Maybe this should have gone in the preemie section, but I wanted a little more general experience.
My daughter was born 5 weeks premature. She'll be four months on the 29th, 2 3/4 months corrected age. It has taken us a while (some of you probably remember me) of EP'ing and trying to get her to nurse but we are now 100% on the breast, other then her bottles to get her heart medication which are expressed breastmilk!!!!!! I had honestly wondered if we would ever get here, but we did!
Here's the problem. She is only gaining 1/3 of an ounce a day. Before, when she was fully on EBM with high-calorie formula added in, she still was only gaining 1/2 an ounce a day. So this is not a drastic change here. She has grown 4 inches since her birth. She's a little fussy, but I've had other babies who were good gainers who were just as fussy, and she's just more sensitive. Plus, she's hardly been put down since we were allowed to hold her, so she's used to that. She does have reflux which we're treating with Zantec.
The pediatrician is freaking and wants her on all formula, or at least rice cereal in the bottles because it's OBVIOUSLY a supply issue or that it takes SO much energy to breastfeed, or else a quality of my milk problem. LC's are certain it's not a supply issue because I can feel breasts softening, have good let down, and if I pump instead of feed (extremely rare these days!) I get 3.5-5 ozs. I don't let down for hte pump anymore, at least not as strongly as I do for her. I can feel it for her. After I feed her, I get about 1.5 ozs. They said that's normal since the breast is never empty. They do not feel I have a supply problem and neither do I, although I do get a bit nervous since I hardly ever pump anymore (too busy nursing!). They suggested starting solids at 4 months instead and adding in higher density foods (like avocado or sweet potato with olive oil) for growth instead of adding formula. That sounded good to me, but when we mentioned it to my ped was when we got the rice cereal in the bottle suggestion (which wouldn't work with giving her the heart meds anyways, it has to be a small amount she can drink quickly.) He wants me to do 10 minutes on each side then give her a bottle. I don't want to do that. He doesn't get the concept of on-demand breastfeeding, and I know from experience I can kiss what we have good bye if I listen to this advice. But even though the hospital LC's are on my side, including the NICU LC, I am still nervous about what we have chosen to do. OTOH, I don't want to give her formula either. I know a preemie with a heart condition is in even greater need of breastmilk then other babies and avoiding the risks of formula feeding then others.
The good points:
* She has 1-3 poopy diapers and over 8 wet diapers a day
* She's eating at least every 2 hours, except at night, where she will go 3-4 hours between feeds
* She is smiling, laughing, cooing, grabbing my hair, excellent eye contact, putting weight on her feet, beginning to roll over, has good head control- in other words, developmentally is exactly where she should be.
*She has grown 4 inches since birth, but she doesn't look scrawny. Long and lean, yes, but scrawny, no.
* She is very alert, self-awakes for all feeds now instead of me having to shove food down her like I did before because she just would not wake up and eat.
*Only 1/3 an ounce a day weight gain.
* She had never done above an half-ounce a day, but she's never plateaued, she is consistently growing.
She eats at least 10 minutes from both sides, often much longer. I think I've covered everything. I have a baby who wants to nurse Any advice?