I'm pretty tired, so this may be all over the place. Tomorrow we are seeing a lactation consultant at our house but I thought if I could get some info in advance, it may help me prepare for her visit.

Our son was born 4 weeks early, weighing 2706 grams via emergency c-section. He is a sleepy little fellow and initially not a great sucker. The pediatrician did not want him losing up to the standard 10% of his birth weight so with the help of the hospital lactation team, I expressed colostrum and supplemented with formula. He did lose weight but within acceptable parameters. DS also had jaundice - initially treated day 4-5 (the day we left). He was readmitted 2 days later for an additional 48 hours of phototherapy for jaundice - we took him in for a re-weigh as per the hospital's request and they did not like his color so they ran a blood test and asked us to wait around (his weight had gone up a tiny bit).

My milk came in while still in the hospital (I stayed with him the whole time, so basically, he only had formula his first 4 days of life), so I was able to drop the formula supplement and supplement breast feeding with EBM - he drinks up the bottle like a fiend and he is now back above his birth weight at 2725 grams as of a few days ago - being weighed again tomorrow by MCHN.

He does attach to the boob but he still gets tired out (he's 16 days old today) - 20 minutes at each boob is an excellent feed for him - and that's with a number of breaks to re-wake him (and the 20 min/boob is a twice a day thing - for all other feeds it is more like 20 at one boob and 10 at the other) - I also can't tell if he is actually sucking/swallowing or just hanging out quite firmly - his jaw moves but I just don't see a swallow but I'm not sure what I'm looking for. Also, we have to wake him for most feeds (3.5 hourly during the day (3 hourly was just too close together for him - he didn't have enough energy for that schedule), 4 hourly during the night). I have rented a hospital grade pump and we are still topping him up with 20 mils of EBM each feed which he continues to drink up (my husband is excellent at waking him from his post-breast feed stupor and getting him to take the bottle which I can't do because I find it all too upsetting when I have breasts full of milk)...lately he has been spitting up more and we are wondering if we could now be overfeeding him breast milk between the breast and EBM. At the same time, we continue to be concerned about his weight gain so we don't want to drop it (he is being weighed tomorrow). Oh - plenty of wet heavy nappies and mustard poo - although last night he missed a bottle feed and his next nappy had only a little pee in it.

My milk supply seems to be good - when I express 5 minutes x 5 min x 5 min x 5 min (meaning 10 min each breast, total 20 min), I get 150 mils on average (twice a day - I could get more but I don't have enough bottles to store any more - we are going to address this in a couple of days).

I so want to stop the bottle top up - it's just such a PITA dealing with the pump, the bottles, the storage and the switch from boob to bottle at the end of each feed...and not what I want to do, but I'm afraid we will "starve" him. He finally has a tiny bit more energy (meaning, he has 10-20 minutes of quiet alert post feeds - previously, he would be just zonked post-feed) and he has actually started to cry close to feeding time - it's a funny thing to be happy about, but when you have a sleepy little fellow, it's a great sound as he never cries - only when changing his nappy and clothes - and it's more like a little wimper!

I'm hoping the lactation consultant can give us a program - what should I be asking from her? What ideas should I run by her? I'm most afraid that she will say he will never be a fully breast fed baby, and I will be forced to pump "forever more".

A completely unrelated question - I have not been sterilizing the bottles/nipples - only washing with really, really hot tap water - it burns my hands through rubber gloves it's so hot. Is this OK?

Thanks...