Expert: ruth kraft - 1/24/2011

Question
I was forced to pump and bottle feed my daughter after 5 weeks of using various lactation aids as my daughter refused to do the work of sucking on her own at the breast.  I recently tried to put her back on the breast and noticed that she seemed to be a "better sucker" and so was given the advice to do something called a 48 hour cure, where the breast is offered all the time with no bottle feeding.  Before beginning this, she was drinking 4 ounces every 3 hours.  The first day seemed to be better then the second as she seemed somewhat satisfied and my breast(s) were partially softened after most feeds.  I cannot say the same for day number 2.  When she was acting hungry and I put her on my breast she either fights with the breast, falls asleep soon after the first let down or just nibbles off to sleep without adequate sucking.  She's had 2 bowel movements, a small one in the morning and a tiny one in the late afternoon.  They both had small parts with a greenish mucus tinge.  She also does not seem as active as she usually is.  I am feeling guilty and gave her a bottle with ebm for bedtime as I feel that she's not getting enough from breastfeeding.
With pumping 6-8 times a day and my goal to breastfeed for 1 year seems very unrealistic.  I've had issues with supply decreasing from plugged ducts and my baby not directly suckling.  

Would you have any suggestions on how to make this transition from bottle to breast easier and less hard on my little ones health?  Your help would be greatly appreciated...thanks.

Answer
It defiantly seems as though she is not eating efficiently at the breast but this would be understandable if she hasn't breastfed in so long. I would suggest pumping and using a SNS ( supplemental nursing system) or finger feeding her ( not bottles) while also doing the 48 hours of constant nursing. this way she gets more and more practice and you know she is getting enough. then every few days, reduce the assisted milk from her routine ( IE.. for one feeding don't give her extra ) and see how well she keeps up with poopy diapers etc.

You can find an in personal lactation specialist to see how her latch and effectiveness is as well. you can also try ww.drjacknewman.com and watch the videos on there about how to see if baby is getting milk etc.