For the mom who expects to be recieving a baby for adoption in a week, I
would recommend that she get a good hand pump (preferably one that can be
operated with one hand, leaving her the option of pumping the opposite
breast while nursing the baby), use that a few times a day to condition her
nipples and not bother with a large double pump.  She does not have time for
pumping with a large pump to make much difference in milk supply, before she
gets her baby, and her time (and money) would be much better spent getting
prepared to nurse the baby as much as possible, as soon as it arrives
(besides nipple prep, education on how to breastfeed, purchasing enough
supplementers to limit washing and preparing to one or two times a day,
etc.).

We currently see some adoptive moms get obsessed with pumping, sacrificing
time with the baby at the breast for time with a pump, or just completely
overwhelming themselves, trying to do it all.  There are some situations
where buying a top-rate pump is likely to be helpful (generally where there
is a significant amount of time to prepare in advance), but also many where
it is more likely to interfere than help.  Mothers need to be assured that a
baby latched well will do a better job of stimulating milk production than a
pump, and especially that the benefits of nurturing at the breast, for both
mother and baby, are irreplacable, where trying to spend a significant
amount of time with a pump can actually interfere with bonding and the
establishment of a long term nursing relationship.

I would also recommend ditching the Reglan.  We just see too many problems
with depression, even from taking it for a very short time.  There are
several things that can make the side-effects from it more of a concern for
adoptive moms, including the very real threat that the prospective birth
mother will decide to parent her baby, which is often experienced by the
prospective adoptive mom like a miscarriage, stillbirth, or even early
infant death (where a baby is placed for a short time and then taken back).
Domperidone would be much better, if she wants to use a medication, but I
would make sure she understands that taking medications is not necessary and
that many moms have provided many benefits (including a significant milk
supply) for their babies, without taking a single dose of medication.

I would also recommend that this mom start slowly with whatever pump she
gets, use Lansinoh or another moisturizer before pumping, and gradually
increase the time and suction, as she can, without making j0annastarrherself
sore.  I have seen ladies beat up their breasts (and tried it myself),
thinking this will help, and have sore nipples when they try to get their
babies to the breast for the first time.

In order to help keep the whole issue of the necessity of pumps for adoptive
moms in perspective, I like to tell of the adoptive nursing moms from Kenya
who completed surveys for me a few years back.  To my questions about
pumping, every one of the Kenya moms had the same answer: "I have never even
SEEN a breast pump!".

Also, please refer this mom to www.fourfriends.com/abrw .  She will find
other mothers there who have successfully nursed adopted babies, with very
little advance preparation, and probably some who are just starting out,
like she is, too.

Darillyn Starr
Adoptive nursing mom to six children
Counseling since 1989

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