Breast milk can often be re-established after a period of cessation, a process known as relactation. This demonstrates the ability of the mammary glands to reactivate milk production even after a supply has dried up or significantly diminished. Although it demands consistent effort and patience, relactation is essentially a process of stimulating the body to restart the hormonal cycle necessary for milk synthesis and release.
The Biological Basis for Restarting Lactation
Reactivating the ability to produce milk is fundamentally controlled by two key hormones released from the pituitary gland in the brain. The process begins with frequent stimulation of the nipple and areola, which sends sensory nerve signals to the hypothalamus. This nerve pathway triggers the release of Prolactin, the primary hormone responsible for instructing the alveolar cells within the breast to synthesize milk components, such as lactose and proteins.
The other hormone involved is Oxytocin, which is responsible for the milk ejection reflex, often called the let-down. Oxytocin causes the myoepithelial cells surrounding the milk-producing alveoli to contract, pushing the milk out through the ducts. Successful relactation relies on continuously removing milk, which signals the body to release more Prolactin and Oxytocin, thereby establishing a new supply-and-demand cycle.
Physical Stimulation Techniques for Milk Production
The most effective way to signal the body to resume milk production is through frequent and thorough breast stimulation and emptying. Experts recommend aiming for breast stimulation at least eight to twelve times every 24 hours, mimicking the frequency of a newborn’s feeding pattern. These sessions should last 15 to 20 minutes per breast, and it is beneficial to include at least one session overnight, as Prolactin levels naturally peak during the early morning hours.
Using an efficient, double electric breast pump, often a hospital-grade model, can provide the necessary strong and consistent vacuum pressure. Combining pumping with breast massage, known as hands-on pumping, helps to more completely drain the milk ducts and further enhances the hormonal response.
Encouraging skin-to-skin contact with the infant is also beneficial because it promotes relaxation and stimulates the release of Oxytocin. Even if the baby is not transferring milk initially, allowing them to latch at the breast is the most powerful form of stimulation available.
Supplemental Aids and Galactagogues
In addition to physical stimulation, some individuals use supplemental aids, including substances called galactagogues, to support the relactation effort. Galactagogues are compounds, either herbal or pharmaceutical, that may help increase milk supply, often by acting on the Prolactin pathways. Herbal options, such as fenugreek and blessed thistle, are commonly used, although scientific evidence regarding their effectiveness is limited.
Before beginning any herbal regimen, it is important to consult a healthcare provider, as herbs can interact with other medications or cause side effects. For some, prescription medications like Domperidone or Metoclopramide may be considered, as they can elevate Prolactin levels. These pharmaceutical options must be prescribed and closely monitored by a physician due to potential side effects.
A Supplemental Nursing System (SNS) is a non-pharmacological aid that can be used at the breast to deliver formula or donor milk via a thin tube while the baby is suckling. This allows the infant to receive full nutrition while simultaneously stimulating the breast and maintaining the crucial bonding experience.
Timeline and Professional Guidance
Relactation is generally a gradual process that requires a significant time commitment, and setting realistic expectations is crucial for success. While some people may notice initial drops of milk within two to four weeks of consistent stimulation, achieving a measurable supply often takes several weeks to a few months.
The process should be undertaken with the guidance of an International Board Certified Lactation Consultant (IBCLC). An IBCLC can create a personalized relactation plan, assess the baby’s latch, and ensure the infant’s weight gain and nutritional needs are being adequately met with supplemental feedings while the supply is increasing.