@filips LC here! Hi mama, first off - you’re doing an amazing job sorting through all this!
Second - I think you’ve received some crappy advice. Losing 9% of birth weight would never been a reason I’d recommend supplementing with formula. Up to 10% is normal, and especially after a C section where they pump you full of fluids (which artificially inflate baby’s birth weight before they pee it all out), that wouldn’t have been cause for alarm for me. And when we recommend supplementing, it should always be with mom’s milk first. The advice to not pump early on is good for moms with well-established supplies, but for moms with low supply, we absolutely want them pumping to bring their supply in. I pumped from day 1 with my little one! Also, 20ml for a mom in the early days isn’t what I’d consider low supply, but I’m not sure when you got that measurement.
This is how triple feeding always should work: baby feeds, mom pumps, someone (ideally dad) feeds baby the milk mom pumped from the last pumping session via bottle. Only if baby is still showing crazy hunger cues does baby then get formula.
How many times per day are you getting baby to stay latched for a feed? If baby is staying latched, you hear swallowing, your breasts feel less full, and baby is looking satisfied after the feeding (relaxed hands, falling asleep, not rooting or crying), that counts as a good feeding. If you pump directly after that, it’s not super surprising that you wouldn’t get much if baby drained your breast!
I think the best case scenario here is you feeding on demand for several days and trying to cut out that formula. What happens when baby gets formula top-offs is that the formula sits in their stomach longer (harder to digest), they want the breast less often, your breasts get less stimulation, and your supply drops. Before your next appointment, I’d recommend the following:
1) Offer the breast every single time he shows anything that looks like a feeding cue. Stirring/rooting, crying, lip smacking, anything… offer the boob. Focus on keeping him alert, but it’s very normal for a fed baby to fall asleep at the breast. Supply is driven by frequency of feedings rather than length of feedings, so if you offer the breast 20 times in a day, that’s not an issue for establishing your milk supply. It will help. Night feedings are also great for your supply.
2) As many times as you can handle sustainably on full-time baby duty, pump for 10 min, but wait to do it until 30 min after a feeding. Don’t do it right afterwards. This will give you time to offer a bottle if baby seems hungry after he’s on the breast and a little time for your breasts to refill as well. If after you pump, you’re able to hand express anything, that means your pump isn’t draining you well, and you need to reevaluate flange size.
3) Dont offer formula unless you’re out of pumped breastmilk, you’ve offered the breast recently, and baby is showing big feeding cues. You may be nervous about this, but between the nursing and pumping, there’s zero reason to believe that your body can’t produce enough milk for your child. It’s baby’s job to bring your milk supply in, and your body will rise to the occasion. If you give baby a bunch of formula, that’s not helping your supply.
Also, when you’re doing this all alone, throw those pump parts in the fridge in a plastic bag between sessions - don’t need to wash them between every feeding. Wash them once a day.
If baby is having latch issues, that’s something to get addressed ASAP, but the pumping should help keep and grow your supply. My guess is that you’re not pumping much because you’re doing it right after a feeding and that baby is sleepy as heck because you’re essentially giving him a full feeding of formula on top of every nursing session!
