Surviving the Triple Feeding: Nurse, Pump, Bottle

Nov 22, 2023

by Casey Williams

Breastfeeding is such a beautiful and amazingly beneficial method of feeding. The benefits are numerous for both mother and baby. It's fantastic when everything goes smoothly and your baby is nursing well and gaining weight. However, it can become overwhelming when breastfeeding is not going well, and you may need to consider triple feeding.

Unfortunately, many possible problems could make breastfeeding more challenging for a new duo. Breastfeeding is a brand-new skill for your baby, and together you and your baby are working to figure out what works best for both of you. Contact your healthcare and lactation team for support and guidance when problems arise. Depending on the issue, some may recommend triple feeding. Triple feeding can be helpful when navigating certain concerns, but they are hard to sustain for long periods.1

So here we go, mama, nurse, pump, bottle-feed, repeat — let's help you survive the triple feeding!

The term triple feeding is used when a mom is nursing her baby at the breast, using her breast pump to express milk, and then feeding the baby expressed milk with a bottle. Triple feeding comes into play when there is a problem not allowing a baby to drain their mother's breasts fully or the mother's milk supply is insufficient to meet her baby's needs.1,2

The following are common problems that can impact a mother and baby duo's ability to breastfeed:1,3,4

These causes can significantly impact a baby's ability to breastfeed. They can cause your baby not to have the stamina to breastfeed for appropriate periods or cause difficulties for the baby to latch properly to the breast. These problems can lead to ineffective milk removal, and pumping becomes essential to the triple feeding method. By expressing milk by pump and then bottle feeding, you can ensure that your baby takes in an appropriate amount of milk and that the mom's milk supply is established and maintained.3

Expressing your breast milk with your nursing baby or a pump is imperative for your supply from birth. The mother's supply will decrease if a baby cannot remove enough milk. Milk synthesis slows down when less milk is removed, decreasing production. This is why it is essential to pump if you’re experiencing breastfeeding challenges. This will keep your milk production high enough to meet your little one's growing needs.3

While triple feedings have been seen to be effective, they are worrisome regarding sustainability. They require ample time each day to feed your baby, set aside time to pump, store your expressed milk, and then clean your pump parts. The to-do list could be exhausting! Taking on all of those responsibilities alone is overwhelming. This is when to ask for help or accept help from your partner or support system. They can play a helpful role in bottle feeding your baby, cleaning bottles and pump parts, and even helping with other chores that need to be done around the house.1

You also want to take care of yourself. Fuel your body with healthy food options, drink plenty of water, and give yourself grace. You are working hard, mama, and doing all the best things for your baby. So don't be too hard on yourself.

Don't worry, mom, the triple feeding method doesn't have to be a forever thing. When your baby is ready, it will be time for exclusive breastfeeding. This transition period is great for contacting a lactation consultant for guidance and support. Check out these helpful tips below for transitioning to exclusively breastfeeding.

Before you are ready to transition to fully breastfeeding, ensure you have addressed the concerns preventing exclusively nursing before. Addressing concerns could be anything from working with a lactation consultant to help work on proper feeding techniques and latch while your sore and painful nipples are healing to waiting on healing after a traumatic birth. This is when consulting with your healthcare and lactation teams can be very helpful.

A deep latch helps your baby pull milk out of the breast and helps keep your nipples intact and comfortable. When a baby has a shallow latch, the nipple is too far in the front of the baby's mouth. This causes increased friction and compression of the mother's nipple when the baby begins sucking, resulting in nipple pain for the mother. Nipple trauma can occur quickly, so correcting the latch and finding a comfortable feeding position as soon as possible is essential.3

Skin-to-skin contact between the mother and infant is beneficial in many ways. Not only has it been shown to increase the mother and infant bond, but it also has been shown to promote more breastfeeding. One study showed that mothers who used skin-to-skin contact with their babies had greater increases in their milk supply volume than those who did not use skin-to-skin.3

Even while triple feeding, you can help set yourself up for success with breastfeeding later by using the paced bottle-feeding method. This method encourages your baby to suck to pull milk out of the bottle's nipple by holding the bottle horizontally while feeding.5

When the baby is still learning to breastfeed, it may be helpful to stimulate your breast to initiate your letdown before attempting to latch. Milk already available gives the baby more instant gratification and encourages them to continue sucking. The same concept applies to using breast compressions during a nursing session. Be careful not to use too much force on the breast because it could cause trauma.2

When transitioning back to exclusively breastfeeding, it can continue to be a concern if your baby gets enough milk from the breast. A great way to see how well your baby removes milk from the breast is through a "weigh feed weigh." This is when you weigh your baby before you start feeding, usually recommended in just a diaper. Then feed your baby at your breast, and weigh again afterward in the same diaper to see how much your baby took in.2

If the triple feeding has you exhausted and stressed out, this could mean it is no longer working for you, and it might be time to transition to exclusively pumping. By this point, you most likely are familiar with using your breast pump and bottle-feeding your baby. The next step will be determining how much your baby needs at each feed, pumping frequency, and how to store and handle expressed breast milk properly.

Triple feeding is no easy task. Mom, you are amazing and doing everything right for your baby. Although this exhausting period of triple feeding seems to have no end in sight, it will. So, make sure to give yourself grace and ask for help!

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