I Am Planning To Adopt A Baby. Can I Breastfeed?
Adoptive mothers can breastfeed their adopted babies. Adoptive breastfeeding is advantageous for both mothers and babies, although adoptive breastfeeding is not common in Western culture, many mothers have happily and successfully breastfed adopted children. Adoptive breastfeeding is an excellent way to connect physically and emotionally with an adopted child.
Usually, the younger the adopted baby is, the easier it will be for the adoptive mother to breastfeed the baby successfully. However, “older babies have been known to take willingly to breastfeeding.”
Induced lactation is “the process of stimulating the adoptive mother’s body to produce milk even though she has not experienced a recent birth or pregnancy.” Most mothers who choose to breastfeed adopted infants do produce some breast milk, though the majority may not establish a full milk supply, and need to supplement throughout the course of adoptive breastfeeding.
Lack Of Hormonal Changes
“Unlike a birth mother, an adoptive mother does not have the benefit of nine months of hormonal changes to cause her breast tissue to grow and physically prepare her body for breastfeeding. More sucking is needed to induce lactation than it takes to establish and maintain lactation after birth. An adoptive mother may or may not eventually produce enough milk to breastfeed her baby completely without supplementing, depending upon how effectively and frequently the baby nurses and her individual body chemistry. …In one survey of 65 adoptive mothers from Western countries, the mothers were asked to calculate what percentage of their babies’ intake they were able to supply by subtracting the amount of formula the baby took from the amount of formula the baby would need if he were completely formula-fed, based on the assumption that a baby needs about two and a half ounces (74 ml) of formula per pound (.373 kg) of body weight. According to these calculations, most mothers reported that they provided between 25-75% of their babies’ intake.”
Full Milk Supply
There are cases where full milk supplies have been established in mothers who are breastfeeding adopted infants, although this is not the usual case.
If baby’s arrival is imminent, some mothers choose to prepare themselves for the arrival of their soon-to-be breastfeeding infant by double pumping (both breasts at the same time) a few times a day at first, with a hospital-grade double pump, such as the Medela Symphony Breast Pump, or Ameda Elite Electric Breast Pump. Each pumping session takes approximately 10-15 minutes when both breasts are pumped simultaneously. There is evidence that double pumping can increase hormonal levels more efficiently than single pumping, and frequent short pumping is more effective than lengthier, less frequent pumping sessions.
Pumping can start a few weeks before the arrival of the baby. The frequency of daily pumping sessions can be increased daily until a mother is double-pumping 8-10 times a day (or every 2.5 hours) at the time of baby’s arrival when the baby is ready to latch-on to the breast. Pumping can be discontinued once the baby arrives and can latch and feed at the adoptive mother’s breasts. As adoptive breastfeeding begins, the mother can then use the SNS to supplement baby with either banked human milk or artificial baby milk at the breast, according to personal preference and physician recommendation. In this way, the adoptive mother can simultaneously feed her baby at the breast while stimulating her milk supply.
Some mothers choose to begin breastfeeding when baby arrives without having expressed milk or prepared for breastfeeding in any way beforehand. Adoptive mothers can put the baby to breast, using good latch techniques, and supplement at the breast. Medela’s SNS allows the mother to supplement the baby at the breast during breastfeeding, using either banked human milk or artificial baby milk, according to her preference and that of her physician. Use of the SNS (supplemental nursing systems) effectively stimulates mother’s supply, while teaching baby the important lesson that breast is a source of comfort and nourishment.
Human milk production is dependent on many factors, and milk can appear anywhere from a few days to a few weeks after stimulation begins. Physicians, IBCLC lactation consultants can help with basic breastfeeding techniques such as latch-on, and with information about normal infant feeding and growth patterns. Mothers may keep in close touch with a physician as breastfeeding continues. Accurate breastfeeding information can be found at La Leche League Meetings, and at La Leche League International’s Web site. As adoptive mothers continue to breastfeed and supplement at the breast, most notice the appearance of milk and a slow increase in milk supply as baby grows. Mothers who are able to focus on the physical and emotional benefits of breastfeeding typically experience feelings of satisfaction and success, while a focus on amounts of milk produced can be disappointing and frustrating.
While most adoptive babies need supplementation, there are several ways to accomplish this. The SNS is the first choice. However, if a family wishes to use methods other than an SNS, cups or baby spoons may be used. Your IBCLC (International Board Certified Lactation Consultant) can help you learn how to cup feed an infant. A typical baby takes approximately 2-1/2 ounces of milk per pound of body weight, per 24-hour period. As an adoptive mother’s supply increases, the amount of supplement needed may decrease as her baby begins to receive more and more breast milk at the breast. Babies of fewer than six weeks should have at least six wet diapers per 24 hour day, and at least two bowel movements per day, with a weight gain of at least 4-8 ounces per week.8 It is important to keep track of baby’s intake and output (number of wet and dirty diapers), and weight gain, to make sure that an adopted breastfeeding baby is getting enough milk and is gaining and growing well. Frequent weight checks (weekly) with a pediatrician are recommended until breastfeeding is well established. Amounts of a supplement will need periodically readjustment as baby grows.
Physical And Emotional
Preparation by pumping before baby’s arrival can cause physical and emotional changes in the adoptive breastfeeding mother, including irregular menstrual cycles, breast or nipple changes, including darkening of the areola, breast tenderness/fullness, and mood swings. Some mothers choose herbal milk stimulants (galactagogues) such as Fenugreek. Fenugreek can be taken by non-pregnant mothers, 2-3 capsules three times a day. Capsules typically contain either 580-610 mg each. Fenugreek should not be used in mothers with a history of asthma. Fenugreek should be used with caution in diabetic mothers, as its use can affect insulin metabolism.
Medela’s breastfeeding products may be useful for the mother who is planning to breastfeed her adopted child, such as:
- Lactina Select or Classic Breast pumps – These hospital-grade pumps are used by mothers who wish to stimulate milk supply before the arrival of their adopted infants. Best results occur when used with Lactina Double Pumping System.
- An SNS is used to provide a supplement to the baby at the breast. When baby nurses at the breast, fluid is delivered at breast via the thin flexible tubing. When using an SNS, it is best to be under the close supervision of a pediatrician, as well as an IBCLC (Lactation Consultant) as breastfeeding begins. This is important to ensure proper supplementation and weight gain for your baby.
- The Baby Weigh Scale or The BabyChecker Scale may be useful for families who wish to pay particular attention to baby’s weight in the home. The BabyChecker scale can be purchased from a local Medela rental/retail station and is accurate to 1.5 ounces for infants under 20 lb./10 Kg. The BabyWeigh scale may be rented from your local rental station on a daily basis, and accurate to 2 grams for infants under 6,000 grams, or 12 lbs. Amounts of milk consumed at the breast may be accurately checked using this scale.