Relactation - advice and suggestions please.

[SirBoobAlot]

I have been asked by two girls at the young mums group to help them start breastfeeding again. Both their babies are three weeks old, and both stopped about two weeks ago. They do know I'm not a peer supporter (yet!) but have said they feel more comfortable asking me then a stranger, possibly because neither of them got much help at all to start with, but that's a whole 'nother (angry) thread.

I told them to attach the baby as often as possible (and said I could / would arrange someone to if they felt okay with it, check their latch), before and after a bottle feed if possible, and to hand express / use a pump very regularly. Have also warned them it could take a while to regain their supply, but that the more they latch their little ones on, the easier / short time it should be. Lansinoh and breastfeeding pillows were also mentioned.

Is there anything else? I have been to the library and photocopied what little I could find about it, and also some pages about good positioning.

TIA.

I've no personal experience, sorry. have you included the kellymom stuff?

Thanks, will add that to the "To Print" stuff!

I would have thought babymoon a good idea, ie excuse to sit in for a week just wearing pj bottoms and baby in nappy, and get baby to feed as much as possible. Probably easiest to do this in front of TV. Thats what I have done when I need to increase supply during growth spurts so would have thought it would be helpful here too. After 2 days usually see big difference, eg breasts much heavier.

Top ups should be given after a BF, ideally small (eg 2oz or less) because a big top up will mean that baby will be totally full and not want to breastfed for another 2-3 hours.

At 3 weeks baby should be drinking roughly 20oz+ per day. Assume that they BF 10x a day (say roughly 7,9,11,1,3,5,7,9,12,3.30) and offer top ups afterwards - say to start with 10x 2oz top ups, gradually reducing the top ups as the supply increases?

I wonder whether the pump is necessary if the baby feeds lots - often mums find pumps demoralising if very little coming out? I guess depends on how efficient the baby is? I think good also to manage expectations ie that to get good supply going again need to BF more often than bottles would be?

They could also try RLT supposed to be good for BFing or other teas like fenugreek or blessed thistle.

How kind of you

On the lll site it mentions using a supplementer for expressed bm.

It might be worth being a bit precise about how often they need to feed and pump (ie. every two hours). I'm not sure on the exact timings tbh, but I would imagine it would have to be fairly frequently. Just a thought.

Best advice is:-

Put baby to breast as often as possible. Every squeak, snuffle, shuffle or rooting baby goes on breast.

Pump 8-10 times a day - both sides with breast compressions during pumping and hand expression after. Don't need to pump every 2 hours or whatever, block pumping is very effective at increasing supply (pump, rest, pump, rest, pump - as though your baby is cluster feeding). Out put is not indicative of supply. 3 letdowns per pumping session is ideal but even if no milk comes out it is still good to pump as it telling breasts baby is hungry. Aiming for 10 mins per session.

As much skin to skin as possible. Babymoon when milk starts flowing again and feed, feed, feed.

Cup feed rather than bottle feed if possible (even if only for a few feeds a day as it can help with tongue movements). Suggest small ebm/formula feed then offer breast so baby doesn't go to the breast starving but is sated enough to allow some time for milk to come down.

If baby is very resistant to latching on then try taking baths with baby and leave off latching on again until more milk present so baby can get instant gratification (could also try hand expression before latching).

Stress breast produce milk like a river not a bucket, it might start off as a very small summer stream but it can pick up quickly.

What ever help you give them they should be seeing their HV regularly to ensure baby is still gaining weight and that they keep a close eye on wet nappies and baby's demeanor. If you could go with them to a LLL meeting or similar so they can get some professional back up in case of difficulties.

Here is a very comprehensive document on relaction.

That should have said 'Best advice I can give

I've often seen cluster pumping recommended for boosting supply on a Dutch BF forum I visit.'tis usually used by those exclusively feeding EBM, but still. Do stress thAt the yeald is not the point of the expressing, doesn't indicate supply level etc.

Cluster expressing: 10 minutes every 20 minutes for 2 or three hours. Once a day, ideally in the evening. Usually done twice a week for supply maintenance, but sometimes 3 several days in a row if supply has got low.

No idea where the random '3' come from...

Ohh thank you everyone! They seemed really pleased to even find out it was possible, so am hoping I can help them do it as comfortably as possible.

Just sad that they gave up initially if they actually wanted to BF.

I guess try to manage expectations that first 2-3 weeks will be hardest while they build up supply and to give them lots of encouragement.

They didn't get any support - they're both under 16, and were kind of fobbed off with "Well, you're going to end up bottle feeding anyway, might as well start now"