Debbie, I have observed that some women who have smaller breast and  
therefore less adipose tissue, tend to have more firmness when their milk is  in.
If the RPS does not help to allow the baby to latch, I would go back to  
trying it again but then follow with some hand expressing, and then see if the  
baby can latch.
Another approach is to use the RPS and then try a nipple shield.  This  may 
be very helpful for a baby who has been receiving many bottles.  
You did not mention how many days old this baby was.  Hopefully she  will not 
have lost some of her milk supply.  I would stay away from the  pumps at this 
time since they really don't seem to be working for her.
I have a similar mother I am working with.  She delivered a 32  weeker.  She 
has been very determined to give her baby her breast milk and  to breastfeed.  
Her baby is now 2 weeks old and her small breast are still  firm when they 
fill with milk.  I have been using the small shield with  great success.  
Good luck.
Ann Perry, RN IBCLC
Boston, MA

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