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How to Successfully Relactate!

Posted by on Dec. 18, 2012 at 11:36 PM
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1 mom liked this
Realistic Goals: Relactation can be time consuming and stressful and it may take several weeks to reach exclusive breastfeeding. While many women can successfully re-establish exclusive breastfeeding, there will be women who are unable, for myriad reasons, to exclusively breastfeed. I encourage women to set realistic goals on how long it will take to achieve success and what success will mean to her but to never give up. After all, a mother who is partially nursing while supplementing is still breastfeeding her child, whereas the mother who quits entirely is not breastfeeding at all. Success in relactation however, must be determined by the goals set by mothers, not lactation professionals.

Support: Lack of support leads to lack of confidence; lack of confidence leads to infrequent suckling; infrequent suckling leads to breastfeeding failure. All three are associated with less successful relactation. Breastfeeding mothers who suffer with feelings of inadequacy due to milk supply problems must be supported by their family and social groups if they hope to successfully relactate. Breastfeeding cannot be one of the many chores a woman must do each day; it must be the priority of the entire family. Mothers who find themselves trying to work pumping, the use of an at the breast supplementer, and breastfeeding into their already full schedule will often find themselves unable to overcome the challenges of relactation.

Breast/Nipple Stimulation: There are several techniques for breast and nipple stimulation, perhaps the most successful is direct infant suckling. However, the mother can augment that with hand expression, breast massage, warm compresses prior to stimulation, and mechanical pumping. Some studies have shown that combinations of these techniques enhance success.
Milk Removal: Since the breasts synthesize milk based on the degree of emptiness, breast drainage must be a part of nipple stimulation. The mother may find that a period of trial and error is needed to determine the best strategy for breast emptying (infant suckling, hand or pump expression, etc…).

Galactogogues: Galactogogues are medications or herbal supplements that increase milk production/synthesis. The two most common medications used to augment milk synthesisare Metaclopramide (Reglan) and Domperidone. Both are anti-nausea medicines which increase prolactin production. Unfortuantely, scientific evidence demonstrating the effectiveness of galactogogues is weak. Both Reglan and Domperidone have been shown to increase prolactin levels and milk production. However, the studies demonstrating this lack credibility in the scientific community. As such, it is important that women who take these medication understand that while they may be helpful, they are by no means a magic bullet that will increase milk synthesis. The evidence in support of Mother’s Milk Tea, Fenugreek and Milk Thistle (all common herbal galactogues) is even more questionable. Given the subjective way that milk production is measured, it is possible that many galactogogues work through the placebo effect rather than by actually increasing activity at the molecular level. That said, the point is moot; the goal of relactation is to empower a mother to breastfeed her child and the exact physiology behind her success is not as important as her success. I therefore support safe and responsible galactogogue use under the supervision of a competent IBCLC.

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by on Dec. 18, 2012 at 11:36 PM
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annaica
by on Dec. 18, 2012 at 11:38 PM
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Oxytocin: Oxytocin is the hormone that causes the Milk Ejection Reflex (MER), also known as the “let down” effect. It surges in response to nipple stimulation, and during pleasurable experiences (skin to skin contact, infant snuggling, and affectionate attention from a loved one). It is therefore, no surprise that stress, anxiety, fear, and pain all decrease oxytocin release. Oxytocin is also released due to conditioning responses, meaning that release is enhanced when mothers do things that remind them of breastfeeding. For example if you always sit in the same chair to breastfeed, the act of sitting in that chair will increase your likely hood of having an oxytocin surge. I often suggest that pump dependent mothers cover their breasts and pump with the baby’s blanket. Not only does this hide the pump and keep mothers from stressing over the actual movement of milk, but it also triggers a conditioned response to breastfeed due to the smell of the baby on the blanket. The important thing about oxytocin is to relax and enjoy the time spent breastfeeding, and as much as possible, the time spent pumping, hand expressing, massaging the breasts. A synthetic oxytocin is available in some areas through compounding pharmacies and can enhance the let down response.

Yes, you can relactate but you and your loved ones have to commit to it. The key physical factors needed for relactation are breast/nipple stimulation and milk removal. I can’t stress enough that in order to enhance the success of nipple stimulation and milk removal the mother must be confident in her abilities, comfortable and relaxed while nursing, and must have realistic goals. The mother must be supported and able to prioritize relactation. I strongly recommend that any mother having difficulty with milk production see a lactation consultant immediately to avoid weaning however, weaning does not have to be permanent. If you have stopped nursing and want to relactate, you can.
In the words of Winston Churchill “Never, Never, Never, Never, Never, Give Up!” You can do it!

From http://lactationmatters.org/2012/11/29/providing-support-for-mothers-who-wish-to-relactate/
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catholicmamamia
by on Dec. 19, 2012 at 12:43 AM

thank you 


         

aehanrahan
by Group Mod - Amy on Dec. 19, 2012 at 2:26 AM
Thank you for sharing!
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maggiemom2000
by Ruby Member on Dec. 19, 2012 at 4:11 PM

Grrat info!

Here's my article on relactation:

 


It is possible to get your baby successfully nursing at the breast, and can be well worth the effort in the long run.  I have worked with other moms with babies who came home from the hospital taking only bottles and learned to breastfeed.  Keep in mind that many moms re-lactate and breastfeed their adopted children (and not just newborns, even older infants who have had nothing but bottles for their first months of life).

Will your baby latch on and nurse at all?  If he will, just start putting him to the breast more and more.  Get him to nurse as much as he is willing and supplement as you need to with pumped milk and/or formula.  Gradually over time you can get him transitioned all the way to the breast.

Don't worry about putting your baby to the breast if you have little or no milk. Remember, no one worries about or questions giving a baby a pacifier and that has no milk coming out of it! Comfort nursing is often the first nursing a baby will do so you can start by encouraging that, even if you have little or no milk.

You will want to get him to the breast at least 8-12 times in 24 hours.  Another thing you can do to help increase supply is to pump between feedings.  Pump one hour after feedings as many times a day as you can.  Pick a schedule for pumping, and stick to that schedule.  After several days you should start to see an increase in the amount you are pumping.  Any milk you pump can be used to replace formula in the bottles. The pump you are using can make a huge difference. Some pumps are much more effective at extracting milk than others. An automatic double action pump made by a reputable company is usually needed by mothers who are establishing a milk supply or relactating. The pump should cycle-suction 40 to 60 times per minute.  It may be worth it to rent a hospital grade pump (even just for one month).  See PUMPING TO INCREASE MILK SUPPLY and  POWER PUMPING

Here are some tips that may help him to get back to the breast:

Put him to the breast when he is not hungry, encourage "comfort nursing".

Give him most of his feeding by bottle, then try to switch him to the breast. Click here to learn more about the “finish at the breast” method

If he is used to the bottle, and completely refusing the breast, he may be willing to take the breast with a nipple shield.

Pump a little before putting him to the breast to get the milk flowing so that he gets an "immediate reward".

You can eliminate supplemental bottles so that he gets all of his sucking at the breast.  You can get milk into him by cup or syringe if he still needs supplemental milk.

Another way to eliminate bottles is to supplement at the breast.  This has been helpful to some moms and babies transitioning from bottle to breast. For this you will need an At Breast Supplementer . Here is a summary of my experiences with At Breast Supplementers as well.

Medela SNS


Lact-Aid

If you are only going to do ONE thing, my best advice is to get an at breast supplementer and do all feedings at the breast.

Increase skin on skin contact:
Many mothers have found skin-to-skin is the absolute best tool we have for increasing milk supply and getting babies to nurse really well. Spending as much time as you possibly can with you undressed from the waist up and your baby undressed except for a diaper, just letting him sleep in your arms against your skin until he wakes and wants to nurse, will help so much. It organizes baby's suck and it stimulates your milk supply. Skin-to-skin contact also keeps your baby warm and secure and helps him use all his energy to grow.

The two of you can cover up with a blanket when you’re resting together. When you’re up and around, you could carry your baby inside your shirt/jacket (a button up works best) when he is wearing nothing but a diaper. Babies love to be held so I'm sure he would be thrilled! If you have a sling or soft baby carrier you can carry him in that under your shirt/jacket.

Warm baths have been known to help too. There's something not only relaxing about a nice warm bath, but it also help the milk flow. If you bathe with your baby that is even better. The warm water helps baby relax and nurse better while it helps you relax and your milk to flow better. For safety only do this when someone is available to help you in and out of the tub.

If you do give pumped milk or formula with a bottle, offer it to him in only his diaper, holding him against your bare chest, turned in close to “simulate” breastfeeding.  You want him to associate this feeling with feeding. Also see BOTTLE FEEDING METHODS THAT SUPPORT BREASTFEEDING

Try breast compression:
Another tool that mothers have found very helpful for increasing milk supply is breast compression. To do breast compression, put baby to your breast and let him latch on and nurse. You'll see the little fluttery sucks at first while he is waiting for the milk to let down, then his sucking will change to slooooow sucks and you'll be able to hear him swallowing. That's how you know your milk is flowing (also called “letting down”).

When the milk stops flowing quickly, your baby will go back to the quick, fluttery sucks. Then you grasp your breast, with your hand well back away from the nipple, and squeeeeeeze and hold. You'll see that your baby goes back to the sloooow sucks again, as your milk begins flowing quickly and he drinks your milk. Keep holding the squeeze until he goes back to flutter-sucks, then release the squeeze for a few moments, and repeat. You can continue breast compression, followed by releasing the compression, for the whole nursing session. Doing breast compression can really help your baby get a lot more milk in a short time.

You may choose to use herbs or contact your doctor about prescription medication to boost your supply.  Here are some links to more information:


Domperidone is the prescription drug of choice for increasing prolactin and milk supply.

also see Domperidone, getting started

Galactagogues at kellymom.com

Fenugreek is an easy to find, safe herb that is often used to increase milk supply.

THE BREASTFEEDING ANSWER BOOK, 2003 states:  “Many mothers try to boost their milk supply by drinking herbal teas, but the dose cannot be as easily controlled as capsules or tinctures, so the results will be inconsistent.  Fenugreek (three capsules three times per day can be taken alone or with blessed thistle (three capsules three times per day).  Experience indicates that it takes 24-72 hours to see an increase in milk supply once the herbs are started in the correct doses.  Fenugreek is listed in the US as a Generally Recognized as Safe herbal.”

Once you have even a small amount of milk you can begin to gradually eliminate the supplemental milk you have been giving: Increasing Milk Production and Weaning from Formula Supplements
Success Stories:
Breast Nurting: A Re-lactation Story

Relactation 6 weeks after a c-section
monilopez
by on Dec. 20, 2012 at 1:02 AM

thanks i really needed this i bf my baby less now than i did she eats More baby food and finger foods but i haven't stopped completely

annaica
by on Dec. 22, 2012 at 1:20 PM
1 mom liked this
You can keep going! Let us know if you have any questions :)

Quoting monilopez:

thanks i really needed this i bf my baby less now than i did she eats More baby food and finger foods but i haven't stopped completely

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