The Triple Feeding Curse

If a baby is having trouble transferring milk from the breast, it is common for a nurse, lactation consultant or pediatrician to recommend Triple Feeding. Triple Feeding is a breastfeeding strategy that calls for 3 steps:

#1 Nurse the baby at the breast.

#2 Pump breastmilk.

#3 Feed the baby with a bottle using either pumped milk or formula.

Easy as 1-2-3? Nope. Triple Feeding is an exhausting and overwhelming chore for any new mom. It is not a surefire way to improve breastfeeding. In fact, there is no scientific evidence that Triple Feeding is associated with breastfeeding success.

At Woven Pediatrics, moms are taken off Triple Feeding regimens immediately. Here's what we see:

Day 0-8, when milk is coming in:

In the first few days of life, milk is not "in" and baby is sleepy. Often there is some weight loss, and parents are worried that baby is not getting enough milk. In order to protect the nursing relationship (Step #1), help moms milk supply (Step #2) and get baby adequately fed (Step #3), doctors suggest Triple Feeding.

The problem with this is that Step #3 is the most important! FEED THE BABY! As Triple Feeding takes a long time, it pushes the most important step to the end. This might mean that baby is too tired to eat at all. Or they are way past when they needed the milk. Dehydration, jaundice and weight loss can ensue. At Woven Pediatrics, the first priority is to get your baby fed!!

Day 9 and on, when supply is low: 

As the days go on, moms might find they have low milk supply (not enough breastmilk for baby). One evidence-based way to improve supply is to increase demand. Remember, breastfeeding is a supply and demand process. Doctors love to recommend Triple Feeding in this situation as well. Nurse and pump! Nurse and pump! Demand, demand, demand!!

The problem with this is that not all bodies respond to supply-and-demand the same way. Moms are nursing and pumping and nursing and pumping, but there is no increase in milk. After 1-2 days, it's time for a medical evaluation.

What do we recommend instead? Woven Pediatrics recommends regimen that puts calories into the baby first, and also considers mom's need for rest. Bottles are okay while the baby gets needed calories and mom's milk comes in. We can work on nursing later. 

At Woven Pediatrics, Dr. Stephanie will work to diagnose the problem and put dyads on a sustainable feeding plan. If your baby is not transferring milk at the breast, there are lots of things to consider. Only a provider, like a physician, can diagnose the problem. Lactation diagnoses sometimes involve the baby, and sometimes is the problem is on the mom's end. Triple Feeding does not diagnose anything, and it can be a road to nowhere!