Fiona brings up some good questions regarding the choice of the bio mom's milk, versus her partner's induced milk supply, in cases where one of a female couple is giving birth.  

One issue that I think should be addressed is whether the non-bio mother should opt for the intensive medical protocol for inducing lactation, when naturally produced breast milk is available.  In one way, this may appear to be a good choice for use of what has come to be know as "the protocol", since the likelihood of going through it and then ending up with no baby is so much less than with a mom who is going through a traditional adoption.  However, unless the bio mother is really unwilling to nurse and/or pump her milk, I think there are some real questions about the advisability of the non-bio mom subjecting her body to the side-effects of taking birth control pills and domperidone together, over a long period of time, which can be substantial, and to giving the baby chemically induced milk, when the option of the milk naturally produced by his bio mother is available.  Also, assuming that the adopting mother would be one of those who responds well enough to the protocol to be able to nurse with little or no supplementation, what happens to the bio mom's milk supply?  

What I have suggested, in the cases I have been consulted on, is that priority be given to getting the bio mom's milk supply well established, and that, if the non-bio mom nurses in the early weeks, it is for short periods, and primarily for comfort.  Then, after milk supply is well established, some feedings can be taken over by the non-bio moms, with EBM in the Lact-Aid.  How much of the nursing time is taken over by the non-bio mom often depends on whether or not the bio mom is returning to employment.  I have known several cases where the non-bio mom has been the stay at home mom, and has done a great deal of the nursing.  In this case, the non-bio mom will usually start to produce some amount of her own milk, just from the suckling stimulation, but still need to provide EBM at each feeding.  Of course, each situation is unique but, if the two moms ended up nursing about half the time each, but the bio mom continued to provide EBM for the other to use in the supplementer, it would tend to result in the baby getting somewhere around three fourths milk from the bio mom and one fourth induced milk, which I think would be a very acceptable situation.

In this case, as with others, an adoptive mother should always consider what is best for the baby, and be sure that she is driven primarily by that, and not her own needs to produce milk.  I don't know if that makes sense to those who haven't had much experience with adoptive moms inducing lactation, but there are times when a woman's personal need to see that her body is producing milk can become her first priority, even before the emotional and physiological needs of the baby.  This is especially true in situations where the adopting mom has been unable to give birth to a baby. There always needs to be a balance.

Aloha,
Darillyn

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