May I add to Jeanette's scenario and ask that we support one another with
ideas. Maybe WE need a support group for frustrated LCs?!

I agree with all her "days" and want to toss in on day 4-5:
 mom is home and only pumping 2-3 times per day, has terrible engorgement and
doesn't ask for help from US - perhaps at this time milk supply is
compromised.
Then she is home and still not pumping at a sufficient level to increase her
milk supply.  Phone calls every few days and the occasional visit to the NICU
(from us) remind mom to pump, etc. but it is hard because she may only get by
on the weekend or evenings to see the baby.  Baby's condition progresses and
is ready to go home, mom wants to get baby to breast but baby is still only
34-35 weeks gest. Developmentally this kid just can't do it as well as is
needed and mom goes home, finds pumping and caring for this baby to be too
taxing and NEVER gets it together enough to feed at breast.
Does this sound like a personal experience? It is. It's hard to support a  mom
in this situation. It's hard to be the LC who has to offer advice and
information that doesn't really help because mom is not committed to investing
the time/energy needed to make it work (or maybe it really can't due to the
poor start). We have many "micropremies" at our hospital and if mom doesn't
get pumping off to a good start, it snowballs.  Her supply is never
sufficient, everything from the pump to her diet gets blamed and baby gets
mixed feeds. This happens to moms who really "want to" breastfeed.  So what do
I do? Support her in her efforts, praise her for her achievements - and try
again next time. Tune in again for the next installment of "as the LC beats
her head against the wall."
Mary Kay Smith, CLE, IBCLC
Romeoville, IL