No CEUs are provided for this webinar after May 18, 2021.

Click here to view the webinar recording.

Click here to view the ppt slides.

The Basics of Breast Massage and Hand Expression video.

Speakers Bios:

• Karolina Ochoa, BSN, IBCLC
• Nichelle Clark
• Je’Miere Colbert

Objectives: By the end of the webinar, attendees will be able to: 

• Explain why relactating may be an option for families
• Describe the physiology of relactation
• Support clinical management of relactation
• Apply best practices to optimize pumping for the best outcomes
• Identify common drugs and herbs that aid to increase milk supply
• Identify tools to facilitate direct breastfeeding
• Support emotional effort during relactation

Time Stamps

0:00- Introduction by host, Robbie Gonzalez -Dow

02:40- Introduction by moderator, Gaby Cavins

05:25- Karolina Ochoa, BSN, IBCLC

06:37- Personal story of relactation

08:06- Definition of relactation: a process of reestablishing a milk supply after the baby has stopped breastfeeding or the mother has stopped pumping.

08:45- Families may choose to relactate because of:

• low milk supply
• maternal/infant separation
• resolved life crisis, formula intolerance
• unnecessary weaning
• regret

12:35- Preventative care: adequate support in the community

13:40- Physiology of relactation

• Cycle of growth, secretion, and removal
• Prolactin increases with nipple stimulation and Oxitocin helps once milk supply develops
• Suckling + milk removal + prolactin increase = key to relactation

16:45- Clinical Management Consider circumstances, baby’s age, time passed from last milk expression, and medicated or unmedicated Circumstances: motivation, support, goal, time availability, obstacles Baby’s Age: still have sucking reflex is easiest On average it takes about the same amount of time to produce a full milk supply as has passed since mother weaned. There are medications and herbs that can help aid the process

27:08- Getting the baby back at the breast. Things to consider: bottles and pacifiers, root cause of initial breastfeeding cessation, and baby’s willingness to latch If baby is willing to latch on, baby should be put to breast every 1-2 hours. If baby is not willing to latch on, assess for oral ties, suggest skin to skin, and try at-breast supplementer or breast shield, and pump regularly.

34:30- If mother desires to exclusively pump. Make sure she has a good pump, correct flange size, frequently empties, and to pump during the night.

41:22- Drugs and Herbs Gradually reduce supplementation

48:12- Managing the expectations

49:57- Emotional Support

54:09- Interview with Je’miere Colbert and Nichelle Clark

55:14- Nichelle Clark’s story as an exclusive pumper to donate milk during COVID-19

58:10- Je’miere Colbert relactated because supplement shortage due to COVID-19

01:00:20- Maintaining milk supply Regular pumping Change between hand pumps, mechanical pumps, hand expression

01:03:40- Hardest part of relactation Not a lot of knowledge out there Scheduling pumping into daily schedule, difficult to make time Have some flexibility with your schedule Baby Buddha and Elvie pumps allow you to move around while pumping

01:10:20- What could improve? Present options- education on relactation and how to do it Holistic and patient-centered care

01:13:20- Staying close to baby Can still do skin to skin Other ways to bond besides just breastfeeding Play with baby

01:16:40- Support groups You can help them and they can help you A real bond between mother Facebook groups, family,

relactation groups, exclusive pumping groups

01:19:25- Hand expression Maya Bolman technique works well Videos help- each mother has different “sweet” spots

01:22:00- Herbs Fenugreek- stopped recommending it because it’s unknown Domperidone- can order online, no prescription needed

01:23:45- Power pumping Can be very helpful for your schedule Shouldn’t be overused Make sure mother has correct flange size and proper education

01:26:10- Milk supply and relactation Many components- hard to know cause of low milk supply

01:28:10- Teas and cookies shouldn’t be used as a crutch, set expectations

01:30:00- Medela app is free

01:31:10- Karolina’s contact information