I started composing a post yesterday about how much better things were with the feeding. Sadly I went to the clinic today to get Pob weighed, and she is precisely - to the nearest 100gs - the same weight as she was 2 weeks ago. Since she was only on the 30th centile for weight to start off with, this isn't good. So all the progress we've made with feeding over the last 2 weeks seems to be for naught. Sheesh this is difficult!
What we've been doing:
About 2 weeks ago now I was so tired of all the pumping (about 11 times a day) that given your advice and the advice of the maternity nurse we had, I decided to just go for it and stop pumping during the day, and just put all the milk into the baby. So we stopped doing top-ups after day time feeds, and just kept putting the baby on the breast whenever she said she was hungry. The first few days were very tough. I did try using the supplemental nursing system, but just couldn't get it to work. So it was just me and the baby. Given she was still producing wet and dirty nappies I did know intellectually that she was doing ok - or I thought I did. We continued to give her a bottle at night - as much as she could take - and I kept pumping after the evening feeds and the night time feeds. Then she started to sleep longer at night, up to 8 hours (I know, I am very very lucky) so I started to wake up to pump in the middle of the night to pump even while she was sleeping. I've been getting around 200 mls from 3 pumping sessions so felt that the supply issues weren't the issue any more.
The baby seemed fine. She is more alert after a feed now, she plays happily for up to 40 mins or so on her mat or chair after each feed, then says she's tired by starting to grizzle, she settles to sleep via rocking or singing or both, and sleeps for 1.5-2 hours until the next feed. She was producing at least 2 dirty nappies a day and plenty of wet ones, so there was no reason to think she wasn't getting enough to eat. So it was a real shock today to find out she hadn't gained at all.
The health visitor was concerned and told me we had to start adding more to each feed, via a bottle since she's already on the breast for an hour at each feed. I do know that her sucking etc isn't great, so I've been trying to tickle her etc to keep her awake, and take her off if she really falls asleep, sit her up etc. until her eyes are open again and I can put her back on. I think at least part of the issue therefore is that she just doesn't eat fast enough - clearly not the child of her mother! - so even in an hour she isn't getting quite enough. She's getting enough that she isn't upset and doesn't feel hungry, but not enough for her to be gaining in the way she should.
It's all rather depressing, just when things seemed to be going better! The thought of adding bottles back in is really depressing after gaining some time back in the day by not using them. But clearly we need to get more food into her, so that's what we'll do, at least for the next week. Wish us luck.