My daughter was born on 12/12 and we have had a lot of challenges with feeding since she had severe jaundice and went to the NICU. There, we had to supplement with formula in order for her to get the high levels of bilirubin out, and since then breastfeeding has been challenging. Because pre- and post-feeding weighs indicated she gets only about 1.5 oz from me, we have been advised to supplement each feeding with 1oz of formula or pumped milk, but I have not had success with an electric pump and am only able to hand express 10ml at a time. We give her the supplement through an SNS now since I am convinced the bottle was contributing to her not being able to transfer milk effectively (e.g, doesn't suck long enough or effectively enough). That is helping, but I would really like any insights above and beyond what I've learned from our lactation consultants. I am wondering (a) how to stimulate more production beyond mother's milk tea and fenugreek supplements + hand expressing after feeding; (b) why, if I can express by hand, I am not having success with the pump (hand expressing + SNS means feeds take 1-1.5 hours ; and c) if there are people who have had success transitioning to breast only after experiences like this. I feel that feedings are getting better, and the lactation consultants are optimistic that soon I'll produce and transfer enough to cut out the supplement, but I don't really feel that production is increasing (for one, I'm not expressing more after each feeding - just a consistent 5-10ml). Any thoughts, advice, or support/encouragement would be much appreciated! I have almost lost hope so many times as this has been such a tough few weeks. I hate that she is getting formula and want nothing more than to be able to give my daughter all she needs from the breast. Thank you!