By Valeria Baena – Colombia 

Do you dream of getting your formula-fed baby back to breastfeeding at your breast, but the milk is no longer flowing? Consider relactation! Relactation refers to the process of reestablishing milk production in a parent who never initiated breastfeeding after being pregnant or who has stopped breastfeeding either by choice or because baby is no longer nursing. 

Want to get your milk flowing again after a dry spell? Some mothers choose to relactate with the goal of getting a baby who takes formula in a bottle to return to nursing directly from the breast, while others choose to relactate in order to provide their own milk in a bottle. In this article, we will explore some strategies for getting a bottle-fed baby whose mother is no longer making much or any milk to return to feeding directly from the breast. 

Each situation is unique, and what may work for one family may not work for another. If you can, schedule a visit with an International Board Certified Lactation Consultant (IBCLC) to develop a specific plan for meeting your breastfeeding goals, while keeping in regular contact with a La Leche League Leader. Discuss your health history, reasons for discontinuing breastfeeding previously (to help prevent those reasons from being a hurdle again!), and any medications you are on. Bring this article with you to the appointment so that together, you can determine which of these 10 strategies apply most to your specific situation.

1. 1. Encourage the baby to take the breast by offering it when baby is half asleep or relaxed, and not very hungry. Offer the breast while you walk, and in the shower or in the tub.Spend a lot of time with your baby in your arms, or in a rocking chair with you. When working around the house or heading outdoors, you can also use a baby carrier to keep baby close. Skin-to-skin contact is comforting for both of you and encourages babies to latch on and nurse more efficiently.
   2. Spending time with other breastfeeding families can encourage your baby to resume breastfeeding. Your local La Leche League meeting is a perfect place to do this!
   3. Offer your breasts during feedings and for comfort between feedings as often as possible. Always offer, never force. Trying to force a baby to latch is rarely effective and can create a negative association for the baby. When there is little or no milk flowing from the breasts and baby is being fed by bottle, offering the breast after bottle-feeding can be a more positive experience for baby.
   4. If the baby falls asleep and/or stops suckling, use your hand to get more milk out of the breast and into the baby. With your hand forming a “C” shape, press on the breast firmly, but not so hard that it hurts. These are called breast compressions.
   5. Avoid using a pacifier while trying to increase your production. This encourages baby to comfort at the breast.
   6. Try to sleep during the day when your baby sleeps — on a safe surface close to you (just be sure to follow safe sleep strategies: https://llli.org/breastfeeding-info/sleep-bedshare/). And look for help! Relactating requires a lot of energy, so you have to take care of yourself. Fatigue, sleep deprivation and stress can interfere with let-down.
   7. The key to resuming milk production is frequent and effective breast emptying. Breast emptying can happen by breastfeeding baby, using a breast pump, or hand expressing. Oftentimes, mothers will use a combination of these tools. (Frequent means at least eight times per day. Effective means that both breasts are fully emptied.)
   8. Supplement breastfeeding in a way that reinforces successful breastfeeding. If baby is able to latch and nurse from the breast, the most effective way to reinforce breastfeeding is to exclusively feed at the breast using a nursing supplementer, a device that delivers formula or expressed milk through a tiny feeding tube at the nipple as the baby nurses. If baby is primarily feeding at the breast and just requires a small amount of supplementation, a spoon, a little cup or needleless syringe can be a practical solution. If baby still requires a lot of supplementation, another alternative is to use bottle teats and bottle feeding techniques that support breastfeeding: a narrow-width slow flow teat and holding bottle as horizontal as possible so that baby must do the work of transferring the supplement without the help of gravity.
   9. If baby is interested in actively suckling and you know your supply is increasing, you can gradually reduce the amount of supplement. Many parents find that they can safely decrease supplementation by very small amounts, up to 1-2 ounces (30 to 60 ml) overall per day or every other day. Keep an eye on your baby’s wet and dirty nappies, his disposition after and between feedings, and on his weight gain, so you know that he’s taking plenty of milk.
   10. Consider using a galactagogue—a medicine or a natural ingredient can sometimes help increase milk production. To find out which galactagogue might be the best option for you, talk to an IBCLC or a La Leche League Leader to find out what others have found helpful in situations such as yours. Remember though that taking a galactagogue does not cause milk production solely by itself. Only regular and frequent breast stimulation, along with emptying the breast, drives milk production. Galactagogues may only enhance effectiveness of these techniques, and do not work in all situations.

Good luck!

A La Leche League Leader, Valeria co-leads a La Leche League group in a large hospital in Bogotá, Colombia (South America), while also supporting La Leche League through administrative work. The mother of two children, Valeria combines her passion for supporting breastfeeding families, with her love for literature and reading promotion.

 

Induced Lactation versus Relactation: What’s the difference?

Experts refer to induced lactation as the process of establishing a milk production without a recent pregnancy, such as by an adoptive mother, an intended parent via surrogacy, or the non-gestational parent in a same-sex female couple. Relactation, on the other hand, involves a recent pregnancy, and entails recommencing lactation after a period of time (typically weeks or months) of not making any (or much) milk. 

References 

Bonyata, Kelly, Relactation and Adoptive Breastfeeding: The Basics, 2018, http://kellymom.com/bf/got-milk/relactation (accessed 20 January 2020). 

Charfén, Ana, Relactar: Como eliminar el biberón y regresar a la lactancia materna exclusiva, http://www.cozybebe.org/index_archivos/regresolactexc.htm (accessed 20 January 2020). 

Mohrbacher, Nancy. Breastfeeding Answers Made Simple: A Guide for Helping Mothers. Amarillo, TX: Hale Publishing, 2010; 603-620.

Padró, Alba, Cómo relactar: pasar de lactancia artificial o mixta a lactancia materna exclusiva, https://albalactanciamaterna.org/lactancia/tema-2-como-superar-dificultades/como-relactar-pasar-de-lactancia-artificial-o-mixta-a-lactancia-materna-excusiva/ (accessed 20 January 2020). 

Schnell, Alyssa. Breastfeeding Without Birthing: A Breastfeeding Guide for Mothers Through Adoption, Surrogacy, and Other Special Situations. Amarillo, TX: Praeclarus Press. 2013.