Hi Nikki,
     You say this mother is pumping lots of milk.  I would try skimming
off the hind milk/creamier milk from the top, or have mom change bottles
mid-pumping to collect the hind milk.  Feed as much of the hind milk as
possible.  Feed the baby whenever she shows the slightest fdg. cues,
reinforce that cluster fdgs. are ok.
      This year my full time colleague and I worked with a mom with a
down's syndrome baby, her 4th child.  Breast feeding was a struggle until
the baby reached about 3 months old, then it got easy.  Mom had to
combine some breast fdg, nipple shield, some bottles, pumping.  But by
the 3 month mark was only breastfeeding!  She called to tell us she was
so happy she hung in there.
     Good luck and let us know what happens!
     Susan in Minnesota
      rn ibclc

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