We started out in the NICU without being able to bf due to needing a special formula with only predisgested fats (she was born full term with Chylothorax if anyone is curious - it's rare, only 1/2,000 NICU admissions). She was discharged at 2.5 weeks on the formula and stayed on the formula until June 2nd (6.5 weeks) when we were given the green light to bf as I had been pumping the entire time.
She appears to have a great latch. I thought things were going well, she would go on each breast for 10-15 min each feeding and she would eat every 2-3 hours and more often in the evenings. I was in a lot of pain the first few days, but that pain had started when I was pumping exclusively. I did get a small blister on one of my nipples that has now gone away. She didn't appear hungry in between and her diapers seemed the same. We had her two month visit last Monday she had only gained 4 oz. from her 1 month weight. So I started to supplement (at pedi's request) with a bottle of breast milk after each bf'ing where she was taking between 1 oz and 3 oz.
Last Wednesday I met with an LC, she agreed that her latch was fine, but it looked like she wasn't doing enough of a long sucks that are needed for bf'ing versus the small chewing-like sucks. (She had already gained 4 oz in only 2 days.) At the visit she only ate 1.5 oz total after bf'ing on each side. The LC didn't give that many suggestions besides to bf more often and try to increase my supply. We started bf'ing every two hours at least (except at night, i tried the first couple nights but she just falls asleep immediately if I wake her up) and I started taking fenugreek.
The LC did mention that her tongue looked a little tight. After reading more about tongue tied it does sound like it might be part of the problem. My nipples do come out squashed with a ridge although they no longer hurt. She mostly does seem like she is chewing. But she can stick her tongue out. How do I go about pursuing this more? Should I find a different LC to meet with?
Right now she is pretty consistently taking 2 oz after each feeding. I started back to work today and have pumped 3 times, the first time I pumped almost 3 oz and the second and third time 2, so it seems like my supply is a little low still. I'm planning on pumping every 3 hours at work (more than that would really be a struggle). Should I start pumping after bf'ing too to increase supply? She does suck better when my breast are 'full' but even after feedings where it seemed like she did really well she'll still take 2 oz. Should I start to gradually offer her less from the bottle afterward? Any suggestions would be great.