Cindi, I would try the simplist thing first, which is to assume it is OALD. Have mom pump out 1 oz, preferrably with a manual pump (I find these don't stimulate the supply as greatly as the electric do). Then nurse baby and see if baby is any happier. Perhaps this will work. 

I really do think this is more likely a suck swallow breathe issue because of your observations with the stethoscope and the way baby is so tired and also so fussy. Some kind of swallowing disfunction. 

Also, I'd be curious to see her on a bottle to assess her ability to suck swallow breathe. Maybe an Avent or a Playtex clear natural latch. Something that she has to work to get milk out of. Sit the baby upright and keep the bottle horizontal. 

I worked with a mom like this. The baby was just as bad on the bottle.  Baby self limited and cried and cried afterwards. No one else could manage to bottle feed the baby but the mom or myself.
 
Kathy Eng, BSW, IBCLC in Houston

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