Hi Sarah!
Yes, it can be done. The moms can also contact a La Leche
League leader in their area for help. LLL's Breastfeeding Answer Book (you should get yourself a copy) has about a 10-page
section on relactation/induced lactation. The BAB mentions a survey of 366 women who relactated. More than half established
a full milk supply within a month; 25% took more than a month; and the rest continued to supplement until their babies weaned.
Here are some suggestions to get started:
1.The mother will need
to devote most of her time for the next two weeks or so. Can she adjust her priorities?
2. A good basic understanding of breastfeeding will help, i.e., knowledge
of supply and demand, proper positioning and latch-on, hunger cues, how to know if baby is getting enough.
3. It's a good idea to contact the baby's doctor to rule out illness or
health problems or to have the baby's weight checked regularly while making the transition.
4. Assuming baby is willing, put him/her to the breast as often and as
long as an average baby breastfeeds, i.e., at least 20-30 minutes every 2-3 hours during the day, and every 4-5 hours at night.
Consider keeping baby close at night so he can suckle for comfort.
5. Breastfeed for comfort (no pacifier).
6. Mother should be careful to get adequate rest, proper nutrition, and
enough fluids. If her urine becomes concentrated or dark in color or she becomes constipated, she needs to increase fluids.
7. Expressing milk between feedings may help increase milk supply. A double
electric pump is faster and may be more effective in increasing supply.
8. Reglan (metoclopramide) (available by prescription) at 10 mg 3x a day
for 7-14 days may increase milk production when used in conjunction with frequent nursing and/or expression. Some herbs are
reported to increase supply as well, but she should contact someone knowledgeable about them.
9. Milk supply may drop temporarily at the onset of menstruation.
10. A baby used to bottles may need extra encouragement to take the breast.
Try other feeding methods when supplementing, i.e., SNS, spoon, cup, eyedropper, feeding syringe, or finger feeding. An SNS
(supplemental nursing system) attached to the breast has the added bonus of stimulating the breast while giving the baby instant
reward. If baby refuses the breast, finger feed with the SNS as a transition (not more than a week) to get baby used to the
feel of mother's skin in his mouth.
11. To avoid baby becoming overly dependent on the SNS, use it in the
first side only. When baby's initial hunger is satisfied, switch to the other breast.
12. Try a few of these suggestions to encourage baby to take the breast:
Try when baby is not too hungry or too sleepy, is relaxed (or even sleeping), while walking or rocking in a rocking chair,
in the bathtub, in a dark room or other place free of distractions, play soothing music. Increase touching: lots of skin-to-skin
contact, spend time each day stroking and cuddling, keep baby close between feedings in a sling or baby carrier, sleep together.
At the breast, make sure to use effective positioning, give baby a "pep talk" and congratulate him when he does well (he understands
tone of voice). Put drops of mother's milk or formula on the nipple and areola to encourage latch-on. While at the breast,
drip expressed milk or formula over the nipple or in the corner of baby's mouth while at the breast with an eyedropper or
feeding syringe.
13. While in transition, keep a record of baby's feedings (frequency and
length), reaction to breastfeeding (is he sucking actively, happy to take the breast?), amount of supplement taken and how
it was given, number of wet diapers (6-8 wet cloth or 5-6 disposables in 24 hours), bowel movements (number and volume)
and weight gain. If baby's urine is concentrated or dark in color, he needs more supplement. A few ounces of weight loss may
occur during transition, but should stabilize and being to climb within about five days.
14. Know the signs of dehydration: 2 or less wet diapers/day, poor skin
tone (when pinched, the skin stays pinched looking), lethargy, dry mouth and eyes.
15. When baby begins actively breastfeeding and begins losing interest
in finishing the supplement, gradually reduce the amount of supplement given (1/2 oz. per feeding per day works well for some).
16. Changes in the color, odor, and consistency of bowel movements are
an indication that milk supply is increasing. Color should become lighter, odor will decrease, and consistency will soften.
BMs may also become more frequent.
