A couple of thoughts...

Does mom have large nipples?  Is baby truly latching to breast beyond 
nipples?  I have seen lots of older babies who were exclusively or mostly 
bottlefed latch only to nipple and not remove milk well.

If baby is on the breast itself, it may be that even after two clippings the 
tongue is still restricted.  Sometimes there is fibrous tissue built into 
the base of the tongue that cannot be clipped.  If you have not tried a 
nipple shield, that is worth a try. If nothing else, it will reveal if the 
baby is tongue-thrusting...you can watch the shield go in and out of the 
mouth.  It will only be helpful if for some reason it helps baby hold 
thenipple farther back in mouth.

Supplementing at the breast is an idea...if baby can create enough suciton 
to get milk flowing, it will keep him motivated.  Otherwise someone would 
have to push a syringe.  Last thought would be to use a Playtex Ventaire 
bottle...I have had some success with those lately.  The baby must create 
suction to get any milk out...chewing does not work.

Good luck-

Kathy Leeper, MD, IBCLC
MilkWorks- Lincoln, NE

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