Relactation - How to Rebuild or Increase Your Breast Milk Supply

Bottles of breast milk in a refrigerator
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Many women start out breastfeeding exclusively, but as the days and weeks go on they may add bottle feeding and infant formula to their daily routine. Some women end up breastfeeding less often or weaning earlier than they would like -- sometimes by choice, sometimes not. Then, they may be able to or want to start breastfeeding again. Is it possible?

Rebuilding a Breast Milk Supply After It Has Decreased

When you begin to breastfeed less often or stop breastfeeding altogether, your supply of breast milk decreases.

So, if you decide to start breastfeeding again, you have to rebuild your milk supply. Rebuilding or reestablishing your breast milk supply is called relactation. From herbal therapy and prescription medication to breastfeeding more often and pumping, there are many ways to reestablish your breast milk supply if you've stopped nursing or if you feel that your supply isn't as strong as it once was.

How to Increase Your Breast Milk Supply by Breastfeeding

To achieve the healthiest amount of breast milk possible, it is essential that you:

  • Breastfeed your baby or pump the breast milk from your breasts at least 8 to 12 times a day. If it has been a while since your baby was at the breast, it may take a lot of loving persistence and consistency. With patience, your baby should find his way back to breastfeeding comfortably. If your baby is having trouble latching on, you may need to review the breastfeeding positions and latch techniques or ask for help.
  • Offer both breasts at every feeding. Breastfeeding from both sides at each feeding provides stimulation to both breasts at least every two to three hours. The more stimulation each breast receives, the greater chance you have of making more breast milk. 
  • Utilize breast compression. The breast compression technique can help your breast milk flow better and encourage your baby to continue breastfeeding. You don't use this technique when the baby is actively breastfeeding. But, when the milk flow begins to slow down and the baby is no longer getting breast milk as he sucks, breast compression can help get more breast milk out of the breast. To compress the breast, you hold it in your hand with your thumb on one side and your fingers on the other side. You press your thumb and fingers together to compress the breast. The compression of the breast not only helps the baby to get more breast milk, but if it keeps the baby sucking longer at the breast it's telling your body to make more breast milk.
  • Avoid artificial nipples. Any time your child needs a feeding or even simple comfort, the breast should be your first choice. Bottles and pacifiers can cause nipple confusion preventing your child from breastfeeding well. They also take away precious time that the baby could be spending at the breast stimulating the production of breast milk. 

Using a Nursing Supplementer Device

If your breast milk supply is extremely low and your baby seems frustrated with breastfeeding, a nursing supplementer device or supplemental nursing system can work wonders. With a nursing supplementer, your baby receives either infant formula or your expressed breast milk at the same time that she breastfeeds. A tube runs from the supplemental feeding to your nipple. The formula or breast milk from the device goes into your baby's mouth as she nurses at the breast. It allows your child to breastfeed and stimulate your milk supply while getting the nutrition that she needs.

Using a Breast Pump

Sometimes, a baby is not able to or not interested in going back to the breast. If this is the case, you can stimulate your breasts to build your breast milk supply by using a breast pump. Removing the breast milk from your breasts with a hospital-grade, double (automatic) pump, eight to twelve times a day would be ideal for reestablishing your supply.

Here are some tips for getting the most out of your breast-pumping capability:

  • Stimulate your let-down reflex first.
  • Only use as much suction as necessary. You shouldn't feel any pain while pumping.
  • Massage your breast in quadrants while you're pumping.
  • Give yourself enough time so you don't feel any stress.
  • Use pump inserts to get the best fit to your breast.
  • Avoid long stretches of constant vacuum.
  • Stop pumping when the flow of breast milk is minimal or nonexistent.

Using Breastfeeding Herbs

There is not that much official research on the use of medicinal breastfeeding herbs (also called galactagogues) to increase breast milk supply.

However, many mothers report overwhelmingly positive responses to herbal therapy in addition to frequent stimulation of the breast. Some of the herbal remedies that may boost your breast milk supply include: 

Remember, to get the best results you need to continue to stimulate the breasts by breastfeeding or pumping often while you're using herbal galactagogues. Milk-making foods such as oatmeal and almonds are also believed to boost the supply of breast milk slightly.

Using Prescription Medication

Higher levels of prolactin are associated with an increase in milk production and a greater supply of breast milk. A few prescription medications that, when taken while continuing frequent stimulation of the breast, have been found to raise prolactin levels. They include:

  • Reglan (metoclopramide): In some (but not all) cases, Reglan has been shown to increase the breast milk supply anywhere from 72% to 110%, depending on how many weeks postpartum a mother is. The dosage is usually 10mg, three times a day for 1 to 2 weeks, but your own dosing recommendation should be made by a physician. Once the supply of breast milk is stable, the dosage should drop by 10mg per week. Since one side effect of Reglan is depression, mothers with a history of depression are cautioned against taking it. Other side effects include headaches and fatigue. The labeling of this medication also has a box warning risk of tardive dyskinesia when the drug is used for more than 3 months.
  • Motilium (domperidone): Motilium is not FDA approved, so it's not available in the United States. However, it is considered a safer alternative to Reglan in Canada and other countries. The side effects are fewer and generally milder. They include a headache, dry mouth, and stomach cramps.

A Word From Verywell

The process of relactation is intense. It's important for you to take care of yourself. Eating a well-balanced diet, drinking at least 64 ounces of water a day, and getting enough rest is important not only for your milk supply but for your health. It might not be easy, but try to keep your stress levels low. Stress and fatigue are known to affect breast milk supply. If you're too stressed or exhausted any attempt to establish a full breast milk supply may be futile. Any kind of help, whether it's physical, psychological, or even domestic, will aid the process of relactation, and get you on your way to a healthy breast milk supply yet again.

 

Sources:

Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol# 9: use of galactogogues in initiating or augmenting the rate of maternal milk secretion (First revision January 2011). Breastfeeding Medicine. 2011 Feb 1;6(1):41-9.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Seventh Edition.  Mosby. 2011.

Riordan, J., and Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2014.

 

Edited by Donna Murray

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