This might be long, so I apologize now..
At my daughters 1 month appointment (which was actually a week early because we were concerned) it was determined that she has reflux (pulling off the breast, writhing in pain, spitting up, etc) so she was put on Zantac. She weighed 9.9 at that appointment. We went for a follow up a week later and she had lost an ounce (same scale, same time a day, everything was the same). It wasn't a big deal, but we talked about alternatives that we might have to do if she hadn't gained any weight by her next appointment.
Anyway, after that appointment I started a feeding diary so I could see just how much she ate, and for how long, with how many diapers. It wasn't much. I came to the conclusion that my own health problems (shoulder and back problems) were keeping me from nursing for as long as I should have, or for as long as she would want too, so I started pumping to supplement (which we had discussed with the doctor). As soon as I started pumping her diaper output was great - 5 sopping wet diapers and two bowel movements in the first day, which was great compared to before the supplementing (only one really wet one in a 24 hour period).
I was pleased that it was going so well and then my pump quit, so she got formula bottles for one day because I wasn't getting enough by pumping manually.
At our last appointment, at 5 weeks, she weighed in at 9.14, which was a gain of 5 ounces in a 5 days. Our doctor was pleased with that.
We also determined that what I thought was an OALD was actually the reflux causing her to fuss, not my let down. In fact, I have a poor supply, and am working REALLY hard to only pump after feedings as opposed to in lieu of nursing her (although once or twice a day I NEED to take a break and feed her from a bottle re: back problems).
Birth weight - 9.2
Left the hospital - 8.7
3 week appointment - 9.10
4 week appointment 9.9
5 week appointment 9.14
Since being on the Zantac she has been much happier, and in less pain. Because of this I have been trying to supplement less with the bottle (still pumping after each session), and today we're back to a poor diaper output. She's only had two wet diapers since last night, with only one being sopping wet.
I would like to pump more to help with my back problems, but I know it would negatively impact my supply even more so I'm really fighting through the pain to nurse as often as physically possible but I'm so disheartened that she isn't thriving.
We have another appointment on Monday to weigh in, but question is how do I pump to supplement her while still nursing? Nursing alone and pumping after each session is not yielding enough to supplement with. If I skip a feeding to pump a full bottles' worth I end up a slave to the pump, because I can't feed her AND pump every 2 hours. It's impossible to tend to her while pumping, washing pump parts, etc etc.
I know the rule of thumb for increasing a supply is to nurse nurse nurse, and I have been ALL DAY.. and nothing (diaper wise).
How do I increase my supply and supplement with EBM?