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Association of breastfeeding mothers - relactation

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Association of breastfeeding mothers - relactation

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https://scholarworks.umt.edu/cgi/viewcontent.cgi?referer=https://www.google.co.uk/&httpsredir=1&article=5263&context=etd

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Page not found - La Leche League International

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https://www.nct.org.uk/sites/default/files/related_documents/Kaufmann%20M%20Relactation%20and%20induced%20lactation.pdf

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Relactation is the process of rebuilding your milk supply once you have started nursing and then stopped for a period of weeks or months. Induced lactation is the process of building a milk supply in a mother who has either never nursed a baby, or who has nursed years before.

Relacation and induced lactation both take time, patience, dedication, and a lot of work. If you are considering either option, I strongly recommend that you contact an IBCLC to help you during the process.

Many mothers start out nursing their baby and end up weaning earlier than they had planned for a variety of reasons - nipple soreness, stress, returning to work, taking a medication that is incompatible with breastfeeding, etc. Often when time has passed and their circumstances have changed, they regret their decision to wean and want to return to breastfeeding. One of the most common reasons for relactating is the baby's allergic reaction to formula.

The younger the baby, the easier it is to get him to return to nursing and to re-establish your milk supply. After giving birth, estrogen levels drop rapidly, and by three weeks postpartum, prolactin levels have dropped back down to normal levels. It is easiest to relactate if the process is initiated during the first three weeks after birth, but it is certainly possible to do it after that time as well. The most important elements to successful relactation are a mother who is highly motivated and has a good support system, has realistic expectations, and a baby with a good sucking reflex.

Most babies younger than three months can be coaxed back to the breast, especially if their attempts to suckle are promptly rewarded. Babies between three and six months may or may not be willing to nurse, depending on their individual temperaments. Babies older than six months are pretty set in their ways and often can't be convinced to nurse.

I would start out by seeing if your baby will latch on and suck. You can offer the breast as a pacifer if he is willing to accept it, even before your milk comes in. Using breast massage and switch nursing (alternating between both breasts several times during a feeding) can help increase your milk production.

I would also recommend taking either Reglan (10 mg, 3 times a day) or Domperidone (10 mg 3 times a day, increasing to 20 mg 4 times a day after you have been taking it for a few weeks). Both of these medications increase prolactin production and have minimal side effects, but Domperidone is the safer of the two drugs, and unfortunately, is available in Canada but not the United States. Both medications must be prescribed by a doctor. In most studies of Reglan, major increases of prolactin and significant increases in milk production were observed, but when it was discontinued abruptly, the supply also decreased abruptly. Tapering the dose is recommended, usually by decreasing it by 10 mg per week. Use of Reglan for more than 4 weeks has been associated with depression, but some mothers have taken it for many months with no noticeable side effects. The average amount of time to take the Reglan is 7-14 days, and by that time, hopefully your supply will have built up and your baby will be providing lots of stimulation so that you don't need it anymore. If you prefer, you can relactate without the use of medications, but in most cases, I have found that it speeds up the process and the side effects are minimal. (See article Increasing Milk Supply for more information about Reglan and Domperidone)

Breastmilk is produced by sucking stimulation and supply and demand. The more often you nurse or pump, the more milk you will have. Start expressing milk with a hospital grade electric double pump, like Avent's Hygia and Medela's Symphony. These pumps are too expensive to buy, so most moms will rent them. When you need maximum stimulation, the cost of the rental is really worth it - here are differences between even the expensive double pumps that you buy and hospital grade pumps. For more information about pumps and pumping, see Pumping and Storing Breastmilk.

To find out about breast pump rental options in your area, ask your hospital, your childbirth instructor, or a local La Leche League Leader.

Try to double pump 8 times a day for 10-15 minutes. Any stimulation at all is beneficial, so don't worry if you can't pump that often. Don't get discouraged by the amount of milk you pump. You are going for stimulation, and it may take a while to see any significant amounts of milk.

Many babies will get frustrated when you put them to the breast initially and little or no milk is coming out, so they won't stay on for long. Using a supplemental feeding system can solve this problem by ensuring that the baby's sucking efforts are rewarded.(SNS by Medela, or Lact-Aid by Ameda). These tube-feeding devices allow you to deliver formula while the baby is nursing at the breast, and your breasts receive stimulation at the same time. Most babies will accept the supplemental feeding systems because they are receiving a steady flow of milk with each suck, much as they would with a bottle. As your milk supply increases, the amount of supplement will level off while your baby continues to gain weight. This means that your supply is filling the gap, and you can gradually reduce the amount of supplement offered. In the meantime, your baby is feeding at the breast and you can enjoy the physical closeness of the nursing relationship, regardless of the amount of breastmilk that he is receiving.

Inducing lactation, which is the process involved in nursing an adopted baby, is more challenging than relactating. You will find that there is a lot of contradictory information out there about inducing lactation. I think that's because there are no exact answers about a 'right' or 'wrong' way to do it. Relatively few mothers have tried adoptive nursing (many people are surprised to know it's even possible) although the numbers are increasing as the many nutritional and emotional benefits of breastfeeding become more well known. What works for one adoptive mother may not work for another, so a lot of the research has been on a trial and error basis.

Breastmilk production is a function of the pituitary gland. When your breasts receive stimulation, either from the baby or a pump, signals are sent to the pituitary gland to start producing prolaction (the hormone that makes the milk) and oxytocin (the hormone that releases the milk). During pregnancy, breast changes occur over a period of 4-5 months. These changes are, of course, not present in the adoptive mother. Sucking stimulation can cause these changes to occur over a much shorter period of time, but the supply builds very slowly. Because your body doesn't have the benefit of these hormonal changes during pregnancy, much more sucking stimulation is needed to induce lactation than it takes to establish lactation after giving birth. Previous breastfeeding experience (or lack of it) is not a major factor in inducing lactation.

It is important to have realistic expectations. An adoptive mother may or may not ever produce a full milk supply. Most women will produce some milk, some produce a full supply relatively quickly, and some never produce milk at all. The majority of adoptive mothers will not produce enough breast milk to adequately nourish their baby without supplements.

How much you produce depends on many factors, such as the baby (his age, sucking needs, previous feeding experience, and temperament; how frequently and effectively you stimulate your breasts; type of pump used, baby's willingness to suckle, how often you are able to find time to pump/nurse, etc.); your individual response to stimulation, since each mother's body chemistry is unique; and how long you have been nursing or pumping (some mother's supplies build slowly, then level off; some keep increasing for many months or years).

Since nursing involves so much more than just transferring milk from breast to baby, many adoptive mothers find that the act of nursing, with the physical and emotional closeness it brings, is just as important as the amount of milk the baby actually receives. Even if you produce only small amounts of breast milk, your baby will get significant benefits from both the milk itself and the security and warmth of nursing at the breast.
The following is what I recommend for the mother who has 6 months or more to prepare for her baby's arrival (this plan can be modified for mothers who have less time to prepare):

Start taking birth control pills that contain both estrogen and progesterone continuously, without the usual one week break each month. This simulates the high levels of these hormones that are produced during pregnancy, and stimulates breast development.

Two weeks before the baby's arrival (or immediately afterward if you don't have advance notice), begin taking either Reglan (10 mg, 3 times a day - call your OB for a prescription) or Domperidone (10 mg 3 times a day, increasing to 20 mg 4 times a day after you have been taking it for a few weeks) See the previous section for more information on these medications.

Two weeks before the anticipated birth of the baby, stop taking the birth control pills and continue taking the Reglan or Domperidone. Start expressing milk with a hospital grade electric double pump, like the Symphony or the Hygiea. These pumps are too expensive to buy, so most moms will rent them. Try to double pump for at least 8 times a day, and remember, you're going for stimulation. Don't get discouraged by the amount of milk you're producing, because it may take weeks for you to see results.

Once the baby is born, put him to the breast using a supplemental feeding system (SNS by Medela, or Ameda's Lact-Aid). These tube-feeding devices allow you to deliver formula while the baby is nursing at the breast, and your breasts receive stimulation at the same time. Most babies will accept the supplemental feeding systems because they are receiving a steady flow of milk with each suck, much as they would with a bottle. Babies older than 3-6 months are often resistant to any feeding method other than a cup or bottle, while younger babies tend to accept the breast more readily. As your milk supply increases, the amount of supplement will level off while your baby continues to gain weight. This means that your supply is filling the gap, and you can gradually reduce the amount of supplement offered. In the meantime, your baby is feeding at the breast and you can enjoy the physical closeness of the nursing relationship, regardless of the amount of breast milk the baby is receiving.

It is important to monitor the baby's weight gain to ensure that he is receiving enough milk. Since he will most likely need to be supplemented in order to ensure adequate nourishment, using a tube feeding device at most nursing sessions will ensure that he receives the milk he needs and also reduce the time you spend supplementing. Preparing a whole day's supply of formula and feeding equipment can save time and energy. As you replace the formula supplement with your own milk, you need to proceed slowly, decreasing the amount by no more than 25 ml per feeding (a little less than an ounce). Monitor urine and stool output and weight gain for about a week before decreasing the supplement again.

These are general guidelines for inducing lactation. Individual responses will vary. The most important thing to keep in mind is that it is possible to establish a very close and rewarding nursing relationship with your baby, regardless of the amount of milk you produce.

There is a great website for adoptive nursing moms, and you might find some answers there, as well as lots of support. The address is: http://www.fourfriends.com/abrw/ (ABRW stands for Adoptive Breastfeeding Resource Website).

(Edited November 2015)

If you found any of the information in this article helpful, please consider making a small donation to my favorite cause - Project Pets: Spay, Neuter, Love - an all volunteer, non-profit organization that provides free spay and neuter services for homeless rescue dogs and cats...because every baby deserves a home, whether they have two legs or four! To find out how you can help, visit Project Pets on Facebook.

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Relactation is the process of rebuilding your milk supply once you have started nursing and then stopped for a period of weeks or months. Induced lactation is the process of building a milk supply in a mother who has either never nursed a baby, or who has nursed years before.

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If your baby isn't keen on attaching then start by lying skin-to-skin and let your baby get used to being close to you. They often start by nuzzling your nipple. Just wait and watch. It can take time for this stage. You can encourage them by dripping some milk onto your nipple, or hand express a few drops. This stage may take some days before they decide they want to try feeding.

You can read more about expressing in our . You may also like to re-visit positioning and attachment.

This link may also help.

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If your baby isn't keen on attaching then start by lying skin-to-skin and let your baby get used to being close to you. They often start by nuzzling your nipple. Just wait and watch. It can take time for this stage. You can encourage them by dripping some milk onto your nipple, or hand express ...

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http://journals.sagepub.com/doi/abs/10.1177/0890334415581646

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Relactation and Adoptive Breastfeeding: The Basics • KellyMom.com

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Relactation or induced lactation (for those who did not give birth to their baby) is essentially a two-fold process: You will be teaching (or re-teaching) baby to nurse at the breast, and to equate nursing with comfort. At the same time you will be developing (or re-developing) a milk supply.

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Breastfeeding your adopted baby - native mothering

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Breastfeeding your adopted baby - native mothering

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http://nativemothering.com/2012/09/breastfeed-your-adopted-baby/

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From the NCT BFC Checklist
Actions:
• Mother may need to explore whether it is her choice to stop or is feeling under pressure to do so.
• Check mother is highly motivate and has plenty of support.
• Inform mother that relactation is possible – grandmothers and adoptive mothers can stimulate their milk production.
• Explain to mother that it can 2 weeks for milk production to increase.
• Explain supply and demand and that initially there may only be a few drops of milk.
• Remind mother to avoid use of bottle/pacifier as far as possible and encourage all suckling to be at breast.
• Encourage mother to put baby to breast frequently.
• Encourage mother to offer both breasts and nurse for long periods of time, letting baby lead.
• Try breast compression while feeding as this helps increase milk flow, enabling baby to obtain more milk.
• If baby is irritable, can try lots of skin-to-contact, bathing with baby and/or biological nurturing positions.
• Express regularly, e.g. 1-2 hourly at first and after feeds. Dual pumping stimulates the supply more.
• Encourage mother to look after herself by eating regularly and resting so that she feels more able to cope.
• Consider use of a nursing supplementer if baby is frustrated by lack of milk available at first.
• Sections on, and also , may be relevant.
• Some mothers choose to use galactagogues (like oatmeal or fenugreek) alongside frequent and effective removal of milk from the breast but there is a lack of evidence that they have more than a placebo effect.

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Can you stimulate your milk supply after you stop breastfeeding, or induce lactation as an adoptive mother? Charlene Yared-West explores relactation.

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."

Extended breastfeeding: What's it all about?

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.

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.

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.

7 reasons why your baby might be refusing your breast

A word on galactagogues

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Relactation | Can you breastfeed your weaned baby again? | Living and Loving

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Can you stimulate your milk supply after you stop breastfeeding, or induce lactation as an adoptive mother? Charlene Yared-West explores 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.

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breastfeeding an adopted baby and relactation (la leche league international book)

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Breastfeeding an Adopted Baby and Relactation (La Leche League International Book)

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Not many people are aware of the fact that induced lactation and relactation are possible. La Leche League International, the world s foremost authority on breastfeeding information, is proud to introduce a book that provides information on these amazing biological processes. In Breastfeeding An ...