Jessica, I would be happy to work with that mother! I have breastfed six adopted babies and been trying to assist other adoptive mothers for more than twenty years.   

The first thing I would tell this mom is to order a deluxe Lact-Aid kit. Many moms, including me, have just started nurturing and feeding at the breast, with the Lact-Aid, with little or no preparation and without taking any kind of medication.  The first drops of milk usually appear in under two weeks and often just a few days. Most moms produce a significant amount of the milk their babies need (before starting other foods) if they just keep doing that.  Many are able to dispense with supplementation, once their babies are taking other foods and liquids by cup. 

I call that the "basic" method and I believe it is one of the most important things to know about.  It is equally important to know about breastfeeding, in general.  We tend to focus on stimulating milk production and then quite often don't get very far with it all, because of not knowing how to position and latch the baby properly, nurse discretely in front of people, etc..  In the weeks this mom has to prepare, I would suggest that she get some good books on breastfeeding, watch breastfeeding videos on the internet, etc.. Finding a La Leche League group to join is a great idea, too.  Most moms she would meet there would not know much about breastfeeding adopted babies, specifically, but will know about general breastfeeding and mothering, and will think it is wonderful that she is breastfeeding an adopted baby, which can make the difference between a short attempt and the establishment of a long term breastfeeding experience that is gratifying for both mom and baby.

I would tell this mom about domperidone and that it is usually helpful, but optional, and suggest that she research it on the internet for further information and sources. I would also tell her that the practice of taking birth control pills with domperidone is only helpful for those who have several months to prepare before their babies' arrival.  That is important because many people have the idea that they must spend time on that combination or they will not produce milk, which is not true, at all.  Getting her baby feeding on demand at the breast, with the Lact-Aid, as soon as he/she is in her arms, will result in the greatest benefits.  

Of course, in addition to feeding and nurturing at the breast, she can use herbal supplements, oatmeal, domperidone, etc.. to help increase milk production.  In my experience, it is best to add a few of those things to one's daily routine and try not to think too much about it, most of the time.  Excessive concern about milk production can turn what should be a wonderful experience into a stressful one, and the stress can also limit milk production.  Periodically assessing milk supply is fine, but I suggest establishing a time for this, like once a week.  Of course, she needs to watch her baby's weight, diapers, etc., to make sure he is getting enough to eat.  Babies will naturally take less from the Lact-Aid as the mother milk supply increases.  If baby starts consistently leaving more supplement in the bag, the amount put into the bag can be reduced, gradually, but it is better to offer too much than too little. Moms also need to be cautioned against adding water to the formula, or using only water in the Lact-Aid.  I also think it is very good to avoid thinking about milk production when the baby first arrives.  Focusing on getting breastfeeding on demand established is the most important thing.  With that going well, both mom and baby benefit emotionally and milk will naturally follow.  

Prospective adoptive moms usually want to pump their breasts while they are waiting for a baby to arrive. Those who take domperidone can usually get a little bit of milk going in just a few weeks.  Without domperidone, most do not see more than drops.  For someone who hasn't ever given birth to a baby, a breast pump usually does not do as well at increasing prolactin levels as a baby suckling. It is very important for moms to know that what they can pump in advance is generally not an indication of what they will produce with a baby suckling on demand.  Some adoptive moms have gotten so discouraged from looking at an empty pump container, day after day, that they have given up on the whole idea before they even got their babies home.

Another option for prospective adoptive moms who have a short time to prepare is to use a pump for a few minutes, several times a day, to help decrease extreme sensitivity (not "toughen" them) and increase elasticity of the nipple/areola area.  A decent hand-operated pump, is sufficient for that purpose.  It is best to start out slowly and increase the time and suction, gradually, over time. Another thing I think is helpful for adoptive moms is to go braless or wear a nursing bra with the flaps down. In the past, they used to say to wear something abrasive, like a coarse sweater, with bra flaps down, but I think something non-irritating, like a lightweight cotton blouse, is better.  Of course, bio moms don't need to do such things, but since adoptive moms haven't experienced the same changes in the breasts, I believe it is beneficial for them.  

Anyway, I can talk all day about this topic, but I will stop.  Feel free to give the mom my email address; [log in to unmask]

Darillyn










 		 	   		  
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