feast or famine, part two

For part one, read this.

Breastfeeding is such a personal subject, and everyone seems to have an opinion. Adoptive breastfeeding is no different. Well, it’s different in that most people don’t realize it’s even possible, that you can trick your body into producing milk without being pregnant and delivering a baby. 

Nursing was always something I envisioned doing. I know it’s not always possible, and I know it’s not for everyone. As with family building, I’d never begrudge or judge anyone for a different decision, nor would I force my views on someone else. There are those who would, and do. 

I know mothers who nursed easily, and those who tried but could not. I know women who still nurse toddlers, women who gave it a few weeks or months, and still others who never wanted to at all. I know of women and professionals who would make you feel guilty if you didn’t try, or if you gave up in exasperation. Still there are others who might be appalled by the sight of a nursing mother. 

Reasons aside, I believe that whatever works for someone, works. Period. There are plenty of reasons why someone would want to breastfeed, and there are also reasons why not. I am not inviting a debate on those reasons here. 

For adoptive mothers, some of the reasons to try nursing, aside from the nutrients, involve the need for intimate bonding and attachment since mama didn’t carry baby for 9 months. There is the desire to normalize the mothering experience, the sense of reclaiming one’s body, of healing some of the wounds of infertility. Maybe it would be some sort of triumph over nature. Or as Mrs. Spit suggested, perhaps some form of redemption.

Plus, good natural formula is a significant expense that many would rather avoid. 

I began researching how to induce lactation a while ago. I know it would not be easy. I’d have to subject myself to even more strange drugs to trick my body into producing milk. It would be technically difficult, inconvenient, uncomfortable, cumbersome. There is uncertainty as to whether it would even work, and ultimately, whether I’d even have a baby to feed. Even if I were able to produce milk, it wouldn’t be enough to sustain my child and would need to be supplemented. And while I might make some milk, I couldn’t produce colostrum. 

On top of all that, I realize that people might think it strange, unnatural even. 

For the curious, the protocol generally involves birth control pills to “mimic” pregnancy, plus another drug (motillium/domperidone) to stimulate prolactin and induce lactation. With a change in the breast you stop BCP and begin pumping. You keep taking the domperidone (which is not yet known to cause major risks or side effects). You take a variety of herbs (fenugreek, fennel, milk thistle, nettles)  to increase production. Since you are unlikely to produce enough to sustain a growing baby, you must supplement, either with milk pumped pre-birth or formula. You can use a supplemental feeder contraption while nursing to help stimulate the nipple for more production. And you hope it works with more benefits than risks and hassle. TMI? 

I know how challenging this would be. And still, I feel compelled to try. For me as much as my child. 

Unfortunately there is not a lot of support out there for women like me. There are established protocols, even a complex decision-making tool (who  knew?). There are several informative bulletin boards and books and articles on the subject. And I am trying to connect with women who have done it, or who have tried. (At least one blogger has been supremely helpful, even going so far as to send me her unused medications. Another blogger might have some insight to share. You know who you are!)

But real life support is scarce. The big organizations and lactation consultants are unfamiliar with true adoptive breastfeeding. Even my ob/gyn, a breast expert, didn’t know much about it and referred me to a lactation consultant. My local Le Leche chapter referred me to a woman who tried but was unable to produce milk. (She felt her wounds had been healed by skin on skin contact, and joy in finally becoming a mother with late night feedings. But as Any Mommy said, that can be achieved in other ways…) Even the midwives offer support, but not firsthand advice or guidance. 

I have serious questions, yet mostly all I’ve found are cheerleaders. Which is nice, but not so helpful. 

There have been skeptics and naysayers too. My doctor wondered who would oversee the protocol (um, me?). A relative experiencing endless nursing challenges suggested I might want to reconsider, because nursing is not all that (for her). My mother expressed caution, reminding me how I’ve been through “so much” already (thanks, mom). Even M, bless him, supports my decision but is concerned about the effects of the meds on me (since they are not FDA approved for this purpose; long story, but the protocol is widely accepted in the international breastfeeding community) (love you honey!). 

Ultimately, I accepted that if I were going to do this, I’d be pretty much on my own. 

When I realized I was avoiding beginning the protocol — which takes a few months to kick in — I wondered why the reluctance (aside from the obvious; see above). I wanted to forego the drugs and try a solely herbal protocol, but that is known to have limited success. I was afraid of the meds, the risks and side effects. I feared another bodily trial. I feared another failure. I was afraid of potential awkwardness around the issue with K, since she’s not sure whether she will feed or pump in those early days, and I don’t want to influence her or the outcome. Understandably, I also feared having no baby to feed at all. 

Yet I have resolved not to live in fear. If I were afraid of every thing that could go wrong, I’d never leave home. And I definitely wouldn’t believe that we might be bringing home a baby in just over two months. I have resolved to dwell in the moment of what may be right now, rather than fear uncertainty and become immobilized by the lack of control. 

So I stepped up the research, made some calls, and tried to connect with other women who might be able help. I needed to make a decision one way or the other and be fine with it. There is no guarantee it will work, or work well. But I decided to try and see. 

I should point out that it is not lost on me that K may soon be looking for guidance on how to stop lactation (if that’s what she decides to do), while at the same time I struggle to produce my own milk. It’s hard not to think about nature’s cruel tricks — feast when you’re not hungry, famine when you’re starving. This time, maybe trick will triumph over my natural limitations.

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~ by luna on March 27, 2009.

27 Responses to “feast or famine, part two”

  1. I think what you’re doing is brave, and loving, and beautiful.

    xo

  2. Well, I am in full support. BF can be hard and you have more obstacles than I did but for me it was the thing that finally made me feel like a mother.

    I think you should approach BF just like you have approached this entire journey. Hoping for the best, doing your research, not trying to guess the outcome, staying open and flexible.

    I am wishing you the best I wish I could help you.

  3. I know that there are others who have done something like this. There was a board I used to visit and both of the women in a relationship were breast feeding to some extent for a while. I don’t know how long or how much. I also know that my aunt breastfed my cousin who was adopted. Again. Not how often or how much and this was years ago as cousin is now in her mid to late 20s.

  4. I am envious. I wish I had looked into it as much as you have.

  5. I am in 100% full support of you, luna. Many intended mothers on SMO induce lactation and have had great success with it. Sam’s mom, Stephanie, was one of them (that’s why I pumped and donated my EBM to my friend for 5 months). Ultimately, after about three months she decided not to continue for reasons other than her supply, but like you said – what’s works for people is what works, no matter what that is. I was thrilled that she tried. It provided a wonderful bonding experiences for her and Sam and when it came down to it, that was the main reason she tried – to feel closer to the child she did not carry. Though it was of benefit and was one of the pros of her inducing lactation, the “breast is best” line just wasn’t the primary or even the most important reason for her lactation induction.

    Peeveme stole my words (for the second time today, I think!):

    I think you should approach BF just like you have approached this entire journey. Hoping for the best, doing your research, not trying to guess the outcome, staying open and flexible.

    I wish I could let you know how great I think you are without sounding like a complete moron. Your constant care of and consideration for how K might feel more than shows what loving person you are.

  6. Years ago when my husband and I were deeply invested in the adoption system, I committed to breastfeeding our future baby for all of the reasons you have outlined so eloquently. We eventually stopped pursuing adoption, so my research did not go far enough that I can point you to any relevant information now. Even if it helps the tiniest bit, know that this cheerleader completely supports your brave decision to venture into breastfeeding so fearlessly – you are truly inspiring!

  7. Another cheer leader.

    3 cheers for Luna’s jugs. May they be full of milk, with a hungry babe in arms. Hoping you find some experienced adoption mums to light the path ahead.

  8. I think it’s wonderful – for exactly the reasons Kym expressed. It is such a great tool for attachment and bonding. I’ll be cheering you too. Wish I could be the person with more concrete info to share. I do have a very close friend who nursed her adopted baby girl successfully and her joy truly did revolve around focusing on the bonding (rather than trying to produce huge amounts of milk). They nurse only at bedtime and have for a year! Either way, I hope your cup overflows, with milk and joy.

  9. I wish I could help in some way. All I can do is tell you good luck and that I think you are incredibly strong.

  10. I have researched this a lot. I’ve decided not to becuase I dont think I can handle the stress on top of every thing else.

    http://www.adopting.org/adoptions/adoptive-breastfeeding.html

    This article talks about how prolactin and oxytocin together create lactation. I have taken oxytocin injections for an experimental IVF treatment and my doc said with another med, he could produce mile effectively. He is total mad scientist doc that I love. Maybe I will call him and get more info from him.

  11. I seriously considred it as well. I got some input from Teendoc and I did some preliminary research on the Net and I hemmed and hawed some more. I do that as you know. I found the task rather daunting, but perhaps I’ll be reinspired one day….

  12. I am currently on the protocol you referenced. I would love to “chat” about it, I don’t know anyone here who has done it and this isn’t something that I broadcast to a lot of people right now.

    email: eyeswideopenmotherhood [at] gmail [dot] com

  13. I can do nothing but raise my pompoms and chant: DARK BEER! (Seriously the darker, the better. Good for production.) Also, OATMEAL! and WATER! Beyond that, I’ve got nothing but awe.

  14. Just another cheerleader here, brimming with pride for you and your commitment to living in the moment and following your heart. Although I will put out queries to all my LL friends and see if they know anyone who’s been through this and forward anything useful your way.

  15. wow, this would be such a wonderful experience between you and your future child.
    go.for.it.
    (sorry, no guidance)

  16. I am having some of the same thoughts as you but it’s not the medicine or protocols that are keeping me from proceeding at this point. I am only considering it because our potential match lives across the country and wouldn’t be able to breast feed (for long) or pump for the baby. I wouldn’t proceed without discussing it with her and getting her blessing but I worry even that discussion would create expectations and obligations that I don’t want her to feel.

    I also know that breast milk can only be stored frozen for a short amount of time (3 months) and that I have longer than that to think about this. I have 2 friends who have done this (teendoc is one and I can put you in touch with the other). They both found it healing for themselves in many ways (and teendoc has written about how unexpected some of that was for her).

    But I worry this is a selfish act on my part. I don’t want to pursue anything because it heals me. I wonder what first/birthmothers think about this.

    But then I think I would consider using donated breast milk if that were a possibility (way too expensive for me to consider) so there must be something else underlying my worries about this.

  17. thank you ALL for your comments, cheers and support. it means a lot.

    @peeveme and @kym, I like your approach. a lot!

    @B, you and my jugs made me laugh. thanks!

    @anymommy, love the image of the overflowing cup.

    @deathstar, it is daunting, for sure.

    @eyeswideopen, thanks and we’ll chat.

    @tash, I’m all over the guinness and oatmeal! it’s not just for breakfast anymore…

    @annacyclopedia, thanks for your kind sweetness, and for the inquiries.

    @millie, I think women will respond differently to the idea. I have already raised the topic with K and we’ve talked with the midwives about the possibility. while K is not now leaning towards feeding for long if at all, she is free to change her mind, of course. we would welcome it but don’t want to force it…

    the potential expectation my inducing could create is different. we talk a lot about how K is always free to revisit all decisions, without regard for how she thinks it might affect us. we all want what’s best for baby, and we’re all very honest with each other (and to clarify, this is NOT about healing ME). I am confident we can work through this. yet I can see how this could be an awkward topic to resolve…

    btw, breast milk can be stored up to 6-12 months (6 ideally) in a deep freezer. see, e.g.:
    http://www.askdrsears.com/html/2/t026900.asp#T026901
    http://www.llli.org/FAQ/milkstorage.html

  18. These last two posts have been great and I really look forward to how you go forward (or not) with this. When talking about it with others I’ve mainly heard all the cheerleader comments with a few, but is that even possibles in between.

    I go back and forwards on this, but my biggest concern is that I could be setting myself up to fail and is the risk of that, and the emotional fall out worth the potential benefits. If we get approved we’d have one week from matching to taking home a 3-12 month old who has probably never nursed. It’s something I really would like to do, but I’m just not sure it’s worth it.

  19. Not sure if you read this blog, but she is also hoping to adopt, and trying to begin pumping in preparation for it. She is not yet matched with a birthmother, but if you are looking for someone to chat with about the attempts, perhaps?

    http://babywait.blogspot.com/

  20. I think that it’s a wonderfully brave decision you’ve made, luna. I know that the offers of advice and encouragement are rolling in from those within the blogging community but I hope that you also receive the support you need from the medical professionals.

  21. So true – the feast and the famine.

    I will be part of the cheerleading crowd if you don’t mind.

    FWIW, I ran into a mom who wanted to share her experience at Costco not long ago – just a stranger who struck up a conversation around a food for kids choice – but she had lots of natural kids and on the 5th or something didn’t produce enough milk. She nursed first and then supplemented (not wanting to use formula, she used goat’s milk) and it took almost 3 months for her to produce enough milk. I haven’t done all the research you have done, but perhaps it is possible to eventually be the sole provider for milk.

    Oh, I do hope this works for you. Especially getting to bring home the baby part, but the breastfeeding would be nice icing on that cake.

  22. How you doing lady? Think of you often.

    B

  23. Add me as another cheerleader! I wanted very badly to do ABF but because my mammary ducts were mostly removed during the surgeries I had, there was no way I could. I know Liana did ABF sucessfully with Zara and found it fulfilling. I hope you have a great experience and that your milk is plentiful. But you know what, even if the whole thing goes bust (heh, bust) you haven’t lost anything by trying. No pressure. I’m cheering you on!

  24. I’m another cheerleader for you! This is something I’ve thought about quite a bit once I learned that it was possible. I keep changing my mind as well, as I come up with good reasons to do it and then reasons not to. I think I’ll need to see what our situation is like and go from there.

    I want to wish you the best of luck, with everything!

  25. I am so terribly behind with blog reading and commenting, and for that I am so sorry. I’m not going to clutter your comments with a long-drawn out message (I’ll save that for my long-promised e-mail) so I’ll be really bulleted here.

    I was thrilled that I was able to nurse Zara for the time that I did. No, I never had a full supply. But I was able to give her enough to boost her antibody protection during her first 6 months of life. And as a pediatrician, that was my main goal.

    Yet the healing I felt from being able to give my milk to my little girl was tremendous. This nursing helped me feel less “broken” and was beneficial for Zara as well.

    The work involved, however, was astronomical. Were I not the stubborn bitch that I am, I would have decided that it wasn’t worth the effort. I just remember transporting that damnnable breast pump through airport security and having everyone think it was a bomb millions of times.

    The meds are a piffle, except for the weight gain. The pumping is annoying. Using a Lact-aid for supplementation is tricky at first, but you get the hang of it.

    What I worry about with your plan is that you haven’t left yourself enough time. (Though you might be much faster than I am in terms of production.) I suppressed with the pill and domperidone from late Nov/early December until we matched at the end of February. I then started pumping. It took me 2 weeks of pumping before I achieved any appreciable milk to collect in the bottle. But I would collect the drops diligently and freeze it. By the time Zara was born on May 2nd, production was up to several ounces/day (let’s not forget that I am as old as dirt so your experience my differ). So time was indeed a factor in developing supply. Yet again, as the support groups all tell you, a baby induces supply better than a pump.

    I did tell Zara’s firstmother that I planned to nurse. The only thing I was asked was to not nurse when she was in the hospital after delivery. When she was discharged to me, that’s when I began nursing.

    So that’s the Reader’s Digest version.

    The reason I asked you in Twitter what your definition of “success” would be is that I’ve spend so much time typing long treatises and explanations to people who’ve been interested (not anyone who has done as much investigation as you have) only to have them say, “well that sounds so hard. I’ll just go with a bottle.” Now sure, that’s a reasonable choice but it seems that some women have the idea that they will develop a full supply without meds and not need a supplementer. And yes, there are the rare women who do that. But the best thing to establish up front is what YOU want.

    Do you want a full supply? The likelihood of that is not great, but it does happen.

    Do you want to avoid meds? Your milk production will most likely be tiny.

    Do you want to give good antibody protection to the baby? You can achieve this with around 4 ounces/day.

    Can you handle the added stuff that goes along with induced lactation? Some women find it bothersome, whereas some hyperanal type-A folk get all focused and into finally doing something that will have an outcome that is achievable. (Whoever those type A folk might be…)

    So in the end, I think I’ve written most of what I planned to put in the e-mail anyway. I hope it is helpful. If you decide to go for it, I’ve got some Lact-aids and tons of bags that you are welcome to. I’ve even got a nice breast pump that isn’t all sucky-pully but is all massagey-less bothersome-y.

    But let’s get to ordering that domperidone from InHouse Pharmacy in Vanuatu and get going!

  26. […] A month ago, I began the protocol to try to induce lactation. I don’t have enough time to do it optimally, but I’ll see how it goes. Last night I had […]

  27. […] breastfeeding revisited, pt.1 About a year ago, I wrote about my intent to explore breastfeeding the baby that would come to us through adoption. Many people in real life have expressed curiosity and surprise that one could even attempt to […]

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