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If you’ve made it here, you likely know that feeding a baby is a journey— and one that often takes a lot of detours. For some moms who intend to breastfeed, those detours come with detours. Long induction of labor, oral anatomy concerns, and various other issues can make exclusively breastfeeding at the outset a challenge. While getting a newborn fed is the priority, some moms want to figure out a way to make breastfeeding work even if they have to supplement, which can lead to something called the triple feed.
Parents who have taken on the triple feed plan can attest, it isn’t easy. It can be downright exhausting considering it is, as the name suggests, a three-pronged approach to feeding (which in those early days is every 2–3 hours). It involves the mom/birthing parent breastfeeding first, then pumping, and then giving the baby a “top off” of formula or expressed breast milk in a bottle.
So why would a mom need to triple feed and how does she do it? We reached out to Jadah Parks Chatterjee for her professional insight into the triple feed plan. Jadah is a maternal child health Registered Nurse, International Board-Certified Lactation Consultant and a Bobbie Medical Advisor.
- What is triple feeding? Why is it called triple feeding?
- Who needs to do the triple feed? When is this plan suggested and why?
- Does the triple feed help build volume in the case of a low supply?
- With triple feeding, do I have to pump every three hours forever?
- How can I tell If my supply is too low in those first weeks?
- Is it possible to re-establish breast milk supply with triple feeding, even if you’ve been supplementing for days or weeks?
- What you can do to increase breast milk volume?
- I have multiples, does triple feeding make sense for me?
- Is triple feeding a long-term, sustainable solution?
- So when do you ditch the triple feed? How long do you do the triple feed for?
What is triple feeding? Why is it called triple feeding?
Jadah: Triple feeding requires the mother/birthing parent to take a three-pronged approach to every feed. The first step is providing human milk at the breast, then pumping to increase milk volume immediately after feeding, and then offering the baby expressed milk or formula as a “top off”.
Who needs to do the triple feed? When is this plan suggested and why?
Jadah: This plan is suggested when there are a combination of the following concerns:
- There is no expressible colostrum present during hand expression
- Long induction of labor increases concern of third spacing, which can delay the onset of milk production (lactogenesis)
- If there has been excessive bleeding
- Weight loss concerns for baby
- Jaundice concerns for baby
- Oral anatomy concerns (lip, tongue, buccal ties)
- Goal is to exclusively breastfeed and plans to eagerly return to exclusive breast milk feeding once baby concern has been remedied
Does the triple feed help build volume in the case of a low supply?
Jadah: Frequent stimulation at the breast with hand expression, the baby, or pumping will support re-establishment of human milk and increase volume. Baby wants to eat, feed at the breast. Baby wants to snuggle? Offer to feed at the breast. Baby wants to play? Offer to play at the breast. You see where I’m going with this?
With triple feeding, do I have to pump every three hours forever?
Jadah: The short answer is, nothing lasts forever. We always recommend beginning a feeding plan with short term goals (24–72 hours) and long term goals (5–7 days).
If you are triple feeding to increase milk volume, support infant weight gain, or decrease jaundice levels, then it’s a good idea to stick to the triple feeding plan until you have reached the priority goal. This goal is a part of your feeding plan established with your pediatrician and lactation consultant / infant feeding specialist.
Keep in mind, the average volume of human milk per feeding for infants 1–6 months of age can vary between 3-5 ounces per feeding. Remember, any amount of human milk is amazing for your baby. It’s okay to pause on pumping to sleep, heal, and recover.
How can I tell If my supply is too low in those first weeks?
Jadah: Recognizing low volume of milk is easier to assess when we are mindful about the sensations occurring in our bodies.
Before your next feeding, assess if you feel the sensation of your breasts filling. Do you feel tingly vibes or a fullness in your breast/chest area before it’s time to feed? Take a pause and observe your baby during feeding at the breast. Can you see them sucking, hear them swallow? Are their head, shoulders, and arms relaxed? These are all indications the baby is feeding successfully.
As a rule of thumb, newborns typically have one soiled diaper per day of life. So at five days, the baby should have five poopy diapers. If there are less than that, offer more food.
If baby is fussy or not sleeping well after feeding, it could be because of a soiled diaper or because they’re still hungry. Change their diaper, burp, and offer more food.
A well-fed baby sleeps, like a baby.
Is it possible to re-establish breast milk supply with triple feeding, even if you’ve been supplementing for days or weeks?
Jadah: In my experience, I’ve learned that it really is dependent upon what’s going on in mom’s postpartum journey. An excess of stress, worry, and concern combined with lack of sleep doesn’t support the release of the amount of hormones needed to increase milk volume and production. So it’s possible, it’s just not clear it’s possible until it’s clear it’s possible.
What you can do to increase breast milk volume?
Jadah: Here are recommendations I make to improve milk production:
Sleep is free and supports recovery of your mental, physical, and emotional state. It’s essential, and two hours can be a game changer.
The pump does a great job at mimicking the baby’s sucking mechanism to increase milk volume and production. However, if low supply is the concern, I would recommend a hospital grade breast pump. The difference is the hospital grade pump is more powerful with stimulation to increase the release of hormones needed.
Acupuncture and getting your chi into balance can also be a relaxing addition to the postpartum journey. I always send my patients to have a chat with experts who can focus on women’s health. (In my area, I recommend Katya at Spirit Gate LA. She is a licensed acupuncturist and focuses on women’s health.)
Have an orgasm, if mom/birthing parent has been cleared by her provider (usually after 6–8 weeks). An additional dose of oxytocin does the body good. Do you!
I have multiples, does triple feeding make sense for me?
Jadah: Anything is possible with moms, because we are bad asses. Do I recommend triple feeding with multiples as a long term plan? No. I look at the entire family and work to ensure there is a sustainable plan for mom to rest and enjoy her babies.
We have a moment of truth when I lock eyes with the patient and support person(s) and ask, ‘What was your plan? How are you feeling now about the plan? Do you have any concerns? What would you like to happen?’
Is triple feeding a long-term, sustainable solution?
Jadah: I do not think this is a sustainable plan for the parent. As this is very energy intensive and requires a lot of planning, memorization, and did I mention energy?
Keep a clear goal in mind. Maybe that’s baby gaining weight, quantifying the volume of expressed or pumped milk, or decreasing jaundice levels. It’s not always easy to measure success, since you’re looking at outcomes for parent and baby.
Babies make changes and adjust quickly. Milk volume improvement timelines can vary. It’s beneficial for the Feeding Support Team (parent, lactation consultant, pediatrician) to communicate and share updates and set daily and weekly goals to understand if the plan is working. The goal should be clear.
So when do you ditch the triple feed? How long do you do the triple feed for?
Jadah: Triple feeding has no specific timeline attached to it— some women do it for a week and are able to re-establish supply and exclusively breastfeed. Some do it for a few months or throughout the duration of their breastfeeding journey. It all depends on what works for the mom and the baby.
It’s okay to pause on pumping and support your baby to enjoy formula and snuggles from your partner and support team, so you can sleep, heal, and recover.
I often ask which part of triple feeding is most fulfilling and working for mom and baby? If feeding at the breast has improved, continue feeding at the breast while offering a top off of baby formula.