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Thread: Pumping to relactate

  1. #1

    Default Pumping to relactate

    Hey y'all! Here is a little back story on my relactation project: I started out EBFing my son when he was born on April 1st. Our BFing relationship started off on the wrong foot with a lot of pain despite a latch that looked okay. The hospital ENT doctor diagnosed a tongue tie and revised it at 3 days old. There was less pain, but it took 5 days for my milk to come in and by that time we had been directed to supplement for too much weight loss and jaundice. We supplemented for a day before my milk came in. I was engorged for the first couple of days, making latching difficult for baby. We dealt with oversupply/overactive let down and suspected reflux, then a five-day stretch where he did not gain any weight. We started supplementing again and only because of that did he make his birthweight at 14 days old. The next day, my husband told me we were quitting BFing and going to formula because I was so depressed and anxious over all the feeding trouble. I ended up being diagnosed with postpartum depression and anxiety a few days later.

    Though I felt sad that BFing didn't turn out like I had hoped, I knew putting my mental state first for a while was the right call. Now that I'm much better off -- and my son is 10 weeks old -- I have started trying to relactate. I would like to at least be able to give him some breast milk, so my goal is to achieve at least a partial supply. Ideally he would get that from nursing, but if I had to EP, that would be okay too.

    I started relactation on Monday. I rented a Medela Lactina and have been pumping about every two hours during the day and at least twice overnight. I pump from 15-20 minutes at a time and try to power pump for an hour (10 on, 5 off) once or twice a day. I also hand express after every pumping. I have been getting milk drops in the bottle consistently today (just started getting enough to drop into bottle yesterday) and the flow seems to be a bit faster now.

    Otherwise, I am taking fenugreek & blessed thistle capsules, drinking to thirst, and eating oatmeal cookies (my version of lactation cookies, haha). He won't latch at all without a nipple shield and cries as soon as I try. He has never been a comfort sucker, so he won't stay latched with nothing but drops coming out, and his bad latch is even worse with the shield. I do have a SNS, but coordinating it with the shield is difficult enough...not to mention that it takes him 20 minutes to eat less than 2oz even with the largest tubing and he still falls asleep.

    Has anyone here relactated fully or partially by pumping alone? Or relactated after starting with only drops, an initial BFing period of only two weeks, or with an eight week gap? How long did it take you to relactate? (And I know everybody is different, I'm just curious.)

    Basically, I just want to know that I'm not crazy for attempting this.

    I'm also writing about my experience on my blog (inthegarwoods.com) if you want to keep up with the day to day!

  2. #2
    Join Date
    Jun 2009
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    10,754

    Default Re: Pumping to relactate

    You are not crazy for attempting this. It sounds like milk is already increasing...I am not sure why you think what you are doing is not working. How long have you been pumping?

    Are there any guarantees? No, not ever. But I would suggest that there are things that help, and one is how you look at the situation.

    When you say your baby has "never been a comfort sucker" I am not sure how you know. I assume you mean baby does not suck on a pacifier, because as far as I can tell, your baby was never really given the chance to learn to comfort at the breast, as in, nursing to sleep or something, given your early challenges and decision to stop nursing at two weeks due to those. I guess I am saying, try to take "never" out of the vocabulary and be more open minded about what your baby will or will not do. A breast and pacifier are not really the same thing. All nursing is comforting, so even when a baby is getting food, that is 'comfort sucking" in a sense. The vast majority of babies WILL comfort suckle- they do it in the womb, if they are still nursing years down the line, they do it then. Since encouraging comfort sucking is very often the key to helping a baby who has been bottle fed learn to nurse again, and comfort nursing is one of the great benefits of nursing to both mothers and babies, plus is excellent for helping a baby get more milk at the breast and to increase milk production (milk transfer happens even when a baby is "comfort nursing") I think that eliminating that idea in your mind and thinking your baby never will do it is self-defeating.

    Also, if baby will latch with a nipple shield, but not without, why not use the nipple shield for now and worry about weaning "off it" later? A situation where a baby is unable to latch without the shield is the perfect situation in which to use a shield. There may be latch tricks you can try that will help baby latch without it, but I think the more immediate goal would be to get baby nursing at the breast as much as possible and worrying about eliminating the shield later.

    What we know about relactation is that there are things that make it more likely for mom to make more milk. One of those is that milk production was established in the first place. Since you report having over production, that would indicate milk production was occurring. I think it is actually more likely that your baby was not able to transfer milk well or frequently enough, not that you had over production, and the inability to transfer milk is why you were engorged. However, the fact is there was milk and you were removing milk with reasonable frequency for 2 weeks. Milk production is not typically considered totally 'established" until about 5 weeks, however, the amount of milk that a mom makes at 2 weeks and at 5 weeks is not nearly as wide a gap that between what a mom makes at one week and at 2 weeks- I am not putting this well, but the point is that the fact you nursed/pumped for 2 weeks puts you in a much better position to re-lactate than if you had not.

    Also, milk production depends on removal of milk from the breast, so yes it can be done only with pumping and hand expression. I do think you want to be encouraging baby to nurse as much as possible as well while you continue to pump.

    You do not mention how bottles are given or how much baby gets in bottles. I would suggest making bottles small and frequent rather than large and infrequent, and using paced bottle feeding technique. A baby who is entirely full is not going to nurse as much or as effectively, so you want to bring baby to the breast often and not when upset, hungry and frantic, but perhaps not entirely full either. That is another reason to keep meals normal sized and normal frequency with paced bottles and cue feeding, so baby is normally hungry, not overly hungry nor over stuffed.

    I do have a SNS, but coordinating it with the shield is difficult enough...not to mention that it takes him 20 minutes to eat less than 2oz even with the largest tubing and he still falls asleep.
    Arn't there ways to increase the milk flow aside from tubing changes? I thought there was...

    That said, I think it would help to rethink why you are using an SNS. There are easier ways to get a larger amount of milk into baby, right? So that is not the main goal...The main goal of the sns is to help baby learn to nurse at the breast again, right? And another important goal is to help milk production get established simultaneously with baby eating - see article on lactation aids I link below.

    Also can I point out your baby nursed to sleep on the breast while using the sns- comfort nursed, in other words, which is something you said your baby never does? So that is a good thing, right? Also, 20 minutes is an entirely normal amount of time for a baby to nurse and 1-2 ounces is entirely normal milk transfer for a nursing session, especially if baby was not all that hungry at the time. Also, remember as you go along that baby is also getting milk from the breast presumably even when using sns.

    It is probably a good idea to adjust your expectations about intake. A 2 month old baby could be given six 4-5 ounce bottles a day and be getting plenty to eat.

    But a breastfed baby this age nurses a minimum of 8-12 times a day, so each individual meal is much smaller. Also, intake varies.,,Your baby may or may not take the same amount of formula at every bottle, but that is NOT how breastfeeding is, transfer at nursing sessions normally varies, anything from a very small amount- half ounce or less- to 3 and maybe 4 ounces by this age. If you start to utilize paced bottle feeding, you may well find that milk transfer will be different at each time, more like breastfeeding, and making bottles more like breastfeeding is the point of paced feeding and very important. See links below for more.

    Shields, sns, paced feeding, pumps, etc etc can seem fiddly and annoying, there is no doubt. If baby would just nurse with very high frequency without all these things, of course that would be a much easier way to relactate. This is how mothers relactated in the past before we had all these gadgets. But that path is not always possible, so we have these tools and they can be very helpful. Not every one is going to help in every circumstance, but when a mom is trying to relactate or induce lactation, keeping an open mind, thinking out of the box, and having a willingness to try different things over and over again even when they do not 'work' at first is usually helpful.

    Here is a great article on encouraging nursing: http://kellymom.com/bf/concerns/child/back-to-breast/

    and one on using a lactation aid: http://cwgenna.com/smartnothard.html

    Paced feeding http://www.llli.org/docs/00000000000...astfedbaby.pdf

    https://www.youtube.com/watch?v=UH4T70OSzGs and https://www.youtube.com/watch?v=ykdFuEOIdeE
    Last edited by @llli*maddieb; June 13th, 2015 at 10:04 AM.

  3. #3
    Join Date
    May 2006
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    24,794

    Default Re: Pumping to relactate

    with MaddieB. I just want to add an encouraging story- my mother was forced to wean my sister at 3 months due to some bad medical advice. This was the early 80s and my mom didn't have a pump or access to good advice about maintaining milk production. 3 months later she was given the go-ahead to nurse again, but she had completely dried up. But simply by putting my sister to the breast and gradually decreasing the amount of formula in the bottles, my mom was able to relactate and nursed my sister until 18 months.

  4. #4

    Default Re: Pumping to relactate

    Thanks for your very detailed response! Sorry it took me a few days to get back with you...we were traveling.

    It's not that I think what I'm doing isn't working...more that I don't know if my efforts will yield enough milk to replace some of his formula. I'm on my eighth day of pumping and estimate that I am pumping 1-2ml per side a day.

    I think our prior nursing problems have made any attempt at nursing a stressful experience for both of us. I was so frustrated after our first few experiences with the SNS that I considered throwing in the towel on relactating altogether. Since I am still recovering from PPD/PPA, I didn't want to overdo the stresses and put up the SNS in favor of exclusively pumping for now.

    With that being said, I did find out that he has a pretty severe upper lip tie and his tongue tie has either reattached or wasn't revised enough originally. I am possibly going to have both of those corrected later this week, so my hope is that we can give the SNS (or simply comfort nursing) another shot after that. Right now, I'm afraid he wouldn't stimulate me as well as the pump because he has a shallow latch, can't stay latched for more than a few minutes without slipping off, and has a weak suck. He has a really hard time with the bottle as well...so much so that we have to thicken his formula to keep it all from coming out the corners of his mouth.

    We have been using the majority of the paced bottle feeding techniques since he started bottles. They intersect with the recommendations for feeding babies with reflux. The only one we haven't been able to do is latch him properly on the bottle because he can't open very wide. He eats about 20-24oz of formula a day. He usually eats anywhere between 1.5-4.5oz per feeding (at least 6 feedings a day) and eats every 2.5 - 3 hours during the day, once overnight.

    I have been elevating the SNS and used the large tubing, but I didn't try venting the other tube yet (recommended in the article). I'll give that a shot next time and see if it helps. He didn't really fall asleep the other day because he was comforted, but because he was worn out. He woke up a few minutes later and was extremely hungry.

    I think I'm pinning all my hopes for nursing on this ULT & PTT revision. It would solve so many of our prior issues and make using a lactation aid much more manageable.

    mommal, thank you for the encouraging story! It motivates me to hear about the successes of others who have struggled or attempted relactating too.

  5. #5

    Default Re: Pumping to relactate

    Quick update if anyone is following this thread:

    Wyatt had his tongue tie and lip tie revised yesterday. He can open much wider now and seems to have more mobility with his tongue. I tried the SNS again after we got home from the hospital. He wouldn't latch without the shield and had a shallow latch still, but was able to take about 3.5oz of formula in 35 minutes when I vented the opposite tube. It's so fiddly and he gets frustrated so easily at the breast right now that I am afraid to use it very often...I don't want him to start refusing to latch even with a shield. I think I will just use it on occasion and try putting him to the breast just with a shield. I'm having a hard time getting him to latch well when using it; he just wants to latch onto the nipple part.

    My supply has been steadily increasing. I pumped 1.5ml three days ago, 3ml the next day, and 7.5ml yesterday.

  6. #6

    Default Re: Pumping to relactate

    So here is the latest on my relactation project:

    I'm pumping 3-4oz per day now. I generally see an increase of a half ounce (give or take a little) per day.

    Wyatt is now willing to nurse using just a nipple shield, no SNS necessary. He has nursed for up to 20 minutes at a time using just the shield. When I pump after he nurses, I get just a few mL, so he is able to transfer at least some milk.

  7. #7
    Join Date
    Jun 2015
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    39

    Default Re: Pumping to relactate

    Thats just awesome progress
    Baby is the best pump so ur supply should be increasing naturally
    Wish ya all the best

  8. #8
    Join Date
    May 2006
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    Default Re: Pumping to relactate

    That is terrific! Keep going, mama!

  9. #9

    Default Re: Pumping to relactate

    Can you give an update please?

  10. #10
    Join Date
    Dec 2015
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    Alberta, Canada
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    Default Re: Pumping to relactate

    You are such an inspiration to me! Do you mind my asking how long it took you to get 3-4 oz? I'm on Day 4 of pumping 10-13 times a day with not a single drop. Thank you!

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