Saturday, October 2, 2010

I Always Knew I Wanted to Breastfeed: My Adoptive Breastfeeding Journey

I always knew I wanted to breastfeed my children. I couldn’t imagine doing it any differently. I was lucky enough to give birth to two beautiful boys and I enjoyed breastfeeding them both. Not that it was easy or without struggle, but it was what I wanted to do and loved doing it. In fact, I liked it so much, and felt so passionate about breastfeeding that I became a La Leche League Leader, so that I could help other breastfeeding moms. I really took to the idea of “Mothering through breastfeeding”. It wasn’t just a feeding method for me, but a relationship with my child.
My husband and I always talked about adopting a child who needed a family. We thought, if we can’t have kids of our own then we will adopt. Even if we can have kids of our own, maybe we will still adopt. After the birth of our second son it became clear that going through another pregnancy was not going to be good for me or our family. My doctor told me not to risk it, that my health was at stake. But we wanted another child. Well, here was our chance to adopt!

We chose to adopt a child out of foster care. We found an adoption agency that places foster children into adoptive homes. We went through all of the training, the homestudy, and all of the waiting. We were open to adopting one or two children (there are lots of sibling groups needing homes) between the ages of 0-5 years old. I knew that I really wanted to breastfeed another baby. I also knew that it was much more likely that we would get a toddler. There was also the issue of would it be okay to breastfeed a foster child? Would I just not tell anyone and do it anyway?

Either way I spent hours researching adoptive breastfeeding. I joined adoptive breastfeeding discussion boards like Ask Lenore and Four Friends. I read every book on the subject, including Breastfeeding an Adopted Baby and Relactation. I read the article Foster Breastfeeding over and over. I tracked down foster moms who had breastfed their foster babies in California (some successfully, and one who described a baby being taken from her home after the baby’s doctor “turned her in”).

On Monday July 6, 2009, we drove to South Lake Tahoe (about a 2 hour drive) to meet with a social worker. We were one of a few families they were considering placing a newborn girl with. We knew that the baby was a “safe surrender” baby, and that she was born premature. They had already asked if we would be able to go stay in Reno (where she was in the hospital) so that we could have daily visits with her in the NICU until she was ready to come home. It would be a few more weeks until she was ready.

We learned at that meeting that we had been chosen to bring her home if we wanted. Also, the hospital had just called and she was ready to go home! The social worker asked if we could go out to Reno, spend the night in the hospital with the baby, and take her home the next day. Of course we said yes (and I cried, a lot!).

At one point in the meeting the social worker looked at me and asked, “Are you going to breastfeed her?” For a moment I wondered if this was a trick question. My heart skipped a beat. But it wasn’t a trick. “We were so excited to see that you are a La Leche League Leader, and were hoping that you would plan to breastfeed her.” I knew this baby needed to be breastfed and I wasn’t going to have to do it “behind closed doors” as many fost/adopt moms told me they did.

I told them that I would if I was allowed. They couldn’t think of any reason why not, but decided that we would not talk about it any more, or put it in writing anywhere. You just never know how someone might react. People can be weird about breastfeeding.

In that meeting we also learned that this little baby was a bit of a miracle. All of the doctors and nurses at the hospital could not understand why she was alive and doing so well. She was born in a campground in the mountains above Lake Tahoe. Her birth mother did not know she was pregnant. In fact she did not know she was giving birth until she heard the baby cry. The birth mother was taken to a local hospital while the baby was flown to the NICU in Reno. To this day I don’t know if the birth mom ever saw the baby, or even knows if it is a boy or a girl. She gave very little information at the hospital when she surrendered the baby (I won’t get into the paperwork mess that her in one hospital and the baby in another at the time of surrender lead to). She said that she drank alcohol about every other week and smoked a half a pack of cigarettes a day. She told them she did no illegal drugs, however she tested positive for THC (as well as alcohol) at the hospital after the birth.

The baby weighed 3 lbs 2.8 ounces at birth. She was exposed and unreachable by rescuers for 30-45 minutes after the birth. (Even a full term newborn can quickly succumb to hypothermia right after birth, not to mention a 3 lb baby.) At first they expected she whould be in the NICU for about 2 months. She surprised everyone when she needed no help breathing and was quickly eating and gaining weight.
When we went to meet her at the hospital she was 17 days old. The NICU nurses were very nice. They had all “adopted” her temporarily. It was clear that she was a very special baby to all of them.

However, she was exclusively bottle-fed formula that whole time and I was wanting to breastfeed her. I was told by the NICU nurses to “just shove it in there” when I held the bottle nipple to her mouth, waiting for her to open like she would for the breast. I was shown the “right” way to hold her and give her the bottle, with her on my lap, away from my body. She was to be fed on a strict every 3 hours schedule. We were told to not hold her too much. “You can’t hold her so much like that when you get her home. You need to put her down so that she can sleep. She really needs to rest.” I smiled and nodded, knowing that we would be leaving in a matter of hours and that when we got home this baby would not get put down for the next several months.

The NICU doctor told us that we MUST keep her on the special 22 calories per ounce formula until she was 12 months old, no matter what her pediatrician said, no matter how well she was growing. Again I smiled and nodded, knowing full well I was going to do everything in my power to get her off of this formula. I had my own “special formula” in mind for her.

We gave her a name we had picked out for a baby girl years earlier. The next morning when we took her home she weighed 4 lbs. 0.8 ounces.

When we got home I called my LLL co-leader and she drove into town and up the mountain to my house to bring me a hospital grade, Medela Symphony breast pump and a Starter SNS. I needed to get started on bringing in a milk supply! I also went on-line and ordered a Lact-Aid, the at-breast supplementer of choice of adoptive moms. On-line I also ordered domperidone (a prescription that has the side effect of increasing prolactin levels, that is not available in the US) from a pharmacy in New Zealand.

I took my baby up to my room and lay back on the pillows on my bed. I took off my shirt and put her in only a diaper. I put her warm, tiny little body on my bare chest. She wasted no time. She threw herself down and latched onto my right breast. She started sucking and her body completely relaxed. She was home. She had found her mommy. Now, I just needed to make some milk!

The first few weeks I tried to put formula in the Starter SNS and then the Lact-Aid and feed her at the breast. She could latch on great, but her suck was weak and she could not get any of the formula through the tube. I went ahead and got a full sized SNS to try as, unlike the Lact-Aid, liquid would flow out just with gravity. I bottle fed, and then tried the SNS a couple of times a day. Eventually she could get an ounce from the SNS. Gradually I increased the number of feedings at the breast. Soon she could nurse with the Lact-Aid and get formula from that as well.

After about a month I did all of the daytime feedings with the Lact-Aid. I ordered more parts so that I only needed to wash and prepare the Lact-Aid supplies once a day. Soon I fed with the Lact-Aid around the clock and completely eliminated all bottles. I stopped pumping at this point, as she was nursing very frequently. I encouraged her to nurse for comfort, or for what little milk she could get between formula feedings.

She was such a good little nurser! She would nurse for a while on one breast, then let go and move to the other side. This is what breastfed babies will do naturally after finishing one breast, but I had to move the tube over to the other side so that she could keep eating. She would nurse and nurse for hours, even when she was getting very little milk. We would often take “nursing vacation” days when Papa took her big brothers out for the day. I carefully watched her weight gain to make sure I wasn’t being too stingy with the formula. I wanted to give her the smallest amount she needed so that she would nurse more and get more from me to help stimulate my supply.

Soon I was able to nurse her first thing in the morning and satisfy her. I would just keep nursing her until it became so frequent that it was clear she needed some formula.
I was so excited when I realized I could go from about 3am until 10 am without using formula. Then I could go until 11am, then 1pm, then 3pm! Before I knew it she would get formula at about 2 am and I didn’t need to give more until about 4 in the afternoon. I could go out of the house with her all morning and not need to bring bags of formula! I was exclusively breastfeeding for more than half the day! She soon gave up her pacifier that she came home from the hospital with. Once you have the real thing, no substitutes will do!

When it got to the point that she needed two, 2-4 ounce servings of formula in the evening I stopped using the Lact-Aid. If I had to fill one more bag or clean out the tubing one more time I was going to go crazy!! She was 5 months old when she was only breastfeeding with the exception of two bottles of formula in the evening, getting a total of 4-8 ounces per day. She would nurse both before and after the bottles of formula. I really wanted to breastfeed exclusively, but this was pretty darn good!

At 6 months old I started to offer her solid foods. She LOVED them! She was on WIC and they gave her an obscene amount of jars of fruits and vegetables and boxes of baby cereal. She gobbled it all up. Within a week we had dropped one serving of formula and the next week we dropped the last one. She was now EXCLUSIVELY BREASTFED! (Well, along with some solids, but close enough!) She never had a bottle again. In fact, the one time I left her at 9 months old for a few hours, she would have nothing to do with a bottle.

I thought that when she turned one year I would stop taking the domperidone. As I tried to wean off of it my supply really dropped. Baby got pretty frustrated. So, I did some more research and decided it was safe for me to continue to take the domperidone longer and ordered another 6 month supply. Making More Milk describes a study showing no adverse effects for people taking 120 mg/day for over 10 years, and although for a while I took as much as 160 mg/day, I am down to only 90 mg/day.
At 15 months old she is still going strong. I really enjoy nursing her to sleep at nap time and bedtime. I love cuddling in bed with her early in the morning and hearing her gulp down my milk. I can’t imagine stopping any time soon.

When I breastfed my boys my goal was to nurse them for at least two years, as this is the suggested minimum by the World Health Organization. I learned about so many benefits of breastfeeding well into toddlerhood, that I really wanted to do this. Sadly, I only nursed my boys 14 months each. We ended early for different reasons with each, but both times I was disappointed that I did not make my goal. I still feel like I let them down, even though I know that I did the best I could at the time with the given circumstances. I am hopeful that I can nurse my daughter at least 2 years, and as long as she wants. I got another chance.

For more information on breastfeeding your adopted baby go to: Breastfeed Your Adopted Baby

In February 2012 Cafemom sent out a crew to interview me about breastfeeding my adopted baby. The kids and I actually had lots of fun. The film crew was great and they really fought to get here. They needed to get new tires on their van to make it to our house due to the snow storm.