Greetings all!

I have a client who has a baby born premature (36 wk), now DOL 11.  BW was 6.0 oz, left hospital 12/23 at 5.12.  Baby wants to feed all the time, 30 min on each side, never seems satiated, only sleeping for 1 - 1/2 hours.  Baby has been checked for tongue tie by 2 other  LC's, and has good negative pressure.  Mom's nipples are not pinched, and only had nipple "bruising" the first DOL.  Normal vag birth, no complications; mom is easily expressible on both sides.  No history of IVF, or breast augmentation/reduction.

I did a WFW on 12/28 and baby transferred 1.2 oz in 45 min feed.  Today @ pediatricians visit  baby weighed 5.13. Doctor wants mom to supplement with 15 mil expressed breastmilk every other feed to get weight back up.  I ordered her a hospital grade breast pump today, and recommended that she pump at the end of a feed for 10-15 min and give baby that.  Doctor seems to think that the mom's milk is not "high caloric" and baby isn't getting sufficient nutrients from her.  Mom really does not want to supplement with anything except breastmilk. 

Does anyone have any suggestions to get this mom and baby transferring more milk?  I'm seeing them tomorrow again.

Thank you in advance!

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