Relactation: How to Start Breastfeeding Again After Stopping

A pause breastfeeding that happens for any reason doesn’t have to be a permanent end. In many cases, restarting is possible with the right steps and made easier with the right support.

Some people confuse relactation with induced lactation.

• RELACTATION refers to breastfeeding or offering breastmilk after a gap where it stopped. What relactation does NOT define is the exact amount of time between stopping and starting, therefore not defining the ”how” and ”when” milk is replenished.
• INDUCED LACTATION is a term used for those who have never lactated and are creating a milk supply without being pregnant. We see this in adoptive parents a lot! 

There will be variation from one mom's journey to another. For instance, if a mother stopped breastfeeding (or pumping!) for 2 weeks, but decided to try again, there’s a high chance her milk never fully “dried up.” After resolving any other obstacles, it could be quite achievable to reach their breastfeeding goals.

For a situation where the gap was 5 or 6 months, it may mean a lot more steps, patience, and readjusting expectations and goals. Ultimately, every drop of breastmilk provided to your little one counts, so there’s no such thing as a small achievement here. Mental health is also incredibly important and crucial, so the road to relactation needs to be a gentle one and realistic.

Many moms are trying to relactate after the recent infant formula shortage. If you have concerns about baby's weight or need resources, contact a health care provider or pediatrician.

Breast stimulation is a key component, as it sends prolactin hormonal signals to switch milk production back on. Depending on the level in which production was happening prior to stopping, returning to an adequate level will most likely be easier for those where the supply was more established- but its not everything!

Stimulation can happen through breast massage, nipple stimulation, or “twiddling”, pumping with an electric breast pump or hand pump, hand expression, and of course letting baby suckle and pacify on the breast if they’re able. Even when milk is not yet trickling out, repetitive stimulation sends signals to alert the body to start producing.

Another way to stimulate is skin-to-skin contact and cuddles, letting the baby smell, lick and nuzzle the chest. Skin-to-skin contact can also happen while bottle feeding! If latching was an obstacle, this is also a great exercise when laying back in a reclined fashion, baby on their belly to explore the mother’s chest, strengthening their neck and instincts to attach.

Ultimately, the steps to relactation are meant to get you to a sustainable place, where feedings or pumping sessions can align with the rest of your lifestyle. For instance, an exclusively breastfed baby feeds every 2-3 hours, occasionally more frequently and with requests to pacify which further stimulates milk production. However with relactation, frequency takes on a new meaning, as stimulation needs to be just as often as the newborn feeding frequencies, regardless of whether or not milk is expressed or not. It can take up to a week to see expression for those whose gap was for a week two, and it can be longer for those whose gap was longer.

A baby may prefer to breastfeed when they are not desperately hungry or at certain times of day. You want the baby to enjoy being at the breast, so anything you can do to avoid making breastfeeding a battle ground will be useful. It’s better not to force the baby into a breastfeeding position but to enjoy time skin-to-skin contact and present opportunities gently.

You may need to use encouragement when bringing them to the breast. IF you have any milk flow yet, you can hand express some drops of milk into baby’s mouth, or you might pump for a moment to get the flow of milk started.

Pumps and hand expression are great ways to build and replenish supply as they can be used regardless of how well baby can stimulate and feed. A baby’s stimulation is preferred and the body is typically more reactive, however, the frequency and ability of a baby is not always part of the equation. These are tools to get the job done in a controlled way so that when you practice later with baby, you can focus solely on them. It can also be a great priming of the nipples to help baby attach if they’re struggling!llit anim id est laborum.

Learning the basics also provides a gauge on progress made with relactation, how much supplementation is needed as things change and progress, and what additional help may be needed. Painful latches, for instance, need to be addressed by a lactation consultant or counselor (IBCLC, CLC).

They can also help guide you on goal setting, expectations, and monitoring weight gain in the baby. Weight checks are also used to determine milk removal before and after a feed. This is also called a “weighted feed.” Any deficits between what was drunk from the breast and what is still needed per feeding can be measured and properly supplemented by pumped breast milk and/or infant formula, depending on your individual needs.

Other tools to help baby back to the breast are nursing supplementers, also known as a supplemental nursing system (SNS), which use a tiny tube taped to side of the nipple, and is slowly fed breastmilk or replacement to encourage suckling and stimulation at the breast. This helps with latching and milk supply stimulation.

Normal feeding frequencies can be overwhelming for any mom to wrap their head around. It’s quite normal to feel discouraged and overwhelmed when doing the same without having the gratification of milk expression. Setting healthy and achievable goals, adjusting expectations, and prioritizing mental health can be the very things that make or break your experience. Make sure to seek out help from a lactation professional and support groups.

• Menses may come, go, or be irregular when supply fluctuates, builds, or stops.
• Postpartum depression and anxiety may be coupled with breastfeeding cessation.
• Until, or if, full supply thresholds are met, your baby needs supplementation.
• Side effects of milk supply fluctuation also include mood and emotional swings- lean in on your support groups during this time!
• Galactagogues may be suggested to support breast milk production. Many IBCLCs recommend avoiding products containing fenugreek, as they can cause a lot of gas and can interfere with heart conditions.
• It does not have to be all-or-nothing. Millions of mothers maintain a status of partially breastfeeding/providing breast milk while supplementing. Supplementing can be with human milk or infant formula.
• This will not be an overnight cure. Supply development takes weeks even without gaps.
• Some days will be better than others. This is true even for mothers with a developed breast milk supply, so remember to have grace for yourself and your body!

Information provided in blogs should not be used as a substitute for medical care or consultation.