RELACTATION - AN EFFECTIVE INTERVENTION TO PROMOTE EXCLUSIVE BREAST-FEEDING

Fifty mothers of hospitalized infants less than 4 months old with part ial or complete lactation failure (LF) were randomly assigned to two g roups of 25 each for relactation. Majority of enrolled mothers (86 per cent) had complete LF and 14 per cent had partial LF. Relactation was attempted in both the groups with motivation, support, and repeated s uckling. Group II mothers, in addition, were given metoclopramide. The characteristics of mothers and babies, and socio-economic background were comparable in both groups (P > 0.05). The primary outcome variabl es measured included the time of appearance of first breastmilk secret ion (incomplete LF), time for partial and complete relactation. Relact ation attempt was successful in 49 mothers (98 per cent), with complet e relactation in 46 (92 per cent) and only partial relactation in thre e mothers (6 per cent). Nipple confusion and frustration of the baby ( 74 per cent) in complete LF, small/retracted nipples (8 per cent), and sore/fissured nipples (4 per cent), which influenced the initiation o f relactation, were overcome with drop and drip method, lact-aid suppo rt and proper positioning of the baby, All the outcome variables of th e two groups were comparable (P > 0.05). The pattern of weight gain, t he rate of reduction in the amount of top milk and subsequent weight g ain in the follow-up was also comparable in both the groups (P > 0.05) . Maternal factors like breast conditions, nutrition, parity, feeding practices in previous babies, lactation gap, and infants' initial refu sal to suck at the breast did not influence the outcome variables as l ong as repeated suckling was ensured. We conclude that relactation is possible in most of the mothers without the help of lactagogues. Apart from educating and motivating the mother for exclusive breastfeeding during first 4-6 months, a strong professional support by a skilled he alth worker is needed to overcome the initial problems during relactat ion.