Sleepy babies, edema and low milk supply—any of these could be causing your baby to not get enough at feedings. Whatever the reason, if she isn't gaining weight or she's acting fussy and hungry all the time, you need to figure out why, then solve the problem.
In most cases, the problem is milk flow; it's simply not fast enough for a newborn who lacks the energy to get all of the milk out when the flow starts slowing down. Since you can't do much about your baby's skill at this point, it's best to concentrate on what you can control: your milk supply. Because the higher the milk supply, the faster the flow rate.
So while your baby is learning her breastfeeding skills and slowly waking up to the world, you can help ensure that she's getting enough to eat by pumping and supplementing.
Before using a breast pump and supplementing feedings, first try the following methods to get more milk into your baby:
These are both temporary techniques to increase milk flow. Sometimes they're enough on their own, but if your baby still isn't getting enough at each feeding after you've tried these methods, you'll need to pump and supplement.
The goal of giving your baby a bottle and pumping right after each feeding is two fold:
For these reasons it's important to keep breastfeeding sessions at 20 to 25 minutes, but only if your baby isn't getting enough. This may seem strange, considering you're trying to get more milk into your baby, but there's a reason for doing this. In cases where she's not getting enough, she's likely going to get the bulk of her supply in the first 15 to 20 minutes. After that, she might just be "flutter-sucking" the breast—not sucking and swallowing effectively anymore—or even sleeping.
At this point, your baby is better off finishing her feeding from a bottle that has a steady flow rate of milk. What's more, the milk left in your breasts is better off being pumped and saved for another feeding. Finally, by draining the breasts every feeding with a breast pump, you'll be going into higher milk-making mode—the secret to increasing your supply and fixing the milk-flow situation.
Always pump within 10 minutes after each feeding to send your breasts the message they're being drained.If you can, double pump both breasts at the same time for about 15 minutes. The milk you pump from one feeding will be used at the next feeding as a supplement.
Source: Heather Kelly is an International Board Certified Lactation Consultant (IBCLC)