You’ve heard of breastfeeding, you’ve heard of bottle feeding, but what about 3-STEP FEEDING? 3-step feeding is when a lactating parent nurses their baby, then pumps, then bottle-feeds using the freshly pumped milk. It’s a strategy to help ensure the baby is getting enough to eat and the lactating parent is stimulating enough milk production, and it’s appropriate to try when there is a concern about the baby’s weight gain.
3-step feeding has a few things to recommend it: It supports a diet of exclusive breast milk for the baby. It boosts stimulation for milk production in the lactating parent. And it helps get extra ounces of milk into the baby, which is just what they need in order to gain weight and grow.
But 3-step feeding is also a grueling lifestyle (yes, it’s pretty much a whole lifestyle) that shouldn’t be undertaken lightly. Consider that newborns need to eat every 2-3 hours, and nursing alone can take 40 minutes. Then another 20+ minutes of pumping, and the time it takes to do a paced bottle feed. By the time you’re finished, you may only have 30 minutes until it’s time to start over. Meeting basic needs like sleeping, eating, and showering becomes difficult by the end of the first day. Setting aside the logistical challenges, 3-step feeding puts additional pressure on the lactating parent and can eclipse the lovely, snuggly bonding experience of feeding a newborn.
So when considering 3-step feeding for a family, I recommend at least 3 criteria be met:
- There is a valid reason to be concerned about baby’s weight gain, the parent’s milk production, or both.
- There is an action plan in place to identify and correct the root cause of the issue – delayed mature milk arrival, oral tie in the newborn, not nursing frequently enough, ineffective latch, etc.
- There is a SHORT timeline around 3-step feeding (one IBCLC I spoke with recommended a maximum of 72 hours); a clear “finish line” for all concerned, after which it will be time for a new plan (hopefully with the root cause from #2 corrected).
Three-step feeding can be a literal life-saver when a baby is struggling to gain weight; I don’t discount its value under the right circumstances. However, nothing raises my suspicions faster than a birth facility routinely recommending 3-step feeding to postpartum families, “just in case.” This is a practice that quickly leads to exhaustion and misery, not to mention confusion and loss of faith in normal breastfeeding. If your provider recommends that you try 3-step feeding, ask them what the concern is. Ask what will be done to identify the root cause. Ask what the timeline is. And if you try it, and hate it, know that it’s ok to change the plan.