I have not recommended pumping to adoptive moms for many years. One mom I
worked with last year chose to pump...pumped every 2-3 hours..in the
Lactation room at work...got small amounts of milk and quit the second day...
 I do suggest that they hand express 2-3 times per day  (more as the the
delivery date gets closer) and possibly pump toward the end )and do nipple
rolls and visualization... and take prenatal vitamins, eat right, and drink
lots of water. I suggest herbs and discuss the pros and cons of reglan. I
personally think pumps are great for emptying a breast but not as effective
with induced lactation. Baby nursing is far superior.  Oddly enough the
adoptive moms do better with hand expression than the lactating moms. I
think it is because they are not under so much pressure to get milk out.
 I am sure others will say pumping worked... we all have to feel out what
"emotional investment" a mom can take. I talked to a mom Tuesday who was so
relieved at the idea of NOT pumping and investing all that money AND time
into it. This has worked well for me.   They seem to be blessed with a low
rate of nipple confusion. Then when the baby comes... I encourage them to
come for a consult after a day or two at home. I find if they have a car
trip home they quit trying to nurse before they even get home.


Patti Carroll, RN, IBCLC
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