Relactation and induced lactation

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 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 bring in a milk supply:

  • 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.

  • You are adopting a child and believe breastfeeding will help with building trust and bonding with your new child.

  • You feel that breastmilk or breastfeeding is important for all children.

  • You are in a same-sex relationship and are the non-birth mother.

  • You are a trans-gender person, but not the birth mother.

  • Your baby is being born to a surrogate mother.

  • You are a grandmother and need to care for a grandchild.

  • You want to provide breastmilk for a sick relative or friend.

Relactate/induce lactation by breastfeeding

The easiest way to bring in a milk supply 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.

  • Carrying your baby in a sling helps her to breastfeed often while you go about your normal day.

  • Sleeping close to your baby makes it easier to feed at night. Night feeds are very helpful for building a milk supply.

  • 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 you have your child with you, you can use a breast pump and/or hand express to build up a milk supply.

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 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. This takes milk from both breasts at once. Not only does it save you time, but pumping both breasts at once results in higher prolactin levels, more let-downs and milk with a higher energy content than pumping one breast at a time. 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 Breastfeedingexpressing and storing breastmilk has information about expressing, handling, storing and cleaning procedures. The website article Expressing and storing breastmilk contains helpful information too.

Hand expressing

Some women use hand expressing only to build their milk supply. However, even if you are using a pump, hand expressing as well can help, especially in the early days, since it can remove small amounts of milk 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 Breastfeedingexpressing 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 building a milk supply. However, some mothers find that drugs and other therapies can be helpful. These should be discussed in detail with your medical adviser, as there is always the chance of adverse side effects. Note that while drugs and other treatments can be useful, they are simply ‘extras’ and cannot replace frequent breastfeeds (or expressing) and making sure that the baby is well attached to the breast.

Breastfeeding supplementer 

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.

In conclusion

As you think about relactating or inducing lactation, 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 induced lactation contains much more information on this topic.  

The information on this website does not replace the advice of your health care provider.

 

Breastfeeding: relactation and induced lactation booklet

Breastfeeding: Relactation and Induced Lactation covers relactation for a birth child who has been weaned, breastfeeding an adopted child or a child born via surrogacy.

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 © Australian Breastfeeding Association October 2018

 

Last reviewed: 
Oct 2018