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Karleen Gribble is a member of the international interagency collaboration the Infant and Young Child Feeding in Emergencies Core Group. She has been involved in the development of

international guidance and training on infant feeding in emergencies and and has acted as a consultant to UNICEF, WHO, and Save the Children on this subject. She is also an Australian

Breastfeeding Association Community Educator and Counsellor and a member of the Public Health Association of Australia. Karleen has received funding from the Sydney Partnership for Health,

Education, Research and Enterprise to research women's experiences of pregnancy, birth, and breastfeeding during the COVID-19 Pandemic..

Nina J Chad worked as Infant and Young Child Feeding in Emergencies Consultant to Save the Children in Myanmar following Cyclone Nargis. She is a qualified breastfeeding counsellor,

community educator, and Trainer & Assessor with The Australian Breastfeeding Association. She volunteers on the National Breastfeeding Helpline. Dr Chad is a member of the Public Health

Association of Australia, the World Public Health Nutrition Association, and the Australian Breastfeeding Association.

Many women find breastfeeding difficult and stop before they planned. Some women are relieved to stop. But others regret it.

If you regret stopping, you may be able to give it another go, even if you no longer have any milk. This may be possible even if it’s been weeks or months since you last breastfed.

Women want to start breastfeeding again for a variety of reasons. Some babies don’t do well on infant formula. Others become sick and their mothers want to give them breastmilk to help them

recover.

If a mother found breastfeeding challenging the first time around, a change in circumstance, a little more sleep, or just the passage of time can bring a different perspective.

Women might also want to restart breastfeeding if they’re in an emergency situation without services like water or power, such as a bushfire or cyclone.

Since the beginning of the COVID-19 pandemic, mothers have contacted the Australian Breastfeeding Association about starting breastfeeding again because they wanted to protect their babies

from infection or were concerned about the availability of infant formula.

Almost any mother who wants to start breastfeeding again can. There are only a small number of health conditions that make breastfeeding inadvisable for medical reasons.

However, relactation needs to be something you want to do because it is unlikely to succeed if your heart isn’t really in it.

When you stop breastfeeding, a protein in the milk signals your breasts to stop making milk. This decrease in milk production usually takes weeks.

If there is still some milk in your breasts, you can start rebuilding your supply by removing milk from your breasts as often as you can. You can do this by breastfeeding, if your baby is

still willing, or by expressing milk by hand or with a breast pump.

If your breasts aren’t making milk any more, you can restore your supply by relactation.

To start, you will need to stimulate your nipples frequently by encouraging your baby to suck at your breasts or by using a breast pump. This triggers the release of a hormone called

prolactin that develops the milk-making structures in your breast to start producing milk. Once milk secretion begins, removing the milk from the breast signals your breasts to make more

milk.

If your baby is willing to suckle, this is the easiest way to relactate. The more frequently they do this, the stronger the message to your breasts to develop and start making milk again.

Providing extra milk to your baby at the breast while they suck can help them suck for longer. You can provide this milk using a breastfeeding supplementer. This is a container with a tube

that carries expressed breastmilk or formula to your nipple. When your baby sucks at the breast, milk is drawn through the tube into your baby’s mouth, along with any milk from your breast.

Alternatively, you can drip milk over your breast while your baby sucks.

However, some babies used to bottle feeding may be reluctant to breastfeed at first. It’s important to not try to force your baby. A breastfeeding counsellor or lactation consultant can

suggest ways to encourage them.

In the meantime, you can use a breast pump to stimulate the nipples and remove milk from your breasts. You can then give that expressed milk to your baby in a bottle or cup.

You can start making milk within a few days or weeks. This depends on how long it has been since your baby last breastfed and how often you stimulate your nipples.

If your baby is willing to suckle, you will need to breastfeed at least eight times in 24 hours for the first few weeks to get milk-making started and to increase your milk supply.

Allowing your baby to breastfeed as often as they want to, even if they are only comfort-sucking, will speed up the process. It also helps to keep your baby close to your body as much as you

can, day and night. This helps to maximise opportunities for suckling. Using a baby sling or carrier can help.

If your baby isn’t ready to suckle yet, an electric breast pump that expresses both breasts at once is more effective than a single-electric (expresses one breast at a time) or manual pump.

You’ll need to use the pump for 10-20 minutes, six to eight times in 24 hours.

Expressing milk by hand after breastfeeds or using a breast pump can help remove any remaining milk. The emptier the breasts, the stronger the message they receive to make more milk.

You can also ask your GP about using a medication to increase your body’s production of prolactin, which can make relactation a little quicker.

If your baby is willing to suck frequently, the process can be quite simple. But other mothers and babies find it more challenging. For instance, sometimes making milk is easy but it takes

more time for your baby to be willing to breastfeed.

If you stopped breastfeeding because of a problem, such as persistent nipple pain or mastitis, you might need some help to prevent this recurring. Every situation is different.

Having a support network to cheer you on as well as practical support from family and friends — such as making meals, helping with housework, or entertaining older children while you’re

occupied — will make the process much easier.

A lactation consultant or Australian Breastfeeding Association counsellor can support you to start breastfeeding again.