How to induce lactation
Even if you haven’t been pregnant, it is possible to generate a milk supply.
We know this because our understanding of how the breast makes milk has developed over recent decades.
So if you are planning to adopt a baby or toddler, it’s possible to work towards this goal. However, it is good to set your expectations realistically.
We know that some women will produce a small amount of milk, while others may produce a lot more, and some may produce a full supply.
The amount of milk that you produce can be related to several different factors, such as your baby’s age and how willing your baby is to try to feed at the breast.
It may be that you have an underlying medical condition that may or may not have been treated.
Chest surgery or breast surgery could be a factor or an injury perhaps, even as a child.
Another factor can be related to the amount of practical and emotional support, you can receive while you’re working towards these goals, as this process does require a lot of patience and commitment.
It’s essential to be aware that even if you’ve breastfed fully before, it may not be a guarantee that you will get a full supply when you try to breastfeed an adoptive baby.
There is considerable variation in the amount of milk produced, and how long it may take to reach those goals.
It’s a wonderful thing to know, though, that however little or however much milk you make during this process of induced lactation, you can spend lots of time in skin to skin with your baby, building up that closeness and bonding.
Understanding the physiology of normal milk production
In the last few months of pregnancy, due to a complex interaction of hormones (particularly estrogen, progesterone, and human placental lactogen), these hormones act to prepare your body for producing milk.
After the birth, the levels of hormones drop and your prolactin increases, as does milk production.
If you are trying to induce lactation, then some strategies will help to dupe your body into behaving as if it is pregnant.
If you have a few months before you are to receive your adopted baby or toddler, there is an opportunity to have medications that can help to prepare your body.
If you do have the luxury of time, your healthcare provider can start you on a course of hormone therapy, which will involve supplemental estrogen and progesterone that can help to mimic the effects of pregnancy.
It isn’t absolutely essential to have this hormone therapy, but it may help the process.
If you do have hormone therapy, you must stop the hormones six to eight weeks before you will be bringing your baby to the breast.
Your health care provider may also prescribe what is called a galactagogue, a medication that can help to increase milk supply.
Ensure that your doctor follows you up while you are taking these medications to keep a check on your health.
Once you have stopped hormone therapy, the next important stage is to use a hospital-grade double pump.
These are the high specification pumps that act to tell your body to make milk, and which will help to increase the prolactin hormone.
At first, you may need to use the pump for only five minutes, three times a day. Lead up to ten minutes – every four hours, and once at night, and this will help to boost the prolactin hormone.
You can carry on until you are pumping every two to three hours and once at night.
Continue pumping right up until the time your baby arrives and when you will start to bring your baby to the breast.
Even if you don’t have a long time to prepare before you receive your baby, pumping is still a significant thing to boost your supply in advance.
Your baby is likely to have been bottle-fed previously, so it may take quite some time to orientate him to the breast.
Here, the pump is your mechanical friend to help you to build up and maintain your supply.
If your adopted baby was breastfed initially, that’s all the better.
However, even if that isn’t the case, studies have shown that older babies (and into toddlerhood), continue to show breast-seeking behaviors.
One of the most lovely things that you can start to do with your new baby, which will also help to orientate him to the breast, is to do lots of skin to skin.
Do at least two hours per day to be beneficial. Skin to skin will keep you both calm and connected and enable you to carry on boosting the hormones that make milk, particularly prolactin.
It will also kick into action all of those pre-feeding behaviors, which will encourage your baby to latch on.
We also know that skin to skin fulfills many functions, including stabilizing your baby’s heart rate, breathing, and keeping him calm, and calm babies latch better.
Because your baby is in skin to skin and spending lots of time in close contact with you, this will encourage good latching too.
Consider various breastfeeding positions to get a comfortable deep latch, so your baby can drain the breast well, and start to build up your supply while he’s attached!
If your baby can latch, it’s important to offer the breast at least every two to three hours – maybe more. Consider doing it every hour!
Bringing your baby to the breast for comfort, for warmth, when he’s just going to sleep, or just waking up – for any reason.
All of that will help to start to stimulate your supply while your baby is attached to the breast.
If your baby is latching and doing a little bit of sucking but not actively swallowing, you may feel discouraging.
However, try not to let that be a negative point, because all of the activity at the breast will start to build up your supply, even if it’s slowly.
If there isn’t a lot of swallowing happening, then try breast compressions, an essential technique that will enable your baby to get more from the breast, if the flow is slow.
You may be bringing your baby to the breast, and there is no latching on at all, but keep pumping your milk.
You will start to build up and maintain the supply so that your baby can have the milk by another means.
If you find that despite all the skin to skin and all the efforts to get that good latch, your baby is still not latching, then you may wish to consider the use of a nipple shield.
The thin silicon shield fits over the areola and nipple area, providing an added stimulus to aid the mechanics of the latch.
Many babies who have not latched at all can latch with a shield.
If you find that your baby is still not latching at all despite your best efforts and including the use of nipple shields, and skin to skin, and all of those measures to promote a good latch, then carry on pumping your milk and building up your supply.
Also, consider alternative ways of offering milk to your baby, helping to minimize any confusion at the breast.
If your baby can latch, while you are building up your supply, you may wish to use a nursing supplementer, e.g., a supplemental nursing system (SNS) or a Lactaid.
These devices can help to keep all of the feeding at the breast.
Your baby can stimulate your supply while still getting all the milk that he needs, and it’s encouraging to know that your baby while using this device, will be able to stimulate your breast to make more milk.
It’s also important to mention that limiting the use of dummies or even avoiding them altogether, will help your baby to stimulate your breast as often as necessary to build up your supply.
While working at building up your supply, do look for the signs that tell you that your baby is getting enough milk and be well educated about this, as the information is imperative.
Seek out skilled support from an IBCLC or breastfeeding counselor or health care provider who understands these lactation issues and who can offer excellent support.
Surround yourself with people, friends, and family who are supportive of your efforts, and pop along to your local breastfeeding drop in and speak with other mothers for added encouragement.
It’s important to know that there isn’t a right or wrong way to breastfeed your adopted baby.
Keep open-minded because there is considerable flexibility, and you have many options to progress.
Review dates, references & further resources
Version 1.1 published in March 2019. Next review date: Jan 2022
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