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Relactation Protocols for Bringing Back Milk Supply


If you are considering relactation, your foundation for success is frequent, effective milk removal.  And the good news is that your breasts have made milk previously and mammary tissue and prolactin (milk producing hormone) receptors are established. It can take time to re-establish milk supply so be ready to put the effort in for the length of time that it has been since you last nursed.  For example if it has been two weeks, you may be able to relactate in as little as two weeks.  If it has been two months, it may take that long.  However, the protocols below may help expedite this process.

Protocols

  • Frequent pumping or nursing (8–12x/day, including overnight when prolactin levels are highest)

  • Latch your baby on if possible.  Feeding tubes allow you to supplement your baby at breast until milk comes in.

  • Get skin to skin with your baby often as it increases oxytocin (milk ejection hormone)

Lactation Aids

  • A high quality electric breast pump such as a Spectra S1 or S2; wearable are not as effective

  • Lactation Aid Feeding Tubes can help keep baby to the breast for assistance with keeping the baby at breast to boost oxytocin for better let-down

  • Supplements can be used to help, but will not work without adequate stimulation and extraction

Medications & Supplements

  • Motherlove More Milk Plus - Tried and true herbal supplement containing goat's rue and fenugreek. Fenugreek is not recommended if you have diabetes, hypoglycemia, or PCOS subtypes sensitive to glucose shifts.

  • Legendairy Milk Liquid Gold - Combination herbal supplement with goat's rue, milk thistle, shatavari, fennel, alfalfa and anise. Not recommended for mothers with SLE disease, plant allergies associated with ingredients listed.  May lower blood sugar.

  • Metoclopramide (Reglan):
    Prescription only. Used occasionally, short-term, and cautiously. Evidence for meaningful volume increase is mixed, and side-effect risk limits routine use.

Manage Expectations

Frequent, effective removal of milk by baby or high quality double electric breast pump is essential.  Pack your tenacity as you will need to keep this up 8-12 times per day and include night feeding or pumping until milk supply is well established. Be prepared that volume increases gradually over weeks and manage your expectations. While a comprehensive study* shows that 79% of moms were successful at being able to resume breastfeeding, full milk supply may not always be reached. Some moms were only able to produce 25-50% milk supply, but every ounce counts for the health of your baby.


Hang in there mama!
Tanya

References:
*Matern Child Nutr. 2022 Oct 12;19(1):e13440. doi: 10.1111/mcn.13440
J Trop Pediatr. 1997 Aug;43(4):213-6. doi: 10.1093/tropej/43.4.21
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