Hi Kimberly,

It's late, I'm just going to fire off my thoughts. The baby is unable (yet)
to create a robust supply. Lots of factors could be at play, we know the
baby is preterm (the weight is not so much a factor as the maturity).
Probably delayed feeding, suboptimal feeding in early days, perhaps
jaundice, and we don't know if mother's potential for production is
high/medium/low as her baseline.
I don't mean to be flip, but it's a matter of math: if baby takes 1.2 oz in
8 feeds that is 9.6 oz in a 24 hr period. That is not enough. The milk is
not weak nor low calorie, it is just not enough. But as a perk, when the
mother compresses and hands on pumps (my advice to follow), the calorie
content for that feed/expression should increase.
My recommendation would be feed about every 2 hours, see global health
media for breastfeeding videos on deep latch and breast compression, switch
sides as soon as active feeding slows, allow time for baby to take the
supplemental ebm from another person while mom expresses with hands on (see
Standford University maximizing milk production video). Use paced bottle
feeding, or a nursing supplementer. I don't think 15 mls is enough, mom can
try to give 30 mls after each bf. Weight checks are essential every day or
two.
As baby gets stronger, more mature, as supply increases, things should
improve. It is important that mom 'calibrate' her breasts  up.
Rest, STS, nutrition, normal hydration. I am not opposed to a safe food
supplement, possibly shatavari or malunggay (I avoid fenugreek has several
side effects), oatmeal. But do not lead mother to believe that is the magic
bullet, the hard work of effective feeding plus effective emptying, and
frequently, is the ticket.
Laurie Wheeler RN MN IBCLC
Gulf Coast Mississippi USA

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