Can I breastfeed my adopted baby?

Is it possible to breastfeed an adopted baby? I plan to be in the delivery room with the birth mom, who thinks it’s great that we want to give this baby the best. The baby will be born in two months -- should I start pumping? What do I need to do?

Question:

Nursing an adopted baby provides many rewards. You can enjoy the physical closeness, skin-to-skin contact and mother-infant bonding fostered by breastfeeding.

You may also be surprised to learn that your baby will benefit from the experience, whether or not you ever produce milk. This is because feeding at the breast improves dentition and oral development. Many nursing adoptive mothers do produce milk, but it’s best to think of that as an extra bonus. Focusing on all the benefits of the nursing relationship can ensure a satisfactory experience. Emphasizing milk production may cause disappointment with slow progress. This could have a negative effect on the responses of your body.

There are many ways to prepare, depending on your preference. Some mothers begin pumping several months before their baby’s birth to elevate hormonal levels that support milk production. Use of a hospital-grade electric pump, such as the Medela Classic Model or the Ameda-Hollister Lact E Model, is recommended.

A typical pumping session would be about five to ten minutes, depending on your comfort. Both breasts are pumped simultaneously using a double kit. Moisten the inside of the breast shell (the plastic flange that is held against your breast) to prevent friction. Use the pump only on the minimum setting unless you are totally comfortable and can increase the pressure with the same degree of comfort. If pumping frequently (at least six to eight times a day), milk production may become evident even before infant suckling is initiated. This does not occur universally however.

Next: Using Your Baby as the Exclusive Stimulus for Milk Production 

 

Some mothers do not establish any milk production until they are able to have the stimulation of their baby suckling on the breast. Reasons for avoiding pumping and using your baby as the exclusive stimulus for milk production include the following:

  • Pumping regularly is not realistic for you;
  • Your nipples are too sensitive and pumping causes discomfort;
  • Or lack of milk production after several weeks would be very discouraging for you.

Once your baby is available to be placed at the breast, you can begin nursing. This is done with a supplementing device that is taped to your breast. The devices that are used include the Lact-Aid and the Supplemental Nursing System. Both consist of a silicone tube attached to a milk reservoir. The reservoir is filled with formula or banked human milk and the container sealed. The silicone tube is taped to the breast so the tip of the tube extends about 1/8 inch past your nipple.

Although this may differ from the manufacturer’s instructions, I recommend placing the tube on the side of the breast, toward the baby’s tongue and lower lip. It’s positioned parallel to the floor. When placed this way, the tube will be against the breast and milked by the tongue while your baby suckles.

There are some differences between the two devices. The Lact-Aid’s milk reservoir is a sterile plastic bag. It’s a closed system, which collapses as milk is withdrawn. It also works against gravity, which probably increases breast stimulation. The plastic-bag feature makes cleanup easier but assembly a bit more difficult. It also is discrete if worn underneath clothing while nursing in public.

Next: Lact-Aid Vs. Supplemental Nursing System

 

The Supplemental Nursing System has a plastic-bottle reservoir that is easier to fill since you can stand it on the counter and pour in the liquid. It comes with three different diameter tubes (small, medium and large) so the rate of flow can be altered if a baby’s suckling skills are not well established. Babies who are already accustomed to bottle-feeding usually make an easier transition if offered the largest tube first. As the baby develops breastfeeding skills, the size of the tube can be reduced to increase breast stimulation.

I usually recommend using the device as a vented system. Keep one tube taped on the breast for the baby and the second tube open and taped to the bottle to allow air to flow into the bottle as milk is withdrawn. Since the bottle is rigid, if the system is not allowed to vent in this way a vacuum will be created, making milk flow increasingly difficult.

Since there are pros and cons to both devices, I recommend getting a few of each. Some mothers find it easier to use the Supplemental Nursing System at night when they are sleepy and the Lact-Aid during the day to maximize stimulation and discretion. Using a tube device on the breast may distract you from proper latch-on technique. It’s best to let the tape hold the tube in place and focus on getting a good latch.

Most mothers want privacy when first learning how to use the device and for the initial latch-on. If you feel this way, you may want to wait until you take your baby home to establish your nursing relationship. If you have difficulty getting a comfortable latch that enables your baby to complete an adequate feeding in 30 to 40 minutes, you should seek expert assistance.

Next Page: Metoclopramide; Oxytocin

You may also want to get medical assistance for establishing your milk supply. Some mothers use medications, such as metoclopramide, to enhance milk production.

Studies done on the use of metoclopramide are primarily based on birth mothers with supply problems but case reports of adoptive mothers’ use of this drug are also available. The studies found that the increase in milk production was related to the amount of medication taken. Doses up to 15 mg three times a day were used. Mothers are weaned off the drug over a few weeks, and use of the medication beyond four weeks is not recommended. Some mothers experience gastrointestinal side effects and discontinue use of the medication. Unfortunately, many of the mothers studied experienced a decline in their supply when metoclopramide was eliminated.

Sometimes medications like synthetic oxytocin are prescribed to assist milk flow. This is usually administered in the form of nasal drops, which some mothers find uncomfortable. Other mothers use herbs including fenugreek, aniseed, black elder, blessed thistle, caraway, fennel, vervain or vitex. One herb -- or several in combination -- is sometimes prescribed. You should consult with a doctor before taking any medicines or herbs for this purpose.

Whether using medication or not, most mothers will notice some milk production during the course of their nursing relationship. I have observed mothers who were able to breastfeed exclusively, although this took several months to achieve.

Next: Breastfeeding with Complementary Solid Foods

 

Other mothers were able to breastfeed with complementary solid foods when their babies were old enough to begin solid foods (after four to six months of age). Women who have nursed a previous birthchild seem to resume milk production faster, but not many adoptive mothers are in this situation. Postmenopausal mothers have also been able to establish milk supply.

As you can see, the strategy, which would be best to achieve the goal of nursing an adopted infant, may differ among women. Some mothers prefer to pump in anticipation of their baby’s birth because they feel this provides a connection during the pregnancy. Others prefer to prepare mentally and emotionally, rather than physically.

Using your infant’s suckling on the breast to either support or initiate milk production is crucial and satisfying. Once your baby latches and begins suckling, the nursing relationship and a powerful journey have begun for both of you.

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