The LC is board certified and works at the hospital where I gave birth. They were more helpful than the girl at the pediatrician's office. They were still concerned about his weight gain, though.
Our problem seems to be the following:
1. I have very large, very soft breasts - he is having trouble latching. Thus we have the nipple shield.
2. He has a "disorganized suck" where he will stick his tongue out the corners of his mouth rather than keeping it centered. This means he will sometime spit out the nipple/shield by accident. We're doing finger feeding, and the LC said even a pacifier will help train that action. I'm nervous about the pacifier, but my husband is all for it.
3. He is not doing the long, controlled sucks, just little fluttery ones, and he swallows maybe once every 10 or 12 sucks.
4. He is not getting very much when he nurses... the LC said less than an ounce, and that was after a while.
5. He will not wake for feedings, or stay awake during them. He'll be sleeping peacefully, but then when I wake him up, he seems to get frustrated very quickly once he's on the breast.
The LC said I should try to feed him as much as I can over the weekend - to try nursing and then to give him whatever I pump. She said it's impossible to give a baby too much breast milk and this way he could get his weight up. She was OK with the 8 times feeding (which is good, because usually the whole process takes 2-2.5 hours by the time I've attempted nursing, fed him with the syringe, and pumped).
The other LC told me not to let him nurse too much since nursing burns a lot of calories and he might end up losing weight because of that. This has kind of made me too scared to do much of anything!
We just bought a scale today... hoping for some good news. And my pumping output is increasing... I can get a reliable 2-3oz each time.