Dear Diane, about the relactation question...what you may find is that the
baby will not want to spend alot of time at the breast because it got used
to bottles with abm that flows quickly. My experience has been that these
moms often need to use a supplemental nursing system consistently. That
way, all the eating occurs at the breast, and the baby will stay at the
breast longer, thereby increasing breastmilk supply by demand. If a
supplemental system is not used, the baby will get irritable at the breast
when hungry, and possibly have a negatiave association with the breast if
it always has to go to the breast first before getting a bottle. It is best
to totally get rid of the bottles (and pacifiers). The other thing I
wouldn't hesitate to do is to give the mom some metoclopramide, a med that
will increase her prolactin levels to boost milk supply. I am always
cautious about telling moms that there is no guarantee that the baby will
ever exclusively breastfeed in the future. Given that she did already wean
once, it depends how shut down her alveolar cells of the glands are, which
make the milk. A high prolactin level from metoclopramide and/or from
frequent nursing does not guarantee sufficient output at the cellular level
at the breast. Your are right that she needs to be off estrogen for sure,
and ideally progesterone too until the baby is alittle older. Good luck
with her! I am always interested to see how these moms end up doing-Anne
Eglash MD