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Expert Q&A

	By Melissa Clark Vickers International Board Certified Lactation Consultant Moms & Babies Huntingdon, Tenn.

I am attempting to relactate in order to feed my 7-week-old son. I fed my daughter for 11 months, but my son was tongue-tied, and my midwife, lactation consultants and doctors I consulted refused to snip it. My son has never been able to latch on, so I have basically half expressed, half formula fed him. He is bigger now, and I was giving up on nursing him, so I was only expressing around 60 ml a day (down from 600 ml). However I found a doctor willing to snip his tongue, and I find he can latch on and suck well at the breast now, but there is little there to interest him. How long should I wait to see if my supply comes back?

First, congratulations on your perserverance! Clipping a tongue-tied tongue can make a lot of difference in how well and how comfortably a baby can nurse, and can actually affect speech later on. And if your baby is willing to nurse at the breast, that is half the battle! Remember that your breasts operate under a supply and demand principle. The more milk that is removed from the breast, the more the breast will make to replace the removed milk. A nursing baby is the most efficient way of removing the milk, and will increase your supply quicker than a pump by itself. However, in the meantime, it is important that your baby continue to eat.

There is a device that you might find useful. It is called a Supplemental Nursing System (""SNS""), manufactured by Medela, Inc. It is a bottle that you wear around your neck, and it has two tiny tubes that you tape to the side of each nipple. You fill the bottle with either pumped milk or formula, and the baby nurses at the breast, getting some of the bottled milk through the tube, and some directly from the breast. This helps stimulate the breast, and also allows your baby to get enough at the breast to reward him for his efforts. You can gradually change the amount he gets from the bottle as your supply builds up.

It would be best to work directly with either an International Board Certified Lactation Consultant or accredited La Leche League Leader in your area as you rebuild your supply and transition your baby back to breastfeeding full time. She could help you track your progress. Using a good, hospital grade electric breast pump can help speed up the return of your milk supply as well. Short and frequent pumping sessions (5-10 minutes at a time) work better than marathon sessions, and any milk you pump can be used in the SNS.

Offer your breast to your baby any time he seems willing to take it, whether for comfort or food. As for how long the process might take, as a general rule, it often takes as much time to get out of a problem as it did to get into it. So it may take a few weeks, hopefully with gradual and steady improvement, for your supply to return to the level of being able to exclusively breastfeed your baby."

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