Denise: I hesitate to mention this, since this mom and baby
have been through so much already, but have you considered
using an at-the-breast supplementer? If the baby is willing
and able to nurse at the breast I find that a supplementer is
often easier all around. The baby can be encouraged to keep
up appropriate ("nutritional") nursing because the mother can
produce artificial MERs for the baby by starting the flow (or
increasing the flow) of the supplementer. Mom may be able
to decrease or stop pumping sooner as baby milks the
breast with longer nursings.

Everyone's practice is different, of course, but I find that in
my practice mothers are discouraged by *long-term*
finger/p-syringe feeds.  IMO it seems to create the sense
that the breasts the "problem." Mothers perceive that their
"equipment" is at fault. And, IMO, with *long-term* finger
feeds the baby is not getting the message that breasts are
the "restaurant." When a baby is willing to nurse I find
supplementers are wonderful tools.

Other things may be going on with this case. I am looking
forward to seeing other Lactnetters input on your case. Good
luck (to you, and mom/baby)!

Margery Wilson, IBCLC
Massachusetts Institute of Technology, Medical Department
(Where we have a Medela rental station but you will note I
used generic terms in this post ;->    )