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Relactating: Restarting Breastfeeding

Relactation – Restarting breastfeeding after a gap / After Adopting a new child

What is relactation?

Relactation is how a woman can re-establish breastfeeding after a period of very little or no breastfeeding. She may have not breastfed for several days, weeks, months or years. Or even a new mummy who has just adopted a new baby and has never breastfed before called induced lactation. This is to induce lactation artificially typically for adoption.

Who would do it?

Mummies who have stopped breastfeeding earlier than they wanted or changed their minds.

Your baby might have been weaned from the breast, but since developed an intolerance to formula.

Mummies who might have been separated from your baby or your baby might have been ill.

Mummies who may have adopted a baby and want to re-start your milk supply to breastfeed him/her.  A woman could also breastfeed an adopted baby if she has never breastfed previously or has never been pregnant – this is called ‘induced lactation’.

You may want to help a sick friend or relative by breastfeeding her baby.

How likely is the mummy to succeed?

There isn’t a lot of research on relactation, but the studies that have been done suggest that, with proper support, most mothers can partially or fully relactate.

Some mummies were very fortunate. They can go from expressing a couple of drops of breast milk to a full supply AND get their baby back to the breast. It can range from a month to 4 months for some, but with lots of determination and effort, it is well worth it.

How is it possible?

Nature is a very clever thing. Breast stimulation alone sends important hormonal signals to switch milk production back on. It is a common misconception that once a woman’s milk has ‘dried up’, she can no longer breastfeed. However, this isn’t the case! Grandmothers have been known to relactate to feed their grandchildren!

How do mummies do it?

Learning the basics of breastfeeding is a great place to start. Breastfeeding works on a supply and demand basis, so the more the baby feeds and the breast is stimulated, the more milk the mother produces.

Learn how to recognise if your baby is getting enough milk. Is he producing six wet nappies in 24 hours and if under five weeks, is he pooping three or more times a day? Is he gaining weight?

If the baby will latch onto the breast:

Try to put the baby to the breast as often as possible (every 2-3 hours at least). Even before any milk is being produced, nipple stimulation will release the hormone prolactin which encourages the growth of breast tissue.

Learn how to recognise a good latch. A baby that latches on effectively will stimulate your supply in a way that a baby latching on poorly won’t. Has the baby got a nice wide-open mouth? Is it pain-free? If breastfeeding feels uncomfortable, do get support.

Ways of stimulating your milk supply whether or not the baby will latch on:

  1. Skin to skin time: Even if the baby isn’t feeding, have skin-to-skin time. Keep the baby on or close to your body as much as possible. This will stimulate the release of hormones needed for milk production and encourage the baby to feed. You could try wearing the baby in a sling. You can bottle-feed skin-to-skin and near the breast
  2. Good Grade Pump: Use a pump or hand express for 10-15 minutes on each breast several times a day. Ideally, at least eight times in 24 hours. Don’t worry about how much (or little!) milk you can express. The nipple stimulation itself will be stimulating your body to produce more milk for the future. Some mums choose to hire hospital-grade double electric breast pumps but this may not be necessary. If you are pumping frequently, remember that you don’t need to wash and sterilise the pump each time. You can store the pump in the fridge in a plastic bag between sessions and just wash it thoroughly once a day.
  3.  Supply and demand: You may get milk immediately, but if you don’t … don’t give up! The volume of milk will increase when the baby starts to feed directly from the breast and as time goes by. It may only take some women a few days to develop their supply. Others pump for several weeks before they see a significant increase in their supply. Everyone responds differently to the process of relactation so it’s very difficult to give a definite timeframe. If a baby will latch, you could also express directly after and /or between feedings. Expressing when the breast is emptier sends particularly valuable signals to the breasts to produce more milk. You may be able to find some time in the day when you ‘cluster pump’ and pump for ten minutes, break for 5, pump for another ten and repeat that a few times. Pumping should be pain-free. If your baby is happy to latch on and stay on the breast, it may not be necessary for you to pump at all. Power pumping is a good way to increase milk supply.
  4. Hydrate: Don’t forget to drink lots of water and have enough rest. A good well-rested machine then can produce a good product right?
  5.  Lactation Supplements: Take cookies, muffins, herbs or even medication (called ‘galactagogues’) to stimulate the hormones that govern their milk supply. Eat food that boosts milk will help too. By finding your milk booster, you will need to trial and error as the different body reacts differently to different food.

Continuing to feed other kinds of milk

It is likely that while you are building up your milk supply and getting the baby used to feed at the breast, you will also be feeding the baby formula. If you are using a bottle, you may want to consider using a technique called ‘baby-led bottle feeding’ (sometimes known as ‘paced bottle feeding’) which may help your baby transition to the breast. This slows the flow down and requires your baby to work a little harder.

Helping the baby to accept the breast

The baby may become frustrated by feeding from an empty breast at first, so you could try hand expressing enough (or pumping just for a moment) to trigger milk flow before putting the baby to the breast.

You want the baby to associate pleasure with being at the breast, so anything you can do to avoid making breastfeeding a battleground will be useful. It’s better not to ‘force’ the baby into a breastfeeding position but to gently enjoy time skin-to-skin and present opportunities. You could hand express some drips of milk or trickle milk into the baby’s mouth.

A baby may prefer to breastfeed when they are not desperately hungry or at certain times of the day. Especially when your baby is younger, spending time holding the baby tummy-down on your semi-reclined body will trigger innate feeding behaviour.

You could consider the use of a nursing supplement. This delivers milk from a bottle through a fine plastic tube that enters the baby’s mouth along with your nipple. This may help stop any frustration the baby might show at the breast and ensure that your breasts are stimulated to produce milk further.

A baby that is very accustomed to the bottle may accept the breast using a nipple shield but this is best done with the support of a breastfeeding counsellor or lactation consultant.

Things to consider:

Why did you stop breastfeeding in the first place? You might want to consider talking with a breastfeeding counsellor, lactation consultant or peer supporter before embarking on your journey to give it another go.

There may be changes in your body. There may be a change in your menstrual pattern as the baby nursing will affect your ovulation. Your breast may physically change in appearance too, the areola may be darker or the breast may be tender or feel full. Due to the hormone changes, you may feel emotionally different. Support is a great help if you are feeling any of these feelings but it is normally a sign that your body is starting to produce milk again.

Remember that if your baby will latch but you are not able to return to a full milk supply, they will still receive important benefits. And if you work hard to increase your supply but your baby is reluctant to latch, they can receive this expressed milk. That is still a valuable achievement.

Relactation may be difficult and time-consuming at times, but it IS possible. With the right support, information and dedication, relactation works for women every day and produces happy and valuable results. Confidence and self-belief will help you on your journey.

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