Let's talk about Triple Feeding. Triple feeding is when a Lactating parent breastfeeds, pumps and bottle-feeds at every feeding. Does that sound exhausting? It is! It is necessary sometimes but it is something I recommend only when truly needed. There are very important points to keep in mind if you are on this care path. First let's review some reasons why this may have been recommended.
1. Excessive newborn weight loss 2. Jaundice 3. Sleepy at breast 4. Late pre-term challenges (babies born between 34-37 weeks) 5. Ineffective suck pattern at breast 6. Difficulty latching (This list is not exhaustive) The first important point is timing: Newborns eat every 1-3 hours so Triple Feeding often can feel like parents have no break at all. I recommend keeping the whole cycle or process of the feeding to 40 minutes or less. This means, breastfeeding, pumping and bottle-feeding all in 40 minutes. This becomes a challenge when the baby is actually improving and nursing better and longer. In this scenario, we don't limit their time on the breast. But if your baby is simply asleep despite adequate waking techniques, trying to wake them for an hour is counterproductive. Give the nursing a good attempt but if its been 10 minutes, and your baby is still not latching well, you can move on to the bottle portion of the feeding. There will be many times to breastfeed in the future. Luckily babies reflexes to suck and find the breast are present for months. The second point concerns duration: This is a Short Term Care Plan! I educate my clients that they can proceed with Triple feeding for 48-72 hours. At that point, a re-evaluation by your (IBCLC) Lactation Consultant is necessary. The goal of Triple Feeding is to build and maintain your milk supply while addressing your baby's latch issues and keeping the baby fed and energized to learn to nurse. Milk supply will increase over 3 days with adequate stimulation and the baby has also potentially changed in that time. A Lactation Consultant (IBCLC) can re-assess your individual situation and recommend a more sustainable long term plan based on your needs. It is not wrong to continue this method for longer than 3 days. But it is a lot of work. Working with a knowledgeable IBCLC who can support you throughout this process is essential. Triple feeding has a place in reaching lactation goals but it can also be discouraging as it is a lot of work. It is recommended for a short term period. During that time, you and your IBCLC will be finding the difficulty and taking actionable steps to improve that situation. As direct nursing improves, triple feeding gradually stops. Your Lactation Consultant can also help you figure out good time management and alternate methods if you find yourself engaged in triple for more than several days. Enlisting partners to complete the bottle portion of the feeding is helpful. Family members can also clean pump parts and prepare bottles. Reaching out for help and support is necessary!
2 Comments
Cat
2/27/2020 04:51:34 am
I have been triple feeding for five weeks! My IBCLC never told me that this was a short term plan. When I cried that I was struggling, she told me I could go down from pumping after every feed, to skipping 1-2. I'm exhausted. Do you have any advice for a mother who wants to continue nursing a few times a day (even if it's just for comfort and bonding), but not do the full triple feed schedule anymore? I want to give him as much breastmilk as possible, but I think the stress of not knowing if I'm feeding my baby enough or the feeling of failing to produce enough is pushing me into PPD.
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Cathy Walker
2/27/2020 09:52:48 am
Thank you for commenting on this topic. I’m so sorry to hear that you are struggling with triple feeding for so long. Your mental health and sanity is more important than any one feeding plan. A successful plan is one that is sustainable for the parents and the baby. A Lactation feeding care plan is always individualized based on the baby’s history, parents history, the feeding history and labor and delivery events. It also based on in person assessment of both parent and baby and how they interact at the breast. Close follow up with your IBCLC is necessary to adjust and change your plan as all these factors evolve. I encourage you to find an IBCLC who listens to all your concerns. Thank you and all the best! Cathy
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April 2023
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