Author: TLN

Relactation and Induced Lactation

No matter who you are, feeding your baby is no small feat: The practice requires patience, support, and commitment—and that is especially true of parents learning how to relactate or induce lactation. We interviewed one of our very own TLN International Board Certified Lactation Consultants, Chrisie Rosenthal, about the challenging but worthwhile processes of reestablishing lactation and teaching your body to lactate without pregnancy. Here’s what we discovered.

Relactation Definition and Examples

Per the CDC, “relactation is the process by which a parent reestablishes lactation after having stopped for some time (weeks or months). 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 nurse 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 to 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, and a parent of an infant who doesn’t do well with formula.” 

Induced Lactation Definition 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 of 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, but 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 who’s specifically experienced in induced lactation and/or relactation.

Once your support system is established, 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. This encourages the production and release of prolactin.” On this course, you would then gradually increase the frequency and duration of your pumping sessions until the baby arrived. 

On the other hand, if you have a short time to prepare or you 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

These processes look vastly different for every family, so “it’s very important to establish expectations [with an IBCLC] before starting a plan for induced lactation or relactation,” stressed Rosenthal. For relactating parents, it’s important 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 less time it has been…the more volume we can expect to see. 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 parents “will need to “combo feed,” i.e., use both breast milk and formula if the baby is under one year,” Rosenthal shared. Combo feeding is nothing to be ashamed of, and 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 also affect your progress. An IBCLC will take all of these factors into account, and make sure you have access to the right tools. While some parents want the baby to latch to the breast, others aim to pump and bottle feed. There are even “supplemental nursing systems,” offered Rosenthal, “that may allow you to feed at the breast even if you’re producing very little breast milk.” An IBCLC will help you create a plan and make sure you have the resources you need. “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, there’s just one thing left to do: Teach your baby to breastfeed. While “newborn babies are wired to initiate breastfeeding,” even older babies and young children can learn to breastfeed with gentle encouragement—you just need to train them (or remind them) to “equate feeding with comfort.” At the same time, regular and frequent nursing or pumping sessions should teach your body to keep producing milk. Just be sure to carefully monitor your child’s weight with your IBCLC and healthcare provider, and supplement with breast milk substitutes as needed. 

Much like parenthood, relactation and induced lactation are not for the faint of heart. These pursuits take dedication, foresight, and expert support… but they’re possible and they can be incredibly rewarding. If you hope to relactate or induce lactation, request a consultation with an IBCLC and specify your unique goals in the notes field. No matter your situation, we believe in you and we’re behind you all the way.