How To Reintroduce Lactation After Stopping Breastfeeding

If you stopped breastfeeding (chestfeeding), it may not be too late to try again. That’s true even if you’ve avoided breastfeeding completely and have never done it. The challenging process of relactation can take weeks or even months to produce milk. But if you’re interested in giving it another go, the process of relactating is both possible and beneficial for your baby’s health. Plus, new guidelines from the American Academy of Pediatrics (AAP) recommend breastfeeding children up to 2 years old and beyond, so it may not be too late for you to start breastfeeding again.

Pediatrician and breastfeeding medicine specialist Heidi Szugye, DO, IBCLC, shares why you may want to try relactation and how you can make that process easier with a few simple tips.

What is relactation?

During relactation, you train your body to produce milk after not lactating for a period of time. It’s possible to relactate if you haven’t produced breast milk in weeks, months or even years. And while some may think relactation is a modern concept, the practice has been around for hundreds of years. During natural disasters, emergencies or when mothers died during childbirth, it was often customary for other mothers to step in and help.

Interest in relactation has peaked since the recent infant formula shortage. New guidelines from AAP have also highlighted a number of benefits for breastfeeding children longer, up to 2 years old and beyond. Although relactation has been around for years, Dr. Szugye is quick to point out that relactation has its challenges.

“People either underestimate or overestimate the time and effort it takes to relactate,” says Dr. Szugye. “Some people think the process is easier than it actually is, but it doesn’t just happen overnight. It’s not impossible, but it takes a lot of time, effort and support.”

Can breast milk come back after drying up?

If you choose not to breastfeed your infant and you don’t stimulate your breasts after your baby is born, your breast milk will dry up typically 14 to 21 days after delivery.

“You need that suckling or stimulation of the breast to tell the body to continue to make more milk. The emptying of the breasts themselves tells your body to make more,” explains Dr. Szugye.

When that milk is left alone in your breasts, a specific protein builds up and acts as an inhibitor causing breast milk production to stop. Fortunately, you may be able to restart breast milk production later on when you feel the time is right.

Why would a parent choose to relactate?

Parents may stop initial breastfeeding for a variety of reasons. If mom is in the ICU or having medical issues after birth, breastfeeding may be more difficult. Some parents who experience postpartum depression may initially be overwhelmed by breastfeeding challenges but, once treated, find they want to try again. Parents who have to return to work sooner than later may also find breastfeeding difficult when they have to go back to the office. Lastly, if your baby is born prematurely or is sick and needs surgery after delivery, it may be hard to directly breastfeed initially.

“Mothers who didn’t breastfeed initially may change their minds down the line and want to breastfeed their baby or provide their baby with breast milk,” says Dr. Szugye. “There are also more unique situations, too, where maybe a mom had a biological child they breastfed previously but now they want to breastfeed an adopted child, so they desire to relactate.”

How to start the process of relactation

Before you begin relactation, it’s important to set goals and expectations and to recognize that it takes a lot of patience and support. Dr. Szugye advises seeing a lactation consultant or breastfeeding medicine specialist to understand why you stopped breastfeeding and help you with the process of relactation.

“If you faced challenges with breastfeeding initially and that led you to stop breastfeeding, these challenges may resurface when you try to relactate,” says Dr. Szugye. “For example, if you had an issue with the baby latching onto your breast or producing enough breast milk, those issues may happen again, so we want to make sure we can support you and work through those challenges and troubleshoot.”

To reproduce milk, your breasts need to be stimulated and your body needs to know you’re removing milk so that it can produce more. You can do this with a number of techniques.

You can begin trying to relactate with your baby directly, but if they have trouble latching onto your breast or they’re a bit older, this may be difficult to do. You never want to force your baby to feed because this can backfire and turn them away from wanting to suckle. Plus, you won’t produce milk right away, so this process will take time and require your continued use of formula or donor milk until you begin milk production.

“You can’t go cold turkey from feeding a baby formula to putting them to the breast. You’re not going to be producing enough for the baby, from a nutritional standpoint, right away,” notes Dr. Szugye.

To increase your baby’s ability to latch onto your breast and begin suckling, you can do the following:

• Avoid pacifiers. “There are textural differences between a bottle, a pacifier and a breast. Putting them to the breast is going to feel different to them,” explains Dr. Szugye.
• Maximize skin-to-skin contact. Try laying your baby on your chest, skin-to-skin, and allow their natural instincts to kick in.
• Allow suckling at your breast when your baby is upset. Although this won’t provide any nutritional value right away, having your baby familiarize themselves with your breast and the act of suckling will also simultaneously stimulate your breast to begin producing milk over time.

To provide additional nutrition, you can supplement with a bottle, tube and syringe, or use a supplemental nursing system that has a tube connected to a bag of formula or donor milk. You can wear this tube like a necklace or attach it to your breast so your baby gets used to the act of suckling for milk in the right location.

In addition, you may want to try hand-expressing milk from your breasts. You can do this by making a C-hold with your thumb and index finger and compressing your breast from behind the nipple to simulate what a baby would do when suckling.

Once you begin producing milk, you can then turn to a pump to handle larger volumes, or use both simultaneously.

“It can become a little tedious to hand express when you start getting bigger volumes of breast milk, but you can combine hand expression with pumping or ‘hands-on pumping,’” says Dr. Szugye.

How long does it take?

Relactation doesn’t happen overnight. You’ll need to stimulate your breasts for 10 to 15 minutes on each side at least eight to 10 times every day. At least one of these sessions should be done at night or early morning when prolactin, the hormone that helps with milk production, is at its highest.

“It takes weeks or months to build up a supply,” says Dr. Szugye. “Sometimes, it can take weeks just to get drops of milk.”

This can sound discouraging and feel daunting, especially given the daily requirements. If you’re able to stick with it, in most cases, you’ll start getting drops of milk after two to four weeks.

Finding support for relactation

You’ll want to work with a lactation consultant and pediatrician to keep an eye on your baby’s weight and growth during this period. You’ll also need to supplement the lack of breast milk with formula or donor milk until you’re able to produce enough milk on your own. In some cases, your doctor may recommend medications or supplements to help with milk production.

While relactating, you’ll want to focus on getting enough sleep, staying hydrated and reducing stress as much as possible because all of these things can affect milk production. If you’re able to get additional help around the house during this time, that can also be beneficial.

“It’s almost like having a newborn all over again,” says Dr. Szugye.

Here are some additional resources that can be helpful when considering relactation:

• The Academy of Breastfeeding Medicine: This resource offers evidence-based information on breastfeeding and relactation.
• The International Board of Lactation Consultant Examiners: The IBLCE has a directory where you can find certified lactation consultants in your area.
• Your local support groups: There are several virtual and in-person community groups and support groups through area hospitals that can connect you with others going through the relactation and breastfeeding process.