Cindy, when nothing else works, I've had reasonable success using Medela
nipple shields. In most cases the baby can latch on, compress areola
effectively and take adequate volume. In the beginning, I always have the
mother pump too (rental grade pump/double kit) and do test weights until I'm
sure infant is doing well. Sometimes, the moms have been successful cutting
the nipple shields back slowly and weaning baby to breast if the nipple
becomes more extendable. I think the beauty of the shield is that moms can
keep baby at the breast and decrease/discontinue the time spent pumping.
Feel free to email me personally if I can help more. Good luck!