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Breastfeeding Outside the Box

We are proud to present a series of podcasts for parents Breastfeeding Outside the Box, where we aim to support the nourishing and nurturing of babies in exceptional families - families who historically have not received the help and support they need and deserve. Our exceptional families include adoptive, intended, and foster families; gender and sexual minorities; families with special needs babies; parents who have had breast surgery; mothers with IGT or low milk production for other reasons; exclusively pumping mothers; and more.
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Jan 26, 2016
It was great to hear from our show's co-host, Hope, about her inspiring journey to nursing her daughter by adoption.  Hope originally learned that breastfeeding in adoption was possible during her doula training.  Armed with the knowledge that breastfeeding would be possible for her even though she

 
was unable to conceive, Hope found resources on adoptive breastfeeding to be pretty scarce at first.  Fortunately, more information and support continued to emerge.  Here are some of the top resources that Hope found:
  • The asklenore website* got her started with a step-by-step approach for inducing lactation, called the Newman-Goldfarb Protocol.  The Newman-Goldfarb Protocol primarily consists of pumping and the use of pharmaceutical medications to induce lactation.
  • Several months later, Hope discovered additional options for inducing lactation in the newly released book, Breastfeeding Without Birthing.  Using some ideas she read about, she choose to enhance the steps in the Newman-Goldfarb protocol by adding some natural techniques, such as herbs and acupuncture
  • Hope also discovered an amazingly supportive and informative Facebook group called Adoptive Breastfeeding.
  • Hope consulted with a local International Board Certified Lactation Consultant (IBCLC) to help guide and support her as she induced lactation, and then with nursing once her baby arrived.  To find an IBCLC in your area who works with mothers through adoption or surrogacy, see the Find a Lactation Consultant page on the Breastfeeding Without Birthing website.
*Note: Updates to increase the simplicity and safety of the Newman-Goldfarb protocol were published in Breastfeeding Without Birthing. Details regarding these updates can be found on the Breastfeeding Without Birthing blog.


 
Supplementation
When Hope started the process of inducing lactation, she was hoping to achieve a full milk supply.  But, like most mothers who induce lactation, she did produce a significant amount of milk but not a full supply.  

Knowing how much to supplement can be tricky - not enough supplemental milk or formula means baby won't have enough to eat, but too much supplemental milk or formula can mean less breastfeeding.  Looking back, Hope wonders if she supplemented too much too early.  Her pediatrician recommended supplementing 3 ounces per feeding within her daughter's first few days of life, but this recommendation was way more milk/formula than a baby needs in total at that age:
  • At 3 days, normal intake during a feeding is 1 ounce.
  • At 1 week, normal  intake during a feeding is 1.5 ounces.
  • At 2 weeks, normal intake during a feeding is 2-2.5 ounces.
  • At 1-6 months, normal intake during a feeding is 3-4 ounces
[Mohrbacher & Kendall-Tackett, 2010]

If a mother has induced lactation with pumping before her baby arrives, she will have a pretty good idea how much milk she is producing at a feeding, and can use the difference between her milk production and the normal intake numbers above as a starting point on how much to supplement.  
Jan 26, 2016
Alyssa shared with Hope the breastfeeding story that inspired Breastfeeding Without Birthing.  It has been 10 years since Alyssa became an adoptive parent who nursed her baby, and she has been working hard ever since to grow information and support around breastfeeding without pregnancy and birth.  

 
Alyssa's passion for breastfeeding grew out of her experience nursing her first two (biological) children.  When she and her husband planned to adopt, she knew that breastfeeding would be a very important part of that plan.
Building a Full Milk Supply when Inducing Lactation

While many mothers who induce lactation hope to build a fully supply, few of them do.  Alyssa was one of the fortunate ones.  Why are some mothers able to produce a full supply and others much less?  We really don't have all the answers, just as we don't have all the answers why some mothers by birth cannot produce a full supply.  But we do have some inclinations:

  • Mothers who've birthed and breastfed before tend to make more milk.
  • Mothers who work with an International Board Certified Lactation Consultant (IBCLC) tend to make more milk.
  • Mothers who effectively and frequently empty their breasts make more milk, usually either by pumping with a hospital-grade breast pump or by breastfeeding with an at-breast supplementer.
  • Mothers who take the medication domperidone tend to make more milk.
  • Mothers who have experienced infertility due to hormonal reasons tend to make less milk.

Alyssa emphasized that nursing very frequently (up to 14 times per day) was a challenge, yet she believes it was an important factor in why she was able to breastfeed her adopted daughter without supplementation. She explained that frequently nursing her baby allowed her to get enough milk over the course of the day, even though her breasts probably didn't produce very much milk at each feeding.  Producing a small amount of milk each time the breasts are emptied is referred to as "small breast storage capacity" and is typical of mothers whose bodies haven't just undergone pregnancy. 

Jan 26, 2016

Alyssa and Hope are hard at work preparing to serve you with some inspiring and hugely informative podcasts to guide you along your journey to feed and care for your precious little one.  We will be talking with experts in the field - both lactation professionals and parents who've nursed their babies outside typical definitions of breastfeeding.  We will cover topics such as helping a non-latching baby, inducing lactation, exclusively pumping, bottle-feeding and bottle-nursing, nipple shields, at-breast supplementers, chestfeeding, co-nursing, relactation, IGT, tongue-tie, herbs and medications for increasing milk production, and more.  

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