Monday, February 23, 2009

Daily Research: Adoptive Mother Breastfeeding

I have a dear friend who will be adopting a baby in one month. She is unable to become pregnant because health problems required a full hysterectomy. My friend was able to have two children prior to the hysterectomy. She was able to breastfeed both of her children and had a wonderful experience doing so. She understands the benefits of breastfeeding and came to me to talk about whether or not it is possible to breastfeed this adopted baby. The answer is, YES!
Adoptive mothers breastfeeding their newly adopted babies has become almost common practice. My friend knew that re-lactation was possible. But she was unsure whether or not it was possible for a women who has had a hysterectomy. I was thrilled to be able to let her know that breastfeeding is indeed possible for a woman who has had a hysterectomy. The hormones that make lactation possible are hormones produced by the pituitary gland, not the ovaries.
Another common question is whether or not a woman who has never been pregnant or lactated before can breastfeed a baby. I am again thrilled to say that the answer is YES!
A woman produces breast milk due to hormone changes in the body and stimulation to the breast. "Prolactin (PRL) or Luteotropic hormone (LTH) is a peptide hormone primarily associated with lactation. In breastfeeding, the act of an infant suckling the nipple stimulates the production of prolactin, which fills the breast with milk via a process called lactogenesis, in preparation for the next feed. Oxytocin, another hormone, is also released, which triggers milk let-down." - Wikipedia Encyclopidia
So how can an adoptive mother begin the process of stimulating lactation and ultimately breastfeeding her adopted baby? Here are my suggestions:

1. Build a support group. The process of stimulating lactaion or re-lactation is not necessarily easy. It takes time, patience, and a positive outlook on the whole experience. It is important to surround yourself with positive and supporting influences.

2. Nourish your body. Begin taking prenatal vitamins (Rainbow Light are my personal favorite.) I also encourage supplementing with Omega 3 (NSI are my personal favorite.) Study up on the fact that what you put into your body eventually may be excreted through your breast milk. Begin making any changes necessary.

3. Start pumping! Invest in a high quality electric breast pump. Make sure that it is a dual pump so you can pump both breasts at the same time. It is also very helpful to have an adapter included that makes it possible to plug the pump in while you are on road trips in the car or away from home. Purchase a hands free pumping bra (here is what I recommend.) This is very helpful when you are trying to pump several times throughout the day. I also highly recommend a nursing cover up (this is what I recommend.) My recommendation is for a woman to pump an average of every two to four hours throughout the day, sleep through the night, and pump again first thing in the morning (not going more then 9 hours in between the last night and morning pumping session).

4. Herbs: Funugreek has been used by women for centuries to promote lactation in women. Rema Jensen MD has written a great article titled Fenugreek: Overlooked But Not Forgotten. She writes from personal experience about how Fenugreek promotes lactation. Milk Thistle is another herb that has been known to promote the production of breast milk in women. Milk Thistle stimulates blood flow to the breasts which leads to increased production of breast milk.

5. Medication: There is a medication that has a side effect that increases the production of Prolactin. It is called Domperidone (Motilium™.) Domperidone increases prolactin secretion indirectly, by interfering with the action of dopamine. One of the actions of dopamine is that it decreases the secretion of prolactin by the pituitary gland. Doctor Jack Newman, MD, FRCPC has written an article on adopting.org about Domperidone. He gives a good overview on the pros and cons of using Domperidone to increase the Prolactin hormone.

How Long Will It Take? What If I Need Milk NOW? This is the big question. Because every woman's body is different, everyone will have a different outcome. Some women have been known to have drops of milk within a week after pumping, other times it takes months. Occasionally women are able to produce enough milk to sustain their baby's needs. Most of the time a secondary supplementing source is necessary. I recommend the Lact Aid Nursing Trainer. Darrillyn Starr has written an article that gives an overview of the different Nursing Supplementers. She writes from personal experience which is always helpful.

Breast Milk or Formula? I am a strong advocate of breast milk. I am not however against formula (especially in this circumstance.) Some women feel comfortable using both the breast milk they can provide as well as formula to fill in the gaps. There is also the option of using donated breast milk from another woman. You would be amazed at how many women have frozen breast milk stored in their deep freezers.:) If this is something you want to consider I suggest asking close family and friends first and then going to your nearest La Leche League International Leader.

What Should I Stay Away From? I recommend talking to your doctor if you are taking any anti depressants that effect the dopamine level in the body such as Wellbutrin. I am not in any way saying that anyone should go off of medication, I just want to make a note that high levels of dopamine might interfere with the production of prolactin in the body.

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