Susan,
How about encouraging the mom to nurse both children simultaneously, to take
advantage of the fact that the MER occurs simultaneously in both breasts.  The
toddler will assist the baby this way.  I might also advise her to switch both
children once the baby stops sucking effectively.  I would like to see her at
least alternate breasts among the children, in case the baby has allowed the
milk supply in "his" breast to dwindle.
        It can be really hard to assess whether the baby is in danger over the
phone.  I usually ask the mom what her gut feeling is, and encourage her to
follow through on that.
        The other issue is the swaddling.  Excessive heat may depress baby's
suck reflex and cause sleepiness.  Would the mom be amenable to carrying her
baby in a sling carrier instead?
Catherine Watson Genna, IBCLC