastitis twice, and I can tell you (and she would tell you too), that this is utter garbage. We all have advantages and disadvantages. The rules should be the same for everyone, or the idea of a minimum standard of competence flies out the window.

I pumped AND had mastitis three times. Just proves what I said before. Not every woman is the same, so you can't judge her based on your wife's experience.
 
I pumped AND had mastitis three times. Just proves what I said before. Not every woman is the same, so you can't judge her based on your wife's experience.

but you can judge her based on the fact that she's done this before and never brought this issue up before. So why now?
 
but you can judge her based on the fact that she's done this before and never brought this issue up before. So why now?

Yes, I believe she has breastfed before, but has she breastfed and been required to take a 9 hour exam before?
 
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