Getting Baby Back to the Breast
Many parents have turned to exclusively pumping due to early breastfeeding difficulties, only to find themselves wishing to go back to breastfeeding some time later when life has calmed down a bit. The milk supply is still there, so there is certainly hope for a return to the breast, but I always want parents to have the real information when making a decision if they want to try to return baby to the breast.
Realistic Expectations
Getting a baby back to the breast is a lot of work, and there is no guarantee that it will work. Often, the issue that first led to removal from the breast will need to be identified and addressed (I’m looking at you tongue-ties and oral dysfunctions that went undiagnosed and untreated). There is a very real possibility that the baby will reject the breast during this process which for some parents is very emotionally traumatizing.
Work with a Skilled Lactation Consultant
At a bare minimum, there should be a preliminary consultation to discuss your breastfeeding history to get an idea what a reasonable plan looks like in your unique situation. There are sometimes tools, like nipple shields, that we use to bring a baby back to the breast, but those require careful judgment calls to prevent additional issues.
Issues that Contributed to Nursing Difficulties will Need to be Addressed
If there are any type of oral restrictions, oral motor difficulties, feeding aversions, or milk supply concerns, they will need to be addressed. Oftentimes, parents are overwhelmed in the early days of breastfeeding, and they get poor support from untrained or unqualified providers that fail to adequately address the issues. These parents may end up exclusively pumping for a period of time, or they may want to attempt re-lactation. Unfortunately, time doesn’t address the types of issues that likely led to the discontinuation of nursing in the first place. The good news is, with a solid history, we can often narrow our focus to the probable problems and make this experience much better for you.
Bottle Feeding will Need to be Done in a Manner that Promotes Breastfeeding
Bottled feeding Should Mimic Breastfeeding
Bottled feeding will need to be used to mimic breastfeeding in terms of frequency and amount at a feeding. Babies at the breast tend to eat smaller amounts, more frequently, and they have to do more work than bottle feeding.
That means smaller amounts, fed more frequently, in bottles that require baby to work to actively eat versus passively eating at the bottle. Nipple sizes often need to come down. Good latching techniques at the bottle need to be promoted and enforced to minimize behaviors that will undermine the success at the breast. If a baby is older than 6 months, consider swapping bottles for sippy cups when feasible to help eliminate the sucking babies find enjoyable to help make the breast a more desirable place to be.
Lots of Skin-to-Skin
Just like in the early days of breastfeeding, skin-to-skin has a huge, positive effect on attempts to reestablish breastfeeding. Skin-to-skin allows baby access to the breasts without expectation and creates a connection to the idea that being at the breast is positive. You can try skin to skin bottle feedings to get baby used to this type of contact again during feedings, skin-to-skin naps (prime time for getting baby to latch!), and general skin-to-skin contact. Skin-to-skin doesn’t just have to be with the lactating parent, the other parent can do skin-to-skin time to help baby re-acclimate to the sensations of skin-to-skin even if they will not be latching the baby.
Strategies that we might use depending on your unique situation:
Skin-to-skin to reacquaint baby with this type of contact
Offering the breast when baby is sleepy
Using non-bottle means of feeding to encourage baby to meet their suckling needs at the breast
Use of a nipple shield
Use of a supplemental nursing system
Addressing milk supply concerns
Addressing oral restrictions and concerns
Parallel pumping to stimulate stronger letdowns to encourage suckling
Oral exercises to retrain baby to be able to latch
Use of a Nipple Shield
Using a nipple shield can be done to allow the baby the familiarity of the texture at the breast, and sometimes be used in conjunction with a supplemental nursing system to maintain a heavier milk flow until baby is better reacquainted with breastfeeding.
What Should a Back-to-the-Breast Consultation Cover?
A solid history of what has gone on in your breastfeeding journey to identify any areas we might need to address
An oral assessment for your baby to determine if there are any reasons your baby may struggle with nursing
A care plan to address known challenges
Discussion of all of the options available to facilitate returning to nursing
Parent decides which options are right and a plan is shaped around those choices
Monitoring progress and shaping the plan as needed
Common Challenges that Can Arise
Baby won’t nurse past the first let down
Baby only nurses when sleepy
Baby still wants a bottle after
Baby is just not having it, they are not recognizing the breast as a place to be fed and comforted
Baby has a bad latch
Baby is older and easily distracted
Remember!!!
A good Back-to-the-Breast consultation helps you plan for dealing with these issues from the beginning!
Challenges do not doom a plan to failure!
Is it ever too late to get a baby back to the breast?
Nope! We have lots of examples of babies learning to breastfeed well into toddlerhood. That’s not to say that it isn’t a challenging and emotionally intense process, but it can be done. The younger the baby, the easier it tends to be as there is less chance of having baby have forgotten how to latch. But, it’s never actually too late.
If you are trying to get your baby back to the breast, or even just considering it, book a consultation today and get the support you need to make this happen!
