Breastfeeding is not just for biological moms. With the right support and some basic equipment, adoptive moms are discovering that breastfeeding is a viable - and beneficial - way to get babies off to a healthy start.
It's not as simple as putting a baby to the breast, says Dr. Anne Eglash, medical director, at the UW Health Lactation Clinic. A woman's hormones need stimulation before the body knows to produce milk. "The breast has to develop, like a tree in the spring," says Eglash. "When a woman becomes pregnant, hormones tell the breast to develop. As the breast ripens through pregnancy, the hormones of the placenta tell the body to get ready, get set."
If a woman has given birth - or had a miscarriage or an abortion - she has an easier time lactating. Breastfeeding is obviously more challenging for a woman who has never been pregnant, and adoptive mothers shouldn't expect to have a full milk supply, but it can work. "The goal should be to put the baby to the breast and nurse," says Eglash.
When Janet Parker and her partner, Walt Novash, decided to adopt a newborn, they found a La Leche League book, Breastfeeding an Adopted Baby and Relactation. "I actually didn't realize it was possible to breastfeed an adopted child, but when I learned about it I thought I would give it a try," says Parker, who is breastfeeding her adopted daughter, Masha, 7 months.
"When I'm breastfeeding in public I like to tell people, because otherwise they might wonder what I'm doing if they know that my baby was adopted," says Parker. "Like so many good parenting and baby-care strategies, this has always been common in traditional societies and in other parts of the world. It's been sort of forgotten about in our society."
The American Association of Pediatrics recommends exclusive breastfeeding for six months and continuing for one year or longer, stating that breastfed infants have lower rates of respiratory tract infections, gastrointestinal problems, allergies, obesity and more. Considering these health benefits - and the bonding that comes with the physical contact - it's only natural that some women are willing to undertake some rigorous preparation to nurse babies they didn't give birth to.
As Masha's birth approached, Eglash suggested frequent use of a breast pump. Once Masha came home, Parker used a Supplemental Nursing System (SNS), a bottle with tubes that can be placed next to the nipple. When Masha sucked, she got milk from the bottle (either donated breast milk or formula) along with the milk that Parker produced, and the suckling stimulated milk production. Eglash says some women benefit from birth control pills (which essentially simulate pregnancy but need to be stopped at least a month before breastfeeding) and drugs that increase milk supply. Other women use herbs, like fenugreek.
Monica Vohmann, a family medicine and obstetrics physician at Group Health Cooperative, had already breastfed her biological daughter when she and her husband adopted their son Jaden when he was 10 days old. "He was very interested in breastfeeding from the get-go," says Vohmann. "Around month three, he was still wanting to nurse on me all the time, so I decided to just do it." She dedicated a 10-day vacation to relactation, latching Jaden onto her breast every three hours. The combination of the SNS, pumping, Chinese herbs and a couple months of taking Domperidone (an anti-nausea drug sometimes used "off-label" to stimulate milk production) worked.
Vohmann nursed Jaden for 15 months. "It was very nice when Jaden was three or four and he would come home from preschool and say, 'Was I in your belly?' I'd have to say, 'No, you weren't in my belly, but I breastfed you; you were at my breast all the time.' That physical connection, I think, meant something to him."
Eglash says it's fairly rare in her practice for women to inquire about adoptive breastfeeding. "Most of my patients who adopt would never consider it. I think they don't see it as part of adoption. One thing that makes it really challenging is that they don't know when they will get the baby."
"It was very challenging," says Lia Gima, a full-time mom and home-school educator in Milwaukee. She and her partner, Barbara Basaj, began considering adoptive breastfeeding about a year before they adopted. (Their children are now 9.) Gima's mother, a lactation consultant, started them both on herbs and supplements, and both women began pumping and filling their freezer with milk as the birthmother's due date approached. On the morning the biological mother went into labor, the couple discovered they were adopting twins.
Gima says it was tricky keeping enough milk in the house for two babies and coordinating nursing with the SNS tube. But it was worth the struggle.
"Breastfeeding and co-sleeping really helped with attachment, which can be tough for adoptive families, as children who have experienced trauma often have trouble receiving the love their parents have to give," says Gima.
Despite the fact that their twins began life in NICU incubators, they are now "amazingly strong and healthy," says Gima. "I credit the breast milk."
"I feel probably the same as any mother who breastfeeds," says Parker, baby Masha cooing at her breast. "Having those times every day of calm and close time with my baby is really special. All those benefits are equally important for a child who is adopted."