I am so glad I found this forum! after reading through several other threads I am very hopeful that I'll be able to find the advice I need here.
A little background - I am 25 and this is my first baby, I have PCOS and had a breast reduction 7 years ago. My son was born at 36 weeks, 6 lbs 3 oz at birth. He was jaundiced and had a lot of difficulty nursing at first and one particular doctor pressured me into supplementing with formula and it's all been downhill from there. I started pumping as soon as possible in the hospital in hopes of increasing my supply. By our 2 week checkup he had lost an oz from the week before and he was still really jaundiced so he was readmitted to the hospital. He was there for 4 days and we got a lot of help from the nurses and the hospital's LC but still ended up having to slightly increase the formula supplements. Baby is now 9 weeks old. Since he's been home he's been gaining weight like a champ and I've seen a small increase in my supply, but we're still having to supplement either by using a supplemental nursing system or by bottle after the feeding or both. I would love to be able to cut out the formula and not have to follow almost every nursing session with a bottle or use the supplemental nurser.
I'm pretty sure my supply is still a bit low because I'm still having to use some formula, but most of the supplements he's getting now are expressed breast milk. Here's one point where I'm totally stumped in all of this, though. After nursing for at least 30 minutes (15-20 minutes on each side usually), he'll still act like he's starving to death, so I'll give him a bottle, but then I'll pump and get anywhere from 1-3 ounces. I know we still have issues with latch because it hurts when he nurses and my nipples are constantly sore and scabby, but I don't know how to fix it. I try to wait until his mouth is open wide, but he doesn't open very wide and I'm constantly pulling his lower lip out/down but he still seems to be tight-mouthing the nipple.
To make matters worse I started back to work this week so I can't just let him nurse all day. We've kind of got a system down but I don't know how long I can keep it up, it's exhausting. I am fortunate in that I work at a daycare so he's in the room right next to me and I get to feed him twice during the day, but each nursing break is only 30 minutes long.
Here's what a typical day looks like:
3 or 4 am - breastfeed about 30-40 minutes, 1-2 oz supplement by sns or bottle
Pump after nursing, usually get about 3 oz
6 am on workdays pump again, usually get 1-2 oz
7 am at daycare 3 oz bottle on workdays, weekends - breastfeed, supplement 1-2 oz and pump after, usually get 1-2 oz
10 am at daycare breastfeed, supplement 1-2 oz, in weekdays - hand express 1/2-1 oz, on weekends pump 1-2 oz after
1 pm at daycare same as 10 am
4 pm breastfeed, supplement 1-2 oz, pump, weekdays 2-3 oz, weekends 1-2 oz
7 pm breastfeed, supplement 1-2 oz, pump 1-2 oz
8:30 pm breastfeed, supplement 1-2 oz, pump 1/2-1 oz
sometime between 11 pm and 1 am breastfeed supplement 1-3 oz, hand express 1-2 oz
this schedule changes from day-to-day. sometimes he eats ever 1 1/2 to 2 hours.
I do my pumping right after nursing, should I do that or wait a bit? any advice on getting him to nurse more efficiently? any tips o latch and/or getting him to open wider?
I take Motherlove more milk special blend (goat's rue, fenugreek, blessed thistle, nettle and fennel) and drink Mother's Milk tea and LOTS of water. I talked to my midwife about taking domperidone but haven't gotten that figured out yet since it's a complicated process here in the US. Is there anything else I should be doing?
Sorry for such an incredibly long post and thanks for reading through it. Any and all advice is greatly appreciated. and please forgive any typos, I'm typing with one hand while baby sleeps in the other.