How to get back to breastfeeding - relactation

CONSULTATION

 

 

Agata Serwatowska -
- Bargieł Ph.D.  

 

 

International certified lactation consultant (IBCLC), neonatologist

 

Few people realize that lactation can be restored, even after weeks or months from its discontinuation. Mother’s milk is particularly important for premature babies, and the time spent by such a baby in an incubator often causes loss of lactation in its mother. It also happens that women who have adopted a child, wanting to experience motherhood in all its aspects, struggle to be able to breastfeed it. In those both case, with the support of a lactation consultant the struggle to be able to breastfeed can be successful.

Relactation involves restoring lactation at any time after the mother stopped producing milk. By induced or adoptive lactation we refer to a process of inducing milk production in a woman who has never been pregnant and breastfed before. Both those process are for simplicity referred to as relactation.

In order for a women to be able to breastfeed several conditions need to be fulfilled:

1. lactiferous alveoli need to develop in breasts,

2. those alveoli need to secrete milk,

3. breast needs to be regularly emptied (by a baby or breast pump).

The development of alveoli requires hormones, the most important of which is prolactin that determines the whole process. Proper stimulation of breasts causes the release of prolactin by the pituitary gland, then lactiferous alveoli are formed and the milk production is induced.

The relactation process is difficult and there is no guarantee that it will succeed. It is very important that the women has the support of a lactation consultant and is strongly motivated. Not without a reason it is often said that mother's milk is ‘produced' in her head.

• mother’s determination

This is probably the most important factor. If a woman is not sufficiently strongly motivated to breastfeed, it will be difficult to restore lactation. She needs to be convinced of the benefits for herself and her baby, both health and physical and emotional ones.

• consultant’s professionalism

The role of the consultant is of paramount importance here. The consultant's co-operation and support, assessment of the factors that may hinder relactation, as well as their ability to skilfully motivate the woman are all important.

• the quality of mother’s relationship with her child

This is particularly important for mothers of premature babies, who have stayed long in the hospital, and women adopting children. In both cases, the relationship may be not too strong or impaired.

What can be helpful in this case is the ”Kangaroo-mother-care” method, otherwise known as skin-to-skin contact method, that involves placing a naked baby to the mother's bare chest, which is primarily recommended for the care of premature babies, but also used in other, less common situations.

This process should be based on their mutual consent, their needs, and should not be performed by force, in spite of the mother or the baby.

• mother’s health condition

What I mean by this is the general health status of the woman, as well as that of her mammary glands. If a woman has had problems with low supply of breast milk, it is necessary to determine the causes and try to eliminate them.

• previous experience with breastfeeding

The attitude of a woman to breastfeeding and whether she has had any previous experiences with it plays a very important role. If a woman has trauma or major anxiety, relactation can be very difficult.

• length of the so-called ”lactation gap”

It is one of the key factors affecting both the mother and also her baby. The length of the ”lactation gap”, or otherwise the break in breastfeeding, is essential to the success of the process. The longer that break, the smaller the chances of success are. It happens that a baby accustomed to bottle-feeding definitely rejects breastfeeding.

• baby’s readiness and willingness to suckle

The younger the baby and shorter the ”lactation gap”, the greater the chance for successful relactation. It is important how the baby has been fed so far, and what were the reasons for stopping the breastfeeding.

• support from environment and professionals

An environment that supports the woman and accepts her decisions can positively affect the relactation process. The consultant should motivate the mother and provide her with all necessary information about the relactation process and her chances to succeed.

The most important activity in the relactation process involves latching your baby to your breast, most preferably every hour or two. The consultant should provide help during the first attempts, evaluate the latching technique and improve it, where possible, and find the best breastfeeding position together with the mother.

Research shows that night-time breastfeedings more effectively affect the production of prolactin, therefore frequent latching at night time is recommended. Another good method involves sleeping with your baby. It is all the more so that frequent physical contact of the mother with her baby stimulates the release of oxytocin in her body, the hormone of attachment, which is also responsible for the effective breast milk let-down.

If frequent latching of your baby is not possible, or it does not suckle effectively, the best method is to express your breast milk using a breast pump. It is important that it is done regularly, hence it is best to use an electric breast pump. The mum should be relaxed and calm. It is worth expressing your breast milk after direct contact with your baby.

At the beginning of the relactation process, where little breast milk is produced, a baby needs to be additionally fed with formula milk. A good way to do so involves inserting, while breastfeeding a baby, a drain into the baby’s mouth, which is also attached to the breast, through which extra milk is fed to the baby from a bottle or a syringe. As a result, the baby stimulates lactation in its mum, while being fed with the sufficient amount of milk.

Some specialists agree that no pharmacological  drugs are needed for successful relactation. It is the more so that some of them have unpleasant side effects. For example, they can cause depression, excessive sleepiness or heart problems.  Metoclopramide and domperidone are the most commonly used and best studied lactation-stimulating drugs. However, they should be taken only under supervision of your doctor, strictly following their recommendations.


There is no rule as to how long it takes to restore lactation, neither is there a guarantee that the undertaken attempts will be successful. It is, however, worth fighting for it. Breastfeeding is the best way choice for the health of the baby as well as provides health-promoting effects for the woman. For adopting mums it can be a beautiful beginning for their relationship with the baby, as well as the fulfilment of their dreams of motherhood in all its aspects.