[newgolddream]

My partner and I are trying to re-start her lactation-- she breast fed previously, and then, had residual lactation for quite a while (probably 5-10 years) after the last child was weaned...

Now, years later, we have begun a program to try to re-start her lactation-- but it has not been successful, so far...

All the info that I have read on this topic says that age is not really a barrier to this process/goal-- even women far beyond menopause can in fact re-start lactation--with various regular activities (which include regular stimulation of the nipples via suckling, as an infant would), and also, certain supplements that can cause (or help cause) the woman's breasts to start lactating again.

There is a drug (available over the counter without a prescription in many countries in Europe and Canada), but not available at all in the US (the FDA has not approved it, for whatever reason)-- the generic name is Domperidone... My partner prefers not to take a drug, if possible.

There are also several supplements that are supposed to have similar effects-- with the most widely touted one being Goat's Rue-- which is what she chose.

So, this process has been underway for nearly 2 months now; she has definitely noticed unusual tingling and sensitivity in her breasts (not unlike what she used to feel, when pregnant and/or breastfeeding)-- but no lactation has occurred.

I am wondering if anyone here has any other recommendations, short of procuring Domperidone outside the US? How long is it necessary to follow the regimen designed to restart lactation, before seeing results? (I had read that it was usually only necessary to take the Goat's Rue and do regular stimulation of the breasts for 1-2 weeks, before most women see results.)...

Any feedback, suggestions, or personal experiences would be appreciated.

[Alison H.]

So given the length of time that's passed, relactation is going to take longer than it would if she'd stopped lactating within the past year.

I understand her preference to avoid medication, for sure.

Keeping in mind that I'm not a doctor, I think the biggest thing is consistency and frequency of breastfeeding or pumping (suckling or using a pump, although the former would probably be more effective). Eight to ten times a day at a minimum. Maybe come up with a schedule, if possible... like five minutes every hour on the hour or something. That kind of activity may help to signal to her body that she needs to produce, since there is a "demand."

Herbal teas might help, like Goat's Rue, but also fennel, fenugreek, and blessed thistle. I remember back when I was nursing, I drank this "mother's milk" tea that had fennel, fenugreek, marshmallow, and a couple other things in it. So it certainly can't hurt as long as your wife isn't sensitive to any of the herbs.

But the consistency/frequency of breastfeeding (or the act of nursing/suckling) is the most important thing. Also making sure she's staying hydrated and healthy, of course.

[newgolddream]

Alison-- your suggestions are helpful; my partner has ordered a supply of Mother's Milk tea, in hopes that this will augment the use of Goat's Rue... then, we have also stepped up the number of times of suckling per day-- we have taken your suggestion of 8-10X/day to heart-- I don't think we were doing it enough times/day, to get the desired result...

Last, here's one variable that we haven't discussed: does it matter at all that she is on HRT? She takes all three of the most common hormones (testosterone, progesterone, estrogen) daily-- should/would that make any difference in this process? I would expect that the two female hormones would only be helpful in this effort-- but perhaps there is some reason that taking testosterone would NOT be helpful?

[Alison H.]

From my research into this, estrogen can stimulate prolactin release, but the progesterone and testosterone *may* be inhibiting production.

So when a woman is pregnant, progesterone is higher until the point of delivery; the quick drop in progesterone after the placenta is delivered helps to signal milk production (alongside the increased prolactin levels already in the body).

Studies have also shown that high levels of testosterone can suppress lactation (NIH, NBK501721). I found one (on PubMed) that showed 180mg of testosterone and 8mg of estradiol being used to suppress lactation.

So those could definitely be a factor, depending on her dose. She might consider talking to the doctor who's prescribing everything to see if her current doses are inhibiting her ability to lactate. If so, and if it's safe, they might be adjusted?