You would like to breastfeed your adopted baby, or one born with a surrogate or gestational carrier? Wonderful! Not only is it possible, chances are you will produce a significant amount of milk. It is different, though, than breastfeeding a baby with whom you have been pregnant for many months. With some determination and perseverance, you will enjoy the wonderful bond that breastfeeding brings and both you and baby will benefit from this experience.
There are really two issues in breastfeeding the baby with whom you were not pregnant. The first is getting your baby to breastfeed, that is to latch on to the breast and drink. The other is producing breastmilk. It is important to set your expectations at a reasonable level because only a minority of women will be able to produce all the milk the baby will need. However, there is more to breastfeeding than breastmilk and many mothers are happy to be able to breastfeed without expecting to produce all the milk the baby will need. It is the special relationship, the special closeness, and the emotional attachment of breastfeeding that many mothers are looking for. As one adopting mother said, “I want to breastfeed. If the baby also gets breastmilk, that’s great”.
Although many people do not believe that the early introduction of bottles may interfere with breastfeeding, the early introduction of artificial nipples can indeed interfere. The sooner you can get the baby to the breast after he is born, the better. The more you can avoid the baby’s getting bottles before you start breastfeeding, the better. However, babies need flow from the breast in order to stay latched on and continue sucking, especially if they have gotten used to getting flow from a bottle or another method of feeding (cup, finger feeding). So, what can you do?
As soon as a baby is in sight, contact a breastfeeding clinic and start getting your milk supply ready. Please understand that you may never produce a full supply for your baby, but it is quite possible that you may. You should not be discouraged by what you may be pumping before the baby is born, because a pump is never as good at extracting milk as a baby who is sucking well and well latched on. The main purpose of pumping before the baby is born is to draw milk out of your breast so that you will produce yet more milk, not only to build up a reserve of milk before the baby is born, though this is good if you can do it.
Using the medications discussed below in A. and B., helps to prepare your breasts to make milk. The idea is to make your body think you are pregnant. The medications are not an absolute requirement for you to produce milk, but they do help you make more.
A. Hormones—Oestrogen and Progesterone. If you know far enough in advance, say at least 3 or 4 months, treatment with a combination of oestrogen and progesterone will help prepare your breasts to produce milk. A birth control pill is one way of taking these hormones, but you skip the placebos (sugar pills for one week out of every four weeks) and go right to the next package; another way is to use oestrogen patches on the breast plus oral progesterone. Get information about this protocol from our clinic and also Induced lactation and relactation. We recommend stopping the birth control pill approximately 6 to 8 weeks before the baby is supposed to be born.
B. Domperidone. See the information sheet “Domperidone”. We recommend a starting dose is 30 mg three times a day, but we have gone as high as 40 mg 4 times a day. The domperidone is continued when the hormones are stopped. Usually it is necessary to continue it for several months after you start breastfeeding. Check the information sheets for more information. Ask at the clinic.
C. Pumping. If you can manage it, rent an electric pump with a double setup. Pumping both breasts at the same time takes half the time, obviously, and also results in better milk production. Start pumping when you stop the birth control pill. Do what is possible. If twice a day is possible at first, do it twice a day. If once a day during the week, but 6 times during the weekend can be done, fine. Partners can help with nipple stimulation as well. See the information sheet “Expressing Breastmilk” for more information.
Maybe, maybe not. If you do not, breastfeed your baby anyhow, and allow yourself and him to enjoy the special relationship that it brings. In any case, some breastmilk is better than none.
Very Important: If you decide to take the medications (the hormones and/or the domperidone), your family doctor must be aware of what you are taking and why. It is very important to have a physical and have your blood pressure checked before starting the protocols and perhaps have a pap smear if you haven’t had one for a while. Significant side effects have been rare, but that does not mean they cannot happen. Your doctor needs to be following you, and once the baby is with you, your baby’s doctor needs to know that you are breastfeeding him and needs to follow the baby’s progress just as s/he would any other baby.
The information presented here is general and not a substitute for personalized treatment from an International Board Certified Lactation Consultant (IBCLC) or other qualified medical professionals.
This information sheet may be copied and distributed without further permission on the condition that you credit International Breastfeeding Centre it is not used in any context that violates the WHO International Code on the Marketing of Breastmilk Substitutes (1981) and subsequent World Health Assembly resolutions. If you don’t know what this means, please email us to ask!
©IBC, 2009, June 2017
Questions or concerns? Email Dr. Jack Newman (read the page carefully, and answer the listed questions).
Make an appointment at the Newman Breastfeeding Clinic.