Absurd weight gain regime - help pls

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DD was weighed yesterday by the midwife and has only put on 20g in 5 days. The midwife recommended the following, to be done every 3 hours, day and night:

Express for 15 minutes
Feed for 30 minutes
Wait 40 minutes
Top up with EBM

...and repeat.

I think that this would send anyone insane, not to mention making my milk supply go rubbish due to stress and lack of sleep.

DD is 17 days old and otherwise fine apart from still producing green poo: she is alert, happy and filling nappies on a regular basis. I have also seen the GP to rule out anything sinister as the cause of the green poo.

My instinct is to express in the morning when I have some oversupply, store it and give it in the evenings.

Has anyone else been recommended this? Is it as mad as it sounds?

have you been demand feeding? has she suggested just feeding more often? so offer bf every 2 hours rather than this system every 3 hours? at that age dd would feed very adhoc, half hour gap here, 2 hours there, 20 mins the other. not every 3 hours at all.

Or,
lots of skin to skin,
switch nurse
breast compression
feeding every 2 hours (wake baby to do this if necessary.)
Hope your baby starts piling on the pounds (or oz) soon.

not suggesting you should make your baby wait 2 hours btw just to think about making that the minimum time between feeds.

I have been demand feeding. She usually feeds at least every 2 hours during the day and 4-5 hours at night, with a tendency to cluster feed in the evening for 3 or more hours at a stretch. She's also quite a lazy feeder and likes to intersperse her feeds with a snooze or two, meaning that one feed can last over an hour.

I (but that's just me) wouldn't bother giving expressed milk in the evening.
The cluster feeding can be a bore (or a good excuse to sit on the sofa all evening will DP does washing up) but it's telling your body to produce milk.

Is she actively swallowing much during these feeds. If you're woried about her intake maybe the breast compression would keep her more interested?

The fact she's sleeping during feeds means she may be running out of milk, so compressions/switching sides more often/giving expressed milk are all good things to do. If she's still a bit underweight then she may also not be sucking strongly in the first place to conserve calories, so you need to help her get what she needs in a more interventionist way than if she was feeding normally. At that low weight gain it's clear you do need to do something, it's not enough for someone at her stage.

I was recommended this regime- to be followed every 3 hours, except that I had to fit in antiobotics between these sessions.
Yes, it nearly drove me insane, but in our case we didn't start it early enough: dd had already been hospitalised due to malnutrition and was getting very weak.

I don't know what to advise or what I would do if I had my time over again. I think I'd do anything rather than what I did do, which was to bury my head in the sand while dd gradually went sleepier and sleepier at the breast through weakness and fed less and less efficiently.

But I do know how hard it is.

Lots of good vibes and hope your dd starts piling it on soon.

Is there a breastfeeding group with a councillor/lactation consultant near you that you could visit. They could help check that bubba is latching on correctly. It could be that bubba is only getting foremilk due to a shallow latch ie not getting enough boob in. Green poo can be caused by this. Talk to someone who specialises in bfing. MW sadly aren't always experienced enough to help. Until then def feed at least every 2 hrs & I wouldn't bother with expressing either. Babies can get nipple confusion if given a bottle before 6 wks which might make getting her to feed effectively even harder.
Good luck, don't give up just seek further advice!

This feeding regime may sound absurd but its standard advice when they are concerned that the baby isn't thriving and your milk needs boosting.

DS was a sleepy feeder and at 3 days old we were admitted into hospital with him suffering from jaundice and too much post birth weight loss. I was already exhausted from birth and new baby sleep deprivation, then spent 48 hours doing the express, breastfeed, feed EBM routine every 3 hours, meaning I was luckiy if I got an hour's sleep before I had to start the whole rigmarole again.

I know when they said that was what I had to do I was horrified but somehow managed it and it did work.

Oh God, stop killing yourself and give the baby a bottle or two of formula a day. I know I will be shot down in flames for saying this but if utter exhaustion is the alternative than do it. You'll soon notice that your baby gains weight, you feel much less under pressure and if you keep breastfeeding in addition to formula your milk supply will still remain/increase.

If I hadn't done this I'd have had a breakdown (or worse). I was utterly sleep deprived as I tried to feed a baby, still recovering from a traumatic birth and with an inadquate milk supply - the pressure was crushing and I had little or no midwife support (discharged from hospital after 24 hours, no midwives in the area for home visits so had to drive to health centres to see anyone).

I'm now almost exclusively breastfeeding. She gets a bottle probably 2 or 3 times a week, usually after several hours of evening cluster feeding when she needs to be full but I have nothing left to give.

Please consider your own health and mental state if you are going to attempt that brutal regime.

It is an absurd way of getting a breastfeeding relationship off to a good start - basically a bootcamp for mothers designed to take all happiness and pleasure out of the experience.
However, I think the problem can stem from baby not being properly latched and then getting exhausted feeding - which is what happened to me. They feed for ages, but not much milk results. So keep checking that baby is properly latched, and causing milk to letdown fully.
THEN
I think any sort of regime where you are told to wait three hours is a mistake, as Lulu said.
This advice can be optional - disregard if you want. Small top-ups of formula are not the devil's work. I gave two a day of 3 oz each when he was 10 weeks (which was when my baby's weight gain faltered) I then bf/demand fed at 2 hour intervals in day, and whenever baby wanted at night.
I never gave a bottle of formula during the night, or replaced a feed with formula as I thought that would be counterproductive to my building up my milk supply.

ALSO, I went to bed with the baby for at least 48 hours and DID NOTHING ELSE to get feeding back on track, I did not stagger around filling in charts and clockwatching and sterlilizing expressing equipment. Well, I tried for a few nights and became utterly demoralized and depressed to the extent I could let down no milk at all. So I stopped following someone else's regime and just listened to the baby and followed his cues instead. It really worked, and he went from from gaining 2oz in a week to gaining Ilb in a week. He WAS hungry, he wasn't getting enough milk, it was a terrible time; but over a period of 2 weeks I managed to turn things around sufficiently that he was getting masses of milk. He went to 98th centile from 25th. I breastfed for 10 months.

I would try and talk to a BF expert ASAP. The numbers for all the national support lines are listed here

When DD was born the MWs commented that it is normal for BF babies (and probably all babies) to grow in fits and starts rather than follow a continuous curve - so they grow in a jump and then weight levels off for a while... Her advice was to get DD weighed every 2 weeks tops (ie don't be afraid to go longer than that if I wanted to) and focus on DD's other signs for whether or not she was thriving.

I'm not saying you should ignore the situation at all (it could be a warning that there's a problem brewing and if there is then easier solved sooner) - but if this is the first time your DD hasn't put on "enough" weight (whatever that may be) and she's fine in every other respect I would want to get a 2nd opinion of whether or not there was actually a problem before making my (and possibly my baby's) life a misery trying to solve it.