Hi everyone, I'm hoping to get a little advice, maybe some encouragement, because right now I'm at my wits ends, and am thinking seriously about giving up. I think the only reason I haven't is because I am such a huge advocate of breastfeeding, and the prospect of not being able to breastfeed my son is too depressing to contemplate. Here's my background (and I apologize for the length):
My son was born at 29 weeks gestation, with IUGR, so he measured at 27 weeks (my placenta stopped working). Aside from a few days on CPAP and a couple of infections he picked up in hospital, he was classified as a feeder-grower.
I had a difficult c-section (my spinal block didn't take, so they ended up giving me ketamine, which I had an adverse reaction to) so I wasn't able to start pumping until the next day (24 hours after delivery). I pumped religiously throughout my son's stay, every two hours (even overnight) using a hospital grade, double breast pump (Medela Symphony). From day one I was plagued with supply problems.
It took the better part of 4 days for my milk to come in, and then it took weeks to be able to pump 1-2 ounces. By the time my son was ready to be introduced to the breast (about 34 weeks gestation) I was only pumping 10 ounces a day. Part of this I suspect was a mild case of primary lactation failure (my breasts did not change at all during my pregnancy).
As my son began nursing, my supply did increase slightly, and for a while I was actually keeping up with his demand (i.e. not having to supplement with formula -- at this time he was still being fed via gavage).
While in the NICU, we worked with 3 different lactation consultants (who gave sometimes conflicting advice) in an effort to get him nursing. By the time we were ready for discharge, he was nursing well enough to maintain his body weight, but not enough to gain weight. The LCs thought his latch and suck were fine, but that is stamina (i.e. ability to suck for long enough to get enough milk) was poor. It was hoped this would improve in time.
He was released one week before his due date, and we have now been home 8 weeks. His stamina has not improved and he has again outstripped my supply. Presently, we are doing the following:
- Feeding on demand (which works out to be 7-10 times a day).
- Doing pre and post feed weighs (I rented a scale) in order to determine how much he's taken (varies from 1-3 ounces).
- Topping up via nursing supplement (gavage tube taped to my nipple) with expressed breast milk and/or formula.
- Pumping until my breasts run dry, plus 2 minutes in an effort to increase supply.
- Visiting a lactation consultant weekly to double check latch and suck.
All of this takes upwards of 1.5 hours. It is exhausting (both for me and for him) and I'm pretty sure neither of us can keep it up much longer.
He is gaining weight, though very slowly (half an ounce a day, if that) and remains in the 3rd percentile of his growth curve (born at 2 pounds 12 ounces, and has just now, at 7 weeks corrected, hit 8 pounds). In all other respects he seems a healthy, happy baby.
I am taking Domperidone and have tried Fenugreek and Blessed Thistle. I eat a healthy diet (including lots of oatmeal) and drink ample water. I try to nap whenever he is sleeping.
I really have no idea what else I can do here. His paediatrician wants to see him up the weight gain, and is pressing me to add more formula (my preference would be human milk fortifiers, but I don't make enough milk to mix anything). I can increase the top ups, but what I'd really like to do is improve my supply (is that even possible at this point?, and if so, how?) and his efficiency. Also, I really can't spend a year following this regiment --it will kill me. Advice is most welcome.
In short, help.