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Is she having plenty of wet and poopy diapers? That's the best indicator that she's getting enough.

I second @creativemomma15: to do a weighed feed!

But your LO sounds a lot like Xander. At four months, he was so distracted and would only nurse well when he was sleepy. If he popped off the boob, I would try putting him back on a few times before switching sides and then do the same thing until I gave up. And his weight gain was similar to your LO's (4 months was when he dropped down to the 17th percentile for weight - had been 33rd at 2 months). But he always seemed happy and alert and was meeting milestones, so my pediatrician wasn't concerned.

My only other suggestion is maybe just try to offer her the boob more often (maybe every 2 hours instead of very 3). But to me, it all sounds normal. I would just want to do a weighted feed to see if she's getting enough from you (our weighted feed showed Xander eating almost 4 oz, although he'd down 5+ oz bottles at daycare).

Ok so I'm going to be a voice of dissent here...while wet poopy diapers are a REALLY good indicator, the BEST indicator is actual weight gain. When you say she's gaining 3oz a week and that's not enough--is that just how you feel or is that what your pediatrician has said? If it's YOU being worried--then don't! Some babies are just small and gain slowly. If she's refusing to eat more , then don't force her--maybe try when she's sleepy or in a dark quiet room to help with the distraction.

However, if your pedi is concerned that the weight gain is slow, then that's a different story. My sister had a similar experience--her LO gained slowly but had a lot of wet/poopy diapers. She was worried about supply due to slow weight gain and decided to start supplementing to see if it made a difference. Her LO's wet/poopy diapers went up DRASTICALLY and he gained weight much better. So I think it's hard to say, "Oh well if the wet/poopy diapers are good, then you're good" because you don't have anything to compare it to, you know? Like, her LO was having like 4-5 poopy diapers a day, and like 6-8 wet diapers a day. Which seems like a lot! but then after she started supplementing, his diapers were significantly wetter, and he was obviously getting more--but she wouldn't have been able to know that without trying it.

Anyway, I'm not saying that you NEED to supplement, I think t really depends what your pedi is saying. I also completely agree with doing a weighed feeding to see how much she is actually getting from you--if it's a decent amount, then she might just be a slow gainer. If it's only an oz or two, then you might want to explore other options/speak to an LC. Good luck!!!

@illumina: combo feeding is definitely sustainable!!! There are a lot of mamas on here who have done it (locavore_mama is one I think). Its GREAt that you figured out what your LO needs! You are a good mama for persisting in both breastfeeding and making sure she is getting enough. And if it turns out that Exclusively FF is what works for you guys that's ok too

@illumina: nothing wrong with combo feeding .., we've been doing it since birth with great succeess . Happy baby makes for a happy mama!

@illumina: Hang in there. Some babies just aren't great nursers and take the bottle better. You're already doing a great job breast feeding her. Supplementing is great too. I EBF both of my boys but had to supplement a lot in the beginning with my oldest and was still able to EBF after a few months. If you want to try to up your supply you can also take supplements like fenugreek to help and nurse more frequently. I took it pretty much the entire time I was nursing my oldest and he gained weight nicely. I never produced a lot of breast milk. Meaning I was never able to pump more after each nursing session. Just enough for each feeding. Sometimes I felt like he was still hungry so then I would give some formula. Do what you feel is best for both of you.