Cheryl,
I had a mother/baby like this during the past year. The baby was a lazy
feeder at breast OR bottle, took a long, long, time, and a complete
physical exam by a sympathetic ped turned up nothing. Unfortunately, this
mother was a high energy person who lacked the will to put in the time to
let baby mature or pump, and so despite two previous successfully
breastfed babies and an excellent milk supply, she chose to dry up and quit.

Having said that, you face a tough situation. When feedings take over an
hour each time, it is hard for a mother to face extra pumping. Most
likely the lackadaisical suck is doing little to stimulate her supply,
and she probably isn't doing quite enough of the extra pumping, either.
My first thought is to add an herbal galactogogue here to at least aid
her efforts: fennugreek tea or tablets. Secondly, she probably needs some
"frequency days" of pumping every two hours, 15 min a session double
pump, to kick up her supply. Perhaps these could be days that she takes a
rest from breastfeeding and fingerfeeds instead so that she has some
sanity. I would think about scheduling these frequency days twice a week
to start, and see where it goes. Meanwhile, baby needs to be feeding at
least 8X a day on the "normal" days using the SNS & pumping in order to
sustain the supply.

It is so hard when you are trying to train baby at breast, but baby isn't
adequately stimulating supply and mother is spending a lot of time
working at it as well as pumping. You'll have to find out what she can
handle, and go accordingly. Sometimes a lethargic suck can be related to
allergies (uh-oh-- there's that controversial word! ;-), and when you
don't have anything else to go on, I think that it is worth pursuing; at
the Lactation Institute this is one area that they seriously consider,
and I have seen babies' suck improve dramatically with dietary changes in
mom. Takes a lot of detective work, though. Good luck!
-Lisa

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Lisa A. Marasco, IBCLC                                /  [log in to unmask]
International Board Certified Lactation Consultant    /  [log in to unmask]

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