Michelle,
You wrote, *Mom only gets 1/4 to 1/2 oz per pumping after a feed, and has
been offering 1 oz or so after feeds at the breast, but says baby usually won't
take it.*
As others have stated, this baby needs to eat and his not getting supplement
following feeds because of sleepiness is likely because baby has no energy
to continue feeding. I recently worked with a similar case and had mom
sometimes breastfeed both breasts for only 10-15 min first, then give supplement
and if baby wasn't swallowing most of those minutes, then had her supplement
first (feeding tube at breast, open, first would be best)and then breastfeed,
using lots of breast compression and switching frequently. Also, I'd increase
the frequency of feeds to every 1-2 hr and when feeds aren't going on for an
hour or more, this is doable. Feeding weights would be important here to
ascertain what baby is actually getting at breast so mom can see the need for
the above mentioned plan.
The baby I worked with was only transferring about 8 ml and when I did the
math with mom, calculating what baby needed in 24 hr, it was very obvious how
underfed this baby was. It took a few days to wake this little guy up and
longer to be able to bring mom's supply up with some power pumping, use of hosp
grade pump, right flange use, and galactagogues. This mom had to use
formula because number one rule is to feed the baby. Baby is now exclusively
breastfeeding and mom even has some milk to freeze for work eventually.
There also was a recent thread here about feeding supplement first and using
the breast as "dessert" until baby is strong enough to breastfeed with vigor
and effectively. Hope this helps and things turn around, which they
certainly can, which I always let moms know. Daily, or twice daily contact, to
follow closely and change plan as needed is vital in these situations.
Barbara Latterner, BSN, RN, IBCLC
Brewster, NY
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