Relactation Basics and Frequently Asked Questions

What is Relactation?

Relactation is the process of re-stimulating a breast that has previously lactated but is not currently lactating. To restart the process of milk production, think of it like turning the system back on after a period in which it has been shut down.

Sometimes, we use the concepts of relactation to increase milk supply in cases where there has been a period of minimal or no breast stimulation, but there is still mature milk present even if it’s mere drops.

How Long Does Relactation Take?

Relactation can take several weeks to see results, or a few months in some cases to see the highest output. Relactation is not a quick process, or one with immediate results. This is part of why the cries for parents to relactate when there is an emergency situation, an infant formula shortage, or a recall on infant formula are not always realistic. The decision to relactate is based on the desire to provide human milk in the future, while still feeding your baby what they need now. It’s also important to note that relactation may result in a lower supply than what a human infant may need to grow exclusively on, which means supplementation may still be required.

How Far Postpartum Can You Relactate?

There is no time limit on how far postpartum you can relactate, but it is easier when the process is started closest to postpartum. It’s not uncommon for parents who opted to stop breastfeeding for any number of reasons in the early weeks to start a relactation plan at 3-4 months postpartum when things feel more stable and sustainable. At that time, supply would be easier to bring in compared to a year or more postpartum. Another factor to consider is how many pregnancies and times lactating a person has experienced. Each pregnancy builds more milk making tissue. Time lactating is time the body has learned what to do with nipple stimulation. For an experienced breastfeeding parent, relactation may be more successful even further postpartum.

Do You Get Colostrum when Relactating?

Despite the fact that early milk in relactation can be yellow and thick, colostrum is not produced with relactation. Colostrum production is uniquely the result of the placental hormones, and it is made starting about 16 weeks of pregnancy, and production of colostrum slows as the production of mature breastmilk is established in the early days postpartum. When relactating, what is produced is milk most similar in composition to mature milk.

Can Low Milk Supply Moms Relactate?

Absolutely. Depending on the reasons for the low supply, results may still be lower than expected, but if the issues were related to breastfeeding management, a solid plan could produce unexpectedly positive results. If you are trying to relactate with a history of low supply, you would greatly benefit from talking to a lactation consultant about herbs and supplements to target not only increasing prolactin levels, but also addressing the underlying physiological issues that can impair lactation.

Why Do Parents Choose to Relactate?

There is no one reason that a parent decides to relactate. The motivations and reasons vary by family, and they are often driven by circumstances in which human milk is desired to improve outcomes for or protect the child.

• Previous failed breastfeeding attempt

  • Sometimes, circumstances result in a failed breastfeeding attempt in the early days, and parents may have a lack of support or be too overwhelmed to continue. Often, as things stabilize, and the parents have the bandwidth to consider relactation, they are in a better place to try again. Relactation can be done in many cases where actual feeding at the breast can be restored if that is so desired, or the milk can be bottle fed.

• Medically Fragile Child

  • A common reason to attempt relactation is when a child who was previously weaned develops health concerns that could be improved with human milk. Examples of this would be a baby who cannot tolerate normal formula, a child who is unable to eat solid foods, or a child undergoing treatments that reduce the functioning of their immune system.

• Covid-19 Antibodies

  • Covid-19 antibodies have actually inspired a lot of people to relactate during this pandemic. Human milk provides immune boosting benefits and improves outcomes for children who are exposed to or contract this virus. Vaccines for young children are still not available as of February 2022, so this may be one of the only ways parents have available to feel like they can protect their younger children.

• Formula Frustration

  • Formula shortages, supply chain issues, and recalls have really hit parents hard in the last few years. The fear of being unable to find food for their infant child is real, and it’s just as awful as it sounds. Relactation can help to reduce the amount of formula a child needs to consume to help parents feel less pressure in the face of these stressors. I do want to note, however, that relactation is not the right option for every family, and parents may not be in a position to even consider this.

• Adoption

  • Adopted children can be breastfed just like a biological child, and many parents adopting young children will want to consider breastfeeding their adopted baby. If the parent has previously lactated, this is a case where relactation is something to be considered. If the parent has never been pregnant or lactated, this could still be achieved with an induced lactation plan, which is where milk production is stimulated for the first time without pregnancy or birthing.

Preparing the Breast for Relactation

When you are pregnant, the hormones associated with the pregnancy prepare the breasts for lactation. In the case of relactation, what we are trying to do is increase prolactin levels to encourage milk production when combined with stimulation of the nipples to signal for milk. If you had never been pregnant before, we would actually be simulating the hormones of the pregnancy as well, but with relactation, the maturation of the breast has already happened.

In order to stimulate relactation, we often use herbal supplements or medicines that can encourage the production of prolactin. These supplements and medications should not be used randomly, and they should be done after an assessment by a trained lactation consultant and under the care of your health care provider.

Stimulating Milk Production for Relactation

Stimulating the milk production is done by providing stimulation to the nipple to signal to the body that milk production is desired.

Stimulation needs to be frequent, effective, and consistent in order for a relactation plan to be successful. To achieve this, you ideally want to empty the breast 8 times a day, with at least 1 (ideally 2) sessions between 11 pm and 5 am, as this is naturally when prolactin is elevated.

You will want to balance using the most effective means of stimulation with what will actually allow you to get these breast stimulation sessions in. If you are nursing directly, you can use an SNS to feed the baby supplemental milk at the breast for maximum stimulation. Be sure if you are pumping that your flanges fit well, and that you monitor your sizing through the process often.

Nighttime Emptying for Relactation

A common question is if nighttime emptying/stimulation is absolutely essential?

Realistically, for the best results, it will be.

Nighttime emptying, or stimulation, between 11 pm and 5 am, is when prolactin is at its highest, and these sessions are the most valuable in terms of stimulating milk production.

If you can only do 1, consider adding in a strategy such as power pumping to help increase prolactin at other times of the day.

Are Supplements Necessary for Successful Relactation?

Yes and No. For some people, herbs, supplements, and medication are the right options to achieve their goals in the shortest amount of time possible. For others, they may have contraindications for these options and will be relying on nipple stimulation alone to trigger the production of milk.

The biggest benefit of the supplements is reducing the amount of time required for milk production to begin and quantity to increase. This is ultimately something to discuss with your lactation consultant and health care provider to determine what options are available for you, and what the right course of action will be.

Will Relactation Effect My Period?

Not typically unless you are using a medication such as Domperidone that significantly raises prolactin levels. The disruption of the menstrual cycle postpartum is thought to be related to the elevated levels of prolactin associated with exclusively feeding human milk signaling the body that ovulation should not occur. No ovulation, no cycle. Typically, with relactation, we do not see this effect, but it can happen. Relactation should not be used as a form of birth control.

Realistic Expectations

Relactation is not an overnight process. It takes time, a solid plan, frequent monitoring, and consistent dedication to make this happen. Some people find they are successful just hooking up to a random pump a few times a day and milk production can resume.

Others need a nuanced and skilled care plan in place to make this happen. Before jumping into relactation, really consider your motivations, and decide what you are willing to do to make it happen.