As with humans, sometimes with horses the mother-baby nursing relationship gets off to a rocky start. A sick foal, for instance, might need to be kept off the mare for a period of time. The mare likely still needs to build and maintain a milk supply, however, and the foal still needs to be fed. Later, when the two can be reunited, the mare might resist nursing if she’s never nursed the foal.

Scott Austin, DVM, MS, Dipl. ACVIM, clinical associate professor, at the University of Illinois College of Veterinary Medicine, in Urbana, spoke at the 2022 American Association of Equine Practitioners Convention, held Nov. 18-22 in San Antonio, Texas, about how to milk mares and maintain milk production.

The average lactating mare produces between 500 milliliters to 1 liter of milk every two hours. Mares can be milked by hand, commercial milker or syringe.

Commercial Milkers

Commercial milkers are easy to use, said Austin, which is an asset when you or your staff are inexperienced at milking mares. Study results show commercial milkers have higher and faster milk yields than other methods.

The downside to commercial milkers is their cost and durability, he added. The O-rings tend to wear out and cause a decrease in suction. Commercial milkers can also be fragile, he said, and do not stand up to getting kicked or stepped on.

“So you probably ought to have two if you’re going to use these,” he said to veterinarians in the audience.

Syringe

Often, you don’t have a commercial milker on hand when you need one, in which case you can try making your own milking device.

Austin recommended starting with a 60cc syringe. Cut off the needle and apply water-based lubricant. Remove the plunger, replace it from the other direction, and place the flange so it seals up against the udder.

The syringe method requires diligence and patience, he said. It’s easy to spill and shouldn’t be rushed.

Hand-Milking

Milking by hand can mean dealing with a mare who might “vigorously resist,” Austin said. Mares might also have udder edema (fluid swelling), which can be sore and painful. For the handler, anatomical variations such as small teats can prove challenging, as well.

To protect the mare’s milk supply when milking by hand, be sure you’re emptying the udder and not simply milking until your hand gets tired. Make sure milk is coming out of both openings in the teat—not just one. Skipping milkings because of the mare’s behavior can also lead to a decrease in milk production, Austin noted. It’s important to stick to the schedule and strip the udder every time.

Milking Tips

Milk every two hours, and empty the udder completely, said Austin. Keep hands clean, or wear gloves, so you don’t introduce bacteria and cause mastitis (mammary gland infection).

“I try and emphasize: Be gentle,” Austin said. “It’s a lot easier to get milk let down when the mare is not stressed.”

Feeding the mare can encourage let-down; the mare needs adequate food and water to produce milk, anyway. Allowing her to nuzzle the foal might help. Austin recommended using a warm compress to get the mare accustomed to being touched, to clean off dirt and smegma, and to stimulate let-down. Administering the hormone oxytocin can also prompt let-down.

Austin said you might need to learn on pharmaceutical aids such as acepromazine, which calms the mare while supporting production of prolactin (the hormone responsible for milk production). If the mare is not making enough milk, you can try administering dopamine antagonists such as  domperidone or sulpiride.

Feeding the Foal

Sick foals often need to be fed through a stomach tube, following precise steps. Austin recommended laminating and posting these instructions near where you’re feeding.

To feed foals the expressed milk, first strain it through gauze. You can hang a commercial kangaroo bag or a 1-liter fluid bag attached to a tube to administer milk via gravity flow. Clean the tube before using it.

“Make sure they don’t have reflux (by checking the tube) before you start feeding,” said Austin. “Babies need to be standing or sternal during their feeding and for about 10 minutes afterward.”

Austin recommended marking the tube with a permanent marker (next to the nostril) to monitor whether the tube has moved and needs to be adjusted.

For the first feeding, start at 5% of the foal’s body weight daily, divided into hourly feedings, and slowly increase that amount to 20%.

Reunification

Keeping the mare and foal close enough to see each other can help preserve their bond and improve milk production.

For the first attempt at nursing from the mare, you want to make sure the foal is hungry and hasn’t been fed in about four hours. If the mare doesn’t show any maternal behavior, Austin recommends giving her dinoprost tromethamine, a prostaglandin that can stimulate such behavior. Wait 20 minutes, then monitor the reintroduction. The mare should start licking, sniffing, and nickering. You can also turn the foal around, lift his tail, and let the mare nuzzle his back end.

If the mare still isn’t showing maternal behavior after another 10-15 minutes, said Austin, separate the pair, administer cloprostenol sodium (another prostaglandin), and try again in a few minutes.