I am posting for a colleague (IBCLC) who is working with a mom who will be
receiving triplets from her surrogate sister.  She is planning to breastfeed
these triplets with appropriate supplementation.  The triplets are due in March,
but of course, the timing of their birth may be very variable.  My colleague is
working with this mom now and is at the stage of discussing the process and
options to induce lactation.  We are also fortunate to have a very supportive OB
who will provide any pharmacologic intervention that is suggested and is working
closely with us to assure this mom's success.

I have a number of resources to support the varied interventions of induced
lactation.  My main question is when to begin pumping and breast stimulation.
In reviewing the handout by Dr. Newman, he refers to a time when the "baby is in
sight".  Does this mean when the baby is born?  I am assuming that his comment,
"even if it means 4 months" implies that this should be undertaken prior to
birth...but you what they say about "assuming".

I am also wondering if anyone used hormones prior to induction of lactation and
if there is a role for them.  My preference at this point, is to recommend
pumping and herbals, fenugreek and blessed thistle, for this mom.  She realizes
the unlikelihood that she can produce milk for exclusive breastfeeding for all
three, but is very interested in the breastfeeding experience itself.

This is a very exciting proposition for us and it seems that all the pieces are
in place for a successful experience.  Your wisdom, experience and advice will
be much appreciated.

Thanks in advance,
Cindy
Cindy Anderson, MS, CNS, IBCLC
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