Archive for the 'Weaning' Category

Is Baby Weaning or Is It a Nursing Strike?

by Nancy Mohrbacher, IBCLC

Your baby has been nursing well for months, then suddenly begins refusing the breast. What does it mean? Is there something wrong with your milk? Is baby sick? Is baby ready to wean?

When a baby refuses to breastfeed, it may not be because he or she is ready to wean. If the baby is younger than a year and has not been eating much solid food or drinking from a cup, the most likely cause is a nursing strike.

A nursing strike is a baby’s way of communicating that something is wrong, and many babies who go “on strike” are obviously unhappy about it. Some nursing strikes come on suddenly, others more gradually. But a nursing strike does not have to mean the end of breastfeeding. If a mother encourages her baby to continue breastfeeding, a nursing strike usually lasts between two and four days, although some last longer. With lots of patience and persistence it is almost always possible to convince the baby to go back to nursing, which offers many benefits to both mother and baby.

POSSIBLE CAUSES OF A NURSING STRIKE

Sometimes the cause of a nursing strike is obvious, but other times, the mother may never discover the reason. Some common causes include:

  • mouth pain from teething, injury, cold sore, or a fungus, such as thrush,
  • an ear infection, which may cause pressure or pain while nursing,
  • pain while being held in the nursing position, perhaps due to an injection or an injury,
  • a cold or stuffy nose that makes breathing difficult while nursing,
  • too many bottles, overuse of a pacifier, or frequent thumbsucking, which may also lead to a reduced milk supply,
  • regular distractions and interruptions while nursing,
  • a strong reaction to a baby’s bite,
  • yelling or arguing while nursing,
  • overstimulation, stress, or tension from an overly full schedule or an upset in the home,
  • an unusually long separation from mother,
  • a major change in routine, such as moving or traveling,
  • limiting and/or rigidly scheduling feedings,
  • repeatedly putting off the baby when she wants to nurse or leaving her often to cry.

Becki Hallowell from Guam discovered on the third day of six- month-old Todd’s nursing strike that “we had all the usual causes and then some. We all had bad colds. (Todd’s was the worst.) We were all very tired and in a new situation with extra stresses. Todd’s grandparents, whom we hadn’t seen in a year, were visiting us for a month. During their visit, Grandpa ended up in the hospital. There had also been two deaths in our family within a week of each other only a few days before. Todd had been biting me due to teething, and I had reacted strongly.”

Other, less common causes of a nursing strike include: sensitivity to a food or drug the mother or baby has ingested (including vitamin or mineral supplements and fluoride drops), creams or ointments applied to the mother’s nipples, change in the taste of the mother’s milk due to a breast infection, and a reaction to a new product (such as a soap, shampoo, or laundry detergent) the mother has used on her body or her clothing. Iowa mother Carol Strait had to play detective to find the reason for her two-and-a-half month old daughter’s nursing strike. “My first clue was that Christie always seemed fussier and wouldn’t nurse when we went somewhere. This was because I had just showered and applied spray deodorant. I’m not sure what ingredients in the spray were responsible. My big problem was easily solved by simply switching from a spray to a solid stick deodorant.”

Naturally not all babies will respond to all of these possible causes by refusing to nurse. Some babies are more sensitive than others, and different babies will display a wide range of reactions to the same thing. For example, one baby with an ear infection might continue nursing well, while a second baby becomes fussy at the breast, and a third baby refuses the breast altogether.

AN UNHAPPY TIME FOR EVERYONE,

No matter what its cause, a nursing strike is upsetting for everyone. The baby may be unhappy and difficult to calm. The mother may feel frustrated and upset and worry that her baby is rejecting her. She also may feel guilty, believing that her baby’s refusal to nurse means she has done something wrong.

Anne Monroe from North Carolina, whose daughter Meghan went on a five-day nursing strike at eight months, “felt terrible grief and rejection during the strike.” Victoria Schnaufer from Pennsylvania, who weathered a ten-day nursing strike with her son Jonathan, says, “Until Jonathan went through a nursing strike at eleven months, I had no idea how emotionally stressful and physically draining this challenging breastfeeding situation could be. By the third or fourth day I was extremely frustrated and was becoming angry.” Carol Strait found her mind racing when two-and-a-half month old Christie began refusing the breast. “A thousand thoughts ran through my mind–I must be eating the wrong foods, maybe she was teething, I was probably too nervous (what nursing mother wouldn’t be nervous when her new baby suddenly refused to nurse?), perhaps she was weaning herself–and even the fearful thought that she didn’t like me!”

There are also physical considerations. As the baby misses feedings, the mother will soon become uncomfortable as her breasts fill up with milk. If her breasts become engorged, she will be at risk for a plugged duct or breast infection. And the baby still needs nourishment. Worries about how to feed the baby can add to the mother’s upset.

KEEPING MOTHER AND BABY COMFORTABLE

While the mother is trying to persuade her baby to take the breast, she will probably need to express her milk about as often as her baby had been nursing. This will keep her comfortable, prevent plugged ducts, and provide her baby with the milk he or she needs.

Expressing milk by hand or with a small breast pump is a learned skill that takes practice to master. If a mother whose baby is on strike is having difficulty expressing her milk, another option is to rent a full-size electric breast pump (available at many medical supply houses and drug stores). The full-size electric pump does not depend upon skill or practice to be effective, because its suction- and-release mechanism automatically mimics the suck of a breastfeeding baby. A double-pumping attachment is available with this type of pump that allows both breasts to be pumped at the same time, cutting pumping time in half.

Then the mother needs to decide how to give her expressed milk to her baby. Most mothers think of bottles first, but it may make it easier to convince a baby to go back to breastfeeding if bottles and pacifiers are avoided during a nursing strike. Artificial nipples satisfy the baby’s urge to suck, decreasing the desire to nurse. In some hospitals in Africa, bottles are never used. Even premature and ill babies are fed from small cups. If the baby is already drinking from a cup, try offering the expressed milk in that. Other feeding methods include spoon, eyedropper, and feeding syringe. Using a different feeding method may be messy at first, but with patience and practice, a baby will usually master it quickly.

The mother also may be concerned about whether her baby is getting enough milk. To set her mind at ease, she can keep track of her baby’s wet diapers. At least six to eight wet cloth diapers per day–five to six disposables–indicate that the baby is receiving enough fluid.

GETTING BABY BACK TO THE BREAST

Patience and persistence are the keys to getting a baby back to the breast. But if either mother or baby become frustrated when the breast is offered, it is time to stop and try again later. Attempts to breastfeed should be kept as pleasant as possible, so that the baby will associate nursing with positive feelings.

The following time-tested suggestions have helped many mothers overcome a nursing strike.

  • Try nursing when the baby is asleep or very sleepy, such as during the night or while napping. Many babies who refuse to nurse when they are awake will nurse when they are sleepy.
  • Vary nursing positions. Some babies will refuse to nurse in one position but take the breast in another.
  • Nurse when in motion. Some babies are more likely to nurse when rocking or walking rather than sitting or standing still.
  • Nurse in an environment that is free from distractions. Some babies, especially babies older than three months or so, may be easily distracted. Turn off the radio and television, and try nursing in a quiet, darkened room.
  • Give the baby extra attention and skin-to-skin contact. Focused attention and extra touching are comforting to both mother and baby. When offering the breast, whenever possible undress to the waist and clothe the baby in just a diaper. A baby sling or carrier can help keep the baby close between attempts to nurse. Taking warm baths together can also be soothing. Sleeping together provides extra closeness and also provides more opportunities to nurse while the baby is sleeping.

Sharon Stauffer from Ontario, Canada, “realized that I had been very busy with a new responsibility and had not given a lot of attention lately to my baby. Ten-month-old Sheldon is usually a very contented child, willing to play nicely by himself, so I unconsciously ignored him. He became more irritable and demanding and he stopped nursing. When I understood what the problem was I immediately laid aside all my other work and for two days played with him and held him a lot. After a while, he let me cuddle him again, and then he nursed while he was asleep. Finally, after three days, he nursed while he was awake and more often, as he had before.”

Monica McMaken from Arizona, whose son Ryan had a stuffy nose and went on strike at two months, found two suggestions especially helpful. “First, I nursed Ryan while he was sleeping, but if he woke up he would stop. Second, I tried nursing him while walking up and down the hall. If I sat down he would stop nursing. My arms sure were sore, but I was so happy to have my baby nursing again.”

Viola Marshall from British Columbia, Canada, blamed her son Keegan’s nursing strike on the three-to-four-hour schedule recommended by the hospital. Keegan spent many hours crying while Viola watched the clock. With the benefit of hindsight she wondered, “How many hours could have been saved for us both if I had given up the schedule!” The most helpful advice came from her husband, “who convinced me to nurse Keegan when he wanted, and not to use ‘fillers’ like apple juice in a bottle or a pacifier in between our scheduled nursings. Nothing changed overnight; it took three days of devoting myself totally to Keegan and trying to nurse him whenever he cried. The first two days he refused to nurse during the day, and I manually expressed my milk, feeding it to him by cup and spoon. Fortunately, he nursed willingly and happily in his sleep. Once Keegan’s nursing strike was over and the schedule was forgotten, nursing became less tense, more comfortable for both of us, and the time never became important again.”

Lee Roversi from Connecticut, who had been feeling overwhelmed by her son Sky’s “seemingly constant need to nurse,” had a change of heart when his erupting eye teeth made nursing painful for him and he went on strike. “We spent the next two days in almost constant touch– holding, reading, cuddling, bathing together, rocking. Thankfully, he would nurse in his sleep during the night and that, along with hand- expressing some of my milk, kept my breasts from becoming uncomfortably full. When his strike ended and he asked again for ‘nanas’ I knew that I had regained my perspective. All else could wait–indefinitely–while I treasured the moment.”

Approaches to Weaning

by Nancy Mohrbacher, IBCLC

Weaning is one of the few experiences all breastfeeding mothers have in common. It begins when the baby takes food or drink other than mother’s milk and ends with the last nursing. Although weaning is often thought of as an event, it is actually a process. Depending on the approach the mother uses, weaning may be abrupt or gradual. It may takes days, weeks, or sometimes months.

The word “wean” is derived from a word meaning “satisfaction” or “fulfillment.” During most of history, weaning was considered a natural stage of growth, an indication that the child had finally had his fill. Today, however, rather than a natural process to be celebrated, many mothers dread weaning as a time of deprivation and unhappiness. The approach a mother takes can make a tremendous difference in the physical and emotional comfort of both her and her baby. A rigid and abrupt approach makes weaning unnecessarily painful and difficult. But this does not have to be. There are ways to wean that are as gentle and loving as the way breastfeeding began. Weaning gradually and with love–with consideration given to the feelings and preferences of both mother and baby–can make it the positive experience it was meant to be.

TRY TO AVOID ABRUPT WEANING

Abrupt weaning is the most difficult for both mother and baby and should be avoided if at all possible. Abrupt weaning has several serious drawbacks. One is the physical discomfort and potential health complications for the mother. Even though a mother stops nursing, her breasts continue to produce milk. If some of the milk is not removed, her breasts will become overly full and painfully engorged, which may lead to a breast infection or a breast abscess. Abrupt weaning also contributes to depression due to a sudden drop in a mother’s level of prolactin, the hormone released during breastfeeding associated with feelings of well-being. Mothers with a history of depression are especially at risk and should always be encouraged to wean gradually.

There are also drawbacks for the baby. Because breastfeeding is a source of comfort and closeness, as well as food, an abrupt weaning may be emotionally traumatic, leaving the baby feeling as though his mother has withdrawn her love as well as her breast. A gradual weaning is a much better alternative because it allows a mother to gradually substitute other kinds of attention and affection to compensate for the loss of nursing.

Even when abrupt weaning is recommended for medical reasons, there are usually other options. If a mother tells her doctor that she’d like to continue nursing or be given time to wean gradually, alternatives can usually be found. For example, if a drug that is prescribed for a mother is found to be one of the few drugs that are incompatible with breastfeeding, the doctor may be able to substitute another drug if he knows the mother wants to continue nursing. Mothers can contact their local La Leche League Leaders for information on the compatibility of specific drugs with breastfeeding. Even when a mother must take a drug that is incompatible with breastfeeding, she still has the option of temporarily weaning, continuing to express her milk, and returning to breastfeeding later. Many mothers have nursed through medical problems, even surgery. With good information and support, abrupt weaning can usually be avoided.

In the rare cases when abrupt weaning cannot be avoided, for example, the mother with cancer who must begin chemotherapy without delay, physical discomforts in the mother can be minimized. The following suggestions can help: wearing a firm bra for support–one size larger than usual may be necessary–reducing salt intake, not restricting fluids, and regularly expressing just enough milk to relieve discomfort. By gradually expressing her milk less and less often, the mother’s milk supply will slowly decrease. Binding the breasts–which is sometimes still recommended–is an outdated practice that can intensify a mother’s discomfort and cause plugged ducts.

The baby also has special needs during an abrupt weaning. The baby’s doctor should be consulted about what foods to substitute for mother’s milk, which may vary depending on the baby’s age. The baby will also need lots of extra holding and focused attention. Although many mothers feel the urge to distance themselves from their babies while weaning for fear the child will insist on nursing, what a baby needs most during weaning is reassurance that he is still loved.

PLANNED WEANING OF A YOUNGER BABY

If a mother wants to wean her baby before he is ready to wean on his own, a planned, gradual weaning is a much better choice than an abrupt weaning. Eliminating one daily feeding no more often than every two or three days allows the mother’s milk supply to decrease slowly, without fullness and discomfort. It also gives the mother time to make sure her baby is adjusting well to the change and to give her baby the extra loving attention as a substitute for the closeness they shared while nursing. Because some babies have a strong need to suck, they may find another outlet, such as thumbsucking, during or after weaning. If the mother prefers that her child use a bottle or pacifier, she can offer this instead.

The practical details of a planned weaning will depend upon the age of the child. For the younger baby, weaning involves first consulting the baby’s doctor about appropriate substitutes for mother’s milk and then replacing breastfeeding with bottles. If the baby is close to a year old and is drinking well from a cup and eating other foods, after first consulting the baby’s doctor, the mother may be able to substitute other foods and drinks for breastfeeding, forgoing the bottle and going directly to a cup.

For the younger baby, the first concern during weaning is nutrition, since breastfeeding is first and foremost a method of feeding that also provides closeness and comfort. In order to gradually wean a young baby, substitute a bottle for one daily feeding every two to three days. In about two weeks, the baby will be down to nursing just once or twice a day. If there is no rush to wean completely, you can continue these nursings for another week or two. Your breasts will continue to produce enough milk for these feedings as long as your baby continues to nurse.

PLANNED WEANING OF AN OLDER BABY OR TODDLER

Although the health and nutritional benefits of breastfeeding continue for as long as the child nurses, the emotional side of nursing becomes more important as the child grows. The older baby or toddler may develop strong preferences about nursing, as he does about all aspects of his routine, so these need to be considered during weaning.

The planned weaning of an older baby and toddler may require several weeks or months of concentrated time and attention to help a child wean with a minimum of unhappiness before he is developmentally ready. As Dr. William Sears, pediatrician and father of seven, says, “A wise baby who enjoys a happy nursing relationship is not likely to give it up willingly unless some other form of emotional nourishment is provided that is equally attractive or at least interestingly different.” Many mothers have found that the following ideas make the process easier.

Offer regular meals, snacks, and drinks to minimize the child’s hunger and thirst. Also, keep in mind some of the other reasons a child may want to nurse: closeness, the urge to suck, comfort (if hurt, ill, or upset), boredom (nothing else to do), habit, and to fall asleep.

Don’t offer, don’t refuse means breastfeeding when the child asks but not offering to nurse at other times. When used with the following suggestions, it can help accelerate the weaning process.

Try changing daily routines to eliminate nursings without tears. Most children have certain times and places they ask to nurse. Start by thinking about when the child asks to nurse and how to change the daily routine so that he will be reminded to nurse less frequently. For example, if he usually asks to nurse when the mother sits in her favorite chair, she might avoid that chair while she is weaning him.

Encourage the baby’s father to play an active role in weaning. If the child typically asks to nurse upon waking in the morning, the father can be the one to get the child up and bring him to breakfast. Fathers can also help a child get back to sleep when he wakes at night and provide special daytime outings together.

Anticipate nursings and offer substitutes and distractions. This is another time-tested way to make a planned weaning more positive for the child. Think about possible substitutes for nursing and consider again the daily routine and the child’s reasons for nursing. Offer substitutes before the child asks to nurse. (Once a child has asked to nurse, he may feel rejected if a substitute is offered instead.) For example, if the mother has a general idea of her child’s nursing pattern, she might offer a special snack and drink right before a usual nursing time and then take the child out to his favorite place, such as a playground or a friend’s house, as a further distraction. If food is used as a substitute, be sure to offer healthy, nutritious foods, not candy or sweets.

Be attentive to the child’s reactions and respect his preferences. One of these ideas may be more effective than another. For example, the child may be unhappy with postponing nursing but do well with distraction and substitution. Also, certain nursings may be more important to the child than others. If so, the mother can continue those until the end and allow the child to give them up last. If the child clings to these nursings even after he has given up the others, the mother has the option of continuing to nurse him at those times for a while. For example, some children react strongly to giving up their naptime or bedtime nursing. The mother may decide to continue nursing the child to sleep until he is more comfortable giving up those last breastfeedings.

One benefit of a gradual, planned weaning is that the mother can be flexible when unusual situations arise. When a child is ill, for example, he may want to nurse more often for comfort. The mother can then go back to nursing more often until he is feeling better, knowing that weaning can always be resumed then. There is no advantage to rushing weaning, as weaning is a big change for both mother and child and it takes time to adjust to change.

NATURAL WEANING

Although it is more common in our society for babies to be weaned within their first year, through most of human history and in most parts of the world, babies have breastfed for years rather than months, with two to four years being the average. It is likely, in fact, that when the human race is viewed as a whole natural weaning, the third basic approach, is the one most commonly used. Some mothers choose natural weaning because it feels right to them; others choose it because it is the least work.

Many mothers fear that if they don’t initiate weaning that their child will “nurse forever.” Actually, children do outgrow nursing on their own, just as they outgrow other babyish behavior. How long does this take? Just as there is a wide variation in the ages at which children learn to walk, get their first tooth, and learn to use the toilet, the same is true for natural weaning. One child may wean naturally at age one or two while another may be going strong at age three. Reasons one child may nurse longer than another include a strong sucking urge, a great need for closeness and body contact, and an unrecognized allergy or other physical problem. Natural weaning allows for differences in children by letting them grow at their own pace, giving up breastfeeding according to their own timetable. Only one thing is known for sure: all children eventually wean.

BABY’S NEEDS AND MOTHER’S FEELINGS

Although the approach is important, the baby’s needs and the mother’s feelings about weaning will also be factors in how weaning goes. Even at the same age, some children will be more ready than others to take this step. If the child becomes upset and cries or insists upon nursing even when the mother tries to distract or comfort him in others ways, this may mean that weaning is going too fast for the child or that different strategies would be more effective. Other signs that weaning may be moving too fast are changes or regressions in behavior, such as stuttering, night-waking, an increase in clinginess, a new or increased fear of separation, or biting, when it has never occurred before, as well as physical symptoms such as stomach upsets and constipation.

The child will also be influenced by his mother’s feelings. If a mother gives of herself lovingly to her child and feels comfortable and confident in her decision, her child is less likely to have difficulties with weaning. On the other hand, if a mother feels guilty about weaning or about pushing weaning too hard, she may find it more difficult to be loving with her child, which may make the child anxious and increase his desire to nurse.

Although weaning itself is universal among nursing mothers and babies, every weaning is unique. The best advice for making weaning a positive celebration of growth is for the mother to listen to her heart and be sensitive to her baby’s cues. Because breastfeeding is more than milk, weaning is best done gradually and with love.

For more information about nursing beyond the first year, order the book Mothering Your Nursing Toddler by Norma Jane Bumgarner from The Art of Breastfeeding. The cost is $8.95 and you can find it under Books in our Educational Resources section.

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.

GETTING STARTED

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,
  • and

  • 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.

TRACKING PROGRESS

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.”