Supporting Families with Relactation
What is relactation?
Relactation is the process by which a parent reestablishes lactation after having stopped for some time (weeks or months). Relactation can also apply to a parent who previously breastfed (or chestfed) a biological child and now wishes to make milk for an adopted child, a partner’s child, or a child birthed by a surrogate.
Why would a parent want to relactate?
- Breastfeeding was not successfully established in the hospital after birth.
- Separation due to an illness or medical procedure led to earlier than desired weaning.
- A parent who lactated for a previous child wants to nurse an adopted infant or infant born to a surrogate mother.
- A non-birth parent who lactated previously wants to build a milk supply to feed to another infant, such as parents in a same-sex relationship or transgender parents.
- Infant does not tolerate formula.
- Desire to have a safe way to feed an infant during uncertain times, such as emergencies from natural disasters or disease outbreaks.
How does relactation work?
Lactation is a supply and demand process that requires 1) nipple stimulation and 2) milk extraction. Frequent stimulation of the nipples by pumping, hand expression, and/or an infant nursing is required to re-establish milk production. Once milk production has begun, frequent and complete removal of the milk helps to develop a milk supply. A lactation support provider can provide specific guidance on relactation practices by assessing each family’s individual situation.
Assistance from a lactation support provider should include an assessment of the infant’s age, weight, and amount of milk produced. This will determine the need for supplemental feedings (pasteurized donor human milk or infant formula) while relactation and milk supply are being established. Infants and young children who are receiving human milk from a parent who is relactating must be carefully monitored to make sure the child is getting enough calories to have normal weight gain. Breast milk substitutes should be continued as needed to make sure that infants continue to receive enough nutrition if milk supply is not (yet) adequate.
How long does it take to relactate?
It is important to help parents set realistic expectations for relactation based on their individual circumstances. Relactation can be a time consuming process. Many parents will be able to partially or fully lactate with the right support. Success will depend in part on parental motivation and dedication to the process and access to skilled assistance from a lactation support provider.
Milk production can start as early as a few days after beginning nipple stimulation, but may take weeks to months. The start of relactation will depend on the length of time that has passed since lactation stopped previously and the age of the baby. Younger babies usually return to (or start at) the breast or chest easier than older babies do. Even if a full milk supply cannot be established or the infant is unable to latch onto the breast or chest, infants can still receive health benefits from being fed expressed milk.
Lawrence RA, Lawrence RM. Induced Lactation and Relactation (Including Nursing an Adopted Baby) and Cross-Nursing. In Breastfeeding: A Guide for the Medical Profession (8th edition pp. 667-687). Philadelphia: Elsevier; 2016.
- Maximizing Breastmilk and Supporting Re-Lactation—UNICEF Baby Friendly Initiative
- Relactation: Review of Experience and Recommendations for Practice—World Health Organization (WHO)
- Relactation in Infant Feeding in Emergencies (IFE) Module 2, Version 1.1—Emergency Nutrition Network (ENN)