Breastfeeding Your Adopted Baby
Yes, you can breastfeed a baby to whom you did not give birth. In fact, breastfeeding an adopted baby is recommended by the American Academy of Pediatrics. It is even possible to breastfeed if you have never been pregnant or have reached menopause. Breastfeeding an adopted baby is different than breastfeeding a baby after being pregnant, but it can be achieved through the process of induced lactation.
There are several different methods used to induce lactation when you have not been pregnant. It may also be possible to breastfeed your adopted baby with no preparation at all. However, if you have advance notice that you will have a new baby joining your family, you may wish to explore methods that stimulate milk production before baby arrives. The same methods can be used by traditional adoptive mothers, mothers whose babies were born to surrogates, and even the female partners of birth mothers.
The physical connection of breastfeeding benefits both mother and child. ALL adoptions involve a loss for the child. Even a newborn infant who is placed right into the loving arms of his adoptive parents is being separated from the only mother he knows:
Adoption universally involves loss. Babies recognize their mothers at birth and at delivery healthy babies placed on the abdomen of their mother will crawl up onto her chest and, locating the nipple via its familiar smell, will attach to her breast and suckle. Newborn infants desire to remain with their mother and if removed from skin-to-skin contact with her will give a specific "separation distress cry/call" as an appeal for reunion. Maternal separation is stressful for infants, and all adopted children have experienced the loss of their birth mother (Gribble, 2006).
Inducing lactation before your baby arrives
When studying the various methods for inducing lactation, keep in mind that it is equally important to learn as much as you can about how the body is stimulated to make milk by the removal of milk from the breasts. Knowing the natural process of lactation can help you as you work to increase your milk production.
To prepare you can stimulate your breasts by hand or by pump for several weeks or months before your baby arrives. Hand expression requires no equipment and can be used to stimulate milk production.
If you use a breast pump it is recommended that you use the highest quality pump available to you when inducing lactation. The first choice would be a rental-grade pump, which you can find in your local area by contacting your birthing facility and asking what rental pumps are available near you and where. These pumps are often available for rent through hospitals, medical supply stores, WIC, private-practice lactation consultants, online vendors, and even some popular baby stores.
Whether you are using a pump, hand expression, or both, this method is most effective when done as many times a day as a baby would be breastfeeding, at least eight to ten times a day. Combining hand expression and breast massage with pumping has been shown to increase milk production more quickly (Morton, Hall & Wong, 2009). Many women begin to notice breast changes in the first 6 weeks of expression. Mothers may notice breasts that feel larger and firmer, breast tenderness, protruding nipples, and drops of milk.
Another strategy, which can be used in combination with others, requires you to take hormones and/or galactagogues daily to prepare your body for lactation (West, Marasco, 2009). A galactagogue is an herb or prescription medication that increases milk production, likely by increasing prolactin (the “milk making” hormone) levels in the blood. One method is called the Goldfarb-Newman Protocol. It involves first taking birth control pills to simulate pregnancy hormone changes and then both expressing and taking medication that increases hormonal levels. Herbal remedies such as fenugreek are available over the counter. You should discuss prescription medications and over the counter galactagogues with your health care provider. Variations in treatment may be appropriate according to the needs of an individual woman.
If you choose to use herbal or prescription galactagogues or hormones to facilitate lactation, it is important that you work with your health care provider. All of these substances have potential side effects and may be contraindicated for persons with certain medical conditions. Your health care provider can help you weigh any risks and benefits and decide what will work best in your situation. If you have questions about the safety of medications and herbs while breastfeeding or inducing lactation, contact the InfantRisk Center. The InfantRisk Center is dedicated to providing up-to-date, evidence-based information on the use of medications during pregnancy and breastfeeding.
Inducing lactation after your baby arrives
If you do not prepare before your baby arrives, you can still begin breastfeeding and expressing milk right away. You can also discuss the use of a galactagogue with your health care provider.
Some moms use an at-breast supplementer so that their babies can receive supplemental milk through a small tube at the breast. There are two main brands available: the Lact-Aid Nursing Trainer and the Medela Supplemental Nursing System (SNS). Both products work by allowing your baby to get supplemental milk while breastfeeding, but there are some differences in how they work. The SNS allows milk to flow by gravity, and comes with a variety of sizes of tubing for faster and slower flow. The Lact-Aid does not allow milk to flow unless baby is sucking. It is worthwhile to do some research on the pros and cons of these products before investing in one.
If your baby is being carried by a surrogate or in an open adoption where adoptive parents have been matched with the birth mother before birth, you may be able to be at the delivery of your baby and put your baby to the breast immediately. Babies are hardwired to breastfeed at birth. If you are able to put your baby to the breast right away then the procedures you will follow will be the same as if you had given birth to your baby, like those described in Baby-Led Latch: How to awaken your baby's breastfeeding instincts.
Even if baby has only had bottles, he may still instinctively root, search for, and take the breast when placed skin-to-skin on his mother’s bare chest. If your baby has a strong preference for bottles, it is still possible to teach him to breastfeed.
When you are working to teach your baby to take your breast, it is important to be patient and relax. The older your baby is, the more time it may take for him to be comfortable being skin-to-skin with you. A child who has experienced neglect or abuse will need time building trust and attachment before he will be ready to breastfeed (Gribble, 2006). There are many ways to get to know your baby and become comfortable being in the close physical contact required of breastfeeding:
- Spending lots of time lying down with your baby skin-to-skin
- Taking baths together
- Frequently carrying or wearing your baby during the day
- Sleeping near your baby
- Holding your baby while bottle feeding
- Sitting baby on your lap while giving solid foods
Maximizing milk production
Perhaps you have been preparing and inducing lactation for several months, or maybe you started when you met your baby. Either way, the key to establishing breastfeeding with your baby is time together. Research shows that adoptive mothers in developing countries are more successful at producing more milk than mothers in the West. These mothers in may have higher milk production due to cultural differences that are conducive to breastfeeding such as frequent breastfeeding and remaining in close physical contact with their babies. Their cultures may be more supportive of breastfeeding as well. Emulating the mothering styles of women in developing countries, and creating a support network for breastfeeding may help to maximize your milk production (Gribble, 2004).
The more your breasts are stimulated, and the more milk you remove, the more milk your body will produce. Be patient; the first milk you may notice will be a few drops, and the increase is very gradual. Nursing as much as possible is the best way to increase production and decrease the need for supplements.
- If at all possible, feed only at the breast using an at-breast supplementer.
- Offer both breasts twice at every feeding, and use breast compressions to maximize the amount of milk removed.
- Encourage comfort nursing between feedings. Offering the breast without supplemental milk flowing provides more stimulation to your breasts and keeps the baby interested and comfortable with nursing at a breast with less milk flow.
- If baby is unable or unwilling to nurse without the supplementer, consider expressing milk between feedings.
Finally, make sure you have built a support system. Consider contacting a Breastfeeding Counselor or International Board Certified Lactation Consultant to work with you. Read as much as you can about adoptive breastfeeding and induced lactation. The resources below will give you a place to start.
Breastfeeding an Adopted Baby and Relactation, by Elizabeth Hormann.
The Breastfeeding Mother’s Guide to Making More Milk, by Diana West and Lisa Marasco.
Websites and online articles
Adoptive Breastfeeding Resource Website
Dr. Jack Newman: Breastfeeding your Adopted Baby or Baby Born by Surrogate
Buckley, K. & Charles, G. (2006) Benefits and challenges of transitioning preterm infants to at-breast feedings. International Breastfeeding Journal 1:13
Gribble, K. (2004) The influence of context on the success of adoptive breastfeeding: Developing countries and the west. Breastfeeding Review; 5-13.
Gribble, K. (2006) Mental health, attachment and breastfeeding: implications for adopted children and their mothers. International Breastfeeding Journal 1:5.
Horman, E. (2006) Breastfeeding an Adopted Baby and Relactation. Schaumburg, IL: La Leche League International.
Breastfeeding Your Adopted Baby or Baby Born by Surrogate/Gestational Carrier. (2009). Retrieved January 20, 2012, from http://www.nbci.ca/
Mezzacappa, E. S., and E. S. Katkin. (2002). Breastfeeding is associated with reduced perceived stress and negative mood in mothers. Health Psychology 21:187-193.
Moore ER, Anderson GC, Bergman N. (2009) Early skin-to-skin contact for mothers and their healthy newborn infants Cochrane Summaries
Morton J, Hall, J and Wong, R et. al. (2009, July, 2) Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. Journal of Perinatology advance online publication; doi: 10.1038/jp.2009.87
West, D. and Marasco, L. (2009) The Breastfeeding Mother’s Guide to Making More Milk. McGraw-Hill.
© Teglene Ryan 2012. All rights are reserved. No part of this article may be reproduced, copied, modified or adapted, without the prior written consent of Breastfeeding USA and the author.