On 4/16/2014 1:20 PM, Jeanette Panchula wrote:
> Mom is pregnant and due in the Summer - however, she had already started adoption process and learned she and her husband were picked by a birth mother.  They decided to go on with the adoption but...adopted baby is due about 6 weeks before she delivers her baby!

That is actually a pretty common situation.
Usually when women do decide to adopt, the pressure to become pregnant
is gone and thus - the probability of pregnancy is increasing.
What makes the situation special is not even the time between adoption
and birth (had a family adopting from China 5 weeks before the due
date), but the age difference between the babies.
But that makes the possibility of successful adoptive breastfeeding
extremely high.

> Her concerns were what and how to feed in-between adoption and birth, as she hopes to breastfeed both once she has delivered.
> ...What would you have recommended?

All those are very good points.
1. I'd bet both local (to the adoptive baby and mother's home) LLL
groups will be able to pitch in.
2. Hand expression of colostrum can be beneficial, BUT - that would not
be enough for a 3-6 weeks old baby.
3. I would not be extremely concerned re: bottle feeding (just make sure
to use a good pacing technique) and/or artificial milks (as much as it
is possible - no power, please), as baby #1 will be still young enough
to get to the breast more or less easily when the baby #2 will be born.
4. While I do not see the need for SNS before some time after baby#2
will be born, as soon as the family will settle at home with both
babies, SNS (one breast without SNS for baby #1 and another, with SNS -
for baby #2) can become come extremely handy both for the purpose of
supplementation of baby #1 and as a mean of additional stimulation for
augmenting the milk supply.
5. One more possibility - check if the birth mother will be interested
in supplying the expressed colostrum and/or milk. Quite a few do.

Hope that helps,
Alla  (happy that finally I can talk about something that brought me
into breastfeeding medicine and onto this list in the first place ;D)

--
Alla Gordina, MD, IBCLC, FAAP
General Pediatrics
Breastfeeding Medicine
Adoption and Foster Care Medicine

Global Pediatrics and Family Medicine
NJ Breastfeeding Medicine Educational Initiative

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