Relactation - What is it and how does it work? – Legendairy Milk South Africa
  • Relactation - What is it and how does it work?

    There are many reasons breastfeeding can be interrupted and just as many reasons why someone chooses to relactate after having stopped breastfeeding. It is possible to begin producing milk after you have stopped, but it does take time, patience, and determination. Having a plan in place with steps to take helps optimize your time and milk production. 

    There are no guarantees. While some people can re-establish a full supply for their baby, others are only able to make a partial supply compared to their baby's needs. Any amount of your milk that you can feed your baby is beneficial to them. Breastfeeding can look many different ways and the more milk you can provide your baby, the less donor milk or supplement they will need.

    Relactation is a process to begin producing breast milk again after having stopped for anywhere from a few weeks to many months. In some cultures, grandmothers re-lactate to nurse a newborn if the mother is ill, there is a separation of mother and baby, or other cultural beliefs including colostrum taboos.(1)

    Reasons people have chosen to relactate include:

    • Baby is not tolerating formula well
    • The parent was not ready for breastfeeding to end
    • Health benefits for the baby (and mother)
    • Having nursed a child previously and now adopting a baby
    • Having previously nursed a child and wanting to be able to co-nurse their new baby
    • Preparedness for being able to safely feed your baby in states of emergency

    How does relactation work?(2)

    Prolactin - this hormone is responsible for the development of mammary tissue, milk storage, and making milk. As milk is removed by the baby or pumping, prolactin is released and tells the body to synthesize milk by pulling nutrients from the parent's blood supply and storing the milk for feeding the baby. Because of this, once you are making milk, you are never truly empty of milk. The more often milk is removed, the more often you are sending the signal to make more and prolactin levels stay more elevated.

    Oxytocin - the hormone responsible for releasing milk. It is also the feel-good hormone. For oxytocin to be released, you must be relaxed. It doesn't release if you are under stress, feel rushed, and have too much going on. This can be a challenge when you are already concerned about increasing milk production. Set yourself up for success by taking a few deep breaths, putting on soothing music, meditating, or dimming the lights. Or, maybe you feel less stressed putting on a favorite show or listening to your favorite comedian. Whatever helps you to relax. As your baby begins to suck or you begin pumping, oxytocin is released and milk is squeezed from the cells and flows through the ducts towards the nipple. It is often called the milk let down, but more accurately is the milk ejection reflex.

    Demand dictates supply - The amount of milk being demanded and removed helps dictate the supply of milk. With relactation, it can take time to build and increase the supply, but with frequent, consistent, and effective milk removal, the body responds and more milk begins to be produced. Strategies that are tailored to you and your situation will help optimize your relactation process. Each parent and baby have a unique situation and may need different tools for helping to achieve your goals with relactation. Meet with an experienced SACLC/ IBCLC to co-create a care plan based on your health history, lactation journey, and goals you have.

    How long does it take to relactate?

    • How old is the baby? - younger babies are often more willing to get back to breastfeeding. Older babies may take more convincing unless you have already rebuilt your supply by way of pumping.
    • How long since you have lactated? - If it has only been a short period since you were last making milk, you may see a response to your relactation efforts sooner. If you have completely weaned and have not made milk, it may take a little longer before you see the drips and milk production flow.
    • Current health status - Your health impacts your milk supply. What you eat and drink and your environment can help or hinder your relactation goals. Choose a wide variety of colorful foods to boost your nutrition, limiting processed foods and sugars. Get plenty of fresh air and sunlight and find alternatives to harsh household cleaners that can be toxic to your indoor air. 
    • Did you have a full supply previously? - If you did, you are more likely to make a full supply again. 

    Tools for relactation

    • Pumping & hand expression - stimulation to the nipple releases prolactin which triggers the development of the alveoli in the breasts and for instructing the cells to secrete milk. Using heat to warm the breast and gentle massage can help encourage relaxation and milk flow. Hand expressing after a pumping session to get more milk out means room for more milk to be stored.
    • Skin to skin - you and your baby exchange a lot of information when you are skin to skin. Being skin to skin raises oxytocin levels improving milk flow and therefore milk removal. The more often you have your baby on you, skin to skin, the more often they are likely to nurse. More contact with your baby allows them to feed even for just a short snack more often rather than waiting long periods between stimulation and feeding. 
    • Supplementer at the breast - babies are often more effective at building milk supply than a pump. Using a supplemental feeding system allows you to feed your baby directly at the breast each time while still getting the calories they need while you build your supply. Their suck stimulates production by the release of prolactin and they will be drinking all the milk you are producing.
    • Co-bathe - another opportunity to be skin to skin with your baby and in a relaxed atmosphere. This reminds babies of their time in utero and can help get babies comfortable with the idea of latching and feeding at the breast again.
    • Co-sleep - safe co-sleeping keeps you and your baby near each other which can lead to more nursing during the night when prolactin levels are naturally higher. Prolactin follows its own circadian rhythm. Milk removal during the night when it is highest optimizes production and can increase the production of milk for the next day.
    • Bodywork - there are many times of bodywork available. Reducing stress and reducing muscle tension can aid in oxytocin release during milk removal. Just like babies, parents can have structural misalignments that inhibit milk production.(3) Chiropractic adjustments that are gentle and release stuck tension, and fascial tension and restore alignment can help your body work better and increase your ability to make more milk.
    • Herbs - Some herbs can support your journey of relationship. Herbs work differently in the body so choosing herbs or a blend of herbs that is best suited to you is recommended. Goat’s rue (found in Liquid Gold) is known for increasing mammary tissue. Moringa and nettle found in Milkapalooza are nutritional powerhouses. Shatavari, found in Pump Princess can increase prolactin and encourage milk flow. All of these are considered galactagogues. Along with nutrient-dense foods that provide ample vitamins and minerals, you can increase milk production as well as the quality of the milk you produce. 

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    Footnotes:

    1. https://www.journals.uchicago.edu/doi/10.1086/675657
    2. http://apps.who.int/iris/bitstream/handle/10665/65020/WHO_CHS_CAH_98.14.pdf;jsessionid=CF3056477AD5AA3795B978FC1DF26C48?sequence=1
    3. https://www.bodyandbalancechiropractic.com/wp-content/uploads/2017/09/Hypolactation.Vallone.pdf

    Other Resources:

    https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/supporting-families-with-relactation.html

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5158159/


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