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Wednesday, April 01, 2020

Yes, new mothers can breastfeed their adoptive or surrogate baby

As actor Shilpa Shetty Kundra joins the ranks of mothers with surrogate babies, a doctor tells us how such women, including adoptive ones, can also experience the breastfeeding process.

Updated: February 22, 2020 5:11:37 pm
breastfeeding adopted baby, breastfeeding surrogate baby Breastfeeding an adopted or surrogate baby through induced lactation is possible. (Getty Images)

By Dr Pratibha Singhal

Becoming a mother is one of the greatest experiences of a woman’s life. The moment child enters in one’s life; it brings the eternal feeling of bliss, happiness, and lots of responsibilities which a mother has to bear, breastfeeding being foremost in this. In addition to the emotional benefits it confers, breastfeeding has a range of benefits on offer for the overall well-being and proper development of the baby, in the short and long term. Since breast milk is recommended as the best food for babies, many families who plan to adopt a child or have babies through surrogacy are keen to understand whether they will have this option with their new addition. The answer is: Yes. Breastfeeding an adopted or surrogate baby through induced lactation is possible, but it takes plenty of planning, introspection, and support. This potentially lifesaving measure is called as “induced lactation” or “relactation”.

Parents will often ask questions like – How does a parent determine how is breastfeeding done, what is the process I need to follow? How often should I pump? How do I learn how the process? How do I know if should take medications? Are these medications safe for me and my baby? There are so many different herbs that can be used to help make milk – which ones could help me? What if my baby doesn’t latch? How much milk can I expect to produce, and how long will it take?

Breastfeeding and breast milk

There are really two issues in breastfeeding the baby with whom you were not pregnant. The first is getting your baby to breastfeed. The other is producing breast milk. It is important to set your expectations at a reasonable level because only a minority of women will be able to produce all the milk the baby will need. However, there is more to breastfeeding than breast milk and many mothers are happy to be able to breastfeed without expecting to produce all the milk the baby will need. It is the special relationship, the special closeness, and the emotional attachment of breastfeeding that many mothers are looking for. As one adoptive mother said, “I want to breastfeed. If the baby also gets breast milk, that’s great”.

How does induced lactation work?

Basically, it is important to remember that prolactin and oxytocin, the hormones which govern lactation, are pituitary, not ovarian hormones. Both prolactin, the milk-making hormone, and oxytocin, the milk-releasing hormone, are produced in response to nipple stimulation. While there are now several regimens which use hormone therapy to assist in bringing in milk, many women have induced lactation with only mechanical stimulation. This consists of breast massage, nipple manipulation, and sucking — either by a baby or a hospital grade electric breast pump. There are many herbal preparations also available  to induce lactation.

Some parents may also be worried about a baby’s nutritional status since induced lactation produces low volumes of milk initially, and skips the colostral phase. Many women use a feeding tube device. This is a bag or bottle which is worn suspended on the mother’s chest. These devices have thin, silicone feeding tubes which are taped to the nipple with hypoallergenic surgical tape. The baby sucks the breast, and milk flows through the tubes as through a straw, delivering donor milk or formula directly at the breast.

It is important to know that the amount of milk that every mother will 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 may be that you have an underlying medical condition that may or may not have been treated. 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. 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.

Here are a few details to consider on how to induce lactation, what happens, and where to start:

Work with a lactation professional

Reach out to your doctor, midwife, or a lactation consultant if you plan on inducing lactation. They can help you build a personalised plan based on your goals, connect you to resources, and provide important expert guidance.

Stimulus and expression

Starting about two months before the date the baby is expected to join your family, if time permits, introducing a routine of stimulus and expression for your breasts can help with milk production. Gently massage your breasts by hand for a few minutes, then use a hospital-grade (multi-user) breast pump for about 10 minutes more. Do this after waking, before going to sleep, and several times throughout the day for your body to begin reacting to the implied “demand” for breast milk. Drops of milk usually appear, on average, about a month or so after starting this routine, and milk supply typically builds over time.

Specialty-feeding devices

Adoptions can be unpredictable. Sometimes parents have plenty of time to prepare. Other families greet the arrival of their baby before milk supply has had a chance to develop. Specialty products like the Supplemental Nursing System (SNS) protect the option to breastfeed because it lets you supplement your baby directly at the breast. The SNS allows expressed breast milk, donor milk, or formula to be fed through a thin silicone feeding tube that is taped to the nipple, providing baby with the sensation of feeding from the breast, and sucking stimulation to help build your supply.

Breastfeeding is not just for biological families. With the right preparation, expectations, and professional support for successful induced lactation, an adoptive mom can provide her child the amazing benefits of breast milk and build a strong, nurturing, and loving bond along the way. A lot will depend on how long the mother has to start the process before the baby is born, or comes to live with the family, and on her medical history.

The basics of milk supply are always supply and demand. Expressing is the main component of bringing in [an induced] milk supply. Remember to seek out skilled support from a lactation or breastfeeding counsellor, 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. Remember there isn’t a right a wrong way to breastfeed your adopted or surrogate baby. Keep flexible because there is great flexibility and you have many options in order to progress.

(The writer is Director and Senior Consultant, Obstetrics and Gynecology, Cloudnine Hospital, Noida.)

Also Read: What affects breast milk composition?

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