Pumping Maniac-- Pumping to Induce Lactation

We got matched on August 21. Of course we were elated to hear the news that we would be welcoming a little girl into our lives. From the very first phone call, I learned that our birth mom was very supportive of my endeavor to induce lactation and nurse our baby. She had stumbled across some information indicating I wanted to nurse this baby, and I was relieved and embarrassed to hear that she knew this information. More relieved when I knew that she was completely on board and had asked our social worker to let us know right away that we had been matched so that I could have milk ready in time.

I started pumping about 4 weeks before our baby was due to be born (per the Newman Goldfarb protocol)-- Mid October as we'd been expecting her arrival sometime around the end of November. I stopped the birth control pill and was looking forward to seeing what would happen (though not excited to get my period after 5 months without a cycle). 

I started out gradually-- pumping just 1-2 times per day and rapidly working my way towards pumpingn10-12 times per day in preparation for feeding a newborn. I used La Leche Leagues "Massage, Stroke, Shake" technique before each pumping session, as well as a warm rice sock compress over my breasts throughout each pumping session. I also used a technique called "power pumping" to help cluster my pumping sessions together throughout the day, and was also hoping that this would help me maximize my output by bumping up my prolactin levels. I strafing of pumping for twenty minutes straight, I would pump for about 10 minutes with a few minutes break and then pump again twice more for 10 minutes each with breaks in between. I tried to do some nipple and breast massage as much as possible. 

It was an incredibly gratifying feeling to get a drop of sticky honey-like milk on the pumping flanges the very first time that I pumped. I completely expected that it may take several days for me to see anything. And that was the beginning-- the beginning of restoring faith in my body. That it was capable of something that could nurture and grow a baby. 

As insane as it sounds, I knew that demand would drive up my supply, so I planned to offer the breast as often as possible once we met our baby. I also knew that I would delay introducing a bottle for as long as possible, and do lots of (continuous) skin to skin in the early days (my bare skin next to her bare skin with a diaper on only). I was researching formula options in the event I would need to use some. Honestly, I was terrified of using any for,usa, and I had to quickly get over that-- but more on that later. I had my plan in place for making this happen, and felt that I had my support people ready too. My husband and I also took an in home Breastfeeding class so that it could be tailored to our specific situation. 

Why and How I Started My Protocol for Inducing Lactation

It's obvious that many people wonder, "Why do you want to breastfeed your adopted baby?" There are lots and LOTS of reasons to choose this. In fact, the American Academy of Pediatrics has issued a statement on breastfeeding which states that breastfeeding is the normal nutrition for babies. ALL babies. They also recommend that babies be breastfeed exclusively for the first 6 months of life, continuing until they are 1 with complimentary foods. You can read the full statement from the AAP here. 

Breastfeeding also promotes attachment. I wanted nothing more to attach to my baby when we brought her home, and I knew that this would be a great way (though certainly not the only way) to attach. 

A very big part of me also knew that it would be healing for me to try. Maybe my body would not grow a baby, but maybe it could produce milk, and nurture this child. Even if it wouldn't produce milk, at least I could nurture this child. Honestly, I was really hoping that I could bring in a full supply. Ultimately though, I thought the biggest benefit would be to nurture a baby at the breast, even if I didn't bring in a full supply. 

I did lots of research on my protocol options. LOTS of research. I felt that my best chance of producing the most milk would be to try the Newman Goldfarb Protocol. You can see the protocol here. That meant starting an estrogen/progesterone combo pill in May, with hopes of having a little time before being matched with a baby. Ideally, I would stay on the birth control trough October at a minimum, but more ideally until December or later to give my body time to build breast tissue so that I could have a bigger supply. 

I felt frustrated with the lack of up to date resources and information. One day, I discovered Alyssa Schnell's recently published book, Breastfeeding Without Birthing. That information was wonderful to have at hand! So many options and helpful information about the many protocols available. 

I knew a local lactation consultant who had worked with other families who had induced lactation, or had low supply. I also knew that she was comfortable prescribing Domperidone. I wanted to talk with her about some concerns (that it is not FDA approved) and ask her if she thought it would be safe for me to use. I set up an appointment, and going to see her was quite interesting. When the nurse took me back for my lactation consult, she said, very confused, "Where is your baby?" I am sure they were not used to seeing people in their office before they had a baby. Once I explained that I was going to induce lactation, she was very excited for me, and supportive.

It was very reassuring to talk with the lactation consultant. She had so much helpful information for me. 

With that, I officially started the protocol in May. After going through infertility for so long, I was actually relieved to skip periods, as I never had before ever in my life!

Later, I did have some spotting. 

I attended a conference in May to become a Lacation Counselor. I wanted to explore what the trainers thought about inducing lactation, or if they had ever worked with moms doing this. I did not let on that I was going to try to do this, which apparently I should have. I was completely shot down. "Moms who try that will NEVER most likely get a full supply." I already knew that, and I also knew of some mothers who HAD achieved full supply. I pressed further-- "What about using Domperidone?"

"It's not recommended," she retorted. "It's not FDA approved, and there can be very serious complications." Thankfully I was already well researched in this area and understood that the serious complications studied were in elderly patients getting the drug for its original use-- heartburn. In breastfeeding moms in Canada where Domperidone is widely used, there have not been any adverse affects reported. 

In mid-June I started the Domperidone-- prescribed by my IBCLC who is also a midwife and was able to write prescriptions. In late June I added Acupunture. 

I started to notice breast tenderness and growth, and had a good mood overall with a very occasional emotional melt down, dealing with infertility feelings. 
Then I also added Chinese herbs, as well as Goats Rue. 

Breastfeeding Without Birthing--My Story of Adoptive Breastfeeding

Believe it. When I trained as a birth doula, I remember hearing the breastfeeding instructor tell us that it was “possible” for a mother who had never given birth to produce milk and nurse her baby. Of course, this was fascinating to me. 

Fast forward 4 childless years later, and we were facing big decisions about what to do next in our infertility journey. We had tried many different things hoping to become pregnant, but came to a place of peace that adoption was the route we ultimately wanted to go. Afterall, it was something that we had always both talked about, but like many other couples first wanted to “have our own” children. After mourning that having biological children was just not in the cards for us in this chapter of our lives and deciding that heading down a potentially long road of medical interventions that may or may not lead us to a baby, we realized that adoption was a promising and very exciting option for us. (You can learn more about our adoption story HERE or see the video about how we got to bring our daughter home HERE). 

As soon as we decided that we wanted to adopt, I knew that I would do all that I could to try to nurse this baby. While experiencing the joys (and discomforts) of pregnancy was not an option for us through this route of domestic adoption, I knew that nursing a baby was. As I researched more, I was overjoyed to find out that not only was lactation possible, but that you could even nurse a baby with no milk or with no lead time at all. This was very encouraging to me as the adoption process is so unpredictable about WHEN you might be matched with a baby. I also learned that while we were hoping to get a newborn, it was also still possible to nurse an older child given gradual attachment and nurturing, and a lot of patience. 

There are many different ways to approach inducing lactation. There are medical and non medical ways, ways to use herbs, or just a pump or even through hand expression. The most simplistic way is to just put a baby to breast, and let the milk come later, as is done in many cultures around the world. 

After weighing all the various options, talking about it with area Lactation Consultants, and reading the book Breastfeeding Without Birthing by Alyssa Schnell, I decided to choose a medical protocol, and also use acupunture and herbs. We simultaneously started the adoption process, and the ever daunting home study ensued. I started the protocol in late May— taking a birth control estrogen and progesterone combination pill, along with a medication that would help me produce milk. I also started taking herbs to increase my breast capacity, and went to acupunture weekly to increase the blood flow in my body and breasts. Just four months later, we were matched with a baby due to be born late November— exactly 6 months after I started the protocol. This would be somewhat ideal timing, as I had hoped to be taking the birth control for about this long before stoping taking it and starting to pump which would bring my milk in. My plan was to start pumping 6 weeks before the baby’s guess date. When you induce lactation, your milk comes in very gradually rather than all at once as it does after you give birth. 

Miraculously, I had drops on the first day! I was dedicated— pumping 10-12 times daily, demanding my body to produce milk just as a newborn baby would. It slowly built from there— and by the time we went to my daughters birth— a mere two weeks later— I was pumping 1-2 ounces of milk at each pumping session. I was thrilled, and had new found faith that my body was amazing. I was reclaiming the womanhood that infertility had tried to take from me. I felt more empowered that I was doing all that I could to nurture this little one. I had stored enough milk to last the first few days after she was born if I needed to supplement, and planned to use an at-breast supplementer to give my daughter additional milk when she needed it, while still allowing her to learn to breastfeed.

My supply build in the beginning was still gradual. I was supplementing with 1-3 oz. of milk per feeding, depending on the part of my cycle I was in. I estimated that on average, I was able to meet 50-70% of her daily needs, which I felt extremely happy with. This was not a cake walk. Not even close. I was offering her the breast around the clock to increase my supply as much as possible, and still pumping 2-3 times every day after feedings. There were frustrations and tears with getting the right latch and figuring out that STUPID (yet helpful) at breast supplementer. But, to me, it was worth it. Nourishing my daughter with my milk was a wonderful gift to give, and nurturing her at the breast everyday was an even greater gift that helped me to attach to her as much as it did her to me. While breastfeeding is not the choice for every mother, I was happy to learn that it still could be an option for us as it was something that I desired very much. 

My husband, family, and community, though at times uncertain about all the details, were extremely supportive of me breastfeeding, and I could not have done it without them. Now my daughter is 14 months old, and still nursing everyday (and night). We are both enjoying this journey, and I am so thankful for how it has brought us together. I hope that every mother pursuing adoption knows that this can be a wonderful option— weather to nourish a baby or child, or simply to nurture with comfort nursing. If you are interested in more information, you can learn more HERE or HERE.