When breastfeeding problems crop up, the main goal remains to feed the baby – whether with pumping and providing your own milk, with donor milk, or with formula. Next, you need to protect your milk supply with regular expression. Finally, you can work on getting baby and breast in sync.
What is “Triple Feeding”?
“Triple feeding” is the sequence of feeding baby, providing a supplement to baby, then pumping breastmilk (to stimulate the breasts and to provide some of baby’s nourishment) at every feeding. Triple feeding may be necessary when:
- Refuses to latch
- Has a weak suck or shallow latch
- Cannot transfer milk well
- Is losing weight
- Are using a nipple shield for latching
- Feel pain with latching
- Have a low milk supply
Three Steps to triple feeding:
- Breastfeed the baby:
Babies need to eat often – aim for 8 to 12 times per day (about every 2 hours during the day). If your baby won’t latch or has problems latching, a nipple shield may be a helpful tool, though you should try without the shield first at every feeding. Use breast compressions when baby is trying to stimulate a let-down or once baby slows down suckling. If your baby completely refuses to latch, move on to step 2.
- Supplement the baby:
Expressed breastmilk is preferred. The next best choice would be donor milk if you have access to it. If you have no other milk, formula is necessary. Supplement with 1 to 2 ounces at every feeding – if your baby will latch, he will likely be getting some milk from the breast directly and may not need as much supplement. You can provide the supplement at the breast with a “supplemental nurser” – tubing leading from the bottle to baby’s mouth while he is latched (this can be done with a nipple shield, too). Or the supplement can be provided after feeding at the breast – by bottle (slow flow nipple and paced bottle feeding recommended), dropper, medicine spoon, cup, etc.
- Protect the milk supply:
Once your baby has finished eating, pumping immediately afterward will help to stimulate your milk supply. Pump for about 15 minutes using a double electric pump. Massage your breasts before and during pumping. If the milk flow slows during the session, turn off the pump, massage your breasts and turn the pump back on. Save any milk you get for the next feeding.
How long do I need to do this?
Triple feeding is a lot of work. And how long you will need to do it depends. Working with a lactation consultant is essential – she can provide information and support for increasing your milk supply. She can assess the baby at the breast, and work with you to improve baby’s latch or milk transfer.
As your milk supply improves, as baby starts latching better, or as baby gets better at transferring milk, less supplemental milk may be needed and fewer pumping sessions may be an option. Slowly tapering the number of supplements and pumpings each day (as opposed to stopping ‘cold turkey’) is recommended.
Keep in contact with your lactation consultant and your baby’s doctor as you work on weaning from supplements and pumping to be sure your milk supply and baby’s weight gain stay consistent.