Kellie,
How about asking this mom to nurse twice as often with half as much
supplement, and then pump for 5-10 mins pc to obtain hindmilk to use as
supplement at the next nursing.  This way you have: freq stimulation
-->increased prolactin-->increased supply and increased fat and increased
emptying-->increased speed of milk production, as well as more concentrated
calories (more fat) going into baby.  I have found this to be the most helpful
regimen in moms with low supply and low/no/negative infant weight gain.  I
know this is a lot for a mom to handle, especially if she has another child.
Perhaps she can get help for a few days.
        One of my clients went to stay at her dad's house for a week (he is a
very supportive ped) and left her 4 older children at home with daddy and the
housekeeper.  Daddy is a physician as well, so they had the financial
resources for this.  She was battling low milk supply, low weight gain baby,
and recurrent mastitis for weeks, and this finally broke the cycle for her.
Catherine Watson GEnna, IBCLC  NYC  [log in to unmask]