Breastfeeding an Adopted Baby

By Barbara Wilson-Clay, BS, IBCLC

Yes, it’s true. Adopting mothers can breastfeed. Down through history, a traditional way of nurturing and nourishing orphans has been for another woman, often a relative, to put the baby to breast. Sometimes the adoptive mother already was lactating, but if not, the infant’s sucking would bring in a milk supply. The process of breastfeeding an adopted baby is called induced lactation. Research has shown that breastfeeding enhances bonding.  Parents are thrilled to learn that their “chosen” baby can receive some of the wonderful health benefits provided by human milk, including experiencing the interactions which foster attachment between mother and child.

How does induced lactation work? Simply put, sucking stimulation causes the breasts to make milk.  In the non-developed world, most women who are inducing lactation simply put the infant to breast and practice very frequent breastfeeding and baby-wearing (holding the infant almost constantly in a sling or carrier). 

In developed countries, where adoption is more likely to be a planned event, the process of induced lactation ideally begins before the baby arrives. The mother starts by manually and mechanically stimulating her breasts and nipples using a combination of gentle massage and a rental grade electric breast pump. The stimulation schedule typically starts with several minutes of massage and pumping several times a day. Gradually, the woman increases the amount of stimulation until she is pumping for 10 minutes 8-10 times during each 24-hour period. (Pumping on a dry breast may pull some. Try lubricating the pump flange with a thin coat of cooking oil to make it more comfortable.)

After massage and pumping are begun, medications may help stimulate the breasts to further increase milk production. Some induced lactation efforts begin with physician-prescribed hormones (estrogen and progesterone) that imitate the hormone levels of pregnancy. These medications are withdrawn after a short while, tricking the body into sensing that a baby has been born. The woman may then begin taking another prescribed drug called a galactagogue (a term that means ‘a milk stimulating substance’). Although there is no research to confirm effectiveness, some women who don’t want to use hormones may use herbal galactagogues such as fenugreek in addition to pumping and breast massage to help establish milk production.

Within a week of beginning the process most women are very excited to discover that they are producing drops of milk! They may notice other changes. Their breasts may feel heavier and the areolae (the skin around the nipple) may darken. Some woman will eventually stop menstruating.

While the milk supply typically builds over time, it is hard to tell how much milk an adoptive mother will make. Some women eventually make enough milk that they can wean their babies off of supplements. Other women have health issues that may affect their ability to make a full supply of milk. No matter. Any amount of milk is of great value to the baby, but the focus should be on the nurturing experience.

Adoptions are unpredictable. Sometimes parents have plenty of time to prepare. Other parents greet the arrival of their baby before the milk supply is well developed. The Medela Supplemental Nursing System™ (SNS) protects the option to breastfeed because it allows mother to supplement the baby directly at the breast. The SNS™ is filled with formula and worn suspended from a necklace device. Thin silicone feeding tubes are taped to the nipple, and the baby drinks formula while breastfeeding. This device provides sucking stimulation for the breasts while ensuring that the baby gets enough to eat. Fathers can tape the feeding tube to a finger, and many fathers share that this experience is far more intimate than feeding a bottle.

Be sure to talk with your baby’s doctor about your plans to induce lactation. Contact your local LC, La Leche League Leader, or Nursing Mothers Counselor for guidance, and for help answering your additional questions about nursing your adopted baby.

 

References:
Bryant CA. Nursing the adopted infant. J Am Board Fam Med 2006; 19(4):374-9.

Britton  JR, Britton HL, Gronwaldt V. Breastfeeding, sensitivity, and attachment. Pediatrics 2006; 118(5)e1436-43.

Cheales-Siebenaler NJ: Induced lactation in an adoptive mother. J Hum Lact 199l ; 15(1):41-3.

Gabay MP. Galactogogues: medicines that induce lactation. J Hum Lact 2002; 18(3):274-9.

Gribble KD: The influence of context on the success of adoptive breastfeeding: developing countries and the 
west. Breastfeed Rev 2004; 12(1):5-13.

Gribble KD. Mental health, attachment and breastfeeding: implications for adopted children and their mothers. Int Breastfeed J 2006; 9(1):5.
 
 

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