Robin,
If the infant has gained at least a pound a month, it might be fine to nurse
4-5x/day.  On the other hand, you mentioned that this baby was a "premie".
How early?  What was the birth weight?  Many preterm infants value sleep above
all else, and need to be gently stimulated to wake and eat.  Increasing the
stimulation in an attempt to get these infants' attention often results in
withdrawal - further sleeping to get away from the annoyance.   It would be my
hunch that this was the start of this pattern.  Most LC's and peds no longer
consider it acceptable to take 3 weeks to regain birthweight.... I would have
been concerned when this little one passed 2 weeks without regaining.
        Does this mom know what she's getting into by considering another
pregnancy?  Does she really know the risks of delivering before 28 weeks?  She
will have this infant to care for, and the prospect of splitting her time
between NICU and home for many months. Has her fertility resumed?  WOuld a
maternity belt help support the prolapsed uterus and assist the pregnancy in
going to term?  What was the cause of the uterine prolapse?  Has she sought a
second opinion as to treatment options and effects of another pregnancy?
These are all things that need to be considered as well as the effects of
breastfeeding through pregnancy.  As far as I know, the risk of preterm labor
due to breastfeeding is strictly theoretical, and based on direct nipple
stimulation.  An infant who is latched on properly does not stimulate the
nipple the same way as an adult pinching a nipple....and uterine contractions
are essential to nourishing the fetus in latter pregnancy, increasing blood
flow to the placenta, and occur naturally.
        The best you can do is explore the theories with this mom, help her
clarify the issues, and support her in whatever she decides.
Catherine Watson Genna, IBCLC   NYC  [log in to unmask]