Cathy Lester- In regard to your 7/3 post, Mom#1.  When the nipples are
far too large for the baby to attach well I have noticed the same thing
your friend has, poor intake.  I agree the SNS is going to be used like a
straw in this case.  It may take months for the baby to grow enough to
accomodate the nipple.  There has been alot of discussion lately on
Lactnet re: finger feeding.  I don't know what the best way is to feed this
baby in the meantime.  It is certainly going to be very time consuming to
pump for months and feed by an alternative method.  I wouldn't rule out
bottles as an option.  In regard to her pumping long term-- The moms I've
worked with who had nipples the size of quarters experienced
discomfort pumping with the standard size opening on the M- kit.  They
did much better with the largest glass flange that can be special ordered.
I do find that brand's version to be inferior to one which is available
locally.  If you'd like additional info on it please contact me directly.

Laura Wham,RN,IBCLC
Primary Children's Medical Center
Salt Lake City, Utah