Can There Be Breastfeeding After Weaning
by Nancy Mohrbacher, IBCLC
Many women are surprised to hear that it is possible to begin breastfeeding again after a baby has weaned. Although this is now considered unusual, it was once commonplace in our society and in other parts of the world. Called relactation, this is the process of rebuilding a mother’s milk supply after it has been reduced or has completely dried up. Mothers often consider relactation when breastfeeding has been interrupted before mother and baby are ready to wean.
REASONS AND OUTCOMES
The most common reasons women give for wanting to resume breastfeeding are the nutritional and emotional benefits it offers the baby and the closeness it brings to the mother-baby relationship. In a survey of 366 women who relactated, most women reported not being as concerned with the amount of milk they produced as they were with having the opportunity to nurture their babies through breastfeeding. Although some mothers made the decision to relactate based on their babies’ intolerance to formula or other health problems, most women were more concerned with the effect breastfeeding had on their relationship with their babies.
The majority of mothers were able to successfully relactate. More than half of the women surveyed established a full milk supply within a month. It took another one-quarter of the mothers more than a month to fully relactate. The remaining mothers breastfed with supplements until the child weaned. Women who attempted relactation within two months of childbirth reported greater milk production than those who attempted it later on.
In order to relactate, a mother needs to accomplish several tasks:
- teach the baby to nurse effectively at the breast (if he isn’t already),
- stimulate her breasts to produce milk,
- make sure the baby receives adequate nourishment while she is increasing her milk supply,
- arrange for necessary help and support for the entire family during the process.
Relactation can consume most of a mother’s time and energy for about two weeks, so any mother who is thinking about relactating should carefully consider her own feelings and her family situation, including any other commitments she may have. If a mother is motivated and willing to take the time, relactation is definitely possible. It can help to have the kind of mother-to-mother support that a lactation consultant or La Leche League Leader can provide.
A nursing baby is the most effective way of stimulating milk production, and because milk supply is based on supply and demand, the more often the baby nurses, the more milk there will be. If you still has some milk and the baby is willing to nurse for comfort as well as for nourishment, put baby to the breast at least every two to three hours for at least fifteen to twenty minutes per breast and gradually decreasing the amount of supplement the baby receives.
When a baby won’t nurse often or long enough or he is not sucking well, some mothers find a breast pump helpful in stimulating milk production. This often leads to a baby staying at the breast longer because the milk supply is more plentiful. The most effective type of breast pump is the full-size electric model that can be rented from some pharmacies and medical supply houses. Hand expression can also help increase milk supply.
A device called a nursing supplementer is another way to teach the baby to nurse, stimulate the breasts, and provide the baby with nourishment all at once. It allows the baby to receive expressed mother’s milk or formula while nursing at the breast. It allows a baby to receive the supplement through a small, flexible tube that is taped or held in place at the mother’s nipple. One type of nursing supplementer, the Supplemental Nursing System (SNS) by Medela, which holds the supplement in a plastic bottle suspended from a cord around the mother’s neck and uses three sizes of tubing. Milk flow is regulated by the size of the tubing used and the height of the uspplemental bottle in relation to the mother’s nipple. The higher the bottle, the faster the supplement flows; the lower the bottle, the slower it flows. To find a Medela retailer near you, call Medela at 1-800-TELLYOU. Its current cost is $43.40.
Avoid giving your baby a pacifier or bottle, which can satisfy her need to suck for comfort. Use a nursing supplementer, spoon, cup, or eyedropper, so she’ll be more likely to accept the breast for comfort, which will further stimulate your milk supply. If you prefer to supplement with a bottle, hold the bottle close to your breast so your baby becomes comfortable in that position and begins to associate skin-to-skin contact with feedings. To encourage your baby to nurse as much as possible, offer her the breast before, after and in between supplementary feedings.
PERSISTENCE PAYS OFF
Not all babies are eager and willing to take the breast at the first offering, but this is not an accurate predictor of how breastfeeding will go. Mothers in the survey who were relactating due to an untimely weaning reported that only 39% of their babies nursed well on the first attempt, 32% were ambivalent at first, and 28% refused the breast. But within a week of consistent trying, 54% of these babies took the breast well, and by ten days the number rose to 74%. The baby’s age and previous breastfeeding eperience also had some influence on whether relactation was successful. Babies younger than three months and those who had previously breastfed tended to be more willing. However, the most crucial factors in persuading babies to take the breast were time, patience, and persistence.
The transition will be smoother if you make sure breastfeeding is a relaxing and positive for you and your baby. Never insist on nursing if the baby is resistant. Good times to attempt nursing are when the baby is not too hungry, when the baby is asleep or relaxed. Certain environments may be more conducive to nursing. Try nursing your baby in a darkened room or a place free from distractions, or while bathing in the tub, rocking in a rocking chair or walking. If a nursing supplementer is not being used, dripping milk or formula on your breast may help motivate baby to latch on. Also, spending time each day just touching is comforting to both mother and baby and may make a baby more willing to nurse. Cuddle and stroke your baby, carry him snuggled close in a baby carrier or sling, and take baths and sleep together.
As the mother’s milk supply increases over time, the baby will need less supplement. Some babies begin leaving supplement in the nursing supplementer or bottle, letting the mother know it is time to cut back accordingly. But more commonly, mothers need to take the initiative and gradually reduce the amount herself as she notices signs of increasing milk supply, such as feelings of fullness in her breasts or the tingling of milk let-down. Decreasing the supplement by a half ounce per feeding per day works well for some babies.
Changing from one feeding method to another is difficult for some babies. A baby should never be stressed by hunger during relactation and formula should never be diluted. To be make sure your baby is receiving enough nourishment, keep a written journal tracking factors that show your baby’s progress:
- Frequency and length of breastfeedings. Most babies need to nurse at least eight to ten times per day. Nursing even more often for comfort will accelerate this process.
- Your baby’s reaction to breastfeeding. Does he suck actively? Is he happy to take the breast?
- The amount of supplement offered and how it was given. This will provide a record of decreasing supplement and increasing milk supply.
- Number of wet diapers and stools per day. Baby should have at least six wet diapers and at least two stools a day. Fewer stools may be normal in a baby older than six weeks. Expect stools to change in consistency and become less formed as mother’s milk becomes a greater part of the baby’s diet. Fewer than six wet diapers are a sign that more supplements may be needed.
- Weight gain and growth. Check your baby’s weight weekly. Baby should be gaining at least four to eight ounces a week. If weight gain is less, more supplements may be needed.
IS IT WORTH IT?
In hindsight, three-quarters of the 366 women surveyed felt relactation had been a positive experience. However, the amount of milk they produced was unrelated to their feelings of success. Time and again they emphasized that breastfeeding is as much nurturing at the breast as it is nutrition from the breast. One mother said she did it “for the sheer joy of holding him close–if not fed by the breast at least at the breast.”
Overall, the women felt the most compelling reason for attempting relactation is the mother’s desire to breastfeed. One mother said, “I would suggest she decide what she honestly wants and do it and not listen to [those who say] ‘wait til your next one.’” Or, as another said: “Breastfeeding to me is a beautiful and natural way of feeding your baby, and I feel that everyone should have the chance to experience it.”