Hi Mary
Lots of red flags. Here are some random thoughts:

have thyroid checked to be sure it is WNL. Perhaps see an endocrinologist 
unless the OB is a good one and will investigate thoroughly. There are many 
nuances with thyroid and often several different tests have to be run to get 
to the bottom of it.

very early pain with latch (lots of pain in hospital) - could baby have 
tongue tie to some degree or some dysfunctional suck (clenching, chewing). 
if your help with latch resulted in no pain, maybe she was just latching 
incorrectly in hospital. did you check tongue?

mom pumped and got 1 oz each breast - did she ever experience significant 
fullness on day 3 or 4? what kind of pump is she using, she should get a 
very effective one and use 8x per day if possible.

baby falling asleep at breast - often indicates low supply
he wakes up in an hour rooting - he's not a sleepy baby he wants to eat, 
sounds like might be a milk supply problem

mom 31, history of problem with 1st baby and mom feels she has low milk - 
need more detailed history of what happened there and lactogenesis II (I 
find this is significant) most moms will answer the question "did your milk 
come in?" with something like "OH YES!"  also did mom have any infertility 
issues? when moms feel they have no milk/low milk after about day 4 or so 
this is usually true.

taking an hour to feed and getting only 31 cc - much too long and not 
enough, obviously.
again, could be a baby+mommy issue.

i find that milk supply down-regulates VERY quickly in alot of moms.

Treatment would be to feed the baby generously - I would recommend a supply 
line of some sort so baby can feed at breast and learn this skill. I realize 
mom has chosen to pump but maybe you could revisit this issue. Baby at the 
breast can be helpful for supply if it is not a baby sucking problem. Again, 
make sure she has the right pump. Pump frequently if she can post feed or in 
between to get more milk out and increase her supply. Baby needs frequent wt 
checks like 2x per week or even every other day until gain is established.

Not sure about the choking, perhaps her supply is increasing or it may be 
baby has some suck/swallow problems. I don't think it is oversupply.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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