problems

[mommiesgirls]

So I had my daughter 8-2-2011... My milk never seemed to come in and my daughter never seem satisfied... so I quit BF and now we are having formula issues and I would like to try again... can I try to BF even though its been over a month?

[Mattee Petersen]

I don't have any experience with this, but here is what the LaLeche League reccomends: 

llli.org/faq/relactation.html

If I were you, I would offer the breast as often as possiblefor comfort sucking & feeds. I would offer the breast before bottle always & let her nurse as long as she will. I also wouldn't use a paci, as that could take time away from the breast. See if there is a La Leche League meeting near you, as it may be hard! Hugs to you & I hope it works :)

[AnkaJones]

Hi,

Congrads on making the decision to go back to breast! It may take some doing, but could turn into one of the most meaningful experiences in your life.  I agree with everything the PP said, and would add a couple more points. 

There are two halfs to what you need to do.  First, you need to convince your baby to go back to the breast.  Your baby has been using an artificial nipple, which has an immediate flow when she starts sucking, and then stays 'on' smoothly once milk is flowing.  Your breast takes a little bit to let down milk once she starts sucking, and comes fast, then slows, then there's another let down and it's fast again, etc.  Some babies who haven't been to breast don't 'get it' and it can take a little time for them to develop the patience to deal with it.  Aside from flow issues, there is a very different technique your baby has to use to get milk out of the breast.  The second half of what you need to do is get your breast to make milk again (relactation).

Different moms and babies have problems with different things, so I'm going to give some starting ideas, but I want to add that you might want to consider seeing a board certified lactation consultant (IBCLC) if things don't look like they're going in the right direction -- they have a lot of tools available and may be able to help figure out what the problem is in a way that is difficult online or in the context of an LLL meeting. 

To get started, try latching your baby on.  Your baby at breast is the single best stimulus to get your breast to produce milk.  Set yourself up for success.  Look at a book or some online videos to get a sense of how you latch a baby (assuming you've never done it before).  Choose a time when you aren't rushed and your baby is calm.  Get comfortable, start with snuggling.  Then, when the two of you are ready, give it a try.  If she doesn't look enthused, wait a little bit and try again.  Don't force the issue.  If things don't come along easily, it's probably time to get help IRL -- it may be you're trying to latch the baby on in a way that's making her reflexivly resist.  If you can get your baby to latch, congradulations!!! That's a big step.  Take a deep breath and celebrate.  If your baby latches, she may come off after a minute or less.  She's not used to waiting for milk to come out, and you might not be making much to start.  Just keep trying to get her to latch on as often as possible.  At some point, it may be necessary to dig into the bag of tricks to get her to stay latched on once you're making milk if she's just not waiting long enough for your ejection reflex.  For example, you can use a supplementer, which is basically very thin tubes you tape to your breast, so that she gets your expressed milk or formula immediately on latching.  If the latch is uncomfortable for more than a couple of seconds, it's probably not right and you'll want to detach your baby.  Press down on the skin at the corner of her mouth to break the suction, then pull your breast out and try again.  Again, if you can't get a comfortable latch, get help IRL.

On the other side of things, if possible get a rental grade pump and start using it every two hours or more.  You might get drops at first, but you're building your supply.  If your baby will latch and eat a bit, go ahead and feed her as much as she'll take, then pump and feed her what you get at the next feeding.  Keep in mind as you go forward that if you're both pumping and breastfeeding directly, the amount of milk you are able to pump doesn't necessarily indicate how much supply you have -- your baby is able to get more milk out of your breast than the pump.

Finally, consider a supplemental nursing system (SNS).  You can put formula in it or your already expressed milk, and it will (1) allow you to get rid of bottles, which is important since you're trying to imprint your baby's sucking habits to the breast, and (2) your baby will directly stimulate your breast to make milk by latching and suckling.  Finally, while the setup for the SNS can be a little cumbersome, it allows you to have the experience of breastfeeding your baby even before you're making much milk -- which is generally a lot more satisfying than bonding with your pump!

Best of luck, and again major kudos for making this decision.

Best,

Anka

[nyakanyasko]

Hi! Good luck getting started on relactating!! The above posts have great info and I just wanted to add a couple thoughts...one is you say your milk never really came in and I'm wondering why. There are a few typical reasons for that. One is if your breasts didn't get much stimulation during the first week after the birth, another is if you have any underlying hormonal issues (PCOS, low thyroid, etc.), and another is retained placental fragments. You didn't mention this, but any breast or chest surgeries or injuries to that area can also have an effect on milk production. A good place to start doing detective work into supply issues is here: http://lowmilksupply.org/

Then as a previous poster mentioned, there are the two parts to the equation, getting your baby to nurse, and getting your supply up. If you are going to be pumping on a regular basis, there is a technique called hands-on pumping http://newborns.stanford.edu/Breastfeeding/MaxProduction.html that can be really useful to help build and maintain milk supply. There is also some more great info on that website about latch.

One more thing is, with relactation, patience is very important. You may begin to see milk pretty soon after starting, and the rule of thumb is, if you stopped nursing a month ago, it will take a month to build your supply back up, if you stopped 2 months ago, it will take two, and so on.

I definitely recommend having a consultation with a lactation consultant in your area if you can, and hopefully this gets you started.

Good luck! :)

Warmly,

Jessica

[Megan73]

NAK
Totally agree with PPs. I would suggest attempting to latch baby with an SNS loaded with formula (or better yet a Lact-Aid, available online), pumping (preferably with a hospital-grade pump - you can rent one) and trying domperidone (a drug for gastric motility that has the side-effect of boosting prolactin which US moms can buy online).
Good luck, mama!