Induced lactation - Transcript
We know so much more now about how breast milk is made, and it’s really exciting to know that even if you haven’t been pregnant, it is possible to generate a milk supply. So if you are planning to adopt a baby or a toddler, know that it is possible to work towards this goal. But it’s good to set your expectations realistically. We know that some women will produce some amount of milk. Others will produce a lot more and some will produce a full supply.
A really encouraging recent study talks about a lady who adopted a baby, and managed to produce so much milk that she became a donor! I do in fact know a lady whose family member acted as a surrogate for her, because she wasn’t able to have a baby of her own, and she managed to generate a full milk supply and breastfeed completely.
What we do know is that the amount of milk that you produce can be related to a number of different factors. It can be related to your baby’s age, and how willing your baby is to try to feed at the breast. It might be that you have an underlying medical condition that may or may not have been treated.
It may also be related to any chest surgery or breast surgery that you’ve had in the past, or an injury perhaps, but another factor can be simply related to what amount of practical and emotional support you’re going to be able to get, while you’re working towards these goals – which does require a lot of patience and diligence.
Please bear in mind that even if you’ve breastfed fully before, it may not be a guarantee that you will get that full supply, when you try to breastfeed an adoptive baby. So there is great variation in the amount of milk that may or may not be produced, and how long that’s going to take to get there.
It’s a wonderful thing to know that however little or however much milk you make during this process of induced lactation, you are able to spend lots of time in skin to skin with your baby, building up that closeness and that bonding.
So let’s talk a little bit about the physiology of normal milk production. In the last few months of pregnancy, due to a complex interaction of hormones (particularly oestrogen and progesterone and human placental lactogen), these hormones act to prepare the body for producing milk. After the birth those levels of hormones drop and prolactin increases and so does milk production.
If however you are trying to induce lactation then there are ways of telling your body, or trying to tell your body that your body 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 which can help to prepare your body in that way.
So if you do have the luxury of time, your health care provider can start you on a course of hormone therapy. This involves supplemental oestrogen and progesterone that can help to mimic the effects of pregnancy. I do want you to know however that it isn’t absolutely essential to have this hormone therapy, but it can definitely help in the process.
If you do have hormone therapy it’s important that you stop those hormones round about 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 galactogogue, a medication that can help to increase milk supply too. Please look at the video relating to this and ensure that your doctor follows you up while you’re taken any of these medications – to keep a check on your medical health.
Now once you’ve stopped that hormone therapy, the next important stage is to use a hospital grade double pump. These are the super duper pumps of the lactation world that will help to start telling your body to make milk and increasing the prolactin hormone.
At first you can use the pump simply five minutes for three times a day. Lead up to ten minutes – maybe every four hours, and once at night. This is all going to help to boost the prolactin hormone. You can carry on until you are pumping every two to three hours and once at night.
You can be doing this right up until the time that your baby arrives and you start to bring your baby to the breast. Even if you don’t have a long time to prepare before you see your baby, pumping is still a really important thing, to start to get that milk made, in advance.
Your baby is likely to have been bottle fed previously. So there’ll be a long time, orientating your baby to the breast – and the pump is your friend to help you to keep that supply up.
It may be that the baby that you are about to adopt has been breastfed initially – that’s all the better. But even if that isn’t the case, please bear in mind that studies have shown that even older babies, even into toddler hood, have shown breast-seeking behaviours.
So 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. At least two hours per day would be beneficial. Skin to skin is going to keep you both calm and connected and enable you to boost the hormones that make milk, particularly prolactin. It’s also going to kick into action all of those pre-feeding behaviours that will encourage your baby to latch on.
We know that skin to skin fulfils many functions, including stabilising your baby’s heart rate and breathing, keeping him calm. Calm babies latch better. So I would encourage you to look at the video related to skin to skin for a little bit more information on that.
And because your baby is in skin to skin and spending lots of time in that close contact with you, then this will also encourage good latching too. I would encourage you again to look at the videos relating to how to get a really comfortable latch, promoting a really good deep latch, so your baby is able to drain the breast well, and start to build up your supply while he’s actually attached.
It’s really important if your baby is latching on straightaway to give as much opportunity to stimulate your supply as possible. This means bringing your baby to the breast at least every two to three hours – maybe more, maybe every hour even. Bringing your baby (to the breast) also for comfort, for warmth, When he’s just going to sleep, or just waking up – any reason. All of that will help to start to stimulate your supply while your baby is attached to the breast.
Even if your baby is latching and doing a little bit of sucking but not actively swallowing, it could be discouraging. But don’t let that be a negative point, because all of that feeding at the breast and offering the breast, will start to build up your supply, even if it’s very very slowly.
If your baby is latching at the breast and starting to do something there, but not actively swallowing- All this stimulation at the breast will start to tell your body to make more.
Breast compressions can be a really useful thing to do to enable your baby to start to get more, when he is there – when the flow is slow as well. So have a look at the videos about how to do that technique, which is quite a vital thing to learn when you’re in the middle of this orientating your baby to the breast.
Now it’s very possible that you may be bringing your baby to the breast and there is no latching on at all. It’s still important that you keep on pumping your milk. You will start to build up the supply and keep that supply so that your baby can have that milk by another means. But at the same time you will be keen to get your baby at the breast.
If you find that no matter what you do with the skin to skin, trying to get that good latch, there’s still no latching, then consider the use of a nipple shield. This is a thin silicon shield that fits over the areola and the nipple area, and it can provide what they call a super stimulus to aid the mechanics of the latch. Many babies who’ve not latched at all are able to 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, building that supply. Look at the video relating to alternative ways of offering that milk to your baby, so that you can try those things to minimize any confusion at the breast.
If your baby is able to latch, and while you’re building up supply, you may wish to use a supplemental nursing system or a Lactaid. This is a device that can help to keep ALL of the feeding at the breast. Your baby is able to 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 while getting that constant supply that he needs.
I think it’s also important to mention that limiting the use of dummies, ideally avoiding them altogether, will help your baby to stimulate your breast as often as necessary to build up your supply.
Of course while you’re working at building up that supply, it’s important that you really understand the signs that will tell you that your baby is getting enough, and all of this is about education. So all those related videos will help to gain that knowledge.
Remember to seek out skilled support from an IBCLC or breastfeeding counsellor, anybody really who understands those lactation issues and who can really offer that good support. Surround yourself with people, friends and family who are supportive of your efforts to do this. Pop along to your local breastfeeding drop in and speak with other mothers who can be really encouraging. Remember there isn’t a right a wrong way to breastfeed your adopted baby. Keep flexible because there is great flexibility and you have many options in order to progress.
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V1 published June 2017. Next review date: April 2020
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