My ds had nipple confusion, he too lost weight the first 4wks of life whilst we tried to establish bf. After wk 2 I was advised to use a bottle of EBM which he took readily, but then when I tried to get him onto the breast he would just gape at it with a wide mouth and didn't know how to latch properly. He was expecting it to come easily like from the bottle. As I was determined to stick with the bf I stopped using the bottles and after about 4 attempts at the breast again he started to latch properly. However, due to his tongue-tie, which wasn't diagnosed till wk 3, he never did latch on properly and would 'click' off the breast quite often whilst trying to feed (a tongue-tie is when the tongue doesn't usually extend past the teeth and gives a heart shape to the tip of the tongue).

IMO I would plan a few days of getting it right, choose a time when you're not going out much and can stand the niggling and fussing that will come with staying away from the bottles. BF is a learnt behaviour in the sense that the baby does need to realise they have to work to get the milk out. I would stop the bottles. Massage your breast before a feed, preferably with a warm flannel so that it's not that difficult for the 'let down' to happen. My ds always struggled the first minute to stay interested and fussed alot, and warming/massaging the breast really helped.

As you're expressing well it's not a lack of milk so that's good (the only way boost supply is to express or feed more) and she shouldn't be on there for more than 45mins at a time this age, say 25-30 mins each side max. After this time they tend to comfort suck rather than feed. They gradually get better and you could be on 5-10min each side by 4 months.

Does she prefer one breast to the other? Is she more comfortable in a particular position. Stick with what she likes for a few feeds and see if that helps. You don't lose your milk for about a week after you stop feeding with it (if then) so a day on one breast won't mess you up.

HTH

found the link to the australian webside, with chin to breast position, which have tried, thought it was going to be successful, as heard her swallow, a number of times, ( which i do not usually) and let her suck for 50 minutes - but she was still unsatisfied, and has now drunk 4ozs of EBM, AND I have expressed about 3 ozs . , so was not succesful, in summary.

Can you not keep her from falling asleep,or waking her with slight gentle pressure on palm of hand or feet,perhaps if she could take a big feed with lots of encouragement,she would have a long sleep and wake up hungry enough to be motivated to have a good feed again?Although rereading your post,it seems you have been doing this for an hour,with no luck.

have you spoken to your hv about the possibility of tongue tie?

saotia - you need good real life help.

I agree - long-term expressing is a difficult prospect and you should not be struggling still.

Try skin to skin and biological nurturing positions to encourage her.

Main thing is to find someone who will really help you get to the bottom of all this.

My 3 week old has never successfully breast fed. she initially fed for hrs ( up to 4 at a time) and remained unsettled , or would feed every hr. I did not worry about this initailly as i thought it was just getting establised , but she continued to lose weight into week 2 .

On advice from hv , gave top up feeds with EBM, which settled her, and is now a much contented baby, and is now gaining weight, thought not at birth weight yet. however now have to try to feed, and i can see that she is not sucking effectively, then she will fall asleep, to wake up crying and will drink EBM., have tried feeding her with breast for over an hour , but is not effective. I am sad at the thought of not being able to br feed her ( as i breast fed my first) but i cannot see me keeping up with the expressing and feeding) .

any advice?

midwife as seen latch on and said it is fine, i have also looked at internet sites, and i think she is latching on ok, but is a very poorly motivated feeder.