Hello Jonathan,
I originally wrote to Lactnet on 4/17 about this mom.  Perhaps you could look
back and read my post.  I wanted to hear--again--the advantages of finger
feeding in the transition from bottle to breast. I got a helpful reply from
Melissa Vickers and have written her a few times about this situation.
This mother has been using an SNS.  Our intention was that she use it, at
first, with one tube taped to a finger, for finger feeding, and the other
tube taped to the mother's breast. I had hoped the mother could go from one
to the other and back again, if need be, depending on the baby's willingness
and frustration level in taking the breast, and with enough conscious,
sensitive attempts, baby would nurse. Forgive that I might seem to be
oversimplifying--I'm tired, I guess!  Having helped one other mother in a
similar situation, I knew that the mom could be working at this for a long
time.
Although on a few occasions, the baby has allowed the breast in his mouth,
and even latched on once or twice (never for very long without getting
upset), mom has needed to alternate finger feeding with bottle feeding in
order to make sure this baby gets the nutrition he needs. She has also tried
a nipple shield, and cup feeding. She, of course, has wanted to settle on an
alternative feeding method that could become routine for mother, dad, and
baby--and one that would help to lead them back to the breast.
She has been working hard to get this baby to take the breast, trying to keep
feeding a happy, stress-free time for everyone.  She is also pumping, and
because it has been longer than 7 weeks that the baby has been off the
breast, she is pumping to relactate--from square one.
My most recent question to Melissa was is this baby being further confused by
having to deal with all these different things going into his mouth--finger,
tubing, nipple shield, cup, bottle nipple--and can the mother just
concentrate on happy at-the-breast experiences in the hope that baby will
latch long enough to realize that he could get a food reward for being there?
 My question was, if we feel that we are going nowhere having to struggle
through alternative feeding, can she forgo alternative  methods and just use
the bottle to feed, continue to offer the breast for comfort?  Melissa wrote
back and agreed that perhaps, in order to decrease stress in this very
difficult situation, alternate feeding methods cease.  She suggested looking
into a method of bottle feeding she was sure had been mentioned on Lactnet a
(long) while back.
I have to say, I believe we are looking at a last-ditch attempt. After
(only?) one month of working in the routines of back to breast, and 3 weeks
of pumping to relactate,  mother and baby have made no breakthroughs.  I
remind mom that it may take as long as 7 weeks to see real progress (rule of
thumb), and that she is only half way to this landmark. I don't pressure her,
but do offer her a lot of support.  In spite of being a very positive,
energetic, sensitive, and intuitive mom, she is wearying.  Though I have been
in very close touch with her--phone, letters, postcards, home visits--it has
now been longer than a week since I have talked with her.
I really think the greatest breakthrough might come if the mom could make an
effort to keep her baby with her, go skin-to-skin, offer the breast
many-many-many- creative-seemingly-wonderfully-lovingly-ridiculous times,
 and devote a focused period of time to it. This requires an intensity of
mothering that she was not anticipating (or even knew was practiced).  She
and I have talked about this a lot. So many mothers struggle with mother-baby
closeness.  Do you understand?
I am making a very long story too short, I realize.  In my haste, I felt I
could get away with not retelling the whole story to Lactnet because I am
looking for a particular piece of information.
I appreciate your interest and your comment, Jonathan.
Sincerely, Diane