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You can start breastfeeding again after stopping. Here's help from our lactation expert
Relactation is the name given to the process of rebuilding a milk supply and resuming breastfeeding at some time after breastfeeding has stopped. Why would a mother want to do this? Some I have worked with originally planned to use formula, and started off bottle-feeding, but found their babies didn’t tolerate formula well. Other mothers relactated because they learned too late that they were given misinformation and didn’t really need to wean. Some had really struggled with breastfeeding in the early weeks, so decided to switch to formula, but once the baby was a bit older and life had settled down, really wanted to give breastfeeding another try.
It isn’t always possible to bring back a full milk supply, but often it is, and even a partial milk supply can make a big difference to a baby’s health and development.
But how do you do it?
1. Recognize that it can be slow-going and requires dedication. In the beginning, the process may be quite time-consuming, as you may need to pump, breastfeed and supplement your baby. It may also take several weeks to build up a full supply of milk – sometimes longer if you have had problems such as a breast abscess.
2. Provide enough stimulation to the breasts. The more often milk is removed, the more often it will be made. Generally, you need to pump or breastfeed the baby at the breast at least eight times in 24 hours, and if you can do it more often, that’s even better. If you are using a pump, try not to set a schedule but simply pump every time you have a few minutes to spare. (You can keep the parts that come in contact with your milk in the fridge between pumping and just clean it once a day – no need to clean it every time you pump.) At first, you will get very little milk. That’s OK: you are sending your breasts the “make milk” signals and it will take a couple of days before they respond. Give the baby any milk you are able to pump as a supplement, as well as formula (or donated human milk).
3. Consider trying herbal supplements or prescription medication to give you a “jump-start.” There are a number of herbs touted as milk-production boosters, but most are not well-researched. Dr. Jack Newman recommends fenugreek and blessed thistle (taken together) and there is some research to show that fenugreek is effective. The prescription medication Domperidone has also been shown to increase milk production, so you could talk to your doctor about this option. Keep in mind, though, that none of these will work without the milk removal plan discussed in point number two!
4. Help your baby transition back to breastfeeding. Your child may have become accustomed to drinking from a bottle and it may take some time to help her re-learn breastfeeding (or she may have never really gotten going). The good news is that babies are born “hard-wired” to breastfeed and often mothers are surprised by how quickly the baby returns to the breast. Consider giving your baby lots of skin-to-skin time, when you are topless and baby is just wearing a diaper. Get in a comfortable reclining position, put baby tummy-down on your chest, and relax. Your baby may just latch on with little help from you. If she doesn’t, watch for these progressive signs that she’s “on her way:” she tries to root, turning towards the nipple; she licks the nipple; she opens her mouth and briefly takes the nipple; and she holds the nipple in her mouth but doesn’t suck. (It may take her several days to get from the first to the last of those signs.) If you squeeze your breast gently at this point, she will get a squirt of milk and that might encourage her to swallow and start sucking. Be patient and keep trying.
5. Learn to know when baby is drinking. Once the baby is taking the breast, it’s important to know when she is actually getting milk. You are looking for slow, deep sucks with a pause at the peak when the baby’s mouth is wide open. Often you hear a sound like a whispered “caw, caw, caw” but the pause is the most important indicator. When you see this kind of feeding for several minutes, you know the baby has taken a good amount of milk. If you are not seeing this, you may need to pump more to boost your milk supply, and/or get some help with the baby’s latch.
6. Watch your baby’s diapers to help you know how much milk he or she is getting. A formula-fed baby has brownish, firm bowel movements; a breastfed baby has very loose, yellow bowel movements. As the amount of milk your baby gets from you increases, you’ll see the bowel movements start to change colour and become looser. Keeping track of the wet and poopy diapers will also reassure you your baby is getting enough to eat.
7. Recognize that supplementing will be necessary in the beginning and probably for many weeks. The best way to supplement is with a lactation aid used at the breast. It saves time (you don’t have to both breastfeed AND give the supplement – you’re doing both at once), encourages the baby to breastfeed, and provides more stimulation for the breast. You can buy commercial lactation aids or make your own with a feeding tube and baby bottle with the hole in the nipple enlarged so you can stick the tube in.
8. Focus on success over a week or so, rather than day by day. With babies, things rarely go in a straight line. One day the baby seems to be getting lots of milk at the breast and you cut back on the supplementary formula, and then the next day he’ll be fussy at the breast and drink more formula than you’d expected. This is normal baby behaviour. But if you compare week by week – he took an average of 12 ounces a day of supplement last week, but only 9 ounces a day on average this week — you’ll see the progress you’re making.
9. Be flexible. If one approach isn’t working, give something else a try. Your baby won’t latch sitting up? Try lying down, or while walking around with baby in a sling. You’re not getting much milk when you pump, even after several days? Try hand-expressing, or use a different-sized flange on the pump. Your baby is sick or just having an off day and not willing to even look at your breast? Feed her with a spoon or syringe or even a bottle if that’s all she’ll take, and try again later. You’ll get there.
10. Round up all the support you can get. Encouragement from friends and family is good, but practical help from them that gives you more time to work on building up milk production can may a big difference. You may also want to work with a La Leche League Leader, a Lactation Consultant, a public health nurse or your family doctor who can help you monitor your baby’s progress and ensure he is getting enough to eat as you build up your milk supply.
