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Breastfeeding your Adopted Baby
Handout #23 Breastfeeding your Adopted Baby. January
2005
Written by Jack Newman, MD, FRCPC. © 2005
You are about to adopt a baby and you want to breastfeed? Wonderful!
Not only is it possible, it is fairly easy and chances are you will
produce a significant amount of milk. It is different, though, than
breastfeeding a baby with whom you have been pregnant for many months.
Breastfeeding and Breastmilk
There are really two issues in nursing an adopted baby. One is
getting your baby to breastfeed. The other is producing breastmilk.
It is important to set your expectations at a reasonable level.
Since there is more to breastfeeding than breastmilk, many mothers
are happy to be able to breastfeed without expecting to produce
all the milk the baby will need. It is the special relationship,
the special closeness, and the biological attachment of breastfeeding
that many mothers are looking for. As one adopting mother said,
“I want to breastfeed. If the baby also gets breastmilk, that’s
great.”
Getting the baby to take the breast
Although many people do not believe that the early introduction
of bottles may interfere with breastfeeding, the early introduction
of artificial nipples can indeed interfere. The sooner you can get
the baby to the breast after he is born, the better. However, babies
need flow from the breast in order to stay latched on and continue
sucking, especially if they have gotten used to getting flow from
a bottle or another method of feeding (cup, finger feeding). So,
what can you do?
- Speak with the staff at the hospital where the baby will be
born and let the head nurse and lactation consultant know you
plan to breastfeed the baby. They should be willing to accommodate
your desire to have the baby fed by cup or finger feeding, if
you cannot have the baby to feed immediately after his birth.
In fact, more and more frequently, arrangements have been made
where the adoptive mother is present at the birth of the baby
and takes the baby immediately to nurse. The earlier you start,
the better.
- Some biological mothers are willing to nurse the baby for the
first few days. There is some concern expressed by social workers
and others that this will result in the biological mothers’
changing her mind. This is possible, and you may not wish to take
that risk. However, this has been done, and it allows the baby
to breastfeed, get colostrum, and not receive artificial feedings
at first.
- Latching on well is even more important when the mother does
not have a full milk supply as when she does. A good latch means
painless feedings. A good latch means the baby will get more of
your milk, whether your milk supply is abundant or minimal. (Handout
A: When
Latching).
- If the baby does need to be supplemented, this should be done
with a lactation aid with the supplement being given while
the baby is breastfeeding (Handout #5 Using
a Lactation Aid). Babies learn to breastfeed by breastfeeding,
not cup feeding, finger feeding or bottle feeding. Of course,
you can use your previously expressed milk to supplement. And
if you can manage to get it, banked breastmilk is the second best
supplement after your own milk. With a lactation aid, the baby
is still breastfeeding even while being supplemented,
and isn’t breastfeeding what you wanted for your baby?
- If you are having trouble getting the baby to take the breast,
come to the clinic as soon as possible for help.
Producing Breastmilk
As soon as a baby is in sight, contact a breastfeeding clinic and
start getting your milk supply ready. Please understand that you
may never produce a full supply for your baby, though that
may happen. You should not be discouraged by what you may be pumping
before the baby is born, because a pump is never as good at extracting
milk as a baby who is sucking well and well latched on. The main
purpose of pumping before the baby is born is to draw milk out of
your breast so that you will produce yet more milk, not to build
up a reserve of milk before the baby is born, though this is good
if you can do it.
If you know far enough in advance, say at least 3 or 4 months,
treatment with a combination of oestrogen and progesterone (similar
to the birth control pill, but without a break, or oestrogen patches
on the breast plus oral progesterone) plus domperidone will simulate
the hormonal milieu of pregnancy somewhat and may allow you to produce
more milk. Get information about this protocol
from the clinic.
a. Pumping.If you can manage it, rent an electric pump with
a double setup. Pumping both breasts at the same time takes half
the time, obviously, and also results in better milk production.
Start pumping as soon as the baby is in sight, even if this means
you will be pumping for 4 months. You do not have to pump frequently
on a schedule. Do what is possible. If twice a day is possible at
first, do it twice a day. If once a day during the week, but 6 times
during the weekend can be done, fine. Partners can help with nipple
stimulation as well.
b. Domperidone. (Handout #19 Domperidone
and Handout #19b Domperidone-2).
This drug can help you produce more milk. It is not necessary for
you to use it in order to breastfeed an adopted baby, but it will
help you develop a more abundant milk supply faster. There is no
such thing as a 100% safe drug. If you do decide to take it, the
starting dose is 30 mg three times a day, but we have gone as high
as 40 mg 4 times a day. Check the handout for more information.
Ask at the clinic. Using pumping and domperidone, most adopting
mothers have started to produce drops of milk after two to four
weeks.
But will I produce all the milk the baby needs?
Maybe, but don’t count on it. But if you do not, breastfeed
your baby anyhow, and allow yourself and him to enjoy the special
relationship that it brings. In any case, some breastmilk is better
than none.
Please note: If you decide to take the medications (the
hormones and/or the domperidone), your family doctor must be aware
of what you are taking and why. Significant side effects have been
rare, but that does not mean they cannot happen. Your doctor needs
to be following you, and once the baby is with you, your baby’s
doctor needs to know that you are nursing him and needs to follow
the baby’s progress just as s/he would any other baby.
Questions?
see
my book Dr. Jack Newman's Guide to Breastfeeding (called
The
Ultimate Breastfeeding Book of Answers in the USA)
See the website www.thebirthden.com/Newman.html
for videos that help you use the Protocol to Increase Breastmilk
Intake by the Baby.
See also the
website www.asklenore.com
for more information and protocols for breastfeeding the adopted
baby.
Handout #23 Breastfeeding your Adopted Baby.
January 2005
Written by Jack Newman, MD, FRCPC. © 2005
This
handout may be copied and distributed without further permission,
on
the condition that it is not used in any context in which
the WHO code on the marketing of breastmilk substitutes is violated
