Triple feeding (nursing, pumping, and supplementing) might sound like a solid plan on paper. But for many parents, it turns into a nonstop cycle that’s physically draining, mentally exhausting, and emotionally overwhelming.

In this Follow-Up episode, Dr. Mona talks with lactation consultant and author Victoria Facelli about why triple feeding is often recommended, why it’s not always sustainable, and what we should be doing instead.

They discuss:

• The real reason triple feeding gets suggested so often (even by well-meaning pediatricians and lactation consultants)

• Why it can feel like torture and rob families of sleep, sanity, and bonding

• How to protect both milk supply and mental health

• What responsive feeding really looks like—and why connection matters more than perfection

This episode originally aired in honor of World Breastfeeding Week, and it’s here to remind you: feeding your baby shouldn’t mean losing yourself.

Check out Victoria’s book (now available in paperback) ⁠Feed the Baby: https://www.amazon.com/Feed-Baby-Inclusive-Bottle-Feeding-Everything/dp/1682689662/ref=tmm_pap_swatch_0⁠

Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and⁠ ⁠subscribe to PedsDocTalk⁠⁠.

Get trusted pediatric advice, relatable parenting insights, and evidence-based tips delivered straight to your inbox—join thousands of parents who rely on the PDT newsletter to stay informed, supported, and confident.⁠ ⁠⁠⁠⁠Join the newsletter⁠⁠⁠⁠⁠!

And don’t forget to follow⁠ ⁠⁠⁠⁠@pedsdoctalkpodcast⁠⁠⁠⁠⁠ on Instagram—our new space just for parents looking for real talk and real support.

We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the⁠ ⁠PedsDocTalk Podcast Sponsorships⁠⁠ page of the website. 

00;00;00;00 – 00;00;22;26

Dr. Mona

Hello, it’s Doctor Mona and this is the follow up. Your Monday parenting reset in less time than it takes to triple feed. Because if you’ve done that, you know that bar is pretty low. We’re rereleasing this episode in honor of world breastfeeding Week, which runs August 1st through the seventh. Because if there’s one thing we need more of during that week, it’s honesty around breastfeeding.

 

00;00;22;28 – 00;00;46;11

Dr. Mona

Today’s episode hits close to triple feeding, nursing, pumping, and supplementing. Sounds like a plan until you’re in it. I used to recommend it. I even did it myself after being hospitalized twice postpartum. I had help and it still broke me. That cycle nearly took me out and I knew I had to talk about it. So I brought on Victoria Facelli, IBC, LC, and author of Feed the Babies.

 

00;00;46;18 – 00;01;06;25

Dr. Mona

So you have to get this book to unpack how triple feeding became the go to, why it’s not sustainable, and what actually supports feeding, sleep, mental health and supply. If you’ve ever felt like a full time feeding machine with no off ramp, this one’s for you. And hey, if you’re liking these follow ups, take a second to subscribe and download.

 

00;01;06;26 – 00;01;25;16

Dr. Mona

You helped shoot us up to number two on the parenting podcast charts in the US for a whole week, and that only happens when you keep tapping that subscribe button and those download buttons. Let’s press play on this episode.

 

00;01;25;18 – 00;01;34;00

Dr. Mona

What is your personal and professional experience with Triple Feeding and why? You know, using that term, why do you hate it so much?

 

00;01;34;03 – 00;01;53;04

Victoria Facelli

I think part of what’s really important to me is to remember that providers are people and they have a lens, right? So like when you were just a pediatrician, you had this lens of like, you’re really looking at the baby, you know, like you’re looking at the whole family, but like your patient, you’re vaccinating that patient. You’re weighing that patient.

 

00;01;53;04 – 00;02;19;19

Victoria Facelli

You’re like making sure that that patient is healthy. And so and then understanding also like what someone’s scope what someone’s education. Right. So as a pediatrician your scope is like newborn all the way to 18. Right? You’re doing everything from like puberty and hormones and broken bones and RSV and all of that stuff and even feeding, which really to do well takes two hours and that.

 

00;02;19;19 – 00;02;45;21

Victoria Facelli

Yes. And years of training. Right. So we have to also understand that our pediatricians aren’t necessarily experts in infant feeding. Yes, they’re experts in growth curves. They’re experts in baby like assessing if a baby is healthy and well, and they’re such a great resource to talk through things with like. Right. They’re sort of like the head of this larger team.

 

00;02;45;24 – 00;03;14;25

Victoria Facelli

But I think what really gets me with triple feeding is that when a pediatrician sees a baby who’s not gaining weight, well, it is often the only tool they have. You know, like, I know I need to protect production, like milk production. I know I need to get this baby gaining weight. I do not have the time and nuance to really figure out why this is happening and what is happening, but but pumping plus formula feeding plus offering nursing.

 

00;03;14;25 – 00;03;51;21

Victoria Facelli

Like maybe we just do everything like it’ll work at that. And that is understandable and without nuance, right. Like I understand why that’s the easy first place to go. Yeah. But what often doesn’t get talked about. So like there’s different people who might recommend triple feeding. The first one is pediatricians. And where I often see the problem, there is not getting to the why.

 

00;03;51;24 – 00;04;11;14

Victoria Facelli

Like is there a plan to figure out the why. Like if a baby is not transferring is it a supply issue. Is it a ten time. Is it a like torticollis. Like a body issue where a baby’s holding tension in their body? Are they like, do they have an allergy? Like, those are pretty rare, but like, are they not absorbing?

 

00;04;11;14 – 00;04;33;22

Victoria Facelli

Well, like, we actually have to get into that. Why? And since half of that equation is not your patient, it’s very difficult to get into that. Why? A lot of the time. Yeah. And there’s not time. And they don’t like see our kiddos as often as other providers do. So that’s like one piece of it is just sort of the idea of like, I don’t know, let’s just do everything.

 

00;04;33;24 – 00;04;55;01

Victoria Facelli

You’re right, and then you’re left with no plan. And then I also see lactation consultants recommending triple feeding. And that comes from a different angle. So I feel like pediatricians are recommending triple feeding because they want to protect a baby’s growth. Right. That’s why my book is called Feed the Baby. Like that’s our rule right. First feed the baby.

 

00;04;55;06 – 00;05;16;26

Victoria Facelli

We don’t do anything else til that baby’s fed right. Right. Like I work in a tongue tie clinic one day a week. Like if a baby is not gaining weight. Well, and I don’t have permission from their pediatrician weight wise, I’m not touching that kid. Like, first we feed the baby. So that’s their perspective. And then I think a lot of lactation consultant are so fixated on nursing.

 

00;05;16;29 – 00;05;51;12

Victoria Facelli

That they can’t let that part go. So ideally they’re working interdisciplinary. They’re looking really closely. They’re trying to figure out like the why of that baby’s low transfer. But in the meantime they’re so focused on direct nursing being important or milk production being important that they’re a little stuck to. And so where I get in there is I really am zoomed out to like, okay, there’s two patients or more in front of me, right?

 

00;05;51;12 – 00;06;22;21

Victoria Facelli

In the case of multiples, maybe more, but we’ll start with two patients in front of me and actually often a third if I’m including a partner. Right. Or sometimes like a sibling who has a lot of needs. Right. So like I’m shooting at like a whole family because as soon as we start triple feeding we’re taking up all the resources, we’re taking up all the time for showering, all the time for connecting with an older sibling, all of the time to walk the dog all of the time to talk to your mom on the phone, all of the time to sleep.

 

00;06;22;21 – 00;06;45;27

Victoria Facelli

Most importantly, and we’re putting it all towards feeding that baby. And one of the things I talk about is that, like, I don’t believe that breast is best. I don’t believe that breast milk is inherently better because you can’t generalize like that. Every choice we make has tradeoffs, and we cannot assume that we know those trade offs for another individual.

 

00;06;45;29 – 00;07;10;08

Victoria Facelli

So when we decide that we’re going to triple feed and we don’t acknowledge those trade offs, that is where I get protective. Yeah. And to my experience of triple feeding. So when I was in practice, I would just like see families who were just undone by triple feeding. And I was like, we gotta do something about this. Like, this is horrible.

 

00;07;10;08 – 00;07;28;06

Victoria Facelli

Like we are torturing these people. Like sleeplessness is used as torture. Like you can actually torture someone by not letting them sleep. Yes. And so if we tell them the most important thing you can do for the health of your child is breastfeed them.

 

00;07;28;09 – 00;07;32;13

Victoria Facelli

Which in the way I read the literature is a little heightened.

 

00;07;32;16 – 00;07;34;13

Dr. Mona

Yes.

 

00;07;34;16 – 00;08;02;26

Victoria Facelli

And then we’re like. And in order to achieve that, you’re not allowed to sleep. You’re like, well, this is my the most important thing in my life. I love this person more than anything I can possibly imagine. I would do anything for her. I’m going to completely sacrifice myself. And so what often gets recommended is that you do a system where first you offer nursing, then you pump and give them a bottle either of what you’ve pumped and or additionally formula.

 

00;08;02;26 – 00;08;18;22

Victoria Facelli

Right. So the idea being that the pumping is protecting your supply. Wow. The supplemental bottle is making sure we’re seeing food go into that baby to protect that. We know they’re gaining weight. And then the problem is yeah yeah. We don’t have a plan to get.

 

00;08;18;22 – 00;08;21;09

Dr. Mona

Off that road. Yeah.

 

00;08;21;11 – 00;08;41;27

Victoria Facelli

And often, like if a baby is not eating well, that means that you’re either spent, you’re often spending a lot of time trying to get a baby who doesn’t want to latch to latch, or nursing a baby who can’t effectively suck anyway. So it’s taking a really long time, and or it’s causing tissue nerve damage and pain. Yeah, right.

 

00;08;41;27 – 00;09;07;21

Victoria Facelli

So like we’re doing something that’s not working for hours on end. Like sometimes, you know, it can take an hour to get a baby who’s really struggling to latch and do some amount of nursing prior to pumping for 45 minutes. And then depending on your comfort level with cleanliness, where you live, the water quality of where you live, your washing pump parts in between that every time sterilizing things.

 

00;09;07;21 – 00;09;27;28

Victoria Facelli

Depending on where you live in the United States, you do not need to sterilize your pump. Parts you do in Europe just need to say that forever, right? Yeah. So the first step in dismantling triple feeding. So triple feeding is just like this blanket recommendation that’s like around the clock do a process that takes give or take two hours and please.

 

00;09;28;04 – 00;09;41;14

Victoria Facelli

And then also sometimes these babies don’t take bottles super easily. So a bottle is also taking an hour. We don’t have parental leave. Our spouses are back at work. Our kid may be is in after school or older. Kid like this is coming.

 

00;09;41;20 – 00;09;45;00

Dr. Mona

Let’s endless hours I mean like exactly.

 

00;09;45;03 – 00;09;47;22

Victoria Facelli

Easy. Yeah. And they’re like, by the way, cannot do.

 

00;09;47;22 – 00;10;05;21

Dr. Mona

This every three. Yes, yes. Because they’re going to wake up in an hour like it’s like it’s, it’s if you do not have help, it’s already hard. But even if you have help, which I did and I did the triple feeding journey for Veera after being hospitalized twice, I was in the hospital, left and was readmitted to the hospital.

 

00;10;05;28 – 00;10;23;08

Dr. Mona

And after that second readmission, I was like, I can’t do this. It’s not sustainable. And in a miraculous way, she was actually a really good lature unlike she, even with the separation. And I was shocked because I was apart from her for ten days when I was re hospitalized and I came back to and it’s like she remembered.

 

00;10;23;10 – 00;10;46;10

Dr. Mona

But then it was still becoming that my supply was so low because I wasn’t able to build it up because of the hospitalization that I needed better, like I needed more frequent removal. And it was I needed the combination and it was not minimal. So I had to make a decision with my colleague. Lactation consultant. I was like, listen, I love this, but it’s not it’s not fun for me anymore.

 

00;10;46;10 – 00;11;04;26

Dr. Mona

Like I’m like you said, looking out for the mental health. I am drained by being a I’m going to use the term being a cow where I’m literally nursing, and then I have to sit there and pump on the other side or whatever side or at right after you’re. Yes, I had help with cleaning pump parts, but then someone had to settle the baby down and then she was maybe clustering.

 

00;11;04;26 – 00;11;06;09

Dr. Mona

It was the I.

 

00;11;06;09 – 00;11;09;19

Victoria Facelli

Had to let go. And you’re not getting any nice time with her.

 

00;11;09;21 – 00;11;40;07

Dr. Mona

No. So you’re not. And that’s a key for me, too. I’m like, when we talk about feeding choices and the mental health choices, what’s most important to me is obviously that the baby is thriving, but that what is the connection and bonding I would rather have a mother give or family give, pump, breast milk or formula and be more connected with their baby than being so stressed with the nursing or so stressed with triple feeding or combo feeding, because that stress has no place in sleep and that stresses no place in bonding with the baby.

 

00;11;40;11 – 00;11;41;03

Dr. Mona

Yeah, I saw that.

 

00;11;41;03 – 00;12;03;09

Victoria Facelli

So it’s funny. Yeah, yeah. If we let it be like if we let health only be one thing that we like, I see a decline in dry skin and dry infections with breast milk feeding. Right. But we’re not thinking about attachment at all. Yeah, right. Like for me it’s like, yeah, feed the baby. Like they got to be calorically in good hands.

 

00;12;03;09 – 00;12;06;29

Victoria Facelli

And then right after that is responsiveness.

 

00;12;07;01 – 00;12;07;28

Dr. Mona

Yes.

 

00;12;08;00 – 00;12;19;28

Victoria Facelli

Can you tell when your baby is hungry? Can you tell when your baby is full? Are you meeting that need because it’s that connection that’s like that’s what carries you all the way through parenting.

 

00;12;20;01 – 00;12;20;24

Dr. Mona

Yes.

 

00;12;20;27 – 00;12;24;05

Victoria Facelli

I don’t care if you sleep train. I don’t care if you bed chair. I don’t care what you do.

 

00;12;24;06 – 00;12;25;05

Dr. Mona

Yes.

 

00;12;25;07 – 00;12;51;04

Victoria Facelli

It’s the responsive harness that holds you. Yeah, that makes us feel connected. That makes us feel human. That is the beauty and joy of parenting. Yeah. And if we take that away from people and then also, like, sometimes if a baby’s struggling to eat, they’re so exhausted from nursing and then bottle feeding that they don’t want to wake up at the three hour mark.

 

00;12;51;04 – 00;13;05;29

Victoria Facelli

So then you’re spending 30 minutes waking them up? Yeah, 45 minutes trying to get them to latch, an hour pumping and like washing pump parts and getting settled to bed. And when exactly in that did you eat a sandwich?

 

00;13;06;02 – 00;13;34;17

Dr. Mona

Yes. Oh. Or just right. Yes. Or take a shower or do something that is possible. But we we when we do this narrative of it has to be the baby in the feeding and all of that, you don’t you forget yourself. And that’s why we see depression. That’s why we see anxiety. That’s why we see women lose themselves so greatly in this postpartum period and lose the joy.

 

00;13;34;19 – 00;13;55;29

Dr. Mona

And that’s your follow up. Just a small dose of the real, relatable and eye opening conversations we love to have here. If you smiled, nodded, or had an moment, go ahead and download, follow and share this episode with a friend. Let’s grow this village together for more everyday parenting wins and real talk. Hang out with us on Instagram at the PedsDocTalk podcast.

 

00;13;56;06 – 00;14;11;20

Dr. Mona

Want more? Dive into the full episode and more at PedsDoctalk.com. Because parenting is better with support. And remember, consistency is key. Humor is medicine and follow ups are everything. I’m Doctor Mona. See you next time for your next dose.