Hi June,

How lovely that this mum is wanting to relactate for her son.
It would be my guess with a child this old that even if he's willing to
suckle without there being milk there that she'll also need to pump. Did she
say why she's wanting to relactate? Is it for the milk or because she wants
to breastfeed? Or is he 16 weeks not 16 months? It makes quite a bit of
difference!

There really is not any research on what is optimum but I usually suggest
that double pumping for 20-30 mins 6-8 times a day is what to aim for
(setting up so pumping is hands free is essential!). However, some mums find
that less works well for them. Hand expression works well to remove small
quantities of milk. Domperidone 80-90 mg a day is helpful to most women who
use it. Some also find the herbs fenugreek, blessed thistle and goats rue
helpful.

If the baby is 16 weeks not 16 months she may wish to just put him to the
breast and encourage suckling as much as possible. A breastfeeding
supplementer may be helpful. Pumping can be an adjunct if she wishes but she
needs to be able to live with it. Keeping the baby close and encouraging
suckling as much as possible will be beneficial (cosleeping, sling avoiding
use of dummy etc).

If the mum has access to the Internet, web based support groups are very
helpful because she can talk to others who have been there.
There is stacks of info on the net otherwise, the best resource for
breastfeding of babies placed as non-newborns is the Australian
Breastfeeding Assoc booklet on relactation and adoptive breastfeeding. You
can buy it via their website http://fourfriends.com/abrw/ (there is a BB
support group associated with the latter) and then email lists
http://groups.yahoo.com/group/1ABSupportGroup/
http://groups.yahoo.com/group/ChinaAdoptionBreastfeeding/

You may also wish to get a copy of the WHO booklet on relactation
http://www.who.int/child-adolescent-health/New_Publications/NUTRITION/WHO_CHS_CAH_98_14.pdf
and she and you may find the ABA booklet on relactation helpful.
You can buy it via their website
http://www.mothersdirect.com.au/prod141.htm.  or LLL was considering
stocking it, I don't know if they have yet. It's particularly helpful
because it has lots of ideas on getting a non-newborn to the breast.

Hope this is helpful.

Karleen Gribble
Australia




> Had a call from a mother  who has had reoccuring mastitis (3 bouts) the =
> last bout started on the 7th January stopped b/f friday  and went to the =
> doctor  on Monday 3 days later, who examined her and found a palable =
> lump in the left breast (?Mastitis) - The advice was to stop b/f  =
> immediately as he wouldnt be able to treat the lump while she was b/f. =
> She  was  prescribed Bromocriptine 2.5mg BD for 2 weeks.  She rang =
> to-day, to ask if she could relactate.  Has anyone had experience with =
> this drug, and a relactating protocol  that they are willing to share.  =
> Her son is 16 mths old.
>
> June Nicholls
> IBCLC

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