Relactation and induced lactation
Feeding your baby requires patience and support — and that is especially true for parents who want to learn how to relactate or induce lactation. We interviewed one of our TLN International Board Certified Lactation Consultants (IBCLCs), Chrisie Rosenthal, about the challenging but worthwhile processes of re-establishing lactation and establishing a milk supply without pregnancy. Here’s what we discovered.
Relactation definition and examples
Per the Centers for Disease Control and Prevention (CDC), “Relactation is the process by which a parent re-establishes lactation after having stopped for some time (weeks, or even years). Relactation can also apply to a parent who previously breastfed (or chestfed) a biological child and now wishes to make milk for an adopted child, a partner’s child, or a child birthed by a surrogate.”
Rosenthal shared these examples of people who might choose to relactate:
- a parent who had breastfeeding difficulty or separation in the early days that led to earlier than desired weaning
- a parent who lactated for a previous child and wants to produce breast milk for an adopted infant or infant born to a surrogate parent
- a non-gestational parent who lactated previously and wants to build a milk supply to feed another infant
- a parent in a same-sex relationship
- a transgender parent
- a parent who wants to safely feed an infant during emergencies from natural disasters or disease outbreaks
- a parent of an infant who doesn’t do well with formula
Definition of induced lactation and examples
Induced lactation is the process of establishing lactation for the first time without biological pregnancy hormones. According to La Leche League, “Because parents who haven’t given birth do not have the hormones of pregnancy to get their bodies started with making milk, they need more information and support to make breastfeeding a reality.” Rosenthal clarified that these parents might include “non-gestational parents, adoptive parents, intended parents (through surrogacy), parents whose partner is birthing, and trans women.”
In all these parenting scenarios, breastfeeding or chestfeeding can provide nutrition, comfort, and essential bonding. And in some families, relactation or induced lactation can enable both partners to share the breastfeeding role.
How do relactation and induced lactation work physiologically?
Typically, with gestational parents, “the natural production of breast milk (lactation) is triggered by a complex interaction between three hormones — estrogen, progesterone, and human placental lactogen — during the final months of pregnancy,” states Mayo Clinic. “At delivery, levels of estrogen and progesterone fall, allowing the hormone prolactin to increase and initiate milk production. Induced lactation [or relactation] depends on the successful replication of this process.”
But Rosenthal cautioned that “success is subjective,” and relactation and induced lactation strategies and limitations vary widely from parent to parent. “Induced lactation usually involves a schedule of pumping, and sometimes hormones or other prescription medication,” elaborated Rosenthal. “The plan varies depending on the timeframe and the specifics of the breastfeeding parent and baby. Relactation is a similar process for a parent who previously established a milk supply.”
Induced lactation and relactation tips and strategies
Parents pursuing this journey need expert support. According to Mayo Clinic, “It is highly recommended that you work with an IBCLC (Lactation Consultant) during this [relactation or induced lactation] process.” Rosenthal added that it’s a good idea to reach out to an IBCLC experienced in induced lactation or relactation.
Once you’ve established your support system, your induced lactation or relactation plan will depend on your timeline, needs, and preferences. “If you have months to prepare,” Mayo Clinic advises, “your health care provider might prescribe hormone therapy — such as supplemental estrogen or progesterone — to mimic the effects of pregnancy. Hormone therapy may last for months.
About two months before you expect to start breastfeeding, you’ll likely stop hormone therapy and begin pumping your breasts with a hospital-grade electric breast pump. Pumping encourages the production and release of prolactin. On this course, parents would then gradually increase the frequency and duration of pumping sessions until they’ve adopted the baby or the new arrival has been born.
However, if you have a short time to prepare or choose not to take hormones, your IBCLC will help you create an alternate plan. Either way, an IBCLC will be essential… and setting up intentions in advance will be essential, too.
Clarifying expectations
Every family is different, so “it’s very important to establish expectations [with an IBCLC] before inducing lactation or relactating,” stressed Rosenthal. For relactating parents, it’s crucial to keep in mind that rebuilding a milk supply takes time, no matter how long it has been since you last lactated. “Generally speaking, the longer it’s been since you last lactated — the more we’d expect that to impact your supply. But there are many factors at work, so that’s not always true,” said Rosenthal. Per the CDC, “Milk production can start as early as a few days after beginning nipple stimulation but may take weeks to months.”
Furthermore, relactating parents cannot always reestablish a full milk supply. Some babies under one year “may need both breastmilk and formula (combo-feed) to achieve appropriate weight gain,” Rosenthal shared. The CDC echoes this sentiment: “Even if a full milk supply cannot be established or the infant is unable to latch onto the breast or chest, infants can still receive health benefits from being fed [some] expressed milk.”
Clearly defined expectations are just as crucial for parents who seek to induce lactation for the first time. According to Rosenthal, you may face many of the same challenges as relactating parents, and your “age, medical history, baby’s feeding ability, pump quality, and medications” can all affect your results. An IBCLC will consider these factors and be able to recommend the right tools.
While some parents want the baby to latch to the breast/chest, others aim to pump and bottle feed. “Supplemental nursing systems,” offered Rosenthal, “also allow you to feed the baby at the breast. These can be great tools to support parents producing very little breast milk and wanting a breastfeeding experience.” An IBCLC will help you create a plan and ensure you have the necessary resources. “Both relactating and inducing lactation can take a lot of time and work,” Rosenthal acknowledged, “but the payoff can be very, very rewarding.”
Teaching your baby to breastfeed
Once you’ve established (or reestablished) your milk supply, you may want your baby to feed at the breast/chest. Your IBCLC will support you in reaching your goals by creating a personalized plan. It may be necessary to monitor your child’s weight with your IBCLC and pediatrician to ensure they gain appropriately during this process.
Relactation and induced lactation require commitment and the skilled guidance of an IBCLC. Request a consultation with an IBCLC to work toward your unique feeding goals. We believe in you, and we’re behind you all the way.
We’re here for you, every step of the way. We work with your insurance to provide in-home, in-office, or telehealth visits with an IBCLC.
