Dear Lyla,
First my introduction since I have been naught but a Lactnet "Lurker"
for the last month or so,  my name is Sarah Chaikin and I am an LLLeader
and IBCLC in southern NJ.

A thought about the mother you are working with with a slow let-down.
Both nicotine and alcohol (if consumed in a sufficient dose) are known
to retard the let-down reflex, use of these drugs might be a useful
topic to explore with the mother.  Best Wishes,  Sarah