XP: Help with formula supplementing

Bamgal25

Hi, this is my first time posting on this board, but I post on my BMB often.  I am looking for advice if anyone wants to read the novel below.
  
Background:  Around the 6 week mark, I noticed/realized that DD wasn't gaining weight at a very fast rate.  I met with a lactation consultant and did a weighted feeding and she did not consume very much at all at that time.  The LC recommended I nurse her for 15 minutes on each side, then pump, then supplement her with what I pumped.  I tried to do that, but it was very time-consuming and DD was not content to let me pump that often.  So I modified what the LC told me and started weighing DD before and after each nursing session.  Then I determined how much to supplement feed her (ie, if her weight increased by 1.5 oz, I would give her another 2 oz or so of previously pumped milk).  I was still pumping, but only about 3 times a day.  That seemed to be working for a couple of weeks.  I did not think there was a problem with milk supply, but rather DD is a lazy nurser. I got her checked for tongue tie and she doesn't have that issue.
 
So fast forward a couple of weeks and that system is no longer working.  I think the reason is two-fold:  she now requires more ounces per day and I am struggling to keep up with her needs and since she is sleeping for fairly long stretches at night we are usually doing 6 feedings per day so she needs more ounces at a time.  I am still weighing her before and after every nursing session to see how much she takes in (in the am, its around 3 oz, but as the day goes on it is less and less, sometimes only about an oz).  Since last Friday, I have been pumping after almost every nursing session in an effort to boost my supply.  Right now I am trying to make sure she gets 24 oz per day.  I started taking Fenugreek on Saturday and have been drinking water like crazy.  With all of that, I'm just barely keeping up with milk production.  And the whole feeding process can take over an hour which is starting to take a toll on my sanity. 
So, I've realized that I'm going to have to supplement with formula some, but I want to use formula as little as possible.  I plan to keep up with what I'm doing in hopes that something will click.  I am hoping she will start consuming more at the breast as she gets stronger/ less lazy (??)  But in the meantime, if I can't pump enough to keep up with what she needs, I am looking for advice on the best way to go about supplementing. 
Would it be better to:
a. pick one feeding per day and do all formula for that feeding, then pump?   
b. when supplementing is necessary, mix formula and breast milk in same bottle?
c. weigh/nurse/weigh, then supplement the difference with formula?

I know there isn't one correct answer, but I am looking for suggestions on the best way to supplement with formula and keep my supply up as much as possible.  Also, how to be more efficient so we aren't spending the entire day feeding.  I know this is really long so if you read all this, thanks.  And thanks in advance for any help!!!

SnoopyLuv

Are you mostly pumping or mostly nursing? It's unclear from your post. ANd 24 oz a day is within the normal range of output, so it doesn't sound like you have low supply. I'd probably get another LC's opinion on the low milk transfer.

Is your goal to ultimately get her 100% on BM or do you want to combo feed? If you want to combo feed, pick the most inconvenient feeding for you and give her a bottle - don't pump afterward. If your goal is exclusive BM, I would do option C but probably not for every feed, maybe a few throughout the day and when you give that bottle pump so you're telling your body to increase supply at that point. Keep in mind it's normal for them to cluster feed at night.

Bamgal25

Right now I am pumping more than nursing- maybe 60/40. I would prefer to do exclusive BF, but if I'm going to have to keep pumping so often I don't know if I can keep it up. I guess another option is cexclusive pumping, but that's not very appealing either.

ncbelle

When you say she wasn't gaining at a fast rate, what was her weight gain like?  Honestly, it sounds like you were given very convoluted advice and a system to follow that simply isn't sustainable!  Many 6 week olds may need to nurse more than 30 minutes.  And time on a single breast shouldn't be limited by the clock.   Plus if weight gain really is a concern, baby needs to still be nursing overnight.

Long story short, meet with a new IBCLC - I don't think you've gotten very good advice from this one.  If you don't want to pump or supplement, then you've got to put baby on the breast more.  And if she's not transferring enough milk - which sounds like she may not be - something is going on with her latch.