By Guest Blogger*, Donna Walls, RN, BSN, ICCE, IBCLC, ANLC
Whenever I mention the topic of breastfeeding an adopted baby, people always look surprised and puzzled and usually have lots of questions. So, here are some answers.
How does it work?
Adoptive nursing is also referred to as induced lactation- meaning the production of milk without the initial start-up process of pregnancy. In the simplest terms breastfeeding happens between the brain and breasts. Pregnancy starts the process by sending the message to begin milk (colostrum) production, but when the infant begins nursing the real magic happens.
Many women who are in the adoption process have been through a lot–hormonal medications, surgeries and disappointments–so the possibility of nursing can be a very emotional decision.
Do adoptive mothers make enough milk?
As a lactation care provider for many years I have had the privilege of working with many adopting mothers and the most important aspect is not the volume of milk, but the mother and baby breastfeeding relationship. Adopting mothers look forward to sharing the closeness and joy of breastfeeding their baby which is the focus, rather than ounces.
What are the best strategies for getting off to a good start?
Physiologically, pregnancy “primes the pump” preparing the mother’s body for full milk production when the baby arrives. So, many adopting mothers choose to begin “priming the pump” by pumping their breasts before the arrival of the baby. But, how much? How often? It all depends on the mother, her individual situation and whatever works for her and her lifestyle. There are no “rules”, just the idea of sending some messages to the brain that there soon may be a customer for their milk.
Some mothers choose to work with their healthcare provider for medications which mimic pregnancy as preparation for lactation. Others may begin a combination of medications and pumping days or weeks ahead of the expected birth.
It is ideal for the adopting mother to hold her baby skin to skin during the hours after birth and offer the breast as soon as feasible. Whether or not this is possible depends on the contracts drawn between the birth mother and adopting parents and/or birth site policies. Discussion between the birth site staff and birth mother prior to birth of the baby is recommended to work out any concerns or questions that might arise in the first hours and days.
Just as with milk production after pregnancy, early and frequent skin to skin and breastfeeding is the key to optimum milk production and early bonding and attachment.
Since many adopting mothers will not produce a full supply of milk there needs to be a plan for supplemental feeding for the newborn. An at-breast supplementer such as the Lact-Aid or Supplemental Nutrition System provides needed extra milk or formula to the nursling while the baby is at the breast stimulating the mother’s to make milk. Other supplementation methods can be offered such as cup feeding or bottle feeding can be offered, whichever works best for the adopting mother and family.
Too often when developing a plan for adopting mothers we concentrate on the process of inducing milk, and we sometimes forget to teach the breastfeeding basics: correct latch, feeding cues, normal feeding patterns, resources for support and anticipatory guidance for the first days and weeks of lactation. Some adoptive mothers may want to attend a prenatal breastfeeding class (I have seen such women leave the class with a whole support group), while others prefer individual discussion and education.
How can I learn more about adoptive nursing^?
Some resources for information concerning adoptive nursing are the books entitled Breastfeeding Without Birthing by Alyssa Schnell or Breastfeeding the Adopted Baby by Debra Stewart Peterson, both with lots of practical strategies.
Other sources of information and support include:
- La Leche League International: Adoptive Breastfeeding The Adoptive Breastfeeding Resource Website
- Breastfeeding USA: Breastfeeding your Adoptive Baby
- Ask Lenore: The Newman-Goldfarb Protocols for Induced Lactation
Adoptive nursing can be a great opportunity for new adoptive families and reminds everyone that breastfeeding is so much more than a food delivery system, it really is about the sharing, caring and finding love between a mother and her baby.
^Please note: Some of these texts and websites may recommend medications, including herbal preparations. It is recommended that women consult a professional health care provider to evaluate the safety of such substances for their own health. Medications, including herbs, can have significant side effects.
*(Ed. Note: Our Milk Way blogger Jess Fedenia is on parental leave for the months of July, August, and September, 2016 to welcome a third child into the family. During Jess’s leave, members of the Healthy Children Project circle are taking up the blogger role.) Thanks to Donna, and all of our guest bloggers for pitching in – we look forward to welcoming Jess back!