Having spent a total of ten years breastfeeding my own six adopted children,
I have lots of thoughts!

The recent interest in medically induced lactation has resulted confusion
about the prospects of producing milk without taking birth control pills and
domperidone.  Women have been nursing babies they did not give birth to for
millenia, using the babies' suckling to stimulate it.  In traditional,
breastfeeding, cultures, women who get a baby suckling the breast generally
produce a good supply of milk.

In modern, bottlefeeding cultures, most adoptive mothers who do nothing else
to stimulate milk production but start their babies spending a great deal of
time at the breast, with a supplementer (preferably Lact-Aid), will be
producing some milk within two weeks, and go on to produce a significant
amount.  This varies greatly, of course.  Some moms produce 25%, some 75%.
There are many factors that influence this, and no good way to predict who
will have what response.  No matter what an adoptive mother chooses to use,
I feel it is essential that she appreciates the fact that, by getting her
baby suckling the breast on a regular basis, she is both providing the
nurturing benefits of breastfeeding AND stimulating a milk supply.
Medications can augment that, but should not take the place of it.
Unfortunately, these days, many women are coming to see it as an "either or"
situation.  The more medicalized the approach used is, the more likely it is
that the breastfeeding relationship will not be established.  We see alot of
ladies who spend months on the medical protocol, and do produce milk, but
develop more of a relationship with their breast pumps than they do with
their babies.  There are also a fair number who go through the whole
protocol, and are never able to pump much milk.  Typically, their babies
will get a little ebm for a while, and maybe a little breast time, generally
without a supplementer, and then that is the end of it.  This is sad,
considering that, had suckling with a supplementer been used as the primary
method of stimulation milk production, they most likely would have learned
to appreciate the nurturing benefits, kept it up for a significant period of
time, and produced more breastmilk, too.  One specific issue in this, I
believe, is that mothers are coming to see the use of nursing supplementers
as a sign of inadequacy, rather than the important tool, for both nurturing
AND milk production, that it is!

In the case of this particular mom, I would suggest that she just get
prepared to start nursing the baby as soon as it is born.  I suggest that
she get a double Lact-Aid kit and take some time getting the feel of filling
and cleaning them.  Also, she can practice using it at the breast, with a
breast pump.  It is not exactly the same as getting a baby latched, of
course, but is similar enough to be beneficial.  Expectations are real
important, with the Lact-Aid.  Mothers who approach it expecting the
Lact-Aid to be difficult to manage often find it to be that way, where those
who expect to be able to learn to use it will usually get the hang of it
quickly.  This mother can also do a small amount of pumping for nipple
preparation, not enough to confuse her body, which is trying to get
pregnant, but just enough to help increase elasticity of the nipple and
areola.

As far as the question of doing the Newman protocol, aside from the fact
that this mom is trying to get pregnant, since the baby is due the end of
this month, she does not have anywhere near enough time to benefit from it
anyway.  Many mothers are doing it for one month, but the results, in milk
supply, are generally no better than with mothers who do not do any
preparation, and often not as good as someone who spends that amount of time
taking domperidone and pumping.

This particular mom also has the benefit of being able to get this baby
before it gets a chance to develop suckling habits that would tend to
interfere with an effective suck.  Although some children will maintain a
good suck after months on bottles, we see a definite relationship between
the milk supplies of moms whose babies come to them immediately after birth.
I have seen a very definite difference between situations with my own kids.
  Of course, once this mom finds out whether or not her conception attempt
was successful, she can consider using domperidone, herbs, etc. to help
maximize milk production.

If it turns out this mom does get pregnant, I would think it would be OK to
try to do some amount of breastfeeding with a supplementer, but I am far
from expert on that.  I do know a few moms who nursed an adopted baby all
the way through a pregnancy, without problems.  If she chooses not to nurse
during the pregnancy, she could try to preserve some breastfeeding behaviors
with the bottlefeeds, and then try to get the baby to the breast after she
gives birth, and tandem nurse.  This is an interesting situation!  Actually,
I was doing infertility treatment when Thomas arrived, on very short notice,
but I did not get pregnant.  I also tried for a while when he was older, and
hoped to be able to tandem nurse.  I ended up tandem nursing him with his
sister, Julia, also adopted.

Best Wishes,
Darillyn

Subject: interesting adoptive nursing question

Talked to a mom tonight who is going to go witness the birth of her
soon-to-be adopted baby in late March.   I spoke to her on the phone about
the
two
aspects of adoptive nursing, one being closeness with the baby through
feeding
at
the breast, and the other being trying to get a bit of a supply.   We
actually
have a breastfeeding medicine doctor here who has told me in the past that
she would be interested in doing the Jack Newman protocol.  The woman is
interested in doing both (feeding at the breast and building a supply, if
possible).
The problem is this:   she has struggled with infertility for years and is
set to do a final IUI (intrauterine insemination) this coming week.   She
said
that the adoption came up very quickly and that if she does turn out to be
pregnant, well, then she'll just have two kids 10 months apart.

My questionis this:   obviously, if she IS pregnant, she can't do the Jack
Newman protocol and probably shouldn't actively try to lactate (e.g. pump);
but
should she even be feeding with an SNS a few times a day?   I'm not sure if
she should but I thought I'd ask the Lactnet list.   Any thoughts???

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