Friend having trouble with breast refusal 5w.o.

I'm posting on behalf of a friend who has a 5 week old. She's been supplementing him with EBM and FF ever since he was born, but is still trying to BF (I think there was a weight concern too?). She's already been to a lactation clinic but doesn't feel that going back at this point would be that useful.

She's now struggling with breast refusal - her son is just screaming and refusing the breast. I'm thinking that the bottles really aren't helping - he's happy to go to easy-bottle-town! Maybe she needs to just bed in for a few days with him, some nice baths together, along with getting a lactation consultant to help her (Barb - I've PM'ed you for a recommendation, as my friend asked me who to use). But, I've not dealt with this situation myself and I really don't know what would be best (my suggestions might be way too simplistic). So I'd appreciate any suggestions.

Incidentally she's also got another friend who's done some lactation counselling and is helping her out... so she's trying to get some help. I guess I just want to know if there's some other things that she can do? (oh and I've already told her to post on here -but she's pretty time-poor BFing, bottle feeding & expressing).

TIA!

Some possibilities:
*She's too engorged for bub to get a grip on - try expressing partly and then attaching
*Bub expects instant gratification - try a small bottle feed and then the boob, or try a supply line (need LC help with this)
*Let down is too fast or too strong - hand express for 30 seconds or so into a towel and then try and attach
*she tastes wrong - nipple shield
*bub has a tongue tie - lactation consultant should pick this
*some other issue that makes sucking uncomfy for bub - e.g. ear infection or thrush - check temp, see GP.
I found the lactation clinic at Jessie Mac to be awesome; also the Ringwood MCHN's are pretty good.

hugs
Kate

If she is in Melb too I would suggest and highly recommend the Breastfeeding Clinic at the Sunshine hospital. A visit there usually starts at about 8.30-9am to mid afternoon in order to get in a few feeds (and sleeps), and helps to get Mums and bubs into a bit better feeding routine. Its covered by Medicare and worth a try. The ladies there are all LC's and lovely. (I've been there with both my kids)