Written by Wendy, IBCLC
If you are the mother of an adopted—or soon-to-be adopted—baby, you may be interested in adoptive breastfeeding. Simply put, adoptive breastfeeding is when the non-birthing mother of an adopted baby breastfeeds that baby. Unless the adoptive mother is already breastfeeding another child, or has recently breastfed a baby, usually adoptive breastfeeding means inducing lactation. As such, this blog will focus on how adoptive mothers can induce lactation.
OVERVIEW OF ADOPTIVE BREASTFEEDING
Anyone who has mammary tissue can theoretically make milk. Pretty cool, huh? How much milk you make and how quickly you make this milk is extremely individualized. Some people have an easier time of it than others, which is why defining success on your own terms is so important.
Although some people talk about a specific adoptive breastfeeding protocol, the truth is that there isn’t one way to induce breastfeeding. There’s no standard protocol from medical organizations like the Academy of Breastfeeding Medicine or the Academy of American Pediatrics.
Components of Lactation Induction
That said, most protocols to induce breastfeeding include the following elements:
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Expression of milk with a breast pump or by hand
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Feeding at the breast
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Medication to help induce lactation
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Herbal supplements to help induce lactation
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At-breast supplementers
The most important aspect of the protocol is breast stimulation, including pumping, hand expression, and direct breastfeeding. This is the basic way that milk is made, and how milk supply is established and increased. If you don’t regularly stimulate your breasts, you won’t be able to induce lactation. The other aspects of lactation induction, like medication and herbal supplements, are optional, but can be very helpful.
WHEN TO BEGIN
The earlier you begin the process of inducing lactation, the better. That’s because it can take several weeks of breast stimulation to see any milk. The sooner you start the process, the more likely it will be that you have milk for your baby when they arrive.
Sometimes, mothers will choose to use medications or herbs in the weeks and months before their baby arrives to prepare their breasts for lactation. Doing this can help you develop more milk-making tissue in your breasts, similar to what happens to a pregnant woman during pregnancy. This is best done in collaboration with a health care professional. For more information about this, you might consider learning about Dr. Jack Newman’s pregnancy protocol for inducing lactation. This is an optional, not required step.
All that said, if you don’t prepare at all before your baby arrives, that’s okay too. It’s possible to begin the process of inducing lactation at any time, and achieve success. You just have to have realistic expectations and understand it will be several weeks before you see any milk.
HOW ADOPTIVE BREASTFEEDING WORKS
Let’s take a look at the different aspects of inducing lactation more closely, so you can get a sense of how lactation induction might work for you.
Breast Stimulation
Stimulating your nipples and breast tissue by pumping, hand expression, or direct breastfeeding is essential to inducing lactation. When you stimulate your breasts, it tells your body to begin the milk-making process. The more frequently you do this, the better, and the more milk you are likely to make.
If you are getting your supply going before your baby arrives, you might aim for pumping every two to three hours, with a somewhat longer rest at night (four to five hours). Most women find that using a high quality breast pump, like a hospital grade rental pump, is best. Hand expression can be used along with pumping to maximize output. It can be helpful to get hands-on help from a lactation professional when it comes to pumping and hand expression to induce lactation.
Medications
There are no medications that are currently FDA approved to induce lactation. It can be helpful to discuss your specific case with a healthcare professional, such as a breastfeeding medicine physician. Certain drugs, like Reglan (metoclopramide), can be prescribed off-label to help stimulate or increase your milk supply during adoptive breastfeeding induction. Sometimes birth control pills are also used for inducing lactation.
Herbal Support
There are certain herbs that are known to be helpful when it comes to stimulating milk production and increasing milk supply. Some are found in capsule form and others may come as teas. Your healthcare provider or lactation consultant can help you learn more about herbal support for inducing lactation.
Once Baby Arrives
Once you have your baby with you, you can begin experimenting with breastfeeding. How often you breastfeed depends on how much of a milk supply you have and what your preferences are. Some motherswill need to continue to pump and feed their baby this pumped milk. Others will need to supplement with formula or donor milk. Using an at-breast supplementer during this time can help ensure that your baby gets the nutrition they need while still practicing breastfeeding and stimulating your milk supply.
It's vital to work closely with a lactation professional and your pediatrician to ensure your baby is getting enough milk. Sometimes your milk supply will increase even more once your baby arrives, and you will gradually be able to decrease supplements. At other times, supplementing breastfeeding will be necessary for the duration that you breastfeed your baby.
ADDRESSING CHALLENGES
While some adoptive mothers can achieve a full milk supply, or close to it, some struggle more to make enough milk for their baby to exclusively breastfeed. Additionally, the process of inducing lactation can be slow and can take a lot of effort. Once your baby arrives, it can be challenging to mix at-breast feeding and supplementation, if it’s needed.
All of this is to say it’s important to cut yourself lots of slack when it comes to adoptive breastfeeding. Try not to compare yourself to others and celebrate each of your successes. Keep in mind, too, that it’s isn’t one “right” way to breastfeed. Even non-adoptive mothers run into challenges and many experience milk supply issues and end up supplementing. Above all else, breastfeeding is about closeness and love, and you can achieve this whether you fully breastfeed or not.
Finally, adoptive breastfeeding is an area where you definitely need support. Lactation consultants can provide much-needed insight and help. Medical doctors are often needed to make induced lactation successful. Online and in-person support groups can be helpful too.
The bottom line is that adoptive breastfeeding can be challenging, but with realistic expectations, hard work, and support, many mothers make it work for them.
SOURCES
Academy of American Pediatrics. Induced Lactation: Breastfeeding for Adoptive Parents. 2022.
Ferri RL, Rosen-Carole CB, Jackson J, Carreno-Rijo E, Greenberg KB; Academy of Breastfeeding Medicine. ABM Clinical Protocol #33: Lactation Care for Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Plus Patients. Breastfeed Med. 2020 May;15(5):284-293.
Schnell A. The Three Step Framework for Inducing Lactation TM. J Hum Lact. 2022 May;38(2):252-261. doi: 10.1177/08903344221076531. Epub 2022 Feb 21. PMID: 35189720.
