Cynthia -- I can't help but wonder how much mom's stress level might be interfering with her milk supply?  Granted, stress is a big factor with letdown, not production -- But we have heard a few reports that increased milk came with decreased stress.  

I can understand her being fed up with all the meds, and all the 
interventions, but why should she give up the SNS, which allows her still 
to get and give the benefits of breastfeeding, while still insuring enough 
nutrition for her infant.   Or the teas, which don't take all that much time to prepare or drink.
You say she is very committed to BF.  For whose benefit?  She sounds
like she is saying "If I can't to breastfeed totally, I don't want to 
breastfeed at all."

You have provided mom with all of the tools and information for improving
milk supply.  Now maybe the job is to help her grieve for the loss of her
ideal, and come to acceptance of the level she has attained.  After all, 
without all this concentration of her energies, would she have been able to
provide even this much.  She has done everything she could, but to what 
purpose?  For permission to bottle feed?  No!  To provide the best she 
can for her baby -- and she can still do that.

We want, as consultants, to achieve 100% success.  We want each of 
our moms to be so enthused about breastfeeding they will do it as 
long as they can, hopefully until the baby self-weans, and to be able to 
breastfeed solely.  But we have to accept limitations put on us by moms' 
own intents, and other considerations (like jobs).  So too we must accept 
the outer limits that nature will allow.  

To me there is success as long as we are doing the best we can:  
There is success when mom doesn't give up in the first place, and with 
each day that she continues to work at it with pumps, and with remedies 
both  pharmaceutical and herbal .  There is success for both of us also 
when mom says I can't breastfeed totally, but I can still  bf partially ( or 
provide some ebm, or provide a nurturing environment for my infant's 
feeding times.  To my mind, there is only not success when lack of 
success was percieved as failure.  It is not failure to achieve that is the 
failure.  It is failure to try.   (Who said that?)

Sincerely, Chanita