The third breast

What do I do if my baby won’t settle after a bottle of supplement?

Sometimes babies are unsettled, but not hungry after feeding on both breasts and then receiving extra milk or supplement. They need comfort, not more milk. One solution is to return the baby to the breast (the “third breast”) for a few minutes. After that, the baby is usually awake and happy or has fallen asleep at the breast. If mothers do not use the third breast and the baby is unhappy, they sometimes give the baby more supplement, which can result in overfeeding, or they offer a pacifier, which can cause other problems. If the baby is still unhappy after breastfeeding on the third breast for a few minutes, the baby may need more supplement.

A) Describing the third breast

If a baby is not breastfeeding effectively, mothers need to supplement the baby with milk after breastfeeding. Having a low milk supply milk supply is one common example. However, the baby may be unsettled after the supplement, particularly a supplement of bottled milk.

The feeding may look like this:

  1. The baby starts the feed on the first breast (the right, for example).
  2. The baby finishes the feed on the second breast (the left).
  3. The baby receives the supplement by bottle or other feeding tool such as a cup or by finger feeding.

After the supplement, the baby:

  • Will have taken in the appropriate amount of milk supplement.
  • Is no longer actively sucking on the bottle or taking in extra milk.
  • Is not happy when the bottle or other device is taken out of the mouth.
  • May act tired or whine.
  • Does not showing hunger signs.

Such babies can be settled by offering the first breast (the right one in this example) for a few minutes. We call this the “third breast.” 

When given the third breast, the baby will:

  1. Breastfeed for a few minutes.
  2. After that, the baby will:
    1. Be happy when held.
    2. Or have breastfed to sleep.

B) Reason for a third breast

The third breast is given primarily for comfort, not for milk. Babies often need a little more comfort than can be given by the bottle or some other supplementing tools. Returning them to the breast creates a warm, comfortable, and familiar environment.

This additional time at the breast can help to stimulate more milk production.

C) Risks of not using a third breast

If the third breast is not used and the baby is unhappy after a supplement, mothers sometimes give the baby more supplement, which can result in overfeeding, or they offer a pacifier, which can increase the risk of other problems. Using the third breast to settle the baby is effective at preventing overfeeding and can eliminate the need for a pacifier.

Pacifiers are appropriate to settle babies who cannot latch onto the breast. They can also be rocked, held, bounced, or walked.

D) Risks of using a third breast

Mothers need to ensure that the baby is getting enough milk. If the baby is still unhappy after breastfeeding on the third breast for a few minutes, the baby may need more supplement.