Triple Feeding

Here is a made-up, but very typical, case-study.

Jo and her partner Sky had their baby a couple of weeks early, by cesarean. Because of the cesarean, Jo’s milk took a few days to “come in”. It’s very common, after the extra stress of surgery, for the body to take a little extra time to start producing mature milk.

And the baby, named Louis, has had trouble getting on the breast well, and emptying the breast effectively, because he’s a couple of weeks early, also a common problem. So he lost a little more than 10% of his birth weight in the first three days.

The doctor recommended that Louis receive some formula to supplement his feeds at the breast. In order to make sure he was getting all the breastmilk possible, Jo would put him to the breast first, at each feed, and then top him up with 1-2 ounces of formula. And in order to make sure her breasts were completely emptied, Jo would pump after each feed for 10-15 minutes.

So Jo and Louis left the hospital on Day 3 and went home Triple Feeding

1. Baby to breast
2. Supplement baby with bottle
3. Pump to empty breasts

Jo found that every feed took over an hour, even if her partner Sky fed Louis the bottle while she pumped. Then Louis would sleep for a couple of hours and then wake up to start all over again. It was exhausting.

At Louis’ one-week doctor visit, he had gained only two ounces since leaving the hospital. Just barely enough. (Babies are supposed to gain an ounce a day, or about half-a-pound a week.) The doctor suggested Jo give him at least 2 ounces of supplement after every feed. Jo and her partner Sky went home determined to get Louis to gain weight well. And they did! The following week, Louis had gained 9 ounces! The doctor was happy and told them to keep doing what they were doing – it was clearly working.

But it wasn’t working. Jo and Sky were on a treadmill of feeding, pumping, and washing bottles, with little naps in between. It was taking both of them to manage and Sky had to go back to work in a couple of weeks. Jo broke down sobbing at the thought of coping with this all day alone. This was when they made an appointment to see a lactation specialist.

Reach out for help!

I see many little families like this one. They have overcome the hurdle of getting their baby to gain weight, but they are stuck in an unsustainable pattern of feeding. Much of what I do when I meet with them is help them figure out a way to feed their baby more sustainably, while making sure their baby continues to gain weight at a good rate.

For some families, I can help them wean from pumping and supplementing, to exclusive breastfeeding. Some will have to continue supplementing, but can stop pumping, and some may decide to pump exclusively. Some may decide to move to exclusive formula feeding. There are as many solutions to the problem of feeding a baby as there are families. It’s a matter of  helping them identify their goals, and helping them understand the pros and cons of various strategies.

What is true for everyone who goes through a period of Triple Feeding, is that they need support and guidance finding a sustainable way to feed their baby. If you are in the situation I described above, please ask your care provider for more help, and perhaps see a lactation professional as well. La Leche League also provides excellent help. The Victoria Breastfeeding Cafe on Facebook is a great way to get peer support.

Remember that, no matter how small the amount of human milk your baby gets, it is always of value. But your own mental health and comfort are also tremendously important. Feeding your baby, no matter how you do it, can be comfortable, manageable, and, dare I say it, even enjoyable!