Hi Mellanie,
I would say that it is certainly very likely that she will produce milk.
I've just spent Easter away and been re reading some papers I hadn't read
for a while (working on a paper- an essential part of a good holiday!).
Anyway, although it is very common for health care professionals etc in
Western countries to say that making milk when you have not recently been
pregnant is difficult and that it is rare for adoptive mothers to make
enough milk for their babies this is simply not the experience of those who
have worked with women in developing countries. I've got a paper here
Abejide et al (1997). Non-puerperal lactation in a Nigerian community: case
reports. Annals of Tropical Paediatrics 17: 109-114
In these cases (6 women) all made enough milk for the babies (whose mothers
has died or abandoned them). In these cases no drugs or even traditional
galactagogues were used. The instruction the women were given was to put the
baby to the breast *at least* 10 times a day for at least 10 minutes per
breast. Babies were supplemented by cup or spoon. There are a lot of similar
studies but all in developing countries. Women in developed countries (US,
Aust, Canada, UK etc) do not appear to do anywhere nearly as well. My take
on this is that the difference is primarily because Western cultures place
physical barriers between mother and child and restrict breastfeeding
frequency. I think it is also important that women are told not to expect to
be good at making milk. So for the mum you are helping I would encourage her
to breastfeed more frequently-much better than pumping. In order to
facilitate this she should also carry her baby a lot (use a sling) allowing
unimpeded access to breastfeeding and use the breast to comfort the baby (ie
as a dummy). Cosleeping will also help with this (and many adoptive mothers
have said that when their babies started breastfeeding a lot at night this
made a huge difference to their milk supply). She needs support to do
this!!! To be around people who will not tell her that she is spoiling her
baby, making a rod for her back etc
 I also think that it is likely in many cases over reliance on the
supplementing system can result in the mother's maximum milk production not
being reached. She should plan now for weaning from it (there are some
excellent posts in the archives on this- basically make the milk flow
similar to breastfeeding ie not constant and not immediately available as
well as making sure the milk is not flowing too easily). Gradually
decreasing supplement and watching the baby to make sure that the supplement
is still sufficient is important. As Laurie said, eventually her production
and the baby's milk need will match up and she will have a "full milk
supply" she just needs to breastfeed enough.
I concurr with Kerrie. Domperidone seems to be pretty low impact in terms of
negative side effects and is worth a try if she wants. My bias is that I
used Domperidone to help in relactating so of course I think it's worth
using.
As Darillyn said, this mum is doing really well and is a successful
breastfeeder! Good on her! Let her know that there are other people cheering
her on and please refer her to a couple of active mother to mother support
groups on the Internet for adoptive breastfeeding
http://www.fourfriends.com/abrw/ and
http://groups.yahoo.com/group/1ABSupportGroup/

Karleen Gribble
Australia

 I would
> appreciate any input you have as to whether it is possible to induce
> lactation without meds or, if not, what protocol you have found to be most
> successful.  Thank you so much for your input.
>
> Mellanie Sheppard
> Arlington, Tx USA

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