Elisheva,

I would be very concerned about a 5-day old who nurses all the time and
is never satisfied.  In fact, I get concerned about 2-day olds who nurse
all the time.  Rule #1  Feed the baby.  Yes, I would be very careful
about how you say what you must say to the mother.  However, she is
likely more concerned than she lets on.  Most moms are relieved when
someone offers to supplement a baby who really needs it.  She knows he
needs milk and that she needs rest.  You need to tell her that you
expect supplementation to be temporary while you work on finding out why
baby isn't satisfied at breast and help her to increase her supply (if
supply is a problem--and it probably is, even if the original problem
was poor milk transfer).

What is the baby's weight?  What is the output?  What is his hydration
status.  How often does he swallow during the feeding?  Does he have a
short frenulum?  a high palate?  Does mom have a low thyroid, abnormal
postpartum bleeding?

Unless I were sure that the baby was getting adequate milk, I would put
milk (ABM, unless mom is able to hand express or pump enough) in a
supplementer and put the baby to breast.  I would expect a big change in
baby's behavior.  An average sized baby is likely to take 1 1/2 - 2 oz.
at a feeding by this age.  If he is starving, he may take more and will
need extra milk for catch-up growth over the next few days.

If he can't get milk from a supplementer, I would try cup or finger
feeding and consider the need for further evaluation of suck and
swallow--ask pediatrician for referral to OT, or speech therapist with
training in infant suck.  Mom needs to hand express and/or pump at least
8 times a day.  Mother's doctor might need to be consulted about thyroid
or prolactin levels or to evaluate postpartum bleeding or for a
prescription for Reglan or consultation regarding use of herbal
galactogogues.

Of course, positioning is still of the essence.

Please let us know what happens.

Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA