A few things jump out at me from your client's story, but the foremost is that this baby is only just now 38 weeks.  What do we expect/hope to see at this point with this type of dyad? 

- a baby who has regained birth weight  ---- Good, she's got this one :)

- a baby who can breastfeed ok or well sometimes ---- mom says yes; mom's assessment skills are unknown and cannot be as good as yours --- is she willing to sit down with you for a consult?

- a baby who can be fed additional volume via a means other than breastfeeding if necessary, i.e. SNS, finger-feeding, cup feeding, or bottlefeeding --- sounds like parents have mastered some other feeding methods but are expressing frustration with them

- a mom with a really good supply due to all the breastfeeding, skin-to-skin, hand-expression, and pumping  ---  a lot of questions here.  

The tragedy is that clearly this mother was not properly taught what to expect from her late preterm infant.  How to help?  Readjust mom's lens: her baby is 2 weeks old, but has 2 weeks to go until she even reaches her completed gestation.  Rather than spending her final 4 weeks in the 5-star Hotel Utero, letting her brain really develop strong connections and her organs mature, she's doing it out here on the streets.  It sounds like mom has done an awesome job of maintaining regular breastfeeding regardless of "success."  It's a matter of patience. 

What's missing from the 2-sided puzzle?  On the breastfeeding side, time and baby's experience level.  This baby is progressing at the expected rate: she can latch and can breastfeed, but as one would reasonable expect of a baby her age and developmental stage, she does not always move milk well.  However, she still seems happy to go to breast frequently (mom didn't mention difficulty or baby rejecting the breast.) On the milk supply side, you have already clarified for her that she is doing just about everything she can reasonably do to protect her supply.  

I fervently hope that "baby is a lazy eater" is the message mom heard and not the exact words the IBCLC used to assess her baby.  Either way, this mom would really benefit from a re-labeling of her baby to normalize the way baby is able to breastfeed at this time.  She is not lazy, she is immature and improving her skills.  These things matter!  A mother who has expended this much effort at maintaining breastfeeding through many obstacles deserves validation and a realistic view of what she can expect from herself and her body.  

Last thing jumping out at me: why stopping the nursing session at 15 minutes?  If it's appropriate due to the baby's stamina, sure.  But if the baby is still breastfeeding well at the 15-minute mark, why remove her?  There's no benefit to removing her, and there's potential gain if baby stays on that breast to keep moving milk rather than mom hooking up to her machine again.  

I hope this helps a little; I seem to find myself working with late preterm dyads way too often.  Interesting and educational for me, but overall sad for the moms and babies being subjected to this type of premature birth and early life.  

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