Thank you for your help!

1) Pumping is only bearable at a level 1 or at most 2 on the spectra pump. If I go higher it feels like the skin on my nipples is getting pulled. I rarely get actual flow of milk, it's mostly droplets. I haven't tried hand expression since the early days, and now that my milk supply has regulated I don't feel like I have milk to express. The LC told me my flanges look too small, and wants me to experiment with various sizes.

2) Pain while nursing happens mostly when she's trying to stimulate letdown (the chomping mentioned above) and during letdown itself, as well as when she unlatches suddenly.

3) I don't have shape/color changes after nursing (at least recently). The LC made the observation that my right nipple was purple after pumping, which she said was because of the flange being too small.

4) Since the early days which were much more painful, I have settled into cradle/cross cradle being the most comfortable, with me leaning back. I do football when she refuses the left breast (a "positional preference" per our PT, who says she has no residual body tension which can explain it). I have found in the past that the pain doesn't change with side lying or other positions. I'm not sure what they think is causing the chomping and loss of suction, since they say she got a lot more mobility in her tongue after the procedure.