Hi Gillian,
If you haven't already read them I'll point you in the direction of the WHO
booklet on relactation
http://www.who.int/child-adolescent-health/New_Publications/NUTRITION/WHO_CHS_CAH_98_14.pdf
and the NEW ABA booklet on Relactation and Adoptive Breastfeeding (if you
have the old one throw it out!!!)
To answer your questions there's really a dearth of research in this area so
it's difficult to make any recommendations. My feeling is that hormonal
protocols can be useful in situations where women have not previously been
pregnant but that if they are helpful they are not as important as frequent
breast stimulation and milk removal and I don't think that there is likely
to be much if any advantage in cases of relactation (as with your client).
There are a number of hormonal protocols around. There is one that has been
used in PNG for many years that uses Depo Provera  and there is another that
is currently being used a lot that involves use of a contraceptive pill for
a minimum of a month (preferably many months). You can find instructions at
http://www.asklenore.info A caution with the latter method is that some
women have some pretty significant side effects from it (bleeding, weight
gain, increased BP, depression requiring medication etc) and I think that
close medical supervision is advisable. However, not all women have a
problem with it and while some don't think it has been useful others
absolutely swear by it. I also had a paper published in BF Review last year
about maximising milk supply in adoptive mothers that you might find helpful
(worldwide, the research in environments where fewer drugs are used shows
more milk being produced in environments where more drugs (incl hormonal
protocols) are used!). Regardless of any drugs that are used maximising
breastfeeding will maximise the milk supply and providing information to
assist the mother in how she can do this would be advantageous.

I'd be a little concerned with the situation.....private adoptions are
illegal in all of Australia as far as I am aware so I'm guessing that an
informal placement is planned. This could get very very messy.

Good luck!

Karleen Gribble
Australia

> > Good morning all,
> I was contacted yesterday by a mother who will be adopting her sisters =
> baby (due end Sept) and wishes to breastfeed it from birth.
  Would she need to mimic a pregnancy first,ie with =
> hormones, or would nipple stimulation +/- galactagogues be all that is =
> necessary to stimulate milk production? Would the use of hormones ensure =
> a full supply?  Which path do we take?
>  Due to a lot of social issues, she is determined to give this baby the =
> best start she can.  It was her partner that suggested she try and =
> breastfeed this baby (great support).  She also has a very supportive GP =
> who is quite curious to see this work (there's gunna be some great =
> learning curves happening here)!  She is aware of what is going to be =
> involved, and is sooo keen to start.=20

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