Breastfeeding is just one aspect of  caring for a baby -- surely this 
mother must have someone with her at all times to help with all the 
baby's many needs.  This mother is going to need supportive helpers who 
understand the importance of what she's achieving, and who aren't 
squeamish about breasts, milk and the whole process.  (Of course, we 
love being right in there, hands-on if need be, and seeing that perfect 
landing, but sadly  that's not universal.)

  Perhaps you can meet with the mother along with her helpers and family 
members, and make sure that everyone understands how to align the baby's 
and the mother's bodies, and to line up the nose-to-nipple asymmetrical 
approach and wait for the big wide mouth before the helper scoots the 
baby's shoulders in. ( In the new edition of the Breastfeeding Atlas. 
the CD's video about nursing laying down shows the mother being so 
impressed by her baby's ability to self-attach -- lovely moment.) .  It 
does seem like nursing lying down would be easier, since it's so stable 
and supported, and babies love being snug into the mother and with their 
heads tipped back for that full eye contact.  A little blanket rolled up 
behind the diaper is usually enough to keep a little baby in position.  
In an upright position, it seems worth experimenting the sling for added 
support, and snugging it in once a comfortable latch is achieved.

Maybe it will help to point out that mothers don't breastfeed -- 
*babies* breastfeed, and as a competent little mammal, the baby will be 
an active partner, and only get better at this innate skill.  Since hers 
is such an unusual situation, maybe it will help to feel that she's on 
some common ground -- most mothers find the first few weeks the most 
difficult, but find that everything grows easier as the baby gets better 
head control   And this mother gains so much by her decision to 
breastfeed.  She needs to hear how soothing and organizing babies find 
that full-front contact and the skin-to-skin touching.  Since her 
physical abilities are limited, she may revel in something that only she 
can do for her baby.  

Good luck to all -- it would be great to hear how this story unfolds.

Margaret Wills, LLLL, IBCLC Maryland

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