Many of us think that breastfeeding is something that could only be done by women who have been previously pregnant. However, an increasing number of mothers want to breastfeed their adopted baby. Is this possible? Let’s find out what my research has to say.
Can you breastfeed an adopted baby? Yes, it is possible to breastfeed an adopted baby by a process known as induced lactation. This works by stimulating a woman’s breasts either by hand expression or pumping to stimulate a breast milk supply. Taking a combined oral contraceptive to simulate pregnancy and stimulate breast development can be considered under close supervision. A galactagogue can also be used to increase milk production.
These methods can assist a woman who has not had the benefit of the hormones of pregnancy which prepares the body for breastfeeding a baby. Below I will explain what methods could be helpful particularly for an adoptive mother.
What Do Studies Show Regarding Breastfeeding and Adoptive Nursing
In a 2004 study, 11 women requested the initiation of milk production in preparation for their adopted babies. Each was given a medication called chlorpromazine, along with nipple stimulation. The results revealed that all the respondents successfully established lactation after one month and started breastfeeding their adopted babies.
An older study regarding adoptive nursing was carried out in 1981. 240 women combined the process of nipple stimulation, maternal diet supplementation, and occasional use of hormones to induce lactation. The study revealed that three-fourths, or around 75% of the respondents evaluated their experience positively.
Considering these facts, it is indeed possible for a mother to breastfeed her baby, even if she has not physically conceived her child.
How can I produce breast milk without being pregnant?
Pregnancy comes with complex changes to your body hormones, which in turn, prepares your body for motherhood, and of course, breastfeeding. Among the hormones responsible for preparing breast tissue while pregnant are estrogen and progesterone. However, the hormone prolactin plays a significant role in milk production.
Estrogen and progesterone prepare the breasts to produce milk once your baby is born. The placenta releases these hormones and during delivery, these hormones are significantly reduced. This gives a signal for the body to produce enough breast milk for your baby’s needs. The other major hormone is Prolactin. This is a pituitary hormone, meaning it is released by the pituitary gland in the brain.
Some medical conditions can affect induced lactation. There could be a possibility with conditions such as Polycystic ovary syndrome (PCOS) where breast tissue may be underdeveloped. Hypothyroidism can also affect lactation. Some breastfeeding mothers milk supply can be affected by an underproduction of the thyroid hormones. It’s therefore important to treat any known conditions before you intend inducing a milk supply.
Can An Adoptive Mother Induce lactation?
Induced lactation is the process of stimulating milk production for women who have not previously been pregnant. Below are some ways where lactation can be induced which may also be suitable for adoptive mothers.
It is possible to breastfeed your adopted baby in a relatively short time before you will actually meet her. Six weeks before your baby is expected you can start the process of expressing milk. Using an electric double pump will make it easier. Pumping every 3 hours for approximately 5-7 minutes at each session will help stimulate a milk supply. After this pumping session massage and stroke your breasts, and then pump for a further 5-7 minutes. You can also try breast massage or try hand expression instead of some pumping sessions as tactile stimulation can yield better results for some women.
Once your baby is with you, encourage him to suckle at your breast to initiate breastfeeding.
More stimulation means more milk production. The combination of hand expression, breast massage, and pumping has shown to increase the rate of milk production.
The rate and success of this process will vary from one woman to another. However, there are some reports that in the first six weeks of continuous stimulation, breast changes have occurred. These include breast tenderness as well as a feeling of fullness within the breasts. Some women have also started expressing a few drops of breast milk.
Galactagogues For Adoptive Mothers
According to the American Academy of Pediatrics (AAP), galactagogues are often used to facilitate lactation, particularly for mothers of preterm infants and may also be used to facilitate lactation in adoptive mothers. They come in the form of prescribed medications, herbal preparations, and hormonal preparations. However, it goes on to say that evidence to support these agents is lacking.
Currently, there are no FDA approved medications that are specifically designed to initiate or stimulate milk production among women. However, some existing medications that are used for other purposes are found to have positive effects on a woman’s lactation. Most of these medications have a specific impact on the dopamine receptors of the body and would only be used under close supervision from a specialized doctor or lactation specialist. These medications increase prolactin (milk-making hormone) levels in the body. Some examples include:
Metoclopramide is commonly used as a medication for nausea and vomiting. It has also been used in the US to induce lactation in breastfeeding mothers. However, one common side effect of this drug is depression. Metoclopramide should be avoided in women with a history of major depression and should not be used for prolonged periods in any mother (source). Other possible side effects include diarrhea, dizziness, headache, fatigue, and irritability.
Domperidone is prescribed to provide relief for nausea and vomiting, such as in those with Gastro-esophageal disease. However, domperidone is also known to raise prolactin levels in the body. Hale’s Medications & Mothers’ Milk (2019) states that domperidone is known to produce significant increases in prolactin levels and has proven useful as a galactagogue. However, due to safety concerns, this product is currently not approved for use in the United States (Breastfeeding and Human Lactation, 2016:p.584)
Sulpiride and Chlorpromazine
These are antipsychotic medications which are currently being researched for inducing lactation. However, their use is limited due to their adverse effects.
Though these medications may help, the AAP warns of their potential side effects. Breastfeeding mothers should only use these prescription drugs under the guidance of a doctor or lactation specialist.
Herbal galactagogues are now widely available over the counter in the US. However, despite the popularity of these products in increasing milk supply, there is no robust evidence to prove there lactation inducing role. Evidence from the studies of herbal preparations is mixed and needs further investigation to determine how effective they actually are (source). The commonly used herbal galactagogues are fenugreek, Shatavari, Anise, fennel, and alfalfa.
Though herbal in origin, the AAP mentions that the purity, content, and possible side effects are not regulated in the United States. Always seek advice from your doctor or lactation specialist before taking any herbal medications for stimulating or boosting your milk production.
If you wish to initiate breastfeeding right away but don’t have a full breast milk supply as yet, using a nursing supplementer can help. This device is attached to a container that holds the supplementary milk. The tube can be attached next to your nipple so that your baby can get some additional milk while suckling. Many adoptive mothers breastfeed their babies using donor breast milk or even formula with the help of a nursing supplementer. It’s a great way to ensure your baby gets enough nutrition while keeping your breasts stimulated to help increase your milk production.
Newman-Goldfarb Protocols for Inducing Lactation
Inducing lactation is often more successful if the above measures are combined to suit the individual characteristics of the mother who would like to breastfeed. One common strategy used by experts is the Newman-Goldfarb Protocols which were developed by Dr. Jack Newman and Lenore Goldfarb. These protocols include the steps which were followed by Goldfarb herself in preparation for breastfeeding her baby, who was born from a surrogate mother.
It involves the use of hormonal pills several months prior to the baby’s arrival to mimic the breast changes a pregnant mother will undergo. It is combined with a daily intake of the drug domperidone, followed by pumping and breast stimulation. You can consult your doctor or lactation specialist if you want to try out this technique of inducing your breast milk production.
How do you breastfeed an adopted baby?
Breastfeeding an adopted baby might differ than if you were breastfeeding after becoming pregnant. However, both circumstances work on the same principle of supply and demand. The more milk that is removed at each breastfeeding session, the more breast milk is produced. Here are some tips on how to breastfeed your adopted baby:
Consider your Adopted Baby’s Age and Experience
Newborn babies or babies under a month old will show a strong preference for breastfeeding. Their instinct to root and find their way to the breast will make the process much easier for mum and baby. You can strengthen your baby’s instincts by putting your baby on your chest and maximizing skin-to-skin contact.
Initiating breastfeeding with an adopted baby older than 3 months can become more difficult. Older infants may not be willing to accept or may reject the breast, particularly if they have not breastfed before.
Provide Adequate time for you to be comfortable with each other
Be patient and maximize physical contact with your baby until both of you are comfortable and ready. Time is needed for you to get familiar with your baby. Factors to get familiar with include your baby’s suckling style, the strength of his suckling and the duration of each breastfeed.
Breast only if possible
To maximize stimulation, it is recommended that you exclusively offer the breast at every feeding session. You may begin by producing a few drops or even none. However, in the meantime, using a nursing supplementer will ensure your baby will get the required nutrients.
Avoid using artificial dummies if possible. If your baby needs more time to suck, offer your other breast until such time that your baby will be relaxed or falls asleep.
Encourage comfort sucking
Many babies are just happy to suckle at the breast even if they are not hungry. Offer your breast between feedings even if there is very little or no milk present. Comfort suckling will help reassure your baby as well as offer more stimulation to your nipples, which is good for building up your milk supply.
Gradually Remove the Nursing Supplementer
Once you have established your milk supply, you may now start to breastfeed without the supplementer. At first, your baby can be resilient to change, so it is important to carry out this process gradually.
You may begin by removing the supplementer once a day. For example, you can eliminate it during your morning feedings because this is when your milk flow is possibly highest. Gradually delay the use of the supplementer later on the day until such time that you won’t be needing the device anymore.
If your baby is highly resistant, you can pump in between feedings and use your expressed breast milk in the supplementer. This technique would maximize the removal of milk from your breast and help boost your milk production.
Consider other potential benefits of breastfeeding
When you think about breastfeeding, the first thing that will come to your mind is how your infant is receiving the best available nourishment. However, many adoptive mothers claim that their decision to induce lactation and breastfeed is not just to feed, but also to build a closer relationship to their babies. Regular intimate contact can also be calming and stress-relieving for adopted babies.
Other things that can help encourage breastfeeding and breast milk production
Don’t get frustrated if your baby refuses the breast or you are not producing enough milk for the first time. Experts suggest that these simple ways can help establish breastfeeding between you and your baby:
- Lying down with your baby skin to skin.
- Carrying your baby in a sling for easy access to the breast while also providing physical closeness.
- Sleeping near to your baby for more accessible night feedings.
Overall, it is definitely possible to breastfeed your adopted baby. Many adoptive moms around the world have managed to provide breast milk whether partially or providing a full supply. However, there is no denying it takes time and lots of persistence to provide breast milk for your baby. But rest assured that all your efforts are worth it. The unique bonding experience and emotional benefits of breastfeeding are just as valuable.
Hale W.T, Hale’s Medications & Mothers’ Milk (2019), Springer Publishing Company
Wambach, K & Riordan, J, Breastfeeding and Human Lactation (enhanced fifth edition) , (2016), Jones and Bartlett Learning