Your first case sounds as if it is resolving.  If mother is pumping a total
of 4 ounces AFTER feeds, her production must be on its way up, no?  You
don't mention birthweight or lowest recorded weight for baby, and the weight
gain you describe of about one ounce daily sounds unalarming unless baby was
WAY behind its own schedule.  However, if the observed feed is typical and
representative, it sounds logical that she feels weary of it.  Nearly an
hour for about half the baby's meal is a long time.  But the observed meal
could have been smaller because it was observed; the MER is like that.  Keep
looking at latch, of course.  You don't mention how she is giving
supplements, so I assume it is not by bottle.
To her question, I would be able to say unequivocally: NO there is nothing
wrong with the mother.  I am not sure I could say the same about her choice
of pediatricians!

In your second case, you wrote 'mom rented scale and is doing her own test
wts.  Inf getting 4 oz pretty consistantly pumping after mom gets =<1/2oz.
Gaining well.'  If the baby is gaining well, mother should use her money for
something more fun than scale rental and test weighings.  Who cares how much
he takes at each meal?  Me, I'd put my money on pleasurable massage for her.
The fussiness here might be that phenomenon sometimes called
foremilk/hindmilk imbalance.  (Forgive me for not remembering whether that
is the current politically correct name.)  But it also might be something
peculiar to the baby.  You wrote 'Baby has been extremely irritable since
birth.'  The medication Zantac is unfamiliar to me, is it the baby or the
mother who is taking it and to treat what?  (Xanax I know of from US TV
series-- which is of course the only reason I watch them!)  I am not
convinced there is a BF problem here apart from the discordance between the
mother and baby.  It really sounds as if BF is the only thing going well in
her life!  So I would want to 1) support the mother in that her life with
this baby is rough, 2) explore with her what expectations she had
beforehand, what has been the most surprising thing about mothering this
baby, and whether any chasms between the two are bothering her.  Sometimes
it is distressing even to have wistful thoughts about the difference between
Dream Baby and Actual Baby.  Sometimes just acknowledging that there is
something needing processing is enough to open the floodgates.  Sometimes it
even coincides with the baby settling in more happily.  No guarantees, but
it happens now and then.  Whether or not the baby acts different, an
awareness by a sympathetic person of her 'right' to be tired, disappointed,
whatever, can be revitalizing to mother.  And of course, reminding her of
the wonderful job she is doing of nourishing him.  If you can find some way
to talk positively about the baby ('spirited', rather than demanding or
'high need')then do that too.
Let us know how this kid is doing, will you?  He sounds like the kind that
don't come thirteen to the dozen!
Rachel Myr
Kristiansand, Norway

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