Inducing Lactation for Adopting Mothers or Babies Born by Surrogacy

Becoming a mother is one of life’s greatest joys.  However, the adventure of motherhood is sometimes a journey in and of itself. Some women become mother’s biologically, where others use surrogacy or adoption. Which ever route you take to become a new mommy, your baby will 100% be yours. What a gift! We all know that breastfeeding is always encouraged and a very strong option for biological mothers who physically give birth to their children. However, what adoptive mothers, or mothers who have used surrogates may not know is that just because you didn’t physically give birth to your baby, does not mean that you have to miss out on breast feeding your baby as well.  Many women are able to successfully breastfeed their infants even if they have never ever been pregnant before.  How you might ask? Well there are some steps to follow, but we as mammals have been blessed with the anatomy, all we have to do is stimulate and trick your body into producing.

Induced lactation, otherwise known as adoptive nursing, is the process of stimulating a woman’s body to produce milk, even if she has never given birth or ever been pregnant. You are a mammal, and therefore have mammary glands. All mammals (yes even men have been known to stimulate breast milk production) can lactate.  Yes, it is a lot easier to accomplish lactation when the pregnancy hormones have been in place already, but that doesn’t mean that you can’t try and stimulate the production. The success of induced lactation has a lot to do with your relationship with your new infant, and the age of the baby when you begin nursing. Your bond with the baby has more of a hormonal effect then the amount of milk that is produced. Most women can make some breast milk, and some will have an adequate full milk supply. Just keep in mind that every drop of breast milk that your baby gets is a gift and will help them start on a good healthy jump start to life.

There are several options for women who desire to breast feed their adopted or surrogate-born infants. Most likely some amount of supplementation is needed with any method. Building a milk supply takes time, and our main goal is to feed the baby. Eventually you may be able to stimulate enough of  a milk supply to solely feed your baby on expressed breast milk, but in the mean time every little bit helps.  Here is a list of the options you have for stimulating milk flow:

1. HORMONE STIMULANT WITH PUMPING: Hormonal stimulation, with the use of birth control pills to stimulate growth and development of the alveoli (breast tissue) and milk ducts, is the first key step to inducing lactation. A minimum of 2 months prior to breast stimulation is recommended, but the longer you take the hormones the better. There are several different brands of birth control that can be used. YAZ used to be the birth control of choice since the hormone combination worked best for stimulation of the pituitary gland, but due to severe side effects your health care provider may recommend another option.  Birth Control combined with the use of a prolactin stimulant medication such as domperidone (motillium) or metoclopramide (reglan) and breast pumping is recommended for the best results. **Reglan however is contraindicated for mothers with a history of depression, as this medication can increase feelings of anxiety and nervousness.

• The hormonal stimulation, which has made the body think it is pregnant, is usually stopped about 6-8 weeks before the infant’s birth to trick the body into thinking it gave birth. At this time breast pumping is initiated. The mother will gradually increase the time and frequency of each pumping session as well as the strength of the pump.  It is vital that the mother use a good hospital grade, double electric stimulation pump such as the Medela Symphony pump which has the capability to mimic the rhythm of a baby’s suck ratio. It is recommended to pump both breasts simultaneously for 15 min every 3 hrs. The automatic cycling breast pump will provide your breasts with as close a resemblance to a baby’s natural suck as possible.
• After the baby is born, place the baby skin to skin immediately. As soon as breastfeeding can be initiated, place the baby at the breast and use any previously expressed milk or formula as a supplement. Ideally the use of a dropper or supplemental nursing system device such as a tube attached to the breast is best. Your lactation consultant can help you get started.
• After each nursing session, the mother should continue to pump for 15 minutes after each feed. A 3-step protocol will most likely be put into place. 1) breastfeed baby for 15 min on each breast 2) supplement baby via SNS or bottle 3) pump for an additional 15 min.  This process usually lasts for at least 2 weeks until breastfeeding, and or a good milk supply has been initiated.
• It is usually necessary for the mother to continue using the prolactin stimulant for the entire duration of the lactation experience.  It may be recommended to include herbal therapies such as fenugreek or more milk plus as well.

2. PROLACTIN STIMULATION WITH MEDICATION AND PUMPING: This is a non-hormonal method using only prolactin stimulants such as the medication Domperidone (motillium) and breast pump stimulation. The mother would begin the same procedures as listed above minus the use of birth control hormones. Instead the mother would begin taking the prolactin medication 6-8 weeks prior to delivery and begin pumping right away. Domperidone is the safest medication option for both mom and baby in helping stimulate or increase breast milk production. This drug, along with its competitor Reglan, are actually medications used to treat gastric conditions. It’s biggest side effect is stimulation of the pituitary gland resulting in increased breast milk. This was a wonderful discovery, especially for mothers with low milk supply. Both medications are FDA approved in the US for the use of GI conditions, only Reglan is FDA approved for the use of stimulation of breastmilk in the US, despite it’s increased risk of neurological and psychological side effects. It is a political thing. Domeperidone (motillium) is much safer, and works better for increasing breastmilk. The AAP (American Academy of Pediatrics) does promote and has approved the use of Domperidone/motillium for increasing milk in breastfeeding mothers and safe for their infants.  However, because of the FDA political battle this medication can only be purchased via an online pharmacy:http://inhousepharmacy.biz .

If you don’t have the 6-8 window before the baby is born, you can begin to pump as soon as the baby is born. Supplementing at the breast with a feeding tube would be initiated until the adopted mother began to see some milk flow from the breast. Using a good galactogogue such as More Milk Plus Special Blend would also be encouraged. The “More Milk Plus Special Blend” has an added herb known as Goats Rue, which is used to stimulate additional breast tissue and ducts, in order for the body to produce more milk. Beginning this along with the pumping regimen is highly recommended.

3.BREAST PUMP ONLY: This would be the option for mothers who do not want to use any form of medication for stimulating growth. This would really only work for mothers who have breastfed previous children. The breasts have cellular memory, so therefore the pumping would awaken the breast tissue and allow the breasts to hopefully begin producing again. If the mother has never breastfed or been pregnant before, this is probably not the best option.

How much breast milk you produce depends again on whether you have been pregnant or breastfed before, the frequency  and effectiveness of breast stimulation by both the infant and the pump, and the use of hand expression and breast massage prior to stimulation. Other factors will be your own hormonal response to the stimulation as well as the infant’s willingness to suckle at the breast.

In all these cases, it is important to nurse your baby as soon as possible after it is born. The baby will use the breast for comfort initially, but will eventually associate the breast with nutrition too. The more the baby is skin to skin and at the “Breastaraunt” the better chances your breasts will produce more milk. Breast tissue always work by supply and demand. The baby has to suck to stimulate flow, so it is recommended to avoid pacifiers initially. Allow the baby to use you as a stimulation for comfort. Nurse before, after, and between other feedings for as long as you and the baby are willing. Be sure to feed your baby 8-12x in a 24 hour period.  As your milk supply increases, the amount of milk you supplement with can be decreased. It may be helpful to keep a log of the number and length of each breastfeeding and pumping session. How much formula was given as a supplement and how many wet and dirty diapers your baby is producing. Keeping a record will allow you to see just how much your baby is actually getting.

Keep in mind every woman is different, the most important thing to focus on is the physical contact and emotional bonds you are creating rather then focusing on the amount of milk that is being produced. Every drop of breastmilk your baby receives is a gift.  Before using any prescription or herbal medication it is ALWAYS recommended that you consult your health care provider first.

For further information be sure to contact a local Lactation Consultant for further evaluation and support. Best of luck!

Copyright© 2011 Danielle Gauss/ JustBreastFeeding.com. All Rights Reserved