The Boob Group
Breastfeeding for Adoptive Parents
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LEILANI WILDE: Are you planning to adopt a newborn? Do you know you can still breastfeed your baby even without giving birth? Is it possible to get a full milk supply? Should you plan on supplementing? Today, we're talking about what it takes to create a milk supply and how this extra effort benefits both mom and baby. This is The Boob Group.
LEILANI WILDE: Welcome to The Boob Group broadcasting from the Birth Education Center of San Diego. The Boob Group is your weekly online, on-the-go support group for all things related to breastfeeding. I'm your host, Leilani Wilde. I'm also an IBCLC and owner of Leilani's Lactation and Doula Services.
Thanks for tuning in today and being a loyal listener of The Boob Group. Don't forget to visit our website and subscribe to our newsletter for updates on new episodes. You can stay connected by downloading our free apps available in the Android, iTunes, and Windows marketplace. Here's Sunny to tell us how you can get more involved with our show.
SUNNY GAULT: Alright, hi everybody. Thanks for listening to The Boob Group. We love to hear from our listeners and we have these segments that you guys could be part of so I'm going to share a couple of different ideas, ways that you guys can participate in our show. So one of the segments is called “Boob Oops”, which is you know our funny breastfeeding or pumping stories that we have.
Perhaps someone walked in on you when you were breastfeeding or pumping. We've had some stories like that, or just funny things happen while you're pumping or breastfeeding your baby. Anyways, we want to hear these stories. They're really funny and it really helps to motivate other moms out there to know that we're not the only ones that you know have something funny happen to them.
There's another segment I really like called Momma Hacks, and it's where we share our pumping and breastfeeding hacks that we've discovered. Things that make life a little bit more simple when you're breastfeeding or pumping for your baby. So if you've discovered one of those amazing hacks and just want to share it with other mommas out there, we would love to help you with that.
So a couple different ways that you can submit for these segments. You can go on to our website and find the contact link and you can send us an email and you can share your story that way. But if you want to tell the story yourself or share the tip yourself the best thing for you to do - and this is my favorite way for people to submit - is to use our voicemail and that number is 619-866-4775. I love it because we can actually hear your voice, you can say the story or the tip in your own words. And then I think it's nice to for other moms to hear other moms, not just hear Leilani and I talk all the time.
So, those are two great ways that you can submit for the show, and also all of our segments are listed on our website for The Boob Group, so feel free to go to our website at www.NewMommyMedia.com and check it all out.
LEILANI WILDE: Let's meet our mom that's with us today.
HOPE LIEN: Hi, I'm Hope and I'm 32 years old and I work as a postpartum and birth doula and also as a lactation counselor. And I'm also an adoptive mom. I have one daughter who is two years old.
SUNNY GAULT: And you breastfed her, right, Hope?
HOPE LIEN: Yes I did. And I'm still sometimes breastfeeding her.
SUNNY GAULT: Alright so before we begin our episode today, there was a news headline that caught my attention I thought might interest you guys. Maybe you've seen it, if you're active on social media. But there's a photo, actually multiple photos, they're calling them emotional photos that are going around on Facebook and probably, I don't know, Instagram and every other social media outlet out there that allows you to post photographs.
It's of a Florida mom, her name is Sarah, and she was diagnosed with breast cancer when she was 20 weeks pregnant. And before she gave birth, she underwent mastectomy and the first round of chemotherapy. And then her child was born. She really wanted to breastfeed her baby but she was about to start another round of chemo so she could only breastfeed her baby for the first two weeks of baby's life.
So there was a photographer that took some photos because this was such an important time for her, and even though it was you know, two weeks, it wasn't exactly what she had in mind, she was still able to do it for a little bit and of course have these photos afterwards to show. And I believe it was the photographer that posted some online, I don't know, photographer, mom, posted some stuff online and it's just been shared by thousands of people on social media. In the photo, you can actually see the mom doesn't have any hair.
She has a scar on her chest that's visible, and she's just holding her baby in her arms and she's crying, you know, because it's such a happy moment for her. Did you see this online, Leilani?
LEILANI WILDE: Actually I have not seen it but wow, it's a powerful photo. Oh my.
SUNNY GAULT: Yeah. You know.
HOPE LIEN: That's amazing.
SUNNY GAULT: I know, right? I mean it's such a, I'm getting chills actually just talking about it because you know we do whatever we can for our kids and it's just so powerful to see a mom, despite everything else that's happening in her life, just be able to have that sweet moment with her baby.
LEILANI WILDE: She found something positive in the moment and took it and ran with it. It's beautiful.
SUNNY GAULT: Yeah and shared it with a lot of other, even unintentionally, she said she had no idea that this was going to be you know people are going to you know take to these photos so much, so. Obviously, we wish Sarah the best, and thank you for posting these, Sarah, if you are ever listening to our show because I think this so emotional but you know can really help other moms out there. And I'll be sure to post this to our Facebook page so if you guys want to check it out, see the photo. There are a couple different media outlets that are talking about it right now. Yeah. Very nice.
LEILANI WILDE: Today on The Boob Group, we're discussing breastfeeding for the adoptive parent. Our expert, Alyssa Schnell, is an IBCLC with a private practice in St. Louis, Missouri. Thank you for joining us, Alyssa.
ALYSSA SCHNELL: My pleasure.
LEILANI WILDE: Alyssa, is it possible to breastfeed even if you didn't give birth to your adopted child?
ALYSSA SCHNELL: Definitely is. And it may look a little different. It may look similar to a mother who has given birth, but it may look different in the sense that the mother is nursing with an addbreast supplementer, which means it's a bag or a bottle which hangs around mommy's neck with a tiny feeding tube that leads to the nipples and it can carry donor milk or formulas or surplus milk that the mother is not making so that the mother can feed at the breast, or a mother may do some feeding at the breast or some nurturing, just comfort nursing at the breast and some bottle feeding. There's lots of ways that can work if the mother has adopted.
LEILANI WILDE: Okay. And she can also make some milk herself, is that correct?
ALYSSA SCHNELL: Yes, definitely. So even the mother is using the addbreast supplementer, may be providing some milk directly from their breast and some from the supplementer. That's typically the way it works.
LEILANI WILDE: And Hope? You had an adopted child and were you able to produce milk for your baby as well as supplement?
HOPE LIEN: Yes. I was able to produce a pretty good supply, but my supply did kind of ebb and flow depending on I guess where I was at with my cycle because I never really didn't have my cycle so depending on what part I was at. I sometimes would have a really good supply. I mean there were times that I could pump seven ounces in one sitting, and then there are other times when I can only pump one or two ounces, so I often used a supplementer, but there were some times that I didn't, and that was always like a really good feeling.
But, eventually I kind of felt that having a full supply wasn't as important as I initially thought that it was.
LEILANI WILDE: And more important was what? What was more important to you?
HOPE LIEN: I think just I realized how our nursing relationship was and that I could have that and maintain that and I didn't really depend on me having a milk supply or not because I could use an addbreast supplementer and that really helped, I guess. I think that that really helped with increasing my supply as well, because I had the extra stimulation all the time from using that breast supplementer.
LEILANI WILDE: Okay. Alyssa, can a mom actually get a full supply?
ALYSSA SCHNELL: It does happen. Most mothers who induce lactation, which is what is the term for bringing in milk without pregnancy and birth, will produce some milk but not all. And the reasons really vary. In been my experience, personally, and also working with my clients, that moms have brought anywhere between drops of milk to a full milk supply. And there are things that can impact that. If the mother has given birth before, she's more likely to make more milk.
If she uses a medication called domperidone, she usually makes more milk. If she uses an addbreast supplementer as Hope mentioned, that creates that extra stimulation, helps them to make more milk. And if they work with an IBCLC, you know having that guided support can make a big difference.
On the other hand, if a mother has infertility issues due to hormonal reasons, that can make it more difficult for her to make more milk. So those are kind of, there are a lot of factors that can come in to how much milk a mother makes and that's why the areas vary so greatly.
LEILANI WILDE: And that's probably why it's so important to have an IBCLC, to help walk you through what you're about to go through in advance, as well, right? You don't wait for the last second or can you wait to the last second if you're surprised with a baby that's arriving or adopting suddenly?
ALYSSA SCHNELL: Right. You know ideally we see the moms as soon as they make the decision they want to breastfeed. And that could be even before they have a match. And we could make a plan then. But we recently saw a mom who was like a Wednesday night and her baby was being born C-section Thursday morning so she had like just hours from when we planned it to when the baby was born. And even you know if the baby's already been born, you know we could start then. You know I'm really about meeting each mom, wherever she's as is said with adoptions, there's so many unknowns, I have to be so flexible.
LEILANI WILDE: It's good to know that each mom that is about to enter into the adventure of adopting a child and want to breastfeed that it doesn't matter when she starts, it's just a matter of a decision she makes and what she does with that decision as far as reaching out for the help and putting the effort into it. Is that correct?
ALYSSA SCHNELL: Definitely, and I think that's probably something that maybe isn’t as well-known. That it's not too late if you don't have much time, you don't need a lot of time. You can just jump right in wherever you're at.
LEILANI WILDE: Alyssa, how much supplement did you need, and did it change as you went through your process of breastfeeding, and still up to this day?
HOPE LIEN: Yes it did change. I worked really closely with a couple different IBCLCs as I went through my protocol and so I was really happy that I had that existing relationship with them for when I brought my baby home. And I also worked with a different IBCLC at the hospital that she was born in because she was born in a different state.
In all of the circumstances, I would often have her weighed and consult with the IBCLC about how much supplementation to be using, and I found that her doctor and pediatrician while she was still in the hospital was wanting me to use way more supplementation than the IBCLC felt was necessary, which I felt was important to consider because I wanted to demand as much for my body and not impact my supply negatively by supplementing with too much.
Then I eventually used the supplementer less and less, and I would sometimes just bottle feed after a nursing session or if I knew my supply was a little bit higher sometimes I wouldn't supplement at all, things like that. And now we mostly just nurse for comfort and so I don't use supplementation at all anymore.
LEILANI WILDE: That's really nice. You know you made a statement in regards to the conflict between the IBCLC and the doctors as far as how much supplement. Alyssa, can you explain to us what happens in that situation or what moms need to know about that?
ALYSSA SCHNELL: Well, probably the first thing that moms need to know is that doctors get very little training on breastfeeding. So you can imagine what they know about breastfeeding in a special situation like this. It's probably nothing. So I wonder if what part of what Hope experienced is sort of just a whole lack of distrust of the process of inducing lactation that the doctors had. They didn't believe it was true, and that was my experience as well.
When I brought my daughter to the doctor for the first time, and she was exclusively breastfeeding, the doctor asked me "well what else are you feeding her?" And I said "nothing" and he said "well I mean in the bottle", and I said "we're not using bottles", "no but what's the other food you're giving her?" and like he could not believe it. And it took like several minutes of just going around and around until like he really believed that she was breastfeeding.
LEILANI WILDE: He's not alone. There's so many people out there that haven't ever heard of this, or ever experienced it or even knew someone that has gone through this so this is what's so important about educating the public and future moms about how important breastfeeding is and it can be done, it's not impossible as you both know.
ALYSSA SCHNELL: Well our bodies are just incredibly amazing.
LEILANI WILDE: They are. But when we come back, we will discuss why a mom should consider creating a breast milk supply and what the steps are to make her supply as full as possible. We'll be right back.
LEILANI WILDE: Welcome back to the show. We're here with Alyssa Schnell, an IBCLC with a private practice in St. Louis, Missouri. Alyssa, why should a mom consider creating breast milk?
ALYSSA SCHNELL: You know there are lots of reasons why a mom would want to induce lactation. In an adoption there's often a lot of stress in utero for the baby, whether its lack of prenatal care, exposure to drugs, nicotine, alcohol in utero, and even the stress of an unplanned pregnancy can affect the baby.
So these babies are already born more susceptible to illness so the advantage of the nutrition and immunities of the breast milk is going to be especially important to these babies. But also, probably even more importantly, is the attachment factor that any baby who is adopted has experience with the disruption in attachment. If that baby is in foster care, institutionalized care, obviously there's going to be multiple disruptions in attachment or even a lack of attachment for a period of time.
But even babies who are adopted at birth, they start attaching to their gestational mother in utero and research has shown that babies experience trust when they're separated from that gestational mother. And so breastfeeding is a really excellent tool to help the baby and the mother bond to each other.
LEILANI WILDE: Hope, what were your reasons that made you decide to create your breast milk for your baby?
HOPE LIEN: Well I think initially, the first and foremost reason I wanted to induce lactation was for nutritional reasons because I really knew all of major benefits of breast milk. But then also just for the close relationship and bond that that would help with just because of adoption and things like that. I knew that that would be important. And then ultimately the closeness and the nurturing relationship that we had because of nursing became even more important than the nutrition aspect.
And then I would also say something that I didn't necessarily expect but definitely came out of it was just a lot of healing from experiencing infertility for so many years and just totally restoring faith that my body wasn't totally broken and that I could do something really beneficial. That was a really healing and wonderful realization that I have.
LEILANI WILDE: You know that's really important. I like what both of you have said. It seems that as an IBCLC, you understand the heart of a woman and are able to carry or not carry and then the benefits of creating that breast milk for the baby. On both ends you guys seem to have captured the whole essence of breastfeeding and the importance of bonding the baby. I love that. Alyssa can you tell us about how production is made maybe what the steps are to make breast milk? We've heard of, or maybe some of these moms out there have not heard of the Newman Goldfarb Protocol. Can you explain that to us?
ALYSSA SCHNELL: Yeah sure. So the primary mechanism in which a mother induces lactation is stimulating the nipples and breasts. So that can be with a breast pump, it could be with the baby at the breast, which ideally with an add breast supplementer. And then she takes medications it could be pharmaceuticals, or herbs, or a combination of both that can boost the effectiveness of the physical stimulation.
So the Newman-Goldfarb Protocol is a set of steps that was developed by Dr. Jack Newman for a mother through servicing Lenore Goldfarb who is also an IBCLC and she's the first to use it and really promoted it so that the rest of us could learn about it and use it as well. It involves using medication as well as pumping to help bring in the milk supply.
It can be a longer-term process taking several months ahead of time to start bringing in before the baby is alive. So just one approach that many moms have found really helpful for bringing in milk involves using some medications to cause the breast to change as if the mother was pregnant to help her grow the breast tissue, as well as auto-hormonal changes that would happen with milk production and with pregnancy and sort of stimulating the pregnancy and the birth, causing the milk to come in.
LEILANI WILDE: Why would a mom choose this particular protocol over her other options? Because there are other options out there, some are not as medicated of a program.
ALYSSA SCHNELL: Let me tell you the main reason that mothers choose this protocol is that it tends to really work well. It's probably the most effective approach as far as bringing in milk that she could use. But it's not a right fit for everyone primarily usually regarding the medications, either.
They choose not to or they cannot take those medications, and so there's lots of other ways to go about it that are great, so we really want to talk to each mother and customize an approach that's going to fit her. And a lot of times, we'll start with the Newman-Goldfarb and take a piece out here and add a piece in there, and when you work with an IBCLC, she can help you do that in a safe and effective way to make the best protocol for each individual mother.
LEILANI WILDE: And as you're working with a mom in regards to using this Newman Goldfarb Protocol, Do you adjust it week to week as you see progress or lack of progress, is that what you're doing?
ALYSSA SCHNELL: Usually I don't even touch with moms that often although they choose to keep in touch with me. I am happy to adjust it as needed but usually we don't tweak it that much as we go along. Usually once we get something set, maybe a little bit of tweaking here and there and especially once the baby arrives, then the game changes, and we can work on that again.
LEILANI WILDE: Okay. Hope, did you use this protocol?
HOPE LIEN: I did because in my research that I tried to do leading up to adoption, I felt like it probably was my best chance of bringing in the most milk. But at the time I was researching it I felt like there was not a lot of good information other protocol options. So I started with that protocol right away when we started our adoption process and I was able to be on it for about six months before our daughter arrived.
And so I know I had that lead time to be on that particular protocol so that was helpful. But then later on in the process, I did discover a list of book breastfeeding without birthing and that actually was really helpful for me to learn a lot of other good options for additional things to add to the protocol like acupuncture and herbs and other stimulation, things like that and techniques for pumping. So that was really helpful at the end.
ALYSSA SCHNELL: To kind of comment on what Hope said, when I first started my private practice and I was working with adoptive mothers, many of them have experienced what Hope had where the only thing they knew of was the Newman-Goldfarb Protocol. So if it wasn't a good fit for them, they would throw out their hands and say "oh, I guess I can't breastfeed".
So that was then my goal in writing the book and my private practice is to open it up for people regardless of whether or not the Newman-Goldfarb was a good fit for them or not, to help them make the protocol that can work for anyone. Or in some cases, not every mother would induce lactation but they can still breastfeed. Some of them will just exclusively use an add breast supplementer and provide all the food that way, or some would just nurture at the breast and bottle feed.
So there are so many options that we can make. Any piece of breastfeeding that that mother wants make that work for her.
LEILANI WILDE: Hope, if you had to do this all over again, would you change anything?
HOPE LIEN: I think I may, actually. I think the Newman-Goldfarb Protocol worked pretty well for me in general, and I found that in my experience, domperidone was pretty helpful in boosting my supply. But I guess it would all depend on if I had the same amount of "me" time and things like that. I think just also now from having so much more information from Alyssa's book and things like that, I know that there is a lot of other options, and so I think I feel pretty open to doing whatever would work for that particular situation, depending on my timeline and things like that.
LEILANI WILDE: Excellent, thank you. Thank you so much, Alyssa and Hope, for helping us all better understand why we should consider inducing lactation to create our own milk supply for our adopted child and what it takes to get there. And for our Boob Group Club Members, our conversation will continue after the end of this show as Alyssa will talk about her own personal experience of breastfeeding her adopted child. For more information about our Boob Group Club, please visit our website at www.NewMommyMedia.com.
SUNNY GAULT: So here's a question from one of our listeners, this is from Mischa and this is what she wrote:
"I have a question but here's some background first. I nursed my first daughter, now five, for fourteen months and rarely pumped and had an awesome supply. My second daughter was born with some health issues and a cleft in her soft pallet, and all I could do was pump. And after the stress of the NICU which she was there for seven weeks, and the stress of a feeding tube amongst her other health issues, my supply dried up around five months. I did however receive donations of breast milk for nearly two years. Such a Godsend.
Now I'm nursing my third daughter and had no problems at all until last week and it seemed that my supply dropped overnight. When I pump, I only get one to two ounces. How do I build it up, and what could be the problem? She is almost four months and i nurse on demand. My husband suggested that I quit pumping for extra milk because of all the negativity that came along with having to pump solely for my second child. Could it be a mental thing with stress? I've been taking supplements for a while to increase my supply. Any thoughts or ideas will be greatly appreciated."
DAWN KERSULA: This is Dawn Kersula and I am an IBCLC and RN at Brattleboro Memorial Hospital in Brattleboro, Vermont. So Mischa, this is quite a complicated question that you have posed for me. And the reason for this is that there can be so many different reasons, as you well know, for drops in supply.
So the first thing that I want to do is congratulate you because your babies are so lucky to have you for a mom. You have persevered under unusual situations and unusual circumstances and so this third baby is so lucky to be getting breast milk as well. So here are a couple of things I'm thinking about.
The first one is, that our bodies change from the endocrine to the autocrine control of lactation usually somewhere between 8 and 12 weeks. So we kind of go on autopilot instead of so much prolactin oxytocin, the thing that we read about so often for how moms make milk.
And so that's a time when we often perceive that we've lost our milk because our breasts get softer and our babies are stealing less so sometimes it's hard to tease out that answer. But usually, those babies continue to nurse on a pretty regular basis and be pretty happy with it. Another crazy thing that can sometimes happen I would be a little worried about is if you had an oversupply, it's possible that you've had just because you've already nursed twice and did such a great job of pumping for that second baby for so long.
Sometimes you can actually have a decreased supply because all this time, the baby has basically been able to be a very lazy nurser and still get all that they want. I've seen babies just lay there and let the milk drip into their mouth so think back a little on this and do some detective work on yourself on that. If you can only pump one to two ounces at a time, I would encourage you to remember that in a full day at this point you probably get only one ounce per hour, maybe a little bit more than that, so if you didn't pump for two hours and you got two ounces, you probably have a sufficient supply and remember that your baby is probably taking some of that as well.
So some of the things I would think about is how is your baby acting? Is your baby acting happy at the breast? Another thing that I would think about would actually be getting a good IBCLC with the skill to help you. You could actually do a preimposed plan to your weight so you could actually see how much the baby was getting in one feeding. That's kind of a clap shoot though because sometimes babies are getting different amounts every single feeding. You have to like watch your fingers around before and after a quote-unquote normal feed.
I would certainly not be afraid to continue to pump sometimes on if you're nervous about that supply, and as long as you're enjoying the pumping, it's not making you feel like "oh, not again", I would certainly continue the supplements. One thing I have to say about stress is, for most of us, stress does not make our milk supply go down. You want to have to be able to feed longer or you want to have to be able to have a let down on that pump.
I have one girlfriend; she always says that the best way to make more milk is to have a big mug of hot chocolate with a big squirt of whipped cream on it. [Inaudible], but wherever you are, think of a way to put your feet up, relax a little bit, maybe that husband of yours or your five-year-old needs to give you a foot massage and see if that doesn't help a little bit with the stress on your pumping. I wish you the best. I would love to know what happened. Thanks.
LEILANI WILDE: That wraps up our show for today. We appreciate you listening to The Boob Group.
Don’t forget to check out our sister shows:
• Preggie Pals for expecting parents
• Newbies for newly postpartum moms and their babies
• Parent Savers for moms and dads with infants and toddlers
• Twin Talks, for parents of multiples.
Thanks for listening to The Boob Group: “Your judgment-free breastfeeding resource.”
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
SUNNY GAULT: New Mommy Media is expanding our lineup of shows for new and expecting parents. If you have an idea for a new series or if you’re a business or an organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com.
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