A Reading on

RELACTATION

In Partial Fulfillment of the

Requirements in NCM 209 – RLE

DELIVERY ROOM ROTATION

Submitted to:
Prof. Sarah Jane C. Pamaloan, RN
Clinical Instructor

Submitted by:
Fhey Bernadette M. Beltran, St. N
BSN 2L – GROUP 2

March 08, 2022

Title: Evaluation of Utility of Various Interventions Related to Relactation and Assessment
of Outcomes of Relactation Practice in Mothers with Infants up to 6 Months of Age.

Bibliography:

Goyal, A., Kaur, A., Kaur, J., Kapoor, R., Kumar A., Mahajan. S., et al. (2020).
Evaluation of utility of various interventions related to relactation and assessment of
outcomes of relactation practice in mothers with infants up to 6 months of age.
Perinatology, 21 (3), 105-111.
https://static1.squarespace.com/static/59f2d244cf81e03e96b107ea/t/5f8680ef8ae6
d9031b3af881/1602650355484/Evaluation+of+Utility+of+Various+Interventions+Rel
ated+to+Relactation.pdf

Summary:

It is not foreign to everyone, especially to mothers, that breastfeeding is the safest

way to feed a baby by different nutrients present in the milk. For the first six months of the
baby, breastfeeding is encouraged. However, it is not always accessible, especially to a
mother who has inverted, cracked, or small nipples and inadequate milk supply resulting
in babies run into trouble. Instances like this will increase the risk of babies developing
malnutrition and fetal illnesses that may result in death. This is not about solely arguing
about breastfeeding initiation and the early food supplemental to babies. Instead, this will
pave the way for assessing the different factors why mothers discontinued breastfeeding.

A Case Study conducted by Dr. Jasmeen Kaur and his co-researchers focused on
the various presented interventions for relactation wherein this is the process of resuming
in secreting breast milk after discontinuing for a couple of months or even years. A
hundred mothers with either term and 6-month-old babies are used as the subject, in
whom lactation is completely discontinued, and those with lactation for more than seven
weeks. It was emphasized that there were no invasive procedures conducted; instead,
detailed medical history for both mother and child was collected. Not only that, both were
thoroughly assessed and examined for any medical ailments, which shows that half of
the new time mothers have inverted nipples and psychological problems that significantly
affect the lactation supply. Furthermore, the participants are grouped into two; the first
group, who solely receives relactating counseling, and the other group, who were
provided with metoclopramide, a dopamine antagonist, for two weeks accompanied with
counseling. As per their daily assessment, mothers and their significant family members
were advised to apply proper nipple hygiene, eat proper food, allot enough rest for
emotional and physical stability, and most especially, practice and initiate skin-to-skin
contact with their infants. Medical professionals endorsed significant others to give
frequent motivations and provide an environment conducive to resting to mothers. This
has the psychological effect of stimulating high prolactin levels beneficial for milk supply.
Afterward, it concluded that initiation of relactation occurs if the infant starts to suck
spontaneously and milk is expressed manually. In that manner, if breastmilk production
increases, the quantity of top feed reduces.

As a result, for attempting relactation, it shows that 97% of the total said population,
60.8% successfully induced lactation, and 39.20% appeared partially successful.
However, on the pitfall, a total of 3% failed to continue lactating. Also, this study paved
the way to assess the etiology behind premature termination of breastfeeding, which is
inadequate milk secretion. In addition, other causes like the feeling of having bad milk,
top feeding of siblings, lower segment cesarean section (LSLC), working mother,
maternal and fetal chronic illnesses, and unsupportive family members also cause to
decrease in milk secretion. Because of that, mothers built up indescribable anxiety that
there infant will not develop the same as infants receiving adequate breastmilk. In
connection with that, caregivers' lack of support and motivation contributes to a failed
relactation despite numerous counseling—new-time mothers who lack knowledge and
assistance from family results in being pessimistic. Hence, counseling should not only
center on mothers but also include educating grandmothers and husbands to reduce the
exposure of negative reinforcements, especially during the time frame of puerperium.

Reaction:

The Psychological, Emotional, and Physical difficulties of an individual should not

equate to being incapable of offering better outcomes. Instead, should we not facilitate
support and guidance to them? Relactating may seem easy to others, for this only focuses
on resuming milk production initiation; however, it is easier said than done. Problems in
breastfeeding appear flexible and causative to many underlying factors that might affect
both mother and infant relationships, allowing professionals to take actions and solutions
considering both individuals. There are only a few items that I can quickly grasp and
understand, specifically why mothers preferred to discontinue breastfeeding even if they
can do so completely. In the Philippines, based on the institution I am practicing with, we
are trained to apply effective nursing actions to patients and become patient-centered—
emphasizing empathy during times of indecisiveness. Similarly, this case study can be
justified as helpful and informative. It offers interventions to different factors affecting
mothers pursuing full-time breastfeeding and emphasizes that emotional support and
avoidance of exposure to harmful vulnerabilities should be seriously taken into account.

Comparably, breastfeeding suppresses nutrients that are beneficial for the baby,
but as student nurses, we should not only practice being “breastfeeding centered” alone
but “mother centered” also. Some mothers may not be as privileged as others due to
chronic illnesses, inverted, cracked, and swollen nipples, mothers undergoing treatments,
and even the feeling of uneasiness that a child might be infected somehow. In concern
with the former issues, nurses should become flexible on helping mothers start the first
stage of relactation to provide sufficient nutrients to the child only present in breast milk.
In doing this action, nurses should not compromise the mother just to give what is due to
the baby. Another point I wanted to highlight is mothers initiating relactation to help those
babies whose parents are incapable, like LGBTQ parents who opted for adoption.
Relactation focuses not only on discontinuing breastfeeding because of milk production
complications but also on the latter. This action can be a leap of help to end the increasing
rate of fetal mortality caused by the absence of breastmilk to a child.

I was raised in a big family with a simple lifestyle. I am very close with my cousins
and very affectionate towards my nephew. Some of my cousins got pregnant at an early
age but never attempted to engage in abortion despite having financial difficulty. One of
my closest cousin got pregnant at the age of 17, and back then, her usual complaint was
not being able to pump enough breast milk to suffice the demand of her child. My cousin
went several times to their near barangay health centers for this is the only accessible
place near her location. She even did what the barangay health facilitator instructed her
to somehow increase milk production. Although there was still no progress after months
of trying, so the family decided to introduce formula feeding even at the early four months
old. I was stupefied and worried by their decision, but my cousin thought it was the least
thing they could give to their child to feed him the right amount of nutrients needed in the
body. Not to mention, she decided to stop sparing efforts in breastfeeding because they
both needed to look for a part-time job. During that time, given that I am still in my Junior
High School, it cannot be denied that I lacked knowledge on what are the right actions to
do. However, on a good note, after a month, my other cousin, a mother of a 1-year-old
baby, initiated to do relactation to extend help for my cousin. After that, my nephew
received adequate nutrients from breastmilk and gained weight appropriate to his age.
As for my cousin, during that year, she continuously seeks therapies and professional
advice on how to stimulate milk production, which is beneficial to their future children.

Furthermore, some content of this article might impose a negative perspective on

others, especially on the idea that low supplement of breastmilk to the baby for the first
six months of life would probably foist health complications. New-time mothers might
perceive relactation as a negative phase during motherhood, which would establish
anxiety for themselves and extreme worriedness and pressure to produce more
breastmilk for their child. Once the mind senses that the body exhibits pressure on
oneself, this might only reduce the production of prolactin that helps milk production. It
does not imply that not being able to supply your baby with breastmilk completely entails
that the baby lacks nutrients. Instead, formula feeding or any nutrient-filling
supplementation can serve as an alternative or what others call “back-up” if the doctor
does not permit breastfeeding due to medical ailments. However, on a good note, this
can serve as additional knowledge to everyone regarding possible actions that needs to
be done to initiate relactation. Not only that, both mothers and their significant family
members can exercise the importance of a support system and uplifting mothers even if
they supply inadequate milk for the baby. For a fact that, when mothers are exposed to
stress and a negativistic environment, this will affect the coping factors of the mother to
offer optimum nutrients to the baby. Moreover, this article can serve as an eye-opener to
broaden our scope of knowledge on extending help to mothers suffering from
doubtfulness and depression due to the said problems.

Devoting ourselves to becoming responsible nurses means dealing with

unexpected hospital cases and even allotting personal time for the patients. For others, it
may appear challenging, but it is more than that. Upholding the core value of our
profession is and will never be easy, for there are a lot of skills and master and personality
to shape. This article contains essential points widely studied in our profession that can
help us modify more effective nursing interventions and develop more comprehensible
health teachings to mothers who attempt to initiate relactation. These are nursing actions
done such as; render instructions for proper hygiene on nipples, maintain a good diet,
practice proper latching, and maintain a suitable environment for both mother and child
distant from any unfavorable circumstances. Moreover, this article can serve as an
additional source for future researchers experts on studying emotional and psychological
behaviors to fully dwell and understand why depression and extreme exposure to stress
develop to inadequate milk supply, which usually worsens over time due to the need for
relactation. What is more to that, students and health care professionals can utilize this
to create a thorough study on how to prevent the onset or development of diseases even
when they are partially fed with nutrient fillers like formula feeding. Lastly, this is vital for
delivery room rotation for this centers not only on developing and exercising optimum
care for mothers but also on being adaptive in becoming mother-and-infant centered.