Hello! This is my first post, so please forgive me for any etiquette gaffes. I have what feels like a saga, so here goes:
My daughter, Lucy, is 3 1/2 weeks old and was born just smidge early at 36w6d. I had an unremarkable, unmedicated labor, and Lucy nursed within an hour of birth. For the next several days, I nursed her on demand. She would nurse for 15-20 minutes every 2-3 hours and unlatch herself to fall back to sleep.
However, at her 2 day checkup, she had lost 10% of her birthweight (7.0 lbs to 6 lbs 2 oz). We rechecked at 4 days and she had lost another ounce, but the pediatrician was confident that this was her low point, breastfeeding sounded like it was going fine, and she'd be back to her birth weight by 2 weeks. At 2 weeks, she had not gained any weight back and was even down to 6 lbs 0 oz. At that appointment, the pediatrician found a tongue tie. We had it fixed that day at the ENT, who also found an upper lip tie.
The pediatrician, who has been very supportive of breastfeeding, and I suspected that Lucy's ties prevented her from nursing effectively, which was not only getting her not enough calories, but not sufficiently stimulating my supply. For about 3 days before her 2 week checkup, Lucy was feeding for 2-3 hours straight. (I never did feel my milk "come in," and I rarely feel let down or even engorged.) Pedi asked me to pump after nursing to stimulate my supply and to begin supplementing with formula so that she could gain weight.
So, our new feeding regime of the past week is this: every 2-3 hours, she breastfeeds first. I try to get her to feed for 30 minutes on each breast. She is rarely satisfied - less than 1x per day - on only one breast. If she's still hungry after feeding on both breasts, I give her pumped breast milk, but I rarely have much to feed. If she's still hungry after that (and she usually is), she gets formula - of which she usually consumes ~2 oz. If she only fed from one breast, I pump the other. This whole routine takes 2 hours (1 hour of BF, 20-30 minutes formula, 20-30 minutes of dozing off between BF and formula - "is she ASLEEPasleep or will she be hungry again in 15 minutes?"). Happily, Lucy has gained 12 oz this week!
SO, my concerns/questions are these.
1) Should I be pumping more? When I do pump after a double-sided feeding, I rarely get more than a few drops and aggravated nipples.
2) Does this seem like a bona fide low supply issue? Will my breasts ever catch up to the 2 oz of formula she takes at most (but not all) feedings?
3) Has anyone else had a tongue or lip-tied baby whose latch eventually improved? She does have a shallow latch in the majority of feedings. They start off promising, and over the course of a feeding, she sort of slides off the breast until she's just on the nipple. The latch hasn't really changed dramatically since getting the ties clipped, despite seeing a lactation consultant.
Any tips or sympathy? Supplementing with formula is certainly not how I envisioned our breastfeeding relationship, but it's something I'm happy to do for her healthy. I'd just like to know whether I can expect my milk to ever fully cover her needs.