adoptive breastfeeding revisited, pt.1

See below for part two.

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 breastfeed an adopted child. Since then, several readers have asked about my experience and whether it was successful or not.

The answer, I think, depends on how you define “success.”

While it is not for every one or every situation, there is a common protocol for adoptive mothers who wish to induce lactation. The protocol usually does not produce a full supply, nor does it always work. Yet when followed properly, some women have successfully produced milk for their babies after adoption. Usually, however, supplementing with formula or donated milk is necessary to meet the baby’s nutritional needs. Rarely will an adoptive mother be able to produce more than a small portion of her baby’s diet.

Essentially the protocol involves loading up on medication to mimic pregnancy (estrogen and progesterone) and induce lactation (with motillium/aka domperidone, which stimulates prolactin). Then you begin an intensive herbal protocol (high doses of fenugreek, blessed thistle, nettles and other herbs) and pumping like crazy with a medical-grade breast pump (every 2-3 hours is recommended).

The longer you take the hormones, the better your chances of inducing lactation. The more you pump, the better your production. Another factor is whether you’ve lactated before. Because my milk came in after our son died four years ago at 21 weeks gestation, my body might actually remember what to do.

The protocol is not for everyone, obviously. Especially after infertility, when you just want to be done with medical intervention and risky drugs. Pumping is a major ordeal, as anyone who has done it knows. It can be technically challenging, inconvenient and cumbersome. And let’s not forget the uncertainty involved in adoption. You can never be sure you will even bring home a baby, until you do.

Still, as someone who always intended to breastfeed, I was interested in checking it out. I knew it could be controversial. I knew it would be challenging. I knew there was no guarantee it would work.

The potential benefits in my view were many. Sure, there was some part of me that wanted to reclaim my body for something good. After the failures of infertility and loss, I wanted to know that I could sustain life. As I wrote before, maybe it would be some redemptive triumph over nature. More importantly, I wanted to be able to nurture and care for my child. But the primary reason was for bonding and attachment. Yes, I wanted to be sure I could bond with a new baby that I hadn’t carried for nine months. But honestly that wasn’t my main concern. Bonding is a two-way street, and I wanted the baby to be able to bond to me. To be clear, I was not trying to replace K. But after being separated from the only mama and body she ever knew after just 34 hours, I thought it was really important for her to feel connected to me. While new families can and do form attachments through other important means (i.e., skin contact, baby-wearing, responding to baby’s needs, etc.), this seemed a more primal way of attaching to a new mama. Then there was a more practical reason of wanting to be able to provide soothing comfort. And of course I wanted the baby to have the essential nutrients from breast milk.

The first step was discussing the possibility with K while she was pregnant. I asked if she had thought about breastfeeding. K felt pretty strongly about not wanting to nurse. I had heard of other families who either wanted or did not want the mother to breastfeed or pump milk after placement. I didn’t want K to think that we had an opinion about it at all. That was completely her decision and we would honor it. I reminded K that she was free to revisit the issue when the time came. (Oddly enough, a medical professional who had already made an inappropriate comment to K tried to make her feel guilty for choosing not to breastfeed. It is completely bizarre to me that anyone thinks it’s their business, ever.)

I asked K if she had ever heard of adoptive breastfeeding and explained that I was researching it. The prospect seemed compelling, and K seemed very supportive. I further reasoned that I could always freeze the milk if K decided to parent.

Then it took a while to get started. I was nervous about the meds and didn’t want to take them for a long time. I had questions. As I wrote at the time, I found resources online but not much in real life. Even my doctor, a breast specialist, had never heard of the protocol and couldn’t prescribe the meds. Then a blogger sent me some to get started and I ordered more online (happily, I was able to repay the favor when I sent her the last of my IVF meds). I found a terrific lactation consultant and rented a good pump. She didn’t charge for a consult when she trained me on how to use it. She was supportive and encouraging, not militant or judgmental. She checked in with me from time to time too.

By the time I started the protocol, however, I didn’t even have the minimum recommended time before Baby J was due to be born. Women who induce successfully take the meds for at least six weeks, and many who produce the greatest supply take them for months beforehand. I had just four weeks before I started herbs and pumping. Plus I couldn’t find the time to pump more than 3-4 times per day. I’d pump in the morning, after work, before bed, and once more on the weekends. It was exhausting, the pumping, cleaning pump parts late at night and early in the morning. It was a lot of work, and I wasn’t even doing it enough.

Would it be worth it?

Stay tuned for part two.

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~ by luna on April 18, 2010.

8 Responses to “adoptive breastfeeding revisited, pt.1”

  1. Thanks so much for writing about this! The more people talk about their experiences the better. There is so little support and information in the local adoption community, I’m glad to read of your experience.

    I’m anxious to read part two of this post. I have researched adoptive breastfeeding extensively and also met with a lactation specialist becaurse we are planning on adoptive breastfeeding when we are matched with our baby. However, we found some good information about the possibilities of not using meds and hormones. The results are mixed on whether all the pumping and medications actually increase production. There are multiple protocols and along with the link you included, folks might find http://www.fourfriends.com/abrw/
    to be a helpful and informative website if they want to read about other perspectives, recommendations and protocols.

    I recently met a woman at an adoption group who had used the protocol you described for her first child with some success and used a supplementer. This adoption she is planning on not using any drugs or pumping in advance, and just starting with the supplementer when the child is placed. She feels that the pumping prep and drugs are a physical and emotional burden that do not guarantee any better volume and may cause issues in other ways. And that for her, breastfeeding with the supplementer accomplishes all of her goals for bonding, nurture, comfort and some nutritive value.

    • thanks, Marie, for your comment. I actually meant to add that link, as I checked that site as well. I didn’t get into this, since my post was getting so long already, but I seriously considered doing an herbal only protocol to induce lactation, possibly adding pumping but avoiding the meds completely. I chose to try the meds because I wanted to increase my chance of producing milk before the baby came. if I were to do it again, I wouldn’t use the meds, I’d take herbs and pump, if anything. for me, the feeder alone was lots of hard work, very challenging, and tough to bond when baby is so frustrated and hungry. thanks again!

  2. Breastfeeding for birth moms tends to be such a divisive issue. It is so great to read personal experience. I’m just glad this is a safe space to say what you went through without people judging and people being comment trolls.

  3. You are such a tease! But I am sooooooo glad you are writing about this. I am considering this but I think it might be too emotionally challenging for me given all of my ttc failures. I can’t wait to read more.

  4. I’ve discussed this topic on my blog before. I seem to be one of the few adult adoptees I know who does not have an issue with adoptive breastfeeding in theory. My MIL lost her mother as an infant and was nursed by a neighbor. My son was given banked breast milk in the NICU after he negatively reacted to formula and my milk was slow to come in. Nobody in our family has a problem with it in theory.

    But I just have to ask about the hormones you were planning on taking to induce lactation.

    I pay extra money to make sure my kids don’t get cow’s milk with hormones in it. I sure as heck wouldn’t want to give an infant breast milk filled with synthetic hormones.

    That is not a judgment but more of a caution.

    Lactation inducing hormones seeping into breastmilk just doesn’t sound like a plus to me.

    • thanks so much for your comment. as someone who eats a mostly whole food and organic diet with no added hormones, I shared your concerns about the meds to induce lactation. that was my main concern. I did a lot of research before beginning the protocol.

      to elaborate a bit, the birth control pills you take and stop at least a month before the baby comes. when you begin pumping it is to create a demand rather than a supply, so any milk that came out is not ingested by the baby. by the time the baby comes, those drugs are out of your system completely. the other drug is regularly used to treat GI tract problems in children (with lactation as an unfortunate side effect when used for that purpose). the research I did was mainly to assess what effects trace amounts in breast milk could have. what I found was that any trace amounts would be far less than the amount prescribed to a baby to treat GI problems.
      every one I spoke with agreed that the benefit of the breast milk would outweigh any risk of those trace amounts. plus, I gradually reduced the amount of those meds over time.

      your point is very well taken. it’s not a perfect system. I had the same concerns myself, but I never would have wanted to subject our child to any risk. thanks again for your comment.

  5. Looking forward to hearing the rest of this one. As always I appreciate your outlook on things and how you express the reasoning behind your motives…

  6. […] adoptive breastfeeding revisited, pt.2 For part one, click here. […]

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