Bonnie, Thank you for the post clarifying the situation with your low milk mom and baby. You are wise to offer one or two suggestions at a time to the mom and to concentrate your work with her on helping her feel more comfortable with positioning and latch, and using the SNS, and keeping her focused on the positives in the situation (number one is that she and the baby enjoy breastfeeding, number two is that the baby has successfully breastfed with the help of the SNS and the mom has managed it--it can get easier, and number three is how committed she and her husband are to working toward breastfeeding). You seem very sensitive to the mom, Bonnie. I'm sure she appreciates this and that her reticence to ask for help will decrease as you develop rapport with her. I wonder if reticence sometimes has to do with the difference between one (maybe the usual) model of problem-solving wherein one goes in, gets the diagnosis, and gets it fixed and the way breastfeeding counselors check into a situation many times--part of a process of problem-solving. I have noticed some moms who call me more than once often apologize for it! Another take on reticence--as a LLLL, I always ask the mom for her permission to check up on her. But I still have to do a little work (with myself) to separate from the situation when she says "no thanks" to an offer of continuing help. . . For a mom who was having difficulty "letting the pump into her life", I once suggested that she not worry about producing and saving milk (since she was barely producing drops) but start out by pumping a few minutes every time she walked past the pump. If it seemed like she was inclined to take detours :), she could take a five minute break every two hours or so and pump a couple minutes on each side. It was a matter of developing, with her, a plan for pumping that started with what she could manage and worked toward her *goal* of double pumping 15-20 minutes every two or so hours to be reached within a couple of weeks. Of course, part of the goal was that she saw an increase in the amount of milk. Once your mom is starting to let down with the pump, a daily pumping while her baby nurses can help to increase supply and the milk flow will encourage the baby. Some of the suggestions for working with a baby who clamps her jaws as she swallows might be helpful, too, like wrapping her in a blanket in a flexed position for nursing; nursing in a darkened, quiet setting; talking in a soothing voice; if she bites while latching on, the mom can try first wiping the baby's face with cool (the BAB says cold, brrr) then warm water several times before nursing; the mom can try holding her breast with the dancer's-hand hold to help control the clamping down baby's chin as she latches on. These suggestions for your bag of tricks if they aren't already there. Bonnie, please let us know how this mom and baby are doing. And pats on the back to you for giving this your all! Diane, LLLL in VT