Worried about milk supply

[1sttimemumma]

Daughter is 7 weeks old and I am worried my milk supply is running low...

After being severely jaundice day 3 we spent 2 days in hospital where I was pumping and bottle feeding to make sure she was getting enough, since then we have mixed the bottle and boob but fed exclusively breastmilk - however she hasn't been able to latch since without a nipple shield, despite tonnes of expert advice. She does however seem happy enough with this and until now always got enough (would pull away with milky face, the shield would still be full of milk and she would be fast asleep).

To start with my milk supply was vast, too much (I could get 130-200ml every 3 hours if I pumped). This has slowed down over the past 4 weeks which I have actually been grateful of to an extent - but now it seems to be continuing to slow down and I am starting to worry. I am only getting about 60ml when I express and am having to get a frozen milk (from when I had excess) put in the afternoon/evening.

Is there anything I can do to up my production again? If not do I need to introduce a formula feed gradually? As she will most likely end up on it by the sound of things. Or can I limp on with bf as long as possible and then swap to formula straight away?

I'm no expert.
Just wondering why you are still expressing. If your baby needs that extra 60ml, she needs to be 'putting the order in" directly from you. Since you have had a bountiful supply previously (and don't overinterpret the feel of your breasts or time spent feeding either) you will certainly be able to quickly boost your supply up again just by your baby demanding. I'd say sit it out, feed loads, and keep the frozen milk in the freezer for future times when you have to perhaps be away for a bit.
I have personal experience with bf babies starting to refuse bottles, which is a PITA, so ideally I would pump and immediately bottle feed one feed a day if I were you to maintain that skill.
Other people will have more advice.

Oops, misread the context of the 60ml figure but I still stand by the rest.
But "limp on"?! That's nonsense! You are a queen. You are doing a magnificent job and I reckon all will be well v shortly.

@villainousbroodmare thank you for the kind words!!
It's just that when I pump I get 60mls, instead of the hundreds I used to get!
When I BF her she always wakes up very soon after so I don't think she gets enough, which is partly why I still bottle feed so much. The nipple shields I have to use are never full of milk when she pulls away anymore and always used to be so I feel like she's struggling to get as much as she needs this way.

You're at a stage now where your supply is becoming adjusted to demand. This is of course a fluid situation: it will increase as she feeds more, reduce as she feeds less, but this is why you don't have milk flooding into the shields, I think. Plus she is going to be getting more effective at feeding.
She is also getting out of that ultra-sleepy newborn phase and into a more wakeful interactive FOMO stage so you definitely can't equate 'doesn't sleep long' with hunger. The way to see if she's getting enough milk is rather output (plenty of wet and some dirty nappies) and weight gain. Remember that most bf babies start to reduce poop frequency to maybe one every 4-7 days.
If you want to keep bf - you sound like you do, and of course you can - then you need to trust your breasts to respond to your baby's needs and you do that by minimising or eliminating that top up. At the moment your breasts reckon that the baby wants X amount of milk so they are producing that much. They don't know that you're sneaking extra snacks in! If you want them to provide all the milk your baby needs, then you've got to let her tell them. And that will probably mean a few days of intense needy feeding but just go with it! I'm bf'ing twins at the moment and have had a couple of wobbles where I've wondered if they are getting enough. The answer has always been yes.

@villainousbroodmare Thank you thank you thank you this is so helpful!
My other concern is tomorrow will be 10 days no poo - the health visitor didn't seem concerned when I told her at 7 days and now I'm not sure... could that be a sign she isn't getting enough? She wees and farts all the time.

Gosh I can't imagine how tough breastfeeding twins must be, that's wonderful - we'll done you and congratulations!

I think DS1 went 12 or 13 days at least once and then unleashed Armageddon! and these two usually go a week or more. I'd be bringing a full change of clothes on all outings with a baby who is due a poop!

You really have nothing to worry about, because you know for certain that you can make tons of milk. You must just hold back the top ups to let the baby place her order. Are you topping up a lot in a day? At what time are you doing it?

I have had a few people who offered to give DTwin2 (the bottle-accepting one) a feed when he cried, because he "must be hungry". This would be with me having assured them that he had recently fed, and was just tired and seriously if you want to help me then FFS rock him a bit or something! One evening under these circumstances he glugged down about half a bottle of formula. I was surprised, and my friend was opening her mouth to tell me that he was obviously hungry when he puked it and more besides, all down her top.