I don't have anything definitive, but do have a few thoughts.  First of all, 
I am amazed that this mom would have been put on such a whopping dose!  I 
take the drug, for severe fibromyalgia, and have for about 8 years.  
However, I take much less, 35 mgs, total, per day.  Even at that dose, every 
time I have not gotten my prescription for some reason and have had to go 
even one day without it, I have started going through withdrawal.  I would 
think that this mom's poor baby would have had a pretty miserable time for a 
while.  IMO, a lower dose and some other treatment for pain, like massage, 
chiropractic, lidocaine injections or patches, acupuncture, etc., would have 
made alot more sense for this mom.  Hopefully, the pain clinic she is going 
to now will offer her something besides massive doses of narcotics.  Perhaps 
something like that could be considered while she is still waiting for the 
surgery.  If she could be weaned off of the huge dose of oxycodone 
beforehand, perhaps it, or a different narcotic pain med, would work better 
for her after the surgery.  Also, I would think that it would take some time 
to wean her off of such a huge dose, and have her still be able to function 
at all.

As for breastfeeding, I would suggest that she plan to relactate whenever 
she is able to get off the drug or at least greatly reduce the dose, rather 
than trying to keep a supply by pumping and dumping all that time.  Or, she 
could keep doing a little pumping, just to keep something going, and then 
plan to start trying to dramatically increase her supply, for the baby, when 
it is safe to do so.  When it is safe for the baby to start breastfeeding, I 
would suggest that she get the Lact-Aid and start feeding at the breast 
full-time.  That would be certain to give her a milk supply, if she does 
nothing else but that, and also provide the nurturing benefits to both baby 
and mother.  She may need to keep supplementing to some extent, over the 
long-term,  or may be able to wean off of supplementation quickly.  She can 
add domperidone, herbs, etc., to help increase her supply faster, but 
nursing with the Lact-Aid is, IMO, the single most beneficial use of her 
time.  With two older children, a new baby, and having had back surgery, I 
am sure that she will need to manage the time she spends as well as 
possible.  Trying to get a milk supply by pumping, while bottle feeding the 
baby, is no where near as time-efficient as getting better breast 
stimulation and feeding and nurturing the baby, all at the same time.

Another issue is trying to help make it as easy as possible for the baby to 
make the transition from bottle to breast.  At the age he will be, he may 
take to the breast immediately, need a little help, or need alot of help.  
There are several things that can be done to maintain breastfeeding 
behaviors, and minimize the possible hurdles that need to be gone through.  
One of the most difficult things for older adopted babies, is being 
comfortable being held facing into the breast.  If the baby will not accept 
being put in that position, latching onto the breast isn't possible.  Bottle 
feeding in as close to breastfeeding position can be helpful, but isn't 
always enough.  The only way to hold a baby facing into the breast, as for 
breastfeeding, is to eliminate the bottle.  The way I figured out to do this 
was to thread the feeding tube from a Lact-Aid or SNS through the hole of a 
bottle nipple.  This has to be done with a nipple that has only one hole, 
and where the hole is small enough to hold the very end of the tube in 
place, so that no air will be sucked in around it.  The baby can feed from 
the bottle nipple this way, while in the exact position for breastfeeding.  
Mom can expose her breast and arrange her clothing around the baby's face, 
just as if the baby was feeding directly from the breast.  It is also 
important to switch sides during feedings.  In this particular case, I would 
also suggest that Dad, or whoever else will be carring for the baby, while 
Mom is gone, could also feed the baby with the nipple up against his chest, 
too.  This may sound complicated, but it really isn't that bad.  Actually, 
having the baby feeding from the bottle nipple positioned on Mom's chest 
eliminates the need to hold a bottle, and makes it easier for her to rest, 
which would be especially important for this mom.  It is important, however, 
to have a supplementer ready, filled with formula, with a nipple attached, 
before the baby needs it.  I found it worked well to leave the tube attached 
to the bottle nipple and clean it together, rather than trying to rethread 
the tube through each time.

I also wonder if the baby might be able to be given a small amount of the 
milk, say four to six ounces a day, in order to provide antibodies and give 
the mom some satisfaction, that way.  It might be worth  checking into.

Anyway, I don't know if any of that is helpful, but a few ideas for an 
atypical case!  I wish this mom and her baby the best in getting through 
this challenge!

Darillyn

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