The arrival of our newborn twins was a blur of bottles, diapers and breast pump parts. Five days after having a cesarean section, I was full of emotions because my breast milk still hadn't let down. After the doctor weighed my babies, they'd lost more weight despite their good latch and me constantly putting them on to nurse.

"I think it's time to give them formula," the pediatrician told me. This wasn't my plan.  

As a Black mom, breastfeeding isn't as normalized for us because of the lack of Black representation in most breastfeeding ads, product images and discussions regarding nursing mothers. I'd determined that I would help tip the scales by taking breastfeeding classes and being open about nursing my babies. So, this advice felt like a stab to my breastfeeding dreams, but my babies needed to eat.

Later that same day, my milk let down — and it was strong. So strong that it came out too fast, causing both twins to throw it right back up. Every time! But what could I do?

I had three major concerns: I wanted my husband to share in feeding our children, I wasn't sure how much of my milk they retained after spitting up (which was literally after every meal) and I was afraid they would lose weight … again. So I chose to give triple feeding a go. Triple feeding is a combination of breastfeeding, pumping and bottle-feeding pumped milk or formula. 

In some cases, it can help moms and babies. But I made a lot of mistakes — decisions that I thought were right at the time that really just made things harder on myself. Here's how and when to try triple feeding (and when to stop), according to feeding experts. 

What is triple feeding?

 It's essential to understand what triple feeding is before you start. It usually involves: 

  • Feeding your baby at the breast for 15 to 20 minutes per side (or until audible or visual swallowing has stopped) 
  • Pumping for 10 to 15 minutes afterward for adequate stimulation, even if milk is not expressed. 
  • Bottle-feeding any collected milk or formula to the baby. 

This process is then repeated eight to 12 times per day. For me, it was very tedious.

What are the benefits of triple feeding? 

While triple feeding takes lots of physical and emotional energy, there are some upsides, especially if your baby hasn't gained much weight and you're not sure why. 

"This method buys time for both mother and baby to figure things out," says Ashley Georgakopoulos, a certified lactation consultant.

It's an opportunity to identify common breastfeeding problems like poor latch or tongue-tie and resolve them while increasing milk supply

Additionally, it allows you to share feeding responsibilities with your partner or other caregivers who can help. My husband, for example, would step in and give me moments of relief.

When is triple feeding recommended?

Your pediatrician may recommend this feeding method to:

  • Help your baby gain weight
  • Combat ineffective suck and latch
  • Allow skin-to-skin stimulation to maintain or build milk supply

What is triple feeding really like?

If I had to sum up my triple feeding experience in three words, they would be: stressful, time-consuming and exhausting. I was in a non-stop cycle of breastfeeding and pumping. Not only was I physically tired, I was emotionally spent. 

As a brand-new mom, I did my best to care for my babies, but I didn't feel like I was doing enough, especially after they lost weight early on. My biggest fear was that they weren't eating enough, and I blamed myself every time they spit up, wondering what else I could do. 

So I worked overtime on the pump to provide as much milk as possible. I barely focused on caring for myself, like drinking enough water and using the restroom.

A week later, I was in the emergency room, dizzy and dehydrated. I didn't go into triple feeding with a clear plan, which should have included a stopping point and managing self-care. 

Triple feeding multiples

Right out the gate, I knew my breastfeeding experience would be unique. I had to produce enough for two babies who both had issues with holding down breast milk and formula. And since I didn't tandem nurse initially, this process took nearly double the effort.

I would nurse one baby, then nurse the other, pump, then make their bottles. But I didn't know how long I would or should do this, and it became too taxing.

If you have multiples, you can try tandem feeding to cut back on some of the time, and don't feel pressured to breastfeed exclusively. 

"One can also breastfeed and then supplement with formula or just give formula if it works best for their family," says Tina Feeley, M.D., M.PH., a pediatrician at Chestnut Hill Pediatrics and a member of the What to Expect Medical Review Board

Tips for triple feeding

Triple feeding is difficult to sustain. Before starting, moms should:

Create a plan

If you're considering triple feeding, talk to your pediatrician. You should make a decision about triple feeding knowing it's just one option of many. 

"It is important that mothers do not feel pressure to do this if it is causing them to not enjoy motherhood or bond with their baby," Dr. Feeley says. "I would only recommend this if a mother is very motivated to breastfeed, and it is not affecting her mental health." 

Set a stopping point

Triple feeding is not a long-term solution. Any plan you make should include an agreed-upon time that you will stop triple feeding (unless you need to stop sooner).

Andrea Syms-Brown, a certified lactation consultant, highly recommends that moms do not triple feed beyond 72 hours because this method can tax everyone involved. Instead, it should serve as a temporary solution while you, your doctor, midwife and/or lactation consultant resolve any feeding issues.

"Once the baby begins to gain weight appropriately and become more proficient at eating, the cause behind the initial challenge can be quickly determined, addressed and, in many cases, overcome," Syms-Brown says. 

Prioritize self-care

Take care of yourself as much as possible between feedings. Drink plenty of water. (Seriously, don't stop.) Let others help by washing bottles, sterilizing pump parts or bottle-feeding the baby.

Monitor your mental health

Don't feel bad if you need to stop breastfeeding for your mental health. In these precious moments, it's important to get the support you and your baby need, and choose the feeding method that works best for both of you.