Poor milk transfer - need advice, maybe just support (long)

christyhal

DS is 9 weeks old.  We have been working with a LC who's generally regarded as one of the best in my area since week 3.  DS has struggled with BFing since the beginning - after our first visit with the LC we learned that he could only pull out 1oz of milk per feeding - despite switching sides, etc. and I had developed clogs that turned into mastitis.  (This newbie mom thought she was still engorged at week 3.  :-( )  My supply was almost gone.  I immediately rented a hospital pump, which I still have.  Over the past 6 weeks, I have been able to increase my supply to about 14 oz per day - only half or less of what DS needs.  This is with taking fenugreek and goat's rue. 

I was having severe nipple pain and compression trauma, and we determined DS had a really tight posterior tongue tie, which was finally cleared (had to clip twice) around Thanksgiving. He's also been seeing a cranial-sacral physical therapist for tightness in his jaw.

We were able to get off the nipple shield and last week for the first time DS took 2 oz at a weighed feeding.    We've been able to nurse with minimal supplementation first thing in the morning only - that's the only time of day that I have enough milk to give him close to what he needs at one feeding.

I am pumping after every feeding with pretty vigorous compressions, and I know the pump is still not getting everything - I get lumps of milk still, that I can't always get out.  (DS can, but since the breasts are not being emptied regularly, we seem to be going in circles with this - he nurses, I pump, not everything is removed, I get lumps, he nurses them out...repeat...)

Any increases to my supply seem to have leveled out.  I have already tried increasing the number of pumpings/feedings to try to boost it, but I am literally bruised (we are talking purple, swollen, even the LC was surprised bruised) by the pump if I pump more often than when DS eats (no closer together than 3 hour intervals).  DS is still causing a lot of pain when he nurses, and biting me, even though he has no teeth - those gums have a lot of pressure behind them!  I am ready to put the nipple shield back on - I am red and raw - but I know that his take will probably go back to 1 oz at a time.  My LC feels that at this point my supply won't increase until my boobs get the message directly from the baby that he wants more, by him taking everything there is, which the pump isn't doing,.

I've exhausted the resources of my LC, my OB, the tongue-tie doctor, and the physical therapist.  We have an appointment tomorrow with the occupational therapy department at the Children's Hospital for a feeding evaluation.  This is our last ditch effort to save BFing. 

I am not able to EP because my supply does not stay - and I get so bruised by the pump - and this is with a rental grade pump and we've tried all the different size attachments to try to find one that fits me without bruising.

I am afraid if DS does not figure out proper milk transfer, the little I do have is going to disappear in rather short order.  And if I go back on the shield he's going to get even less.

I would love to continue as-is, at least, but I can't.  DH and I are both losing our sanity.  I nurse (45 mins to an hour), top DS off with a bottle (15-30 mins) and then pump (30 mins) plus cleanup time, and I get maybe an hour before I have to start all over again.  I almost can't leave the house without it affecting my meager supply.  Overnight - forget it.  Factor in putting DS back to sleep, and I can be up 2+ hours out of every 3-1/2 or 4.

My LC, my OB, DS's pediatrician, and my mom (who was a LLL leader for years) are all surprised I've stuck with it this long given all the pain I've had and the hoops we've jumped through already.  I wish I could stick with it longer, and I am hoping the feeding specialists tomorrow can pull a miracle solution from somewhere.

I guess what I am looking for is... has anyone else gone through this kind of problem and gone on to nurse successfully? How did you do it?  Have I tried everything there is to try?  If I have to throw in the towel, I want to know I exhausted all possible resources to try to make it work.  If you've been here and it didn't work out, how did you deal with it?  I'm not feeling really good about myself or the situation right now.