I posted this in another area, but thought it might be appropriate here, too. Maybe I'm not producing enough?
Here's the facts. DS was born 8 weeks early and is now 4 months old (2 months adjusted). He SCREAMS and fusses a lot all day long and would probably nurse around the clock if I could accommodate him - I do a pretty good job of giving him ample time on the breast, though. He nurses on demand and I generally let him suck until he falls off - usually about a half hour. He actively sucks on and off for about 15 minutes total, and many times I will let down twice. I have been offering the same side for a few hours to make sure that he gets hindmilk (his poops were green for a while before I started the one-side deal). We are pretty sure he has reflux, and he's very gassy - he tends to swallow lots of air, both when he's eating AND from the crying. We started Zantac about 2 weeks ago, but he still screams and fusses a lot. He likes to be held ALL the time. He's still sleeping ON me at night, and if he falls asleep and I try to put him down in the crib he usually wakes up within 5 minutes.
We had a pediatrician's appointment this morning. In the past 6 weeks he gained a pound and a half - he's 8.5 lbs now, which is about 3rd percentile compared to other 2-month-olds. He has gained about a pound a month since we brought him home three months ago. Lengthwise he's 22", which is around 25th percentile. He spit up what looked like his entire morning feeding right before we left the house and I had to clean the car seat and put him in a new outfit before we went out. He was really screaming when we were at the doctor's office. The pediatrician asked me all kinds of questions about baby's breastfeeding (how long is he actively sucking, one side or two, etc.). He commented about how it would help to know how MUCH the baby is eating when he nurses and how pumping could help determine how much I was producing. But I pumped for two months (1 month while baby was in the NICU, and baby's first month home), and I never got more than an ounce per side. From what I've read, pumping isn't a really good way to tell how much baby gets, anyway. Doc said that he's concerned about baby's relatively low weight and, combined with the fact that baby screams a lot, it could mean that baby is HUNGRY. So he recommended supplementing with 3 oz. of Alimentum every other feeding. I like the dr. and he's very supportive of my breastfeeding, but I understand why he suggested supplementing.
But I'm so discouraged by this advice. I breastfed my first born exclusively for a year and he was also on the thinner side - still is. But I think it's just his body type - he's three years old and he's STILL tracking at 3rd percentile for weight (only 26 lbs!), but 75th for height. I'm thinking the baby might just be growing the same way. He's doing fine in terms of dirty and wet diapers, and I can hear him swallowing and feel myself letting down. If I supplement, then my supply will go down unless I pump, and I HATE pumping. The baby extracts the milk so much more efficiently and comfortably. Supplementing just feels WRONG for me. Instinctively, though, I feel that my supply should be, and IS, matching baby's demand. But I don't want baby to be hungry, either, and the fact that he was premature adds to my insecurity about what is the right thing to do.
Sigh. Thanks for letting me cry on your shoulders. :-(