How Do You Induce Lactation if You’re Not Pregnant?

In addition to all of the amazing physical, mental, and emotional benefits for both mother and baby, breastfeeding can help in healing a mother’s heartache associated with infertility or not being able to conceive her own baby for whatever reason. When a mother is able to induce lactation, a baby and mother are able to connect through breastfeeding, there is a biological connection that takes place and this can help a new mother and new baby.

What does it mean to induce lactation?

Induced lactation means that a mother is trying to promote milk production through her own breasts. A mother tries to induce lactation because she is likely receiving the gift of a baby soon and wants:

A breastfeeding bond with her baby
To feel the attachment that comes with breastfeeding
To nurture her baby through the best nutrition possible, and many other reasons that are specific to a mother’s situation.

Every mother’s circumstance is unique, so it’s important to work with a lactation consultant and have the support of your partner, family, and mother-to-mother support to aid in the experience.

The benefits of breastfeeding for the new mom and baby

In the case of mothers who have experienced infertility especially, breastfeeding their baby really allows them to heal from some of the traumatic experiences they may have endured in trying. Breastfeeding helps them feel accomplished and “normal” in a sense, they can relate now to all the other mothers who were able to breastfeed.

Babies are thrown into a cold new world, and they are not ready to be separated from their “mother figure” at birth, so breastfeeding can create an attachment experience for them similar to an umbilical cord in the womb. There is a lot of research surrounding this topic as it relates to the “fourth trimester.” Babies need that time to continue to develop attachment and bonding, and breastfeeding allows for that. According to one study, birth is not the end of the reproductive cycle of a mother, there is one more step for both mother and baby, and that is breastfeeding. This period also promotes the creation and release of the “feel-good” hormone oxytocin which aids a mother’s milk letdown reflex.

In what circumstances can a mother try to induce lactation?

A mother may want to breastfeed that has:

Experienced infertility and wants to adopt or have a baby through surrogacy may benefit from breastfeeding.
Is adopting a child may want to breastfeed from that baby’s infancy or even toddlerhood.
Or, a mother that is expecting a child through surrogacy may want to breastfeed her baby from infancy.

In the case of surrogacy, it would be beneficial to ask the birth mother in both of these situations if possible, to provide colostrum and expressed milk for the first several weeks of the baby’s life. A mother that has a timeline of when her baby is expected, can prepare more definitively than someone who is adopting, or may not know when they are taking full care of a baby.

Other situations arise when mothers may want to induce lactation like foster mother scenarios who may intend on keeping the baby long-term, a lesbian mother who wishes to co-breastfeed with her partner, relactating mother who birthed her baby but didn’t breastfeed initially and wants to now.

From newborns to toddlers and even young children, they can all benefit from breastmilk because it is the best and easiest food for a baby to digest. The World Health Organization recommends babies breastfeed until they’re two years or older.

What should a mother expect when there has not been a prior pregnancy/lactation?

A mother that has not had a prior pregnancy will want to ensure she’s equipped with knowledge and confidence going into the situation. She should also keep an open mind about the possibility of producing milk. It won’t be an easy journey, and it will take time.

A mother inducing lactation will want to look at the journey as part of the experience and enjoyment of nourishing her baby at the breast. Enjoying the process as part of the experience will be critical to avoid a negative mindset and giving up when she may not produce milk at first. A proper latch is important in the milk production process, as are stimulating the hormones to induce milk production. A mom’s breasts can be prepared for breastfeeding, and breast stimulation by the baby can help trigger additional milk production. When the hormones are present, which can help in induced lactation with frequent breast stimulation and hormone therapy, milk supply is based on a supply and demand theory. The more milk that is removed, the more the body knows to produce.

Milk production will be nonexistent at first (unless she had a prior breastfeeding experience), and then start out slowly, a few drops hopefully, but the goal will be to gradually increase it in time through physical techniques like frequent breast stimulation, the baby breastfeeding at the breast, and supplementation with hormone inducers, herbs, and foods.

Is lactation possible if you’re never been pregnant, or you aren’t pregnant and trying to lactate?

Yes, it is totally possible! With the right strategy, support, and techniques, it is totally achievable. My advice for any mother trying to induce lactation is to understand the process, educate herself on what to expect, get proper support through a lactation counselor like me, support through other mothers with a similar experience, a La Leche League Leader, and her health team. It’s important to avoid false expectations, have an open mind going into the process, and allow the mother to give it her very best!

She can start by preparing her breasts and body prior to the baby’s arrival into her life, and continue to introduce the baby to the breast to make milk once the baby arrives. Refer to the Newman-Goldfarb protocol for specific steps.

What kind of milk supply can be expected?

The amount of milk a mother is able to create will depend on a wide range of factors including:

The Mother’s health history
Her motivation to induce lactation
The condition of her breasts
Whether she has ever breastfed in the past
Amount of support for the mother from the partner, family, healthcare team
The amount of time she has to prepare her breasts/body
The routine and protocol the mother follows to make milk once the baby arrives, such as taking herbs/medications, and frequent breast stimulation

According to the book Breastfeeding without Birthing, “most mothers from Western countries who induce lactation produce 25% – 75% of their baby’s nutritional needs.” Some mothers have been able to produce to meet 100% of their baby’s needs, and some mothers don’t produce at all. Milk content will be like that of a 10-day postpartum mother according to lab tests.

There is a particular protocol called the Newman-Goldfarb Protocol that has a very good success rate (60-100%) for inducing lactation for most mothers. It includes a combination of steps and can be started at any point prior to the arrival of the baby. The idea with any of the protocols to induce lactation is to mimic the pregnancy and what happens after in terms of a drop in progesterone and estrogen, and a rise in prolactin after delivery. Prolactin is the “milk maker” and oxytocin works to “release the milk.”

How Do You Induce Lactation if You're Not Pregnant? 1 — The Process of Milk-Making

What supplements, foods, and medications may help with promoting a milk supply?

A baby suckling at the breast and/or frequent breast stimulation is the best way to induce the hormones needed to produce milk. And combine this with other herbal and prescription medications, and you have a protocol for inducing lactation. There are several different protocols that have been developed by various experts in the field like the one mentioned before. There are also other ways mothers can help support milk induction, including using a breast pump to stimulate the breasts, herbal supplementation, prescription medication, and certain foods.

Preparing Breasts for Milk Making

If a mother has plenty of time to prepare for a new baby’s arrival into her life, starting a birth control pill for 6-9 months can help prepare her breasts for breastfeeding. The pill mimics the estrogen and progesterone that a pregnant mother would have in order to support breastfeeding. It helps create the glandular tissue and milk ducts. A mother can really start a protocol at any time to help prepare her breasts for making milk.

Making More Milk

Once a mom is able to produce milk, the act of removing milk will trigger the body to create more milk. The most effective prescription medication initiating that milk-making process initially is Domperidone because it can be used for an extended period of time without significant side effects to the breastfeeding mother or baby. If a mother has heart-related conditions, it’s advised she not take it. Domperidone is approved in many countries including Canada, Switzerland, United Kingdom, South Africa, Mexico, New Zealand, and others, to increase milk supply, but it is still in the process of being approved by the FDA in the U.S.

Herbal Supplementation

Herbal supplements that may be helpful in inducing lactation include moringa, alfalfa, blessed thistle, fennel, fenugreek, goat’s rue, and saw palmetto. Each of these has its unique characteristics and timing may also be important in terms of when each should be taken, and under specific circumstances. A mother is advised to work with an herbalist to understand what’s right for a particular mother’s need.

As with all supplementation, it’s best to work with a healthcare team to ensure it is the best solution for you.

Lactogenic Foods

As far as specific lactogenic foods to increase milk production, there aren’t a lot of studies, but, we do have information from mothers that has been passed down to us from thousands of years of breastfeeding mothers. Specific foods may be helpful for some mothers to increase milk production, but eating a diet rich in healthy fats, dark green vegetables, fruits, whole grains, and nuts and seeds is truly the best way to ensure optimal nourishment for a mother’s body.

One of the very few foods that has been studied is moringa or the Malunggay tree. It is a “superfood” grown in Asian countries and can be bought in a powdered form or the leaves can be cooked like spinach leaves. This is a supplement I’ve used myself and can attest to its milk boosting powers, with no noticeable side effects.

What devices can be used to help a mother “experience” breastfeeding and promote at-breast feeding?

An at-breast supplementer is a great way to breastfeed while physically stimulating the mother’s breasts and giving the baby the nutrition needed. Basically, it mimics the flow of milk to the baby through a tube that is inserted into the side or corner of their mouth. It should be placed in such a position that hopefully, the baby doesn’t notice that it’s there and it is mimicking a true breastfeeding experience through latching and milk transfer. The hope is the baby will think the milk is coming from the mother’s breasts through the baby’s suckling. Some babies outsmart the system and figure out that by suckling at the end of the tube, the milk comes. On the other end of the tube, a bottle or bag of breastmilk is being used to transfer to the baby.

Over time, a mother may be able to use the supplementer less and less as she makes more milk. If there’s nothing coming from the breasts initially, this is a great way to still encourage the baby to suckle at the breast without losing interest because there’s nothing there. The two most popular supplementers in the U.S. are called Lact-Aid and Supplemental Nursing System. Both have their advantages and drawbacks, and sometimes babies figure out where the milk is coming from, but overall it is definitely worth trying and can be the bridge that fills the gap between when a mother is not producing to when she is able to produce milk.

How can you tell how much milk is being transferred when lactation starts?

Small quantities of milk may be produced at first, but within a month, if a mother is consistently removing milk out of her breasts, it may increase. Mothers can use frequent breast massage and expression to see how much you may be producing. This breast massaging tool helps massage the breasts while pumping or nursing to encourage milk flow and removal through the milk ducts. A mother can also keep an eye on the baby’s cues, weighted feedings, baby’s weight gain, and adequate diaper output (both pees and poops). Read more about milk transfer here.

What are some helpful mindset techniques to help with inducing lactation?

Keep an open mind so you are not disappointed; if you’re able to produce milk, great, if not, know you tried and still were able to build a bond with your baby.
Remember why you want to breastfeed your baby. Just like in many areas of our life, we have to have a strong enough “why” in order for us to stick with something.
Keeping a list of all the reasons why a mother wants to breastfeed will help in the times that she may need some encouragement.
Positive affirmations can help mothers feel empowered and equipped to mentally and physically handle the experience. Saying things like “I’m a strong mother who produces breastmilk for my baby” can really make a difference.
Enjoy the process along the way, enjoy the relaxation as your hormones start increasing in your body, especially the oxytocin.
Remember the nourishment that you’re offering your baby, the best source of nutrition for all babies is breastmilk.
Breastfeeding helps you bond with your baby and create an attachment that your baby may otherwise feel upset without. Breastfeeding can help your baby transition from their birth mother to you.
Keep a positive mindset, a mother CAN do this!

What kind of time and effort is involved with inducing lactation?

Once a mother accepts the commitment, her mindset will play a huge role in motivating her to continue the journey to induce lactation, but the rewards are monumental for the mother and baby’s relationship. It’s important for a mother to understand the time and energy involved in inducing lactation, there may be appointments required to meet with doctors, herbalists, nutritionists, and other complementary healthcare providers to find the best hormone inducers, herbs, and foods to support the mother. There may be financial resources involved too, like purchasing a breast pump, an at-breast supplementer, herbs, medications, although some of this may be covered by insurance. If time is available prior to her baby being born, she may want to start preparing a month before by stimulating her breasts through pumping and medicine or herbal supplementation. And of course, there is the time involved in pumping- whether it be hand expression or with a manual pump.

Can a mother use her own milk through induced lactation and formula/donor milk to supplement if necessary?

A mother can definitely use her own milk through induced lactation in addition to donor milk, or perhaps expressed milk from the birth mother if it was a surrogate type situation. Milk banks like Human Milk 4 Human Babies and Eats on Feets are two that a mother can research in their area to see if any donor milk is available. Mother-to-mother sharing or community milk sharing is also common, but ensure you’re practicing safe sharing techniques and can verify a mother’s maternal health history.

If breastmilk isn’t available, then the next best is formula according to The World Health Organization’s hierarchy of feeding choices.

Keep in mind, any breastmilk is better than no breastmilk, so I encourage mothers not to get down on themselves if they’re only able to supply a little bit, especially in the initial days of trying to induce lactation. Be proud of what you can supply and don’t stress yourself out in the process, because that will only hurt your production, not help.

What are helpful hints to induce lactation?

Babywear and co-sleep safely to allow the baby to get used to being close to the mother
If the baby is comfortable with skin to skin, try that first.
Allow baby to breastfeed when not super hungry.
Try offering it when the baby is tired.
Try finger feeding first which can mimic breastfeeding.
Don’t force or push the baby or he/she may develop an aversion or negative association with breastfeeding.
Learn proper positioning and latching techniques to ensure optimal milk removal and transfer.
Understand how pumping works, not as efficient as baby removing milk, need oxytocin released for milk to flow.
Eliminate the use of a pacifier and offer the breast when the baby wants to suck.
Try breast compression, hand expression, breast massage, pumping, or a combination to stimulate the breasts.

Here’s an example of a strategy as outlined in the Breastfeeding without Birthing book:

Bottle feed baby skin to skin
Breastfeed using a nipple shield and a feeding tube at the breast
Breastfeed with a feeding tube on bare breast
Breastfeed without any aids

What are some of the baby variables that may play a role in relactation/inducing lactation?

As with all breastfeeding experiences, effective latching and milk production are the two key factors in establishing a successful breastfeeding journey. The instincts for breastfeeding diminish over time in a baby, but even a 4-year-old can learn to breastfeed, so it’s important for a mother not to get discouraged even if she is trying to breastfeed a toddler. Exposing a baby to breastfeeding can be helpful too- find breastfeeding groups locally, show videos of breastfeeding babies, read children’s books, or model it in a role-play situation.

According to research, babies who are less than 8 weeks old are more likely to latch on successfully. If a baby has any prior experience in breastfeeding from birth, that will certainly be in a mother’s favor. A baby’s emotional state also plays a role in whether or not they want to breastfeed, if they are coming from a negative place or situation, or was left unattended with a bottle, the baby may not be interested in breastfeeding at first. On the other hand, if a baby had some exposure to breastfeeding or was at least held by a caring person prior, the baby may be more likely to engage in a breastfeeding relationship.

Responding to the baby’s cues, doing skin-to-skin, and keeping the new baby close to the mother can help foster a close and trusting relationship encouraging breastfeeding.

In Conclusion

It’s important for mothers to remember that even if their new baby never latches, they’ve still built a bond that they didn’t have before. Their baby now can learn to trust them by responding to their feeding cues and need for physical touch and cuddling. This is still so valuable to the mother and baby’s new relationship. And whether the mother makes a few drops of milk or a full supply, success shouldn’t be measured on that, but rather the bond created and the fact that the mother breastfed! If the baby suckles at the breast, that means the baby is breastfeeding.

As with any breastfeeding journey, a mother will want to monitor her baby’s weight gain, diaper output (pees and poops), and satisfaction to ensure the baby is getting all the nutrition he/she needs to thrive. And of course, breastfeeding has to be wanted by the baby and mother for it to be a successful and healthy experience.

References:

Breastfeeding Outside the Box

Breastfeeding Without Birthing

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