What is relactation?
According to Leana Habeck, a breastfeeding consultant and La Leche League leader, there is a difference between relactation and induced lactation.
“Relactation is about re-establishing milk secretion after weaning your baby from the breast. Adoptive breastfeeding, also called induced lactation, can occur in a woman who was not pregnant with the current baby. It may involve hormonal preparation (oestrogen and/or progesterone) to simulating a pregnancy, followed by sudden cessation of the hormones to simulate a birth, and then the commencement of pumping or suckling. A galactagogue, that increases prolactin secretion, will also be given.”
International board certified lactation consultant and midwife Emma Numanoglu explains the protocols for inducing lactation, which were developed by Dr Jack Newman and Dr Lenore Goldfarb, as involving a regime of taking the contraceptive pill together with domperidone, a dopamine receptor antagonist. “A few weeks before the expected arrival of the baby, the mother stops taking the Pill, continues with domperidone, and starts expressing milk. This mimics the process of pregnancy and lactogenesis after birth. This method has been used successfully and safely for three decades,” she says. “A mother who is planning to apply one of the protocols will need to find a doctor who can explain the risks and benefits of taking the medication, and will prescribe domperidone in doses that exceed guidelines for licensed use.”
Commitment is key
Relactation, explains Emma, is also an option for mothers who have opted to bottle-feed, but wish to return to breastfeeding, or even those whose babies are not tolerating formula well. “In my practice, this is the most common reason for relactation. The reasons are important as it requires a commitment from the mother,” she says. “It is essential not to only place emphasis on her milk as evidence of success. This can cause anxiety and, thereby, inhibiting milk production and the ejection reflex. For these reasons, it’s important to discuss the benefits, concerns and problematic elements of relactation with the mother.”
Emma sees the most success in relactation with babies under three months. However, it is not impossible with older babies, but may take more time and effort.
“Induced, or adoptive, lactation is becoming more popular. Mostly, adopting and lesbian couples seek assistance in breastfeeding their adoptive baby.”
Emma continues that, “Success also depends on other factors, such as the determination of the mother, no underlying medical conditions and the baby’s age.”
Methods of relactation
Emma recommends holding your baby skin-to-skin as often as you can, in a calm environment. Feeding your baby from the breast is the most effective way to relactate. Offer your breast to your baby frequently when she is happy as this is when she is likely to latch the best. “This is an extremely important step. Although it sounds simple, this is how babies become interested in breastfeeding again.
You can start pumping if you find your baby does not want to breastfeed for very long, or is not interested in taking the breast. Since you are trying to build your supply back up or induce lactation again, it is important to pump frequently,” she says. It is ideal to pump every two to three hours. When you start pumping, you might get little or no milk − just keep going! Some women find it takes a couple of months to really get their supply going again, especially if their babies are not breastfeeding or are only occasionally breastfeeding.” She adds that most women will be able to partially breastfeed and many will eventually be able to breastfeed exclusively.
A word on galactagogues
- Galactogogues are medications, or other substances, believed to assist initiation, maintenance, or augmentation of the rate of maternal milk production.
- Leane cautions against galactogogues that are recommended prior to trying other methods of increasing milk supply such as frequent feeding and regular draining of the breasts.
- Herbal remedies have been used throughout history to enhance milk supply. Some plants noted as galactogogues include fenugreek, goat’s rue, milk thistle, oats, dandelion, millet, seaweed, anise, basil, blessed thistle, fennel seeds, marshmallow, and many others. “Although beer is used in some cultures, alcohol may actually reduce milk production.
- A barley component of beer (even non-alcoholic beer) can increase prolactin secretion, but there is no hard evidence supporting this,” she says.
- Emma points out that the most important point to remember is that a herbal or prescribed galactogogue will only work if you take it while actively trying to build your supply at the same time. “You will not see an increase if you do nothing except take a galactogogue.
- You should only take a galactogogue if your doctor is in agreement and all side effects and contraindications have been discussed,” she says.