You are about to adopt a baby and you want to breastfeed
him? Wonderful! It is not only possible, it is fairly easy and the
chances are you will produce a significant amount of milk. It is not
complicated, but it is different than breastfeeding a baby with whom
you have been pregnant for 9 months.
Breastfeeding and Breastmilk
There are really two objectives involved 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, 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 get 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 your 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 adopting 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 amongst 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.
- 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 (see Using a Lactation Aid). Babies learn to
breastfeed by breastfeeding, not cup feeding or 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.
- 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 specialized lactation clinic
and start getting your milk supply ready. Please understand, you may
never produce a full supply for your baby, though it 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. The main purpose of pumping
before the baby is born is to start the changes in your breast so that
you will produce 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 6 or 7 months, treatment with a
combination of oestrogen and progesterone (as in the birth control
pill, but without a break) plus domperidone will simulate 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, but 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 #19 Domperidone). This drug can help you
produce more milk. It is not necessary for you to use 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 dose is 20 mg four 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.
This article may
be copied and distributed without further permission
 About the
Author
JACK NEWMAN
graduated from the University of Toronto medical school as a pediatrician in 1970. He
started the first hospital-based breastfeeding clinic in Canada in 1984 at Toronto's
Hospital for Sick Children. He has been a consultant with UNICEF for the Baby Friendly
Hospital Initiative in Africa, and has published articles on the subject of breastfeeding
in Scientific American and several medical journals. Dr. Newman has practiced as a
physician in Canada, New Zealand, and South Africa.
If you would like to contact Dr. Newman, you can mail him at: newman@globalserve.net
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