Relactating 4 months post partum

My good friend had a baby girl four months ago, and has formula fed from birth. She was certain that she did not want to breastfeed, and their first daughter (birthed by the other mother) was formula fed from birth as well. Since the start, Soren has had issues with formula, and their original goal of only organic formula has now turned into mass market hypo allergenic formula and she's still having issues. Mel has major regrets over allowing her milk to dry up and formula feeding her for so long, and wants to relactate so she can get her off formula, or at least give her mostly breast milk.

She's renting a hospital grade pump and is going to start pumping like mad. We have reglan, but no domperidome (I don't even know where to order it... someone point me to the right place?), but she is willing to do that as well. AJ hasn't pumped in months, but she is going to start pumping again (we have a Medela PIS, but she'll rent a hospital pump if she has to) to give them the milk so that they can stop giving her as much formula and get her on breast milk as soon as possible.

I have two questions about this. I KNOW she can relactate, but I don't know how long it will take or the best way to go about it. Also, what is the likelihood of an exclusively bottle fed 4 month old (probably older by the time Mel gets any milk), taking to the breast? I know she wants to nurse her as well, but she is mostly interested in her health at this point and will be fine exclusively pumping if that is all she ever gets done.

Any advice?

I have no personal experience, but Kellymom.com has some great info on it:
Relactation and Adoptive Breastfeeding: The Basics
Good luck to your friend.

Getting her to the breast NOW is important so that she'll stay there when there is milk to be had. Mom should get a SNS or other similar system and do ff at the breast as much as possible - the nipple stim will also help her bring in some milk.

If she never established a supply when her milk came in, it's unlikely that she will produce enough to maintain baby now. It could happen.. but I haven't heard of it.

She needs to use the hospital pump 12x/day (I forget how long, 10m maybe?) and then increasing.. Kellymom has good info
http://www.kellymom.com/bf/supply/relactation.html

She needs to try and get a supplemental nursing system and get that baby to the breast. Kellymom.com is a great site for help.

It is alot of hard work and the more I researched it I realized that there were no garrentees that my milk would ever come back in (it still hasn't) though some moms have LOTS of milk...
It is very important for her to get a SNS asap. Camille would not even nurse at the breast with that, it had been so long since she nursed.
The fastest place I could find Domperdone was ebay. I got 200 tablets off of there because I knew they would get to me in a couple of days. Then I ordered a months supply off of a Canadian pharmacy that came 2-3 weeks later.
Good Luck!!

IBCLC...
I'll look in my books when i get home... she needs the meds NOW, she needs baby at breast NOW ...
She needs to be pumping atleast every 3 hours round the clock BETTER would be every 2 durring the day if possilbe.
Pump for atleast 2 minutes after the last drop of milk or for a total of 30 minutes per breast.

Not sure if she can take fengreek w/ the reglan... i'd have the check the books again...
Support like crazy, get her in touch with LLL if possilbe. and really shoudl see an GOOD IBCLC that is suportive and will follow her wishes and goals.
Realisticly i don't see her being able to give ALL breastmilk, but impossilbe, no. Stop birth control pills if she's taken them.
Hummmm that's all i can think of at this time... i'll post back later.

It's a lot of work so bravo to your friends for trying! The SNS is a pita to use but I can't imagine that she'll be sucessful without it. I think it might be possible to get her to take the breast at 4 months, especially if they stop using regular bottles completely. They can use the boob bottle, a flexable cup, or an eye dropper but I think as long as the baby has the choice, she's gonna pick bottle. I use the Adiri nurser with the baby I nanny for since he's breastfed only otherwise so it's the only bottle he will take. The Adiri bottle is as close as any bottle gets to an actual breast. They can cover the vent hole at the top to simulate the need to suck for a time before milk comes out. I think waiting for let down is a hard concept for bottle feeding babies to learn so it's worth trying to mimic that so she will figure it out.
Good luck to your friends!

If baby will latch onto moms breast AT ALL, get an SNS. Use that instead of a bottle, if baby will not latch onto mom she needs to go out TODAY and buy these bottles with the slow flow nipples. http://www.toysrus.com/sm-the-first...le-9oz-3pk-by-learning-curve--pi-2449561.html

Next, she needs domperidone, I don't know where the quickest place to get it, but it's usually cheapest here www.inhousepharmacy.com

Feed her with the breastflow bottles and try to get her to nurse for comfort, as soon as she is nursing fairly well at the breast, start using an SNS and get rid of the bottle.

Also, fwiw, my friend who had a 25 week preemie.. baby was bottle fed breastmilk for 9.5 months... mom tried once a day to latch baby from the time she came home from hospital. Baby rejected the breast all the time. Mom found most success at night when baby was partially fed, she'd slip the bottle out and breast in. At 9.5 months baby latched and refused bottles, and is now 2.5 and still nursing.

This site also has helpful info http://www.asklenore.info/breastfeeding/induced_lactation/gn_protocols.html .

A nipple shield, if the baby's used to a bottle, can be a way to get the baby used to suckling at breast. It can hinder milk production, though, so she has to be careful.

My DS was preterm and I pumped for four months...until he was able to nurse. I took Domperidone, which really helped with my low supply. Bought the Domperidone mail order from Lloyd's Center Pharmacy in Portland, Ore.

A hospital-grade pump is better than a PIS for relactating; it's much stronger.

Good luck to your friend!

Mother may need to avoid common allergens in her own diet in order to keep the milk clean for the sensitive baby. The proteins also pass through mother's milk.

LLL and SNS to help her give it a go!

I nursed until my son was 3 and half months old, and I had to take some meds he couldn't have (and I was drying up, I have PCOS). Two months later (when he was about 5 months old) I got a hospital grade pump, an SNS and started trying to relactate. I got a little...took fenugreek, got a little more (we're talking drops here!) and took Reglan and got quite a bit more. But I had a severe reaction from the Reglan, note that one of the side effects can be hyperactivity, they weren't kidding. Sounds mild, but if it happens to you it's like taking speed! I wasn't successful, though as a SAHM I pumped every hour for a month and got nothing. My son also wouldn't take back to it again. He rejected the breast. My biggest regrest so faras a parent - stopping nursing for that stupid mediacation!!!
Sorry - touchy subject. Just thought I'd share my experience. From what I learned when I Was doing it, the odds of her getting a full suply to not have to supplement with formula is slim.
Amy

Moms nursing babies with food allergies don't need to avoid "common" allergens. They need to avoid all foods that baby is allergic to, whether they're "common" or not.