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Date: | Wed, 28 Jan 1998 13:32:47 -0500 |
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Dear Jack,
I have worked with two different lesbian couples where the second,
non-birthing mother was interested in the possibility of feeding the
baby at the breast. In both cases, the couple viewed this as an
alternative feeding method that would eliminate the baby's having
bottles and as a way of enhancing the baby's bond to the second
mother.Both couples were very concerned about equalizing the child's
bond to the non-bio mother.
In one case, the nursing was just going to be very occassional and so it
seemed extremely unlikely that the second mother would actually lactate
unless she pumped in place of most other feeds. The couple decided that
she would nurse with the bio mother's milk in an SNS. THey seemed very
happy with this arrangement.
In the second couple, the baby was going to stay in the care of the
second mother during the day. THey originally wanted her to develop a
full supply and share the nursing. I talked to them about the likely
need for the biomother to express to maintain her supply and about the
low likelihood that the second mother could get enough milk to fully
satisfy the baby's needs during the day without supplemental EBM or ABM.
As it turned out, the second mother was on HRT. After looking in to the
effects of HRT on developing milk, they abandoned the entire thing and
the second mother fed bottles of EBM.
I think every couple deserves very individual attention and education.
There is a lot of misinformation about induced lactation and sometimes
(as with my second couple) the couple's plan is based unrealistic
expectations. If a couple understands induced lactation and its
limitations when the inducing mother is not fully feeding and that this
may impact the other mother's supply, then they can make an informed
choice about the family's breastfeeding practice. I view my role as
1) supporting the family, 2) educating them about the implications of
their choices and 3) advocating for the baby.
I don't think there is one right answer as to whether the second mother
should take medication to support development of a supply while inducing
lactation.
Warmly,
Judy Gelman, IBCLC
Washington,DC
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