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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?
1. 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.
2. 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.
3.
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 When
Latching).
4. 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?
5. 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 #19a
and 19b,
Domperidone 1 and 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? (416) 813-5757
(option 3) or drjacknewman@sympatico.ca
or my book Dr. Jack Newman’s Guide
to Breastfeeding (called The Ultimate Breastfeeding
Book of Answers in the USA)
See
the videos
that help you use the Protocol
to Increase Breastmilk Intake by the Baby.
See
also the website www.asklenore.info
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
1. Breastfeeding:
Starting out right
a) The
importance of Skin-to-Skin contact
2. Colic in the Breastfed Baby
3. a) Sore Nipples
b) Treatments
for Sore Nipple and Sore Breasts
4. Is my baby getting enough?
5. Using a Lactation Aid
6. Using Gentian Violet
7. Breastfeeding and Jaundice
8. Finger Feeding
9. a) You should continue breastfeeding
(Medications and breastfeeding)
b) You
should continue breastfeeding (Illness in the mother or baby)
10. Breastfeeding and other foods
11. Some breastfeeding myths
12. More breastfeeding myths
13. Still more breastfeeding
myths
14. More and more breastfeeding
myths
15. Breast compression
16. Starting solid foods
17. What to feed the baby when
the mother is working outside the home
18. How to know a health professional
is not supportive of breastfeeding
19. a) Domperidone 1
b) Domperidone
2
20. Fluconazole
21. Breastfeed a toddler –
Why on earth?
22. Blocked ducts and
mastitis
23. Breastfeeding your adopted baby
24. Miscellaneous treatments for problems
25. Slow weight gain after
the first few months
26. When the Baby refuses to
latch on
27. Expressing Milk
28. Toxins and Infant Feeding
How breastmilk protects Newborns
Risks of formula feeding
Breastfeeding and guilt
Candida protocol
Protocol to increase the intake
of Breastmilk by the Baby ("Not enough milk")
When latching
Protocols for Induced Lactation
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