What is relacation?
Relactation is a breastfeeding term for a mother who had a biological child and either never breastfed or has already weaned but later goes back and stimulates her milk supply to breastfeed that baby. She may have nursed her child for a short or long time and it may have been recently or years earlier that she weaned her baby. Either way, the “re”-lactating is reversing the weaning. This is different from induced lactation where a mother hopes to stimulate her milk supply to nurse a child that she has not given birth to (adoptive breastfeeding).
Important questions to consider
- Did the mother ever breastfeed this child? If so, for how long?
- How long has it been since she last nursed this infant? The shorter the gap since last breastfeeding will typically mean it takes less time to re-stimulate a milk supply.1
- Why did she wean?
- Were there any maternal issues such as flat/inverted nipples, insufficient glandular tissue, low milk supply, or nipple pain?
- Were there any infant issues such as illness, prematurity, tongue tie, poor latch, inability to suckle effectively, etc.? Have these issues been resolved?
- How old is the infant? What is the likelihood of him latching again on the breast? In general, the younger the baby (particularly within first three months), or if the baby was breastfed for most of the first year, the higher the chances for the infant to latch and breastfeed again.2 Please read strategies for encouraging baby to breastfeed.
- Is the mother able to be with baby throughout the day and night or is she separated for periods of time? If she is separated, can she reduce/eliminate this separation temporarily while re-establishing her milk supply?
- What are the mother’s goals – full breastfeeding, partial breastfeeding, comfort at the breast, nursing at the breast with an at-breast tube feeding device, etc.?
- How motivated is the mother to relactate?
- Does the mother have a supportive network around her? Having a strong support network of family and friends, and a qualified lactation consultant to work with, are essential for successful relactation.
Strategies for relactation
- Frequent and effective breast stimulation/milk removal
There are many things that will help a mother relactate but this is the most critical component. In fact, no amount of additional tools (galactagogues, skin-to-skin, etc.) will effectively build a milk supply without this first step. Until beginning solids somewhere around the middle of the first year of life, babies nurse 6-12 times a day (or more!). You will need to stimulate your supply at regular intervals both day and night.
- Stimulate your supply while feeding baby
If a baby will latch and suckle at the breast, a mother can use an at-breast tube feeding device. This allows her milk supply to be stimulated by her child rather than pumping or hand expressing. It reduces a step because while you are “pumping” you are also feeding your baby. As a mother begins to develop a milk supply she can reduce the amount supplemented in the tube feeding device. It is important to make sure a baby has a good latch in order to effectively stimulate the milk supply.
- Pump if baby will not accept breast
Frequent and effective breast stimulation (and milk removal once milk appears) is essential. If your baby will not accept nursing at the breast with an at-breast tube feeding device, pump (ideally with a double electric breast pump) regularly – at least 8 times every 24 hours, for 15 minutes on both sides.
Lots of skin-to-skin time together! Breastfeeding is about more than the nourishment but also a relationship. Skin-to-skin is wonderful for bonding as well as a mother’s hormones that help her breast milk supply. It’s not just for newborns either. Mothers and babies need lots of time together to build a mother’s milk supply and skin-to-skin contact is a wonderful way to spend this time.
Galactagogues are herbal or pharmacological substances that can increase a mother’s breast milk supply. Domperidone is generally considered the safest pharmacological option and fenugreek and blessed thistle are common herbal options. Eating oatmeal several times a week or even daily may also increase milk supply.
Acupuncture may also increase a mother’s milk supply through enhancing the secretion of the hormone prolactin, which is necessary for milk production.3
- Surround yourself with a tribe of support
Relactation is not always easy! It can take a lot of determination, work, and perseverance. Having a support system around you cannot be overestimated! Family and friends that can support and encourage you as well as getting involved in a local mother-to-mother breastfeeding support group are essential. There will be challenges with relactation. Having others to encourage you and share their experiences will help you tremendously.
- De, N.C. et al. (2002) Initiating the process of relactation: An institute based study. Indian Pediatrics, 39, 173-178. ↩
- Riordan, J. & Wambach, K. (2010) Breastfeeding and Human Lactation, 4th ed. Sudbury, MA: Jones & Bartlett Publishers. ↩
- Jenner, C. & Filshie, J. (2002) Galactorrhoea following acupuncture. Acupuncture in Medicine, 20, 107-108. ↩