Okay, I'm very confused and not sure who I need to talk to about this.
My daughter is six weeks old. We had some breastfeeding troubles at the beginning, jaundice, supplementation, etc. She lost 15% of her birth weight in four days, and my milk didn't come in until the fifth. After giving formula it she refused to latch for two weeks. Then we used nipple shields for two weeks. I was able to wean her off the nipple shields successfully and she is doing well, has a great latch and is gaining well.
I saw two LCs and neither one was very helpful. I went to both for latch problems. The first LC told me that she didn't think I had a latch problem, she thought I had a supply problem because my milk came in late (5th day) and I have PCOS and PCOS is sometimes associated with supply issues. She tried to get me to use an SNS, but that was never successful because an SNS is useless if the baby won't latch. She didn't seem to have much hope for me to ever establish a good breastfeeding relationship. I was pumping at the time, about 7 days post partum, getting 1.5 oz per double electric pumping session (using a hospital grade Lactina). She told me to get a prescription for Reglan but kind of shrugged and said that if I couldn't get BF going, at least I gave it a shot.
Before getting the Reglan, I tried Fenugreek. I didn't notice a huge increase at the time. I was taking 1200 mg 4 times a day, I believe. I went up to getting maybe 2 oz per session, which was only half of what my daughter was eating. So I was still supplementing with formula. I saw another LC at a different hospital. This LC did work with me on latch, although ultimately she couldn't get us to establish a consistant one. She seemed unsure about whether I had a supply problem but cautioned me against Reglan because of the potential side effects. She did say that with a hospital grade pump I should be getting more than I was at the time, though, even though my understanding and belief is that not every woman can pump equivalent to what a baby would eat, even if she pumps consistantly. I was double pumping 15 minutes at a time approximately 8 times a day, although it was getting more challenging because my husband had gone back to work and I was trying to feed and care for my newborn at the same time.
Finally, a friend suggested I try a nipple shield. My pedi mentioned it, too. I figured it was worth a shot so I tried one and got a latch immediately. I was nervous about having enough for her so I started taking the Reglan my OB had prescribed. We were able to stop giving her formula and the first week she was exclusively breastfed, she gained 5 oz. After 2 weeks she easily weaned and is directly on the breast now, but I am still taking the Reglan. My doctor gave me 2 weeks' worth with 2 refills. I am in the middle of the first refill and have one remaining.
I am terrified of weaning off the Reglan and suddenly finding myself with a supply issue. PCOS supply issues are supposed to be pretty difficult to overcome, and since I don't have a successful relationship with any of the LCs I have been to, I don't know who to turn to. My daughter is gaining very well now -- she is 6 weeks, her birth weight was 7lbs10oz, her lowest weight was 6lbs8oz, and her current weight is 9 lbs. As I said, she is exclusively breastfed on demand now. We kept track of her diapers and she has always had sufficient diapers; recently she has entered the "store it up" phase so I don't know if they would be a good indicator in the future of how much she is getting.
So if I wean off the Reglan what do I look for to know she is still getting enough and could that be dangerous for her? I know the basic indicators, but I don't want to create an emergency situation where I can't manage my supply and I have to supplement again. Should I go back on Fenugreek as a backup? Should I look into domperidone? I don't think my OB would be willing to prescribe but it has been recommended to me by a BFing peer.
I just feel confused and scared. I keep reading that PCOS-related supply issues can be insurmountable, and I don't want to ruin a very hard-won but successful BFing relationship with my daughter, or jeopordize her health. I wish I had a healthcare professional I trusted to advise me on this, but I don't.