The Chance to Change Course for Baby’s Sake
By Susan Sempeles
You breastfed your baby for a few weeks, tried to transition to formula but your little one isn’t adjusting. Maybe your newborn had to remain hospitalized after birth and you’re just beginning full-time nursing at three weeks. Or perhaps you were seriously ill or hospitalized for a week and had to temporarily refrain from nursing.
These are just some of the real-life situations that can present a new mother with the challenges of relactation, whereby the body returns to producing milk after having stopped or slowed down.
The amount of time it takes to re-establish a good milk supply depends on how long it’s been since the body stopped producing milk.
“You also have cases where a new mother just changes her mind after leaving the hospital,” says Barbara Shocker, RN, BSN, IBCLC, certified lactation consultant and member of the International Lactation Consultants Association. “We see that sometimes in young women who think they don’t want to breastfeed – maybe friends and family have influenced their decision initially – and then they discover that they do want to try.”
Is it difficult to re-establish a milk supply? Shocker discusses two key factors: the age of the infant and how much time has passed since initial lactation. And, she stresses, each case is unique.
“A 10-day-old infant will more readily take to the breast than a 4-month-old,” she says. “Babies on a bottle for a while get used to it and don’t want to work harder at the breast. And the mother will need the stimulation of her baby to help milk production.”
Questions to Consider
Because it can be challenging and time-consuming, Shocker suggests a woman considering relactation ask herself these questions:
- What is my primary reason for wanting to do this?
- What is my baby’s age? Is it reasonable to expect him or her to nurse again?
- How much time has elapsed since I lactated?
- What is my breastfeeding goal? If I can only produce half of what my baby needs, will I be satisfied?
- Do I have my family’s support for this decision? Do they understand that feedings will take longer and may be frustrating?
- How do I feel about using a supplemental feeder?
The amount of time it takes to re-establish a good milk supply also depends on how long it has been since the body stopped producing milk. And there is a point of no return, Shocker explains.
“As an example, if a mother was ill and didn’t nurse for 10 days, it might take about 10 days to re-establish a supply,” she says. “But the time would be different for each woman and the point at which she cannot successfully relactate is different for each.”
How to Start, Where to Find Help
If you are considering relactation, Shocker says the first step is easy, but be prepared for a few challenges. Start by simply putting your baby to your breast and see what happens. If the baby has been on a bottle or is reluctant for suck for another reason, you will need to stimulate milk production with a pump. In fact, you may want to consider using a double pump, pumping each breast simultaneously.
“You’ll need to use a hospital-grade breast pump, because most standard pumps won’t be effective enough,” Shocker says. “You also may need a supplemental feeder, such as one with a small bottle and tubing that positions the bottle nipple next to your own. This measure helps encourage the baby to suck and helps ensure sufficient milk intake at each feeding.”
Shocker also says mothers dealing with relactation must be prepared to invest the extra time it may require and to realize that, after all their efforts, they still may not be able to produce a sufficient milk supply.
“You have to ask yourself if you’ll be happy with any amount of milk you can produce, and realize that any amount of Mother’s milk is a bonus of nutrition,” she says.
Mothers attempting to relactate have a few sources of information and help. Shocker recommends first going back to the maternity or post-natal professionals at the hospital where you delivered. Many hospitals today have certified lactation consultants on staff. Shocker, for example, heads the Breastfeeding Resource Program at the Milton S. Hershey Medical Center of The Pennsylvania State University in Hershey, PA.
“Hospital-based experts will have access to the current literature and to the hospital-grade breast pumps you may need,” she says. “They also have the specialized experience of assisting women in this situation.”
Some additional sources for help and answers include:
- International Lactation Consultants Association Phone: 919-787-5181 Maintains a directory of certified lactation consultants.
- La Leche League Phone: 1-800-LALECHE
- Medela, a breast pump manufacturer. Information and resources: 1-800-TELL-YOU.
An Extra Helping Hand
The San Diego County Breastfeeding Coalition provides some information to new mothers about two supplements that can sometimes help in milk production. One is the prescription drug, Reglan, which is used in infants, children and adults to improve upper gastrointestinal function. As a side effect, Reglan has the ability to increase prolactin, the milk-making hormone in the brain. To increase milk production, its use is recommended along with frequent and regular breast pumping.
The herb fenugreek has been reported to be effective for some women with low milk production. Although it’s unknown precisely why it helps, one school of thought suggests that fenugreek may affect milk production because the breast is a modified sweat gland and the herb is known to stimulate sweat production. It is important to discuss medications and herbs with your doctor before using them.