It is often possible to reestablish milk production, a process known as relactation, even after a significant drop or complete cessation of supply. Lactation is a dynamic process governed by hormones and the principle of supply and demand. The body’s ability to produce milk is not permanently switched off but is downregulated when the demand signal is removed. Reversing this requires sending new, frequent signals to the body to restart milk synthesis.
How Milk Supply Declines
Milk production is fundamentally a matter of supply and demand, where milk removal is the primary signal for continued production. When milk is not removed frequently and thoroughly, a protein called Feedback Inhibitor of Lactation (FIL) accumulates, signaling the breast to slow down production. This reduction in milk removal is the most common cause of supply decline.
Insufficient milk removal can stem from a baby who is not latching effectively or from an infrequent nursing or pumping schedule. Hormonal shifts also play a significant role, such as the return of a menstrual cycle or a subsequent pregnancy. Furthermore, certain medications, including some decongestants or hormonal birth control containing estrogen, can interfere with the hormones that support milk production. Maternal illness, high levels of stress, and chronic anxiety can also contribute to a reduction in supply.
Mechanical Strategies for Relactation and Boosting Supply
The most effective method for restarting or increasing milk production is through frequent and efficient milk removal and nipple stimulation. This mechanical action signals the pituitary gland to release prolactin, the primary milk-making hormone. Stimulating the breast frequently, even when little to no milk is initially present, is a direct way to signal the body to increase production.
Aiming for 8 to 12 sessions of breast stimulation every 24 hours, including at least one session during the night, can help maximize prolactin levels. These sessions should involve frequent nursing or pumping for 15 to 20 minutes per breast. A technique called “power pumping” simulates the cluster feeding pattern of a baby to vigorously stimulate the breast. This method involves pumping for 10 minutes, resting for 10 minutes, and repeating the cycle for about an hour once a day.
Using a high-quality, double electric breast pump is recommended for efficiency, as pumping both breasts simultaneously results in higher prolactin levels and more milk output. The effectiveness is enhanced by using breast compressions and massage while pumping, which helps to fully drain the milk ducts. Skin-to-skin contact, often called kangaroo care, also supports the process by stimulating the release of oxytocin, the hormone responsible for the milk ejection reflex, or “let-down.”
Supporting Supply with Galactagogues
Galactagogues are substances, either herbal or pharmaceutical, that may help increase milk supply by influencing prolactin levels. They are typically used in conjunction with a consistent schedule of frequent milk removal, as they cannot work effectively without mechanical stimulation. Common herbal galactagogues include fenugreek, blessed thistle, and moringa, available in various forms like teas or capsules.
The evidence supporting the effectiveness of many herbal substances is often anecdotal or based on limited clinical research, and their dosages are not standardized. Prescription galactagogues, such as Domperidone (Motilium) or Metoclopramide (Reglan), are sometimes prescribed by a physician to increase prolactin. These medications are used “off-label” for lactation and have potential side effects, including mood changes like depression with Metoclopramide.
Consulting with a healthcare professional before starting any galactagogue is necessary to discuss potential side effects and interactions. While these aids can offer a moderate boost, they are not a substitute for the fundamental practice of frequent and thorough breast emptying.
Realistic Expectations and Professional Guidance
Restoring milk supply requires commitment and patience, as it is a process that takes time. While some may see initial results within a couple of weeks, achieving a significant or full supply can take weeks to months. A common guideline suggests that the time required for relactation may be roughly equal to the length of time since breastfeeding stopped.
The degree of success is influenced by factors such as the baby’s age, with infants under six months often having a higher success rate, and how well established the supply was before it declined. It is important to define realistic goals, understanding that even a partial supply of human milk provides benefits to the infant.
Seeking professional guidance is highly recommended to create a personalized, effective plan. An International Board Certified Lactation Consultant (IBCLC) is specifically trained to assess the situation, identify the root cause of the supply issue, and offer targeted strategies. Additionally, a physician should be consulted to rule out underlying medical issues that can impede supply, such as thyroid conditions or retained placental fragments.