Most people think about breastfeeding as something that only occurs after a woman has given birth. However, lactation (the process of making breastmilk) can work in other situations too. For example, it is possible for a woman to start to make milk again after weaning or to feed an adopted baby (even if she has never given birth or been pregnant).
The hormones prolactin, progesterone and oestrogen prepare breasts to make milk during pregnancy. Prolactin on its own can do the same job and it is also released when the nipples are stimulated, for example by a suckling baby or expressing. This means that you don’t need to have been pregnant for lactation to happen. Once the breast starts making milk, it is the milk being taken out that causes more milk to be made.
Reasons why you might want to relactate for your weaned biological child
• Weaning occurred earlier than you wanted it to.
• Your baby is not doing well on formula.
• Your child is sick and breastmilk would provide immune protective factors to help him get better.
Reasons why you might want to induce lactation
Lesbian mothers who wish to breastfeed (when they are not the birth mother).
Trans women who wish to breastfeed.
You breastfed one of your older children and see breastfeeding as an important part of being a mother.
You always thought that you would breastfeed when you became a mother.
You believe breastfeeding will help with attachment and building trust with your new child.
You think breastfeeding will help you to regain confidence in your body (eg if you have a history of infertility).
You feel that breastmilk or breastfeeding is important for babies.
Your child is showing signs of wanting to breastfeed.
Relactate/induce lactation by breastfeeding
The easiest way to relactate/induce lactation is through a baby suckling at the breast. The more often a baby suckles at your breast, the more likely your breasts will make milk. As a first step, try putting your baby to the breast to see if she is happy to suck. If she suckles at all it is a good sign, but if she won’t it does not mean that you should give up the idea. There are many other things you can try to help your baby to breastfeed:
· Being patient and gently persistent. It is important not to force a baby to breastfeed.
· Offering breastfeeds when your baby is relaxed and happy or sleepy.
· Making any bottle feeds more like breastfeeding by holding your baby close and using a slow flow bottle teat.
· Using a breastfeeding supplementer can help to keep your baby sucking, as it gives her extra milk while she breastfeeds.
· Putting a bottle teat filled with milk over your nipple to help get your baby used to taking milk in this way.
· Triggering your let-down reflex (if you already have some milk) before offering your baby a breastfeed.
· Spending lots of time skin-to-skin with your baby.
Once your baby is breastfeeding, there are many things you can do to encourage her to breastfeed often:
· Keep her close to you and give her access to your breast at all times.
· Many mothers find carrying their baby in a sling helps them to breastfeed often while they go about their normal day.
· Avoid anything that makes your baby suck less, such as a dummy. Instead, offer a breastfeed as a way to help settle her.
Expressing to relactate/induce lactation
If your child is not yet willing to breastfeed, or you wish to prepare for breastfeeding before placement of an adopted child, you can use a breast pump and/or hand express to relactate/induce lactation.
Women vary greatly in how they respond to pumping. It is a good idea to pump at least six to eight times a day. Many mothers find that this amount of expressing is enough to start them making milk. It may be helpful to pump even more often than this, including at least once during the night. It is better to pump more often, for shorter periods, than less often for longer periods. Start out slowly, pumping only for 5–10 minutes on low suction to begin with. Gradually increase the length of each expressing session up to about 15–20 minutes.
Using an electric pump with a double kit is best. Not only does it save you time, but pumping both breasts at once results in higher prolactin levels than pumping with a single kit. Double electric pumps can be hired from many local Australian Breastfeeding Association (ABA) groups. Make sure that your pump is working well and is suited to long-term use. Some of the smaller pumps, like those that take batteries or that only allow you to pump one breast at a time, are not designed for constant use and may lose their suction with time and just not work properly.
The ABA booklet Breastfeeding: expressing and storing breastmilk has information about expressing, handling, storing and cleaning procedures. The website article Expressing and storing breastmilk contains helpful information too.
Some women use hand expressing only to relactate/induce lactation. However, even if you are using a pump, hand expressing as well can help, since it can remove small amounts of milk in the early days that the pump can’t. If you have been only pumping and find that your milk supply is not increasing, try doing some hand expressing after pumping or between pumping times. This may help to encourage your breasts to increase the amount of milk they make. The emptier the breasts, the stronger the message they get to make more milk. Hand expressing is a very useful skill that takes practice to master. This is covered in detail in the booklet Breastfeeding: expressing and storing breastmilk. You can watch videos of hand expressing.
Combining hand expression with breast massage can help to get the milk to flow. Massage first, then express. Massage again, and then repeat the hand expressing and so on. To massage your breasts, work evenly around your entire breast, stroking gently downward toward your areola.
Drugs and alternative therapies for increasing milk supply
Frequent breastfeeding is the most important aid to relactation/induced lactation. However, some mothers find that drugs and other therapies can be helpful. These therapies should be discussed in detail with your medical adviser, as there is always the chance of adverse side effects. Note that while drugs and herbs can be useful, they are simply an ‘extra’ and cannot replace frequent breastfeeds and making sure that the baby is well attached to the breast.
While you build your milk supply, you may wish to use a breastfeeding supplementer. This is a device to provide extra milk to your baby while he breastfeeds. At the same time it stimulates your breast and removes what milk you have made. It consists of a container which holds the milk and fine tubing that carries the milk from the container to your nipple. When your baby suckles at the breast, milk is drawn through the tubing to his mouth.
As you think about relactating for a biological child or adoptive breastfeeding, keep in mind that everyone is different. No two mothers are the same; no two children the same; no two situations the same. The road to breastfeeding is different for everyone. You will approach this in your own way with the resources you have and what suits you. It is important to keep in mind that breastfeeding is not just about the milk. It’s also about the close contact between a mother and her baby which is important for a baby’s brain, emotional and social development. Some mothers never build up their milk supply to a point where they can stop using supplements. They choose to continue mixed feeding because they value the emotional bond they develop through breastfeeding.
Whether you have successful lactation or whether you decide not to pursue breastfeeding right now, you are very welcome to join your local ABA group for support as a mother. For further support or information you can contact an ABA counsellor.
For further information
The ABA booklet Breastfeeding: relactation and adoption contains much more information on this topic.
The Ask Lenore website has some further information about inducing lactation.
· Yahoo support group for Adoptive Breastfeeding Mothers and Mothers to be, and women who are re-lactating after weaning
The information on this website does not replace the advice of your health care provider.
© Australian Breastfeeding Association May 2014