Relactation: Starting Over with Breastfeeding

The American Academy of Pediatrics recommends human breastmilk as the sole source of nutrition for a baby's first 6 months, and continued breastfeeding after solids are added to the diet for as long as the mother and baby desire it. If you decided against breastfeeding at first, or had breastfeeding challenges that led you to wean your baby earlier than you hoped, it is sometimes possible to begin again. This is called relactation.

Even if the goal is not to completely nourish your child with breastmilk, relactation can at least let you maintain the breastfeeding relationship. This may be especially important if you stopped breastfeeding only to find that your baby did not tolerate infant formulas. Read on for more information.

Relactation works best if you either gave birth fairly recently (particularly if your child is less than three months old) or if your milk supply has been low or nonexistent for only a short period of time. While doctors may prescribe such drugs as metoclopramide to adoptive mothers who have not previously breastfed or to women attempting to relactate, the baby's frequent suckling and other forms of nipple stimulation, such as an electric breast pump, are critical to establishing or reestablishing milk supply.

If you are attempting to relactate, nurse your baby frequently, whenever they show signs of hunger. Hunger cues may include a pursed mouth, sucking motions, or increased activity or alertness. You may need to nurse 8 to 10 or even more times per day, with 2 or more night feedings, for about 15 to 20 minutes per session. If your baby is not eager to nurse as you are building your milk supply, provide them with positive reinforcement by using a nursing supplementer to provide formula or expressed or donor human milk. You should also stimulate your breasts with breast massage and a good-quality breast pump.

Don't expect this process to lead to instant results. Your baby may resist nursing for a week to two before they settle back down to breastfeeding, and it may take weeks for your milk supply to increase. To improve your chances of relactating, try to keep your nursing sessions relaxed and pleasurable for both you and your child. Drink enough fluids, and try to maintain an adequate diet.

This is a process that will be much easier with the assistance of a physician with special expertise in breastfeeding management or a lactation consultant. In addition, you might ask for help from family members and friends who may have experienced a similar situation.

Relactation does not always mean a return to exclusive breastfeeding. Since your milk production may well be lower than it was originally, you may need to supplement your baby's nutritional intake with formula, with breast milk from a donor milk bank and with solid foods if they are older than 6 months. Meanwhile, it is crucial to monitor their weight gain and other signs that they are getting adequate calories and nutrition.

Let your your pediatrician or family physician know about your breastfeeding situation. And to make sure your baby is getting the nutrition they need, be sure to bring your child in for recommended checkups.