Alternatives to Triple Feeding
Why is triple feeding recommended?
When baby is not gaining enough weight when nursing at the breast, triple feeding is a protocol which involves:
Nursing baby on both sides
Bottle feeding x amount (will vary depending on age and weight history)
Pumping both breasts
This is typically not a sustainable feeding strategy (especially if there are not support people around) and can lead to burnout and mental health challenges.
What are the alternatives?
When discussing alternatives, it is important to look at what the goals of triple feeding are and how we can meet those goals with a different strategy. The purpose of the triple feeding protocol is to keep baby practicing at latching, ensure they are getting enough milk to gain and grow appropriately, and removing milk with pumping when a baby is not nursing effectively to maintain or increase supply with the overall goal of getting baby back to breast.
With some creativity, these goals can be met with a variety of different feeding approaches, continue reading to review a few options:
The Prolactin-Maximizing Approach
Breastfeeding parent nurses very frequently from early morning to early evening, offering at least every 2-3 hours but encouraging more frequently as long as infant is willing to latch.
Starting in early evening, support person bottle feeds larger quantities (amounts will vary depending on age) while nursing parent pumps every 2-3 hours, or more frequently if possible.
This approach takes advantage of the surge in prolactin (milk-making hormone) in early morning so baby gets more from the breast in the daytime.
This approach works well when:
Baby latches easily/has a positive relationship with the breast
Nursing parent is home during the day and able to feed frequently
Support usually doesn’t show up until late afternoon/evening (ex. partner has returned to work)
This approach is not recommended for a baby that is very fussy at the breast or has not been known to significantly transfer at the breast.
The SNS Approach
Breastfeeding parent nurses at least every 2-3 hours and uses a Supplemental Nursing System (SNS) at majority or every feed to keep baby active.
No bottles necessary if baby takes the full amount of supplement and both sides of the breast.
Parent can pump if possible to further encourage milk supply but the SNS will encourage baby to stay active at the breast and increase supply with more effective stimulation.
This approach works well if a parent does not have a reliable support person available, wants to keep baby at breast, feels comfortable with using additional tech while nursing, and baby latches easily.
The Triple Feed by Day, Double Feed by Night Approach
During daytime hours, the standard triple feeding process of nursing for 10-15 minutes on both sides, support person bottle feeds x amount after nursing, and pumping on both sides for 10-20 minutes is folled.
At nighttime, breastfeeding parent pumps every 3 hours while partner bottle feeds.
A similar routine would be to switch off ever other feed with a triple feed and then a pump/bottle feed.
This approach works well when:
Baby struggles to latch, especially at night when sleepy and it’s too frustrating to try at every feed.
Support person is available throughout day/night to help with bottle feeds.
Breastfeeding parent feels comfortable with pumping set up and pumping is effective.
Sometimes an even more individualized approach is needed to create a feeding routine that feels sustainable for everyone involved. Schedule a consultation today to get support!