This is long but I am trying to be as concise as possible.
My sister, L, had her first baby, A, ten days ago and they are having some problems with breastfeeding. She was 8lb6oz at birth (08/02), 08/03 she was 7lbs12oz, 08/06 she was 7lbs3oz and 08/09 she was 7lbs2oz.
L has one inverted nipple and A didn't latch very well on that side, L didn't try very hard to get her to take that breast. A also has a fractured clavicle from birth that seems to bother her when we try to put her on the side with the inverted nipple. So she was feeding only on the left breast and her nipple became very sore. The nurses in the hospital were not very helpful, kept asking her to give formula, and the one LC the hospital employs was apparently on vacation. So, L got really discouraged but she is very committed to nursing.
Once we came home from the hospital, nursing seemed to be going okay. A was feeding every 2-4 hours but she was very sleepy and somewhat jaundiced. She would sleep 4-5 hours at night, she was really hard to wake up. L did not really want to wake up to nurse at night because she was exhausted. We tried pumping the right breast (the one with the inverted nipple) a few times and syringe feeding, but we only got an ounce or two each time so L didn't really want to bother.
We went to well baby check on 08/06 and the ped was concerned about A's weight loss so we saw an IBCLC on 08/08. The LC didn't seem too concerned. She told L to use a nipple shield on the painful nipple (L was seriously wincing in pain when A latched) and not to bother trying to nurse on the inverted side. She said we should pump that side and give A milk with a finger feeder. So we did that but L still didn't really want to pump, baby was still sleepy.
At the weight check with the ped 08/09, A was still losing and the ped gave L a lecture that freaked her out and made her feel suuuuper guilty. She told us to give 2oz of milk after every nursing session, whether BM or formula and be sure to put A to breast every 2 hours on schedule.
Well, L can't pump enough milk to give 2 oz after every feeding and A won't take that much anyway. We could give her maybe 1oz after feedings (mostly BM but some formula) and even that was a huge struggle to get her to take it.
So, I have L taking fenugreek and blessed thistle, lactation cookies and tons of food and water. A has been wanting to nurse pretty much constantly and we are pumping as much as possible, though she doesn't really come off the breast long enough to take any expressed milk. We got her to take the inverted side finally today with the nipple shield; the other nipple is still really hurting.
We go for another weight check tomorrow, so hopefully it's working. Issues that remain, though: (1) A has plenty of wet diapers but only maybe 1 dirty every day or day and a half. It is dark, kind of greenish with some yellow; and (2) I'm concerned we are creating latch problems by using the nipple shield.
So basically.... ADVICE PLEASE! :)