From Bottle to Breast: The Remaking of Mother's Milk
by Alisa Ikeda
Perhaps you left the hospital intending to feed your baby formula, but you now long to breastfeed, or your little one's system has proven intolerant to formula. Maybe you've been apart from your newborn due to hospitalization and your milk has already "dried up." Perhaps you got off to a poor breastfeeding start because you had an unusually difficult time healing after a c-section or your baby "weaned" far earlier than you'd hoped. Maybe you're adopting and would love the chance to breastfeed. Read on! With a little know-how and lot of patience, you can indeed make—or remake—mother's milk.
Relactation and Induced Lactation
Relactation, the rebuilding of one's milk supply weeks or even months after lactation has stopped, or induced lactation, the production of milk from where there was none (as may be the case with adoptive moms), are both viable options for any woman eager to breastfeed.
But under these circumstances, the making of milk is a time-consuming undertaking likely to be fraught with moments of heartbreak, frustration, and worry—but many more, and more lasting, moments of joy, tenderness, and pride. A few dos and don'ts will get you through the worst of it and on to the best:
- Do it for the right reasons—not because you think you should but because you truly want to experience the unparalleled closeness of breastfeeding.
- Don't expect your milk to show up overnight.
- Do get the support of your family and doctors.
- Don't be discouraged by the need to supplement; recognize that supplementation, in the beginning and possibly throughout your breastfeeding relationship, doesn't at all diminish the importance of your commitment and the value of your milk.
- Do enlist the help of a certified lactation consultant (you can locate one through your hospital, La Leche League, or the International Lactation Consultant Association).
How it Works
Ideally, a woman's pregnancy prepares her body to produce milk, the experience of birth gets the milk "flowing," and her baby's suckling provides the demand that keeps the milk supply up. Though this may not have been the case in your particular situation, that doesn't mean you can't now make milk.
Prolactin and oxytocin, the milk-making and milk-releasing hormones, are pituitary (not ovarian) hormones. That means even a woman who's never been pregnant may be able to lactate, as may a woman who has had a hysterectomy. Both prolactin and oxytocin are produced in direct response to nipple stimulation by massage, breast pump, and baby's nursing. Most effective in stimulating your milk supply, of course, is your baby. So nurse as frequently as possible. Next to your baby, an efficient hospital-grade double-electric pump, used frequently (every two to three hours) for about 15 minutes a session, may be your ace in the hole.
How Much Milk Will You Get and When?
Be patient, as your milk may be painfully slow in coming. Don't be discouraged by mere drops after weeks of effort—where's there's any milk at all, there's likely to be much more! Look for other encouraging signs of success, including fuller, more tender breasts, nipples changing color, increased thirst, and changes in menstrual cycle or libido.
Don't fall prey to performance anxiety, as it will only hinder milk production. Rest assured that most all mothers are able to produce at least some milk, though the amount varies considerably from woman to woman. If you view supplementation as your ally in this process, you'll be much happier, more relaxed, and pleasantly surprised by all that you do make. Remind yourself that any amount of mother's milk will benefit your baby.
It's impossible to determine how long it will take to build your supply. It is known that the hormone level is naturally highest in mothers who delivered a baby within three months. So if you're a mom trying relactation within that 3-month window, you're chances for success are especially high.
Breast Over Bottle
It will, of course, be easier to "train" a 10-day-old newborn to take the breast over a bottle than it will a 5-month-old baby. A baby must work harder at the breast than at a bottle, so many babies habituated to bottle feedings may initially be reluctant to nurse. Make the transition a gradual and gentle one. Start by bottle-feeding the baby in nursing position, keeping her cheek close to your bare breast, and positioning her such that she must turn in toward you to take the bottle. Offer the breast frequently, and always before the bottle, but don't fret if she doesn't readily suckle. She will in time.
Many relactating or induced lactating women opt for a supplemental feeding system like Medela's Supplemental Nursing System (SNS) and the Lact-Aid Nursing Trainer, which can help you to nourish your baby at the breast whether or not you're yet producing milk. A hidden pouch holds supplemental milk or formula, and a small, discreet tube is taped to your breast to extend just beyond your nipple. At once, baby is rewarded for suckling your breast, she gets enough nourishment, and she stimulates your own milk production. As your milk comes in, you'll find yourself able to gradually lessen the amount of supplementation needed to satiate her.
Note: Be sure to have your baby's weight gain closely monitored by a supportive pediatrician.
More Milk, Please
With these supply boosters up your sleeve, your milk-making success is even more likely:
- Try fenugreek (diabetics, please seek the counsel of a physician before taking) and blessed thistle (Mother's Milk tea is a good source of both) or brewer's yeast.
- Seek the guidance of a trusted doctor and certified lactation consultant; a few moms are advised to take milk-inducing hormone therapy.
- Rest often and eliminate as much stress as possible.
- Keep your baby close and encourage her to nurse often.
- Consider pumping several weeks in advance of an adopted baby's arrival.
- Opt for pumping more frequently over lengthening individual pumping sessions, and maintain a regular pumping schedule.
- Eliminate all caffeine and alcohol.
- Be wary of any drugs, including contraceptives, allergy medications, and hormone replacement therapy, which may adversely affect your milk supply.
- Pump after every feeding to stimulate further milk production (many women pump one breast while the baby nurses from the other).
- Go on holiday (be sure to enlist your partner's support on this one): indulge in a whole week spent doing nothing but eating well, drinking lots of fluids, resting, snuggling, and, of course, nursing!
Breastfeeding—or the return to breastfeeding—can be a beautifully intimate, loving, and rewarding experience for both mother and baby. If you want that for yourselves, don't spend another minute simply wishing, wondering, or worrying about it. Go forth and make milk!
For Further Support:
La Leche League
International Lactation Consultant Association
Alisa Ikeda is a writer and editor in Marin County, California, with a B.A. in sociology and a background in book publishing.