What is relactation and how do you do it?

What is relactation?

You are relactating when you're either allowing your baby or toddler to suckle from your breasts or you're commencing pumping after a period during which you've not been removing much milk from your breasts. Resting your breasts results in a drop in, or disappearance of, your milk production.

Most of the changes that occur in the breast during weaning (or stopping milk removal) have taken place within about two weeks. That's why we'd usually say that relactating occurs after a period of breast rest which ranges from a couple of weeks to months. If you are relactating for a toddler, the period of breast rest might even have lasted a year or more. But of course the principles of relactation apply even when you've had just a short breast rest, less than a couple of weeks, though hopefully in that case your milk supply is quicker to retrieve.

When might you decide to relactate?

Relactation plays a particularly important role in times of crisis, such as severe weather events when there is no electricity or commercial milk supplementation available, or if you're experiencing the shocking disruptions to normal life and safety caused by war or social unrest. In an era of planetary polycrisis, all families have the right to understand the principles of relactation.

Here are other contexts in which you might decide to relactate.

• You had a very difficult initial experience breastfeeding your baby, and weaned. Now you would like to try again, perhaps bringing in different knowledge and support.

• Your baby seemed to wean herself. Now you would like to try again, perhaps bringing in different knowledge and support.

• Your little one has been diagnosed with a medical condition, and you would like her to receive the immune benefits of your milk.

• You feel that you were wrongly advised that you needed to wean. Perhaps the provider who recommended complete weaning was concerned about the effect of breastfeeding upon your own wellbeing, or was concerned about your baby's wellbeing or weight gain. Unfortunately, women quite regularly receive unhelpful advice concerning breastfeeding and weaning. Even when you are not able to meet all your baby's caloric needs with your own breastmilk, and even when the occupational fatigue caused by pumping becomes too burdensome, you may find that things are easier if you still feel you can use your own breasts to dial your baby down or provide at least some breastmilk at times. You can find out about our health system blind spots concerning breastfeeding here and here.

During the period of time when your breasts were resting, your little one will have received nutrition from other sources. This other nutritional source will continue to play an important role in maintaining your baby's health and safety, while you relactate.

What's the best way to get started with relactating?

Very often, breastfeeding women are led to believe that each time their baby comes to the breast, he needs to be receiving a meal, which fills up his tummy. This misunderstands how successful and exclusive breastfeeding has worked throughout our evolutionary history as Homo sapiens.

You can find out about frequent and flexible breastfeeds here.

The best way to approach relactating is to think of allowing your baby to suckle at the breast as a time of sensory motor nourishment, and of enjoyment (of the cuddles, caresses, smiles, closeness), without any pressure on your baby to 'get milk' or your breasts to make milk.

You can offer your breasts just as often as you want, to help your baby dial down. You can find out about the dial on your baby's sympathetic nervous system here.

Then the amount of milk being transferred is a less important consideration, and you and the baby won't feel under pressure. It's very important baby isn't under pressure to breastfeed, as this can result in a conditioned dialling up at the breast. You can find out about here.

If you stopped breastfeeding because of breastfeeding problems, which is often the case, I strongly recommend that you work through the articles in Possums Breastfeeding & Lactation which address with the problems you faced. You might also seek the help of an NDC Accredited Practitioner, here.

Many women have to stop breastfeeding because of fit and hold problems, which weren't identified or were misdiagnosed. These same problems might recur as you try to relactate, if they have not been addressed. You can find out about fit and hold starting here.

You may or may not decide to also remove milk from your breasts with a pump, to help build your supply. The most important thing is that you are not under such pressure or stress that the whole project of relactation becomes overwhelming. You can find out about pumping starting here.

You are in crisis and need to relactate urgently

If you are needing to relactate urgently because of crisis, there is even more reason to make sure that you've read the sections in Possums Breastfeeding & Lactation addressing the problems which caused you to wean baby from breastfeeding in the first place.

When you are relactating, the more milk you remove from the breast, the more you build your milk production. Before all else, your baby is your best pump (although if underlying problems haven't been addressed, this might not be the case.) You can offer your breast even when baby isn't cuing, as long as he isn't under any pressure. He may not stay on for long, but short and very frequent suckles are much better for your milk production than longer, less frquent opportunities.

Women wishing to relactate in a crisis are also likely to start to pump, if you have access to one, to increase milk removal, which builds your milk supply. You can find out about pumping starting here.

Selected references

Camacho NA, Von Schreeb J, Della Corte F. Interventions to support the re-establishment of breastfeeding and their application in humanitarian settings: a systematic review. Maternal and Child Nutrition. 2023;19(e13440):https://doi.org/10.1111/mcn.13440.