25 years old
first baby
breasts became more tender during pregnancy
spontaneous pregnancy
40 weeks
water broke and epidural
3.8kg approximately
day 3
she said she pumped and got a little yesterday
when I hand expressed I was able to see a few drops easily so I assumed it was okay
formula only at night while in hospital – plans to breastfeed fully at home
checked latch and saw it was good and deep and saw baby sucking well
mom was concerned baby sleeps too much on the breast
went over breastfeeding management and also how to ensure baby wakes up for the feed

a few hours later the nurses came to find me to tell me to visit with her again. they said that the baby was crying too much so they gave him a bottle of formula and he drank the whole bottle.
I went to check on the mom and she said she wants to nurse completely. grandmother was there and she told me she had difficulty nursing exclusively and always had to supplement because of malnutrition from her milk alone.
I tried SNS with her and the baby was aggressively nursing for the beginning but then fell asleep easily. Mom said this seems too hard to keep up. I just didn't want her to lose the skin to skin (that the nurses told her she had to do) and saw that the baby really had a good latch. Instead we worked on a plan that she would try and build up milk supply pumping and give the pumped milk to the baby and supplement his daily total with formula. pumping every 2 hours for about 10 minutes per side and feeding him also closer to every 2 hours. They kept them longer in the hospital because he has a shaking problem.