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 ;-> )