After I had my first baby, my son and I struggled with nursing, and he wasn’t gaining weight. Before we left the hospital, the doctor recommended “triple feeding” – or nursing, pumping, and bottle feeding – each time I fed my baby.
Triple feeding is difficult and exhausting, but can lead to a successful breastfeeding relationship (whether that ends up being nursing or exclusive pumping). Here are some tips on how to make triple feeding easier.
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What is triple feeding?
As mentioned above, triple feeding means that you do three things every time you feed your baby – nurse, pump, and bottle feed.
The idea is that first, you nurse your baby as much as you can.
Then, if your baby is still hungry, you top him off with a bottle of either pumped breast milk or formula.
Finally, to make sure your supply stays even with what your baby is taking, you pump in order to remove as much milk as possible from your breasts. (You can then bottle feed whatever amount of you pump to your baby at a later feeding.)
Why would you triple feed?
Nursing moms generally end up triple feeding when their baby isn’t gaining sufficient weight via nursing.
The goal of triple feeding is to keep the baby fed, via nursing and the top up from the bottle, while continuing to work on nursing so that eventually the pumping and bottle feeding steps can stop. Or sometimes, the mom might decide to drop the nursing step and switch to exclusively pumping.
I asked my followers on Instagram whether or not they triple fed before switching to exclusively pumping or nursing:
How can you make nursing, pumping, and bottle feeding easier?
Here are some ways to make triple feeding manageable.
1. Get a hands-free pumping bra.
Since you’re going to be spending a lot of time pumping, you need to be able to do other things while you pump.
A hands-free bra or a hands-free breast pump can be life-changing! You can get stuff done on a laptop, eat dinner or even just relax a little bit while you do the pumping step.
Hands-Free Pumping Bras
2. When possible, get someone else to do the bottle feeding step.
If you have a partner or another caregiver around when you finish nursing, ask them to do the bottle feeding while you get started pumping.
This is the one step you can hand off to someone else, so don’t be afraid to do so.
3. When that’s not possible, see if you can do the bottle feeding step while you pump.
If you pump with a hands-free bra, you might be able to pump and bottle feed at the same time. Some babies need a lot of burping or to be held at a special angle due to reflux, and this might not be possible for those babies.
However, if you are able to lay your baby in your lap (or next to you on a Boppy or bouncer) and feed while you pump, this will save you 10-15 minutes each feeding session, or almost two hours total each day.
Here’s what that might look like:
4. It’s okay to skip either the nursing step or the pumping step once in awhile.
In most cases you should try to do all three steps to make sure you keep your supply up and your baby learns to nurse.
However, burnout is a real concern. If you need to take a break and skip nursing or pumping once a day to save your sanity, it will likely be okay.
5. If you’re having pain with nursing or pumping, don’t just grin and bear it – see if you can fix the issue.
Ideally, nursing and pumping should not hurt. If you’re having pain while nursing and you’re not working with a lactation consultant, it might not be a bad idea to see one if possible.
If you’re having pain while pumping, the most common issue is incorrect flange size or elastic nipples. If that’s not the issue, there are a few other things that could be causing nipple pain while pumping – here what to consider.
6. If possible, do something you enjoy while nursing/pumping.
Watch Netflix, read on your Kindle, or talk on the phone – whatever you can do to take a break.
If that’s not possible and you need to wrangle your baby while you pump, here are some tips on how to make it easier.
7. Let as much go around the house and in your life as you can.
When you are spending an hour and a half feeding your baby eight times a day, you’re going to have to drop some responsibilities.
That’s 12 hours a day, and no one who works 12 hours a day gets everything else in their lives done – they either have help, or it just doesn’t get done. Figure out what you can let go of during this short time period.
8. Remember that this isn’t forever.
Triple feeding is not sustainable over the long term. It is something that should be very temporary – a way to keep your supply up while you and your baby figure out nursing.
Hopefully, you can switch to just nursing fairly quickly, and if that doesn’t work out, either exclusively pumping or formula feeding are good options too.
How do you transition from triple feeding to nursing?
To transition from triple feeding to nursing, you’d reduce the amount that you’re topping your baby off after a nursing session until the top offs aren’t necessary. This could be gradual or abrupt – as soon as your baby is getting what he needs from nursing, you don’t need to pump and bottle feed anymore.
How do you know when he’s getting enough from nursing?
If baby is satisfied for several hours after nursing and continues to gain an appropriate amount of weight, then it’s likely that nursing is going well.
Another option, if you’re nervous, is to get a baby scale and weigh baby before and after nursing. The difference in weight is the amount he took. (Poop can complicate this, so try to weigh as soon as you’re done feeding, and don’t change baby’s clothes or anything.)
How do you transition from triple feeding to exclusive pumping?
Once you decide you want to exclusively pump, you can just drop the nursing step.
If you want, you can continue to comfort nurse if you’d like, or you can continue one triple feeding session a day to keep working at nursing.
Have you used triple feeding to feed your baby? Give us all your tips in the comments!
Comments & Chitchat
hi Amanda , i have premature baby , he spend 35 days in nicu and he used to feed by bottle, he refused to nursing , i use nipple sheild but also he not become stastifed , he was nursing 20 minutes, therefore i make tripple feeding , my question when he can nursing without need bottle ? he is now 8 weeks and he born in week 30
Hi again! Once he’s doesn’t seem hungry again soon after nursing, then you should be able to stop pumping and triple feeding. You kind of have to do some trial and error – nurse and see what happens. Is he hungry again in an hour or can he make it 2-3? If he can make it 2-3, then you may be able to stop pumping. It might help to do weighted feeds – where you weigh baby before and after feeding to see the difference and how much he took. I hope that helps! You can also see if you could work with an IBCLC to make the transition. Good luck!
I did this with my now 21 month old, not because of weight gain, but because he had a lip and tongue tie and was always hungry. The pediatrician said the oral ties were not an issue so it took me a couple of weeks and doing my own research to realize what the problem was. I would pump on one side while he nursed on the other. Then pump on the other side while he got pumped milk. We survived until he got his ties revised at 11 weeks. After that everything was great. I just had #3 Saturday and she has a bad lip tie, so we are doing the same thing until her appointment next week.
Good luck Heather!
Hi Amanda, I’ve been triple feeding for 3 weeks as my baby is an inefficient feeder (falls asleep on my boob no matter how hard we try) and it can take 30-40 minutes to do 10 minutes on each side. We’ve been topping up with bottles after each feed and only doing a bottle before bed and during one night feed. At night I wake up after 4 hours to pump. My questions are, how do I draw the line between pumping too much during the day or not enough? If my breasts feel semi full, so I need to pump or could I ever skip? What is the ultimate time to pump after a feeding? 30 minutes? If I wait more than 30 minutes, Is doing a quick 10 minute pump 1-2 hours after a feeding (or before if I wake up and she’s still asleep) going to create a foremilk and heindmilk in balance when we use the milk later? Thank you so much!
Hi there! I would probably err on the side of pumping too much rather than too little. I would pump as soon after nursing as you can, but maybe once or twice a day it’s probably okay to just nurse and not pump. But also you have to balance your mental health with it – so it’s really up to you.
Hi Amanda
I’m relieved to find this post and see comments from others – I’ve been triple feeding forever (5 weeks hah!) without knowing it was ‘a thing’!
My 8 week old has posterior tongue tie. We won’t be getting it snipped. I’m currently nursing with a nipple shield (still somewhat painful but I bear it). I was offering only one side at a feed for up to 60 mins (per advice of midwife) and pumping the other side for 20 mins. She’s not an efficient feeder so productive sucking perhaps amounted to 5-10 mins in that time. I’d then top her up with what I’d pumped from the other side.
The past few days I’ve instead offered both breasts, limiting her to 30-40 mins on the breasts, and then topping up while I pump for 20 mins. Not pumping at the same time means I focus on her (I had been focussing too much on the pump) and do more breast compressions. She has good productive sucking/swallowing now, but still takes really big top ups.
Overnight I don’t nurse – just pump when she wakes and partner bottle feeds (normally x2, sometimes x1).
The top ups she takes after nursing are substantial – minimum 60ml, up to 150ml. Making it seem she barely gets anything from the breast. I know the nipple shield plays a part.
My method had been to try to pump 7-8 times, but I realise now that my daytime pumps til now were only one side. I was aiming to pump more than her bottle intake each day, which I’ve done by an average of around 200ml over the last 10 days.
Now I’m pumping after every feed, trying to power pump before bed, only pumping without nursing at night, and will try to add another motn pump to do 2 if she only wakes the once (I simply couldn’t wake for the second one last night!).
I’ve been seeing an LC and will touch base with her again next week, at the mo our plan is to see if her tongue stretches out and latching may be an option again.
The more I’ve read on your site the last 2 days has just made me freak out a bit over my supply since I wasn’t pumping the 8+ times for 120, and it seems my supply may be regulating. Do you think my method is going to see us through – we may have to EP if she doesn’t improve at the breast. It’s impossible for me to add any more pump sessions in, I’m home alone while partner works and we have no help. I also have to be super hands on to get good output, so I feel like I’m neglecting her while I pump 🙁
Any insights or advice much appreciated!!xx
Hi Dani! First, congrats on your sweet baby and amazing work managing triple feeding for as long as you have!
So really quickly – the 120 minute rule is for exclusive pumpers, and you’re triple feeding. You’re also getting milk removal and nipple stimulation from her nursing, so the 120 minute thing doesn’t apply. so don’t stress about that! I don’t see anything wrong with what you’ve been doing at all. I would just keep doing what you’re doing, until you’re ready to switch to mostly or completely nursing or exclusively pumping. ❤️
Hi! When going from triple feeding to exclusively pumping, won’t that be half the stimulation which would decrease milk supply? For example, right now I do 30 minutes breastfeeding followed by 15 minute pumping. If I exclusively pump, does that mean I should pump for 45 minutes? Thanks for your help!
Hi Alexis! The stimulation is important, but milk removal is more important. If you can get the same amount from the pump that you would in breastfeeding and pumping in (for example) 25 minutes, I think that’s enough. The tricky thing is that it’s hard to tell how much milk is being removed when nursing. You could maybe do a few weighted feeds to get an idea? I hope that helps – good luck!
I stated triple feeding my son when he was 6 days old, and he was not transferring any milk. He had a pretty significant tongue tie, but getting that corrected didn’t immediately fix anything. He is now 5 months old, and we are still triple feeding. He had gotten much better at nursing, but I don’t think I will ever be able to trust that he is getting enough milk directly from me. He feeds 6 times a day. The only time I nurse without pumping and giving a bottle Is when he wakes up in the middle of the night.
I was triple feeding over a long weekend while I waited for a lactation consultant appointment. Turns out babe had some oral motor difficulties making it hard for her to eat. When our consultant suggested I continue to triple feed until we got an appointment with our oral motor therapist, I just started to cry, it was so draining and I couldn’t take anymore (plus baby was about 2 weeks old at the time and I was TIRED). She quickly offered me alternative plans and I’ve basically been exclusively pumping since: This site has been a godsend to help me figure this out (thank you!) as I did not expect to be pumping so early and was totally unprepared. I will offer the breast but not for every feeding. Sometimes she’ll take it and sometimes not. Sometimes she wants a bottle after and sometimes not. We’re nearing on 3 months now and it doesn’t seem likely for her to switch back at this point. I didn’t think I’d make it this long exclusively pumping, because even that’s tiring, but so far I’m hanging in there. Best to you mamas doing the triple feed!
Baby boy is 6 weeks and triple feeding due to weight percentile drop from 45% to 9% at week 2, now back up to 33%, gaining 1.5-2 oz a day!. Using a scale to check weight he is getting 1-2 oz breastfeeding 15 min each side. Then my husband feeds a bottle of expressed milk, usually 1-1.5 oz. then a bottle of formula, usually 2-3 oz. while he is bottle feeding I pump for next time. Total from bottle is around 3-4 oz, 7-8 times a day. I also try to work in a ‘power pump’ session once a day. Twice a week while my husband is at work the boy breastfeeds for several hours off an on with no bottles.
After three weeks of this I have seen my supply increase from around 2oz 8 times a day to around 3 oz 7 times a day. Including breastfeeding and pumping.
Boy seems to want around 4-4.5 oz 7 times a day, and I assume this will continue to increase?
How long should the triple feeding / power pumping routine take to see results? Just keep going until supply = demand? Is it possible there is just a genetic limit and I will never get there?
Appreciate any insights, tired and exhausted. Pediatrician and lactation consultant seem to say just keep up the triple feed, boy will ween off the bottle naturally when the breast supply is meeting his needs. Is that true, or do I have to make an effort to cut his bottles down at some point? He would be really upset!
hi there! Congrats on your sweet baby and on making it triple feeding for this long! Baby’s intake shouldn’t increase too much from here. It sounds like you’re doing great with supply. I don’t have any advice that’s different unfortunately. Do you think you could do some feedings that are nursing-only and some formula-only where you pump? I’m not sure if that would work with your supply but just trying to think of ways to get baby off the bottle over time.
My 10 week old is not gaining enough weight (between 1m and 2m she gained only 260g, and in the past 2 weeks she’s gained just another 200g). I have done weighed feeds to see if she’s getting enough milk and she eats between 100-160ml per feeding adding up to about 700-800ml per day. I’m wondering if triple feeding is the right move for us? She takes about an hour to nurse most of the time, so I’m concerned that she’s just having to work too hard/burning too many calories trying to get the milk out, and thought that maybe nursing for shorter periods and topping her up with a bottle would be a solution? We give her a bottle for her last feed every night and I have no problem with pumping, so I don’t think I have a supply issue. She seems happy and otherwise healthy, I’m just so concerned that I’m not seeing the numbers on the scale rising!!
Hi Amanda! I think it could be worth a try! Is your pediatrician concerned at all or no? ❤️
Yes, my pediatrician said since she dropped from 50th percentile to 20th percentile in a month that she’s a bit concerned. She basically said if she hasn’t improved her weight gain by her 3m appointment that she’d recommend we move to formula. I’d really like to continue breastfeeding if I can though, so I’m hoping that triple feedings for a week or so will help get her weight up but if not I’ll be considering exclusively pumping before making the move to formula.
Hi Amanda this is a great post I just had a couple questions for you on the triple feed. My son was born at 37 weeks but had some respritory issues and was in the NICU for 12 days. After the first week of him being in the hospital we were able to try and nurse he did ok but got tired really quick. But it was taking him so long to nurse that he wasn’t gaining anything from it so had to put it on hold till he got back up to birth weight. He is now two weeks old and the Dr gave us the go ahead to try nursing again. My question is how do I figure out how much to bottle feed him? How much time in between feeding sessions? Should I slowly add in nursing times or just jump staright to doing all day everyday tripple feeds? Thank you for your help!!
Hi Terra! Congrats on your baby! So I would bottle feed baby until he doesn’t want anymore. I would aim for 2-3 hours between sessions. Either way is fine with adding the nursing sessions – do what works best for you. Good luck!
We are currently triple feeding with our 10 week old, except instead of bottle feeding, I am using a supplemental nursing system after latching and solely breastfeeding as much as possible — and then pumping. It is EXHAUSTING and my supply has increased just a tiny bit, still not enough to fully breastfeed. Exclusively pumping is now becoming an interest as my sanity is worth it at this point. Thanks for posting this!
Good luck Ashley! Let me know if I can help!
No paci, if she falls asleep she is not awake and ready. She hasn’t gained weight just stayed stagnant for a week. She is 10 days old. Worried she isn’t getting enough through just breastfeeding so this I give her the bottle breast milk…
Hi! I do triple feeding and sometimes I get through all three steps and while my husband is feeding and I am pumping baby still fusses and acts like she wants to nurse more. I go back and nurse her after everything and then she will fall asleep. Sometimes this process takes me up to two hours and my dr recommended repeating the process every 3 hours during the day. So I just don’t know how to time everything! Any input or advise?!
Thank YOU!!
Jes
Hi Jes! Are you using a pacifier at all? Maybe that would help her fall asleep?
Another question – say she falls asleep at the two hour mark. Is she awake/hungry to eat again in an hour, or no? Also, how old is she?
I’m struggling with my milk supply. Doctor said try to supplement so I’ve bern doing that and pumping when I give her a bottle.
She is a week old.
Doesn’t seem satisfied after I nurse her. Heeellpppp.
Hi Rebecca! Have you seen a lactation consultant to help with the latch? That might help! How much milk is she is taking from a bottle?
How long did it take you to get off triple feeding? I have been doing it several weeks, because my 32-weeker now 3 weeks corrected always needs more in a feeding than he transfers (takes 60, needs 90 to be satisfied). I have only managed because both my partner and mother are also home with me, but Mom leaves next week and my partner goes back to work a few weeks after that. So far I haven’t spoken with anyone successfully got away from pumping most feedings earlier than 3-4 months, if at all. I’m just wondering if there’s *any* hope this might get better before my husband is back at work.
Hi Carrie! I did it for 1-2 weeks and then switched to exclusively pumping. I didn’t end up being able to nurse. Good luck – I hope you are able to switch to nursing quickly!
Hi! Thanks for a great post. I was wondering, once the issue is fixed (milk supply is up and baby’s weight issue sorted etc), how do you go about reducing amount of pumping to exclusively breastfeed? I don’t mind pumping some sessions, but doing it after every feed is exhausting, especially the night ones!
Hi Victoria – great question! So once the milk supply is up and your baby is taking enough milk from your breast, I would stop one pumping session at a time. So say you’re triple feeding 6 times a day – once you think baby can get everything they need from nursing and you no longer need to bottle feed – drop the pump/bottle feed step at each session 1 at a time. This gives to time to make sure your supply stays good and baby doesn’t need the bottle feeds anymore. Hope that helps!
Hi again Amanda,
Just wondering if you have a post about getting out and about with milk? It’s summer holidays and I need to get my older girls out to the beach etc… how can I take my milk out for the day, stored in the best way (chilled in a cool bag?) and then have a way to warm it (at the beach? In the park?) for my daughter to drink it a few hours later? Any top tips? Thanks!
Hi Anna! This might be a little complicated, but in the scenario you describe (the beach), where you don’t have access to hot water and it’s pretty warm out, I would keep the milk chilled in a cool bag until you need to use it, and bring hot water in a Thermos. When you’re ready to feed, stick the bottle in the warm water and hopefully within a minute or two it will be warm enough. Make sure the water is pretty hot when you put it in so it’s still warm enough to warm it on the beach.
In a scenario where it’s not so warm out (say, 60-75 degrees), I would just keep it in the diaper bag at room temp and feed it that way. Or, if you have access to a Starbucks or something, you can ask for hot water and warm milk in that. But neither of those will work at the beach so this is the best I could come up with. 🙂 Hope that helps!
I am triple-feeding right now. My baby (our third) is 9 weeks old, and I have chosen to triple-feed as she had some complications after birth that meant she couldn’t breastfeed effectively yet, and she was losing weight. I am nursing, pumping, and bottle feeding her a mixture of expressed milk and high-calorie formula. I am hoping as she gets bigger we will be able to move towards exclusive breast feeding. You are right this is exhausting and I am on the verge of burn out some days, especially with three trips to school every day for school and nursery drop-offs and pick-ups to fit in. Just taking one day a to time. I wish I could pump hands free like you mention, but I have to use breast compression/massage throughout as well as intermittent hand expression, otherwise I would get much less milk. It’s very full-on! Thanks for your articles on getting more milk. Appreciated those. 🙂
You are doing an amazing job! Congratulations on baby #3!