Breastfeeding a baby can be a special time of bonding for a mother and her child. For adoptive mothers and mothers who choose to use a surrogate to have a child, this was an experience that they could not experience many years ago. In 1999, a lactation consultant who was needing assistance bringing in a milk supply for an adoptive child appealed for assistance from a pediatrician, Dr. Jack Newman, a well known speaker and advocate for breastfeeding . Together they developed a tool to help in this process. At the The Women’s Hospital Great Beginnings Store, we have had the privilege of helping mothers in their journey to breastfeed their adoptive baby.
There are many reasons a family chooses to adopt a baby. This may be due to difficulty having a child of their own due to physical issues with the mother or father, due to age, or simply because they have a heart for adopting. There are also many reasons a mother may choose to use a surrogate to have a baby including the reasons listed above. If a mother has previously breastfed, the process which will be discussed in this paper is referred to as “relactating”
. For a mother who has never had a child and thus never breastfed, she will be “inducing lactation”
. Though the terms are different, the process is the same for both mothers.
At the Great Beginnings Store we feel it is important for the mother to understand that sometimes the birth mother changes her mind at the last minute, and then the adoptive mother is faced with not only dealing with sadness over the failed adoption but she also has the reminder with the milk she now has. This is a risk that could become reality and we want the mother to be prepared for that.
The next issue we deal with is that not all mothers will bring in a full milk supply. If a mother breastfed a child before and did not have any issues with developing a full milk supply, she has a better chance. A mother who has had difficulty getting pregnant or maintaining a pregnancy may have more difficulty, possibly due to hormonal issues, which are key to bringing milk in or lactating. Either way, any amount of milk is a gift to that baby and the goal is to provide what she can for her child. She must rethink how she defines success; that she sees success as the ability to provide any amount of breastmilk to her baby.
In the ideal situation, a mother begins the process six months prior to the baby’s birth. Unfortunately, mothers seldom are given this much notice. All of the calls we have received are from mothers who have two to four months to prepare. We all know that babies seldom deliver on the date they are expected, so this date can change. There is an accelerated program for these mothers and we have found this to be successful.
Mothers begin the process by taking a hormone and a galactogogue (a medicine that increases milk supply) together. During this time the mother takes the hormone pill or birth control pill without a break. She will not expect to see any milk, but will notice her breast increasing one cup size. Once she has experienced this change in breast size and has taken the birth control pill for at least 30 days, she can discontinue the birth control pill. The remaining time is spent pumping at least every 3 hours with a hospital grade pump. How long it takes for her to produce milk varies, and can take days to weeks. If her milk is not in by the time the baby arrives, she can breastfeed using a SNS or Supplemental Nursing System. She would also need to continue to pump. Unlike mothers who deliver their baby, these mothers will not experience the period of colostrum, but will produce mature milk.
Our experiences at The Women’s Hospital with adoptive mothers or mothers with a surrogate pregnancy who wish to breastfeed, have varied from a mother producing very little milk to one with almost a full milk supply. We’ve learned most are successful when their physician supports their desire to breastfeed and collaborates with a knowledgeable lactation consultant, when the woman stays in touch with a lactation consultant about how things are going and chooses to follow the established protocol. Those who produced less milk, elected to solely pump. That is, they chose to pump without taking the recommended medications. This technique is typically not as successful.
If you are or if or someone you know is interested in adopting a baby or planning a surrogate pregnancy and would like to breastfeed, please contact The Great Beginnings Outpatient Lactation Clinic for a consultation. You can call for an appointment at 812-842-4239.