Mothers stop breastfeeding for a variety of reasons. Some may have decided against breastfeeding initially or experienced breastfeeding problems that led to unplanned early weaning. A separation from a baby due to hospitalization or other causes may have led to a decreasing milk supply despite pumping. An unaddressed imbalance in the breastfeeding rhythm or stress may have affected your milk let-down. Whatever the reason, it is sometimes possible to begin again, or relactate—if not always to completely nourish your child, at least enough to maintain the breastfeeding relationship. This may be especially important if you stopped breastfeeding only to find that your baby did not tolerate infant formulas.
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 he shows such hunger cues as a pursed mouth, sucking motions, or increased activity or alertness. You may need to nurse eight to ten or even more times per day, with two or more night feedings, for about fifteen to twenty minutes per session. If your baby is not eager to nurse as you are building your milk supply, provide him 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 he settles 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 lactation consultant. In addition, you might ask for help from your obstetrician or pediatric care provider, La Leche League volunteer, or 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, or with solid foods if he is older than six months. Meanwhile, it is crucial to monitor his weight gain and other signs that he is getting adequate calories and nutrition. Be sure that your pediatrician or family physician is aware of your breastfeeding situation and bring your child in for checkups as requested.
**The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for about 6 months, followed by continued breastfeeding as solid foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.