Re-lactating

I stopped breastfeeding. Can I start again?

Some mothers can start breastfeeding or making milk again after having stopped. This is called re-lactating. It is more likely to be successful if the baby is willing to breastfeed and the mother had a normal or large milk supply to begin with and has only recently stopped breastfeeding. To start breastfeeding again, the mother should offer the breast whenever the baby is hungry, feed the baby on both breasts at each feeding, supplement the baby with milk, and provide as much supplement as the baby needs. Breastfeeding stimulates the production of milk, but there are other ways a mother can provide stimulation, such as expressing after breastfeeding. If the baby is not willing to breastfeed, mothers can express instead. The milk supply should begin to increase within a few days.

A) Describing re-lactating

Re-lactating means resuming making milk after having stopped.

Some mothers are very successful at re-lactating and others are not. Re-lactating is more likely to work if mothers:

  • Had a full or large milk supply to start with.
  • Have a baby who will latch and breastfeed.
  • Have only recently stopped breastfeeding or expressing.

B) Reasons a mother may want to re-lactate

There are many reasons for a mother to have stopped breastfeeding or expressing but then wish to re-lactate. The mother may have (Horman 1998):

  • Been temporarily separated from the baby but is now back with the baby.
  • Used too much supplement, causing the baby to stop breastfeeding.
  • Been ill and not able to breastfeed but is now well.
  • Had to stop breastfeeding for medical reasons but is now able to resume.
  • Had a baby who:

Some mothers may have decided to wean but find that:

C) How to re-lactate

1) Resume breastfeeding

To re-lactate, a mother should resume breastfeeding and:

  • Offer the breast whenever the baby is hungry.
  • Feed the baby on both breasts at each feeding for at least 10 minutes and up to 20 minutes on each side.
  • Supplement the baby with milk.
  • Give as much supplement as the baby needs, according to the baby’s hunger signs.
  • Use the breast to settle the baby instead of a pacifier.
  • Breastfeed the baby to sleep.

 2) Additional breast stimulation

The baby stimulates milk production by breastfeeding. For additional stimulation, a mother can:

  • Use a tube-at-the-breast system to increase breast stimulation and to avoid other supplementing tools that may interfere with breastfeeding.
  • Express after breastfeeding for as long as the milk supply is increasing.
  • Use herbs or medication to increase milk supply, if they are effective and safe.

3) If the baby won’t breastfeed well enough

a) Won’t stay on the breast long enough

If the baby will latch but won’t stay on the breast for 10 to 20 minutes because the milk supply is low or non-existent, a tube-at-the-breast system can help keep the baby interested. Mothers can also express after breastfeeding to ensure good breast stimulation. Mothers can use one or both options.

b) Will not latch at all

If the baby will not latch at all, the mother should express after each time the baby is given a replacement feed.

The mother should also try various tools, such as a nipple shield to encourage the baby to breastfeed. In general, milk supply is more likely to increase if the baby can breastfeed than if the mother expresses.

D) Increases in milk supply

Increases in the milk supply should be seen within a few days of starting the above plan, and the milk supply would likely be maximized within one month (Muresan 2011). 

As the milk supply increases, the supplements decrease. Mothers need to make sure the baby is getting enough milk during this transition. For some mothers, the milk supply will return to full, but others may need to continue supplementing.

For mothers with a partial milk supply, once the supplements are stable and the baby is growing well, before-feed and after-feed weights can be used to show a mother exactly how much milk she is making.

References

Hormann E, Savage F. Relactation: review of experience and recommendations for practice. Geneva, Switzerland: World Health Organization; 1998

Muresan M. Successful relactation--a case history. Breastfeed Med. 2011 Aug;6(4):233-9