Last week I had the pleasure of speaking at a workshop for families considering adoption and/or surrogacy.  The topic of my presentation was Breastfeeding for the Adoptive or Intended (through surrogacy) Mother.  Most of the families in the audience had no idea that a woman could breastfeed without birthing her child and their faces just lit up when I discussed that this was a possibilty for them.  

While I have worked with several mothers in San Diego to induce lactation for an adopted baby or baby born by surrogate, I thought I would invite my colleague, Alyssa Schnell, to answer a few questions about this process.  Not only has Alyssa personally experienced inducing lactation for her adopted daughter, but she also recently published a book on this topic as well, titled Breastfeeding Without Birthing:  A Breastfeeding Guide for Mothers Through Adoption, Surrogacy, and Other Special Circumstances (Praeclarus Press, 2013)

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Why would a mother consider breastfeeding her adopted baby or baby born by surrogate?

Most people are not even aware that it is possible to breastfeed a baby who arrives via adoption or surrogacy! The lucky few adoptive or intended (through surrogacy) mothers who learn that breastfeeding is possible for them usually learn about it through their own diligent research.  Many times, breastfeeding is just a sentence or two in a book about adoption.  

What are some benefits of breastfeeding an adopted baby or baby born by surrogate?

Breastfeeding is the normal, healthy way to feed and nurture babies.  All babies.  And babies who arrive via adoption or surrogacy may benefit from breastfeeding even more than most babies. 

• Human milk protects babies against illness.  The protection can be especially important for babies who have experienced adoption since adopted babies - for several reasons - are more likely than other babies to get sick (Gribble, 2006).
• Breastfeeding helps babies attach to their adoptive or intended mothers. All babies who experience adoption or surrogacy experience a disruption in attachment, because babies begin attaching to their mother in utero (Gribble, 2006).  Some adopted babies experience multiple breaks in attachment if they are in foster or institutionalized care before adoption.
• Breastfeeding helps babies to develop normally.  Babies who experience adoption are more likely to be developmentally delayed due to drug or alcohol exposure in utero, parental abuse, and/or institutionalized care.

Are there benefits for the mother, as well?

Yes, breastfeeding is just as important for mothers as it is for babies.  And, just as with babies, adoptive and intended mothers may benefit from breastfeeding even more than other mothers.

• Breastfeeding is a normal part of the female life cycle.  It provides protection against breast, ovarian, and uterine cancers, osteoporosis, and cardio-vascular diseases.  For women who do not experience the health benefits of pregnancy, breastfeeding can be especially important (Ip et al., 2007; Collaborative Group on Hormonal Factors in Breast Cancer, 2002). 
• Breastfeeding can help heal the loss associated with infertility.  Breastfeeding provides a unique opportunity for the adoptive or intended mother to participate in her baby’s birth cycle. 

Can a mother breastfeed without making milk?

Yes!  A mother can most definitely breastfeed without making milk.  She can feed her baby at her breast using an at-breast supplementer (a feeding tube attached to the breast) such as a Lact-Aid or Supplemental Nursing System (SNS).  Or, she can bottle-feed her baby and comfort nurse her baby at the breast (just as a baby might suckle on a pacifier for comfort).  Breastfeeding is so much more than making milk!

Photo credit: Barbara Robertson, IBCLC 

If a mother wanted to make milk for her adopted baby or baby born by surrogate, what are her options?

Even without being pregnant, frequent stimulation of the breasts and nipples - usually by a nursing baby or an electric breast pump - can cause a woman’s breasts to start making milk.  Taking medications or herbs can help the breasts to start making milk sooner and/or more abundantly.  Most mothers who induce lactation, or make milk without pregnancy and birth, will produce some milk and a few will produce a full milk supply.  Many adoptive or intended mothers will use an at-breast supplementer so that they can fully feed at the breast even if they are not producing a full milk supply.

Several protocols, or step-by-step instructions, have been developed to help adoptive or intended mothers induce lactation.  In my book Breastfeeding Without Birthing, I describe five protocols for inducing lactation, ranging from very simple to more intricate.  The simplest protocol for inducing lactation has been used by adoptive mothers in developing countries where there is no access to breast pumps or medications for inducing lactation.  Another protocol uses an electric breast pump and herbs but no pharmaceutical medications.  Another uses an electric breast pump as well as a couple of pharmaceutical medications.  Each adoptive and intended mother is encouraged to choose a protocol that suits her individual values and circumstances or, with the guidance of an International Board Certified Lactation Consultant, to mix-and-match the established protocols in order to customize an approach just right for her. 

An adoptive or intended mother can start the process of inducing lactation, or making milk without pregnancy and birth, several months or weeks before her baby arrives.  She can also wait until her baby is in her arms to begin.  There really isn’t one ideal time to start inducing lactation, since each mother’s circumstances are unique. 

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About Alyssa: 

I am an International Board Certified Lactation Consultant (IBCLC) in private practice, a La Leche League Leader, and mother to three breastfed children – two by birth and one by adoption.  Breastfeeding my adopted daughter was a highlight of my life – something so special and so important to both of us that I want to do whatever I can to help other adoptive or intended mothers and their babies have the same opportunity we did.  For more information on breastfeeding a baby arriving by adoption or surrogacy, see my new book Breastfeeding Without Birthing:  A Breastfeeding Guide for Mothers Through Adoption, Surrogacy, and Other Special Circumstances (Praeclarus Press, 2013). It is available through my website www.BreastfeedingWithoutBirthing.com or on Amazon.  My facebook page is another great way to keep in touch!  www.facebook.com/BreastfeedingWithoutBirthing .

References:

Collaborative Group on Hormonal Factors in Breast Cancer. (2002). Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet, 187-195.

Gribble, K. (2006). Mental health, attachment and breastfeeding: implications for adopted children and their mothers. International Breastfeeding Journal, 1(5). doi:10.1186/1746-4358-1-5

Ip et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries: evidence report/technology assessment no. 157. Rockville, MD: Agency for Healthcare Research and Quality.