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Inducing Lactation: Breastfeeding Your Baby You Did Not Give Birth To


Yes, you can breastfeed a baby you did not give birth to. 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. Although it is different than breastfeeding a baby you were pregnant with, through the process of induced lactation you can breastfeed your  baby. There are many benefits to nursing your adopted child.

There are several different methods used to induce lactation when you have not been pregnant. It is possible to breastfeed your  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, the female partners of birth mothers and even transgender women.

Before learning about the process involved in breastfeeding a baby you did not give birth to, consider why you want to do it in the first place. You may wonder if it is necessary to induce lactation if you have the option of using donor breastmilk. It is important to know that there are differences to bottle feeding breastmilk and breastfeeding directly.

Breastfeeding a baby you did not carry in your womb takes a lot of time and effort but can be very rewarding. If your wish is to produce enough milk to exclusively breastfeed your infant, then you may need to adjust your expectations. Mothers who induce lactation can make enough milk for their babies, but when they produce this amount is different for every mother. For some it may be in early infancy, and for others it can be after their babies are well on solids, or even after a year. It may not happen right away, but eventually you can expect to get there. While providing breastmilk may be the primary goal for many mothers, the reasons to consider breastfeeding an adopted baby go far beyond the milk itself.

How much milk a mother can produce through induced lactation varies a lot from woman to woman and even baby to baby. There is no way to know ahead of time how much milk you will be able to provide for your baby, especially in the beginning. It is important to keep in mind that even small amounts of your milk, tailor-made for your baby, will be of benefit. Try to keep your focus on the breastfeeding relationship and not just the milk.

The physical connection of breastfeeding benefits both mother and child. The reality is that 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. Even your baby born to a surrogate knows only her body:
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).

Breastfeeding naturally puts you in skin-to-skin contact, which is important to your baby’s development and in forming attachments between you and your baby. Some benefits of skin-to-skin contact for your baby are better organization of reflexes, stable temperature, and regulated heart rate. Some benefits for you include increased milk production, easier breastfeeding, and better oxytocin release (Moore, Anderson & Bergman 2009).

Research has shown breastfeeding to have positive psychological effects for mothers as well. One study compared mothers when they both breastfed and bottle-fed breastmilk to their babies. The researchers found a correlation between breastfeeding and a positive mood immediately after breastfeeding, but the same effect was not apparent for bottle-feeding. The researchers suggested that the higher levels of the hormone oxytocin released by breastfeeding contributed to the positive mood (Mezzacappa and Katkin 2002). Bonding is a crucial aspect of adoption, and the hormones released during breastfeeding can facilitate that process.

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 lactation and 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.

You may also use a breast pump to stimulate your breasts. 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 available for rent through hospitals, medical supply stores, private-practice lactation consultants, online vendors, and even some popular baby stores.

Whether you are using a commercial pump, hand expression, or both, this method is most effective when done as many times a day as a baby would be breastfeeding, 8 to 10 times a day. Combining hand expression and breast massage with pumping has been shown to increase milk production faster(Morton, Hall & Wong, 2009). Many women begin to notice breast changes in the first 6 weeks of expression including 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. 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 patient. 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 donor milk or formula 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). While both products work by allowing your baby to get supplemental milk while breastfeeding, most adoptive moms report that they prefer the Lact-Aid system because the Lact-Aid does not allow any milk to flow without baby properly latched and sucking at the breast, so it tends to be better for stimulating mother’s breasts. The SNS allows milk to flow by gravity, and there can be a tendency for baby to not latch and suck properly when using it. Many moms also find the Lact-Aid to be more discrete and easier to use away from home. It is worthwhile to do some research on the pros and cons of these products before investing in one.

    A supplementer has dual benefits: the baby gets nourishment, while mom’s breasts get the stimulation needed to begin producing milk. In fact, some mothers do not use a bottle at all. They find that, if they can get the baby to the breast frequently using an at-breast supplementer and encourage comfort nursing between supplements, they do not need to spend time expressing milk between feedings. Don’t worry about offering your baby a breast with no milk. Keep in mind that babies enjoy comfort suckling and are often offered pacifiers. There is no milk in them, either!

    Bringing your baby to the breast

    You may be surprised to learn that you can breastfeed a baby of any age, even a toddler. When considering how to get your baby to take the breast and learn to breastfeed, first you need to consider the age and experience of your baby.

    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 hard-wired 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 on teaching 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 and decreasing supplemental milk

    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 developing countries 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.
    As you are able to produce more milk, you can decrease the amount of supplemental milk your child is receiving. Counting wet diapers and watching baby’s weight-gain will reassure you that your baby is getting enough. One technique for decreasing supplements that can work well is to start by eliminating supplements in the morning, when milk flow is usually highest. Try not supplementing after the first morning feeding. Each time your baby finishes nursing on one side, offer the other side. Keep offering the other breast until baby seems satisfied or falls asleep. Gradually delay the first supplement later and later. When your baby begins to eat solid foods, let the solids begin to replace supplemental milk, not time at the breast.

    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.


    Adoptive Breastfeeding Stories

     A Story of Adoption and Supplemental Nursing

     My Adoptive Breastfeeding Story

     Breastfeeding My Adopted Child

     We Are Breastfeeding

     My Adoptive Breastfeeding Journey

     Becoming Nana


    Co-Nursing

    How It's Possible for 2 Lesbian Mommies to Share Breastfeeding Duties

     How Two Lesbian Mamas Share Breastfeeding Duties
    How these two lesbian mothers BOTH breastfeed their newborn daughter

     Additional Resources

     Trans Women and Breastfeeding: A personal interview


     At Breast Supplementing

     Books
    Breastfeeding an Adopted Baby and Relactation, by Elizabeth Hormann.
    The Breastfeeding Mother’s Guide to Making More Milk, by Diana West and Lisa Marasco.
    Breastfeeding Without Birthing, by Alyssa Schnell

     Articles

     Induced Lactation

     Dr. Jack Newman: Breastfeeding your Adopted Baby or Baby Born by Surrogate

     Websites 

     Asklenore.com

     Four Friends Adoptive Breastfeeding Resource Website

     Lowmilksupply.org

    Video
    Adoptive Breastfeeding and using the Lact-Aid
    References


    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.


    Induced Lactation and the Newman-Goldfarb Protocols for Induced Lactation


    International Breastfeeding Centre. Breastfeeding Your Adopted Baby or Baby Born by Surrogate/Gestational Carrier


    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.