The Boob Group
Inducing Lactation Without Giving Birth
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ROSE DEVIGNE-JACKIEWICZ: Mothers who are adopting babies or having babies by surrogate often have a desire to breastfeed. Is it possible to breastfeed and bringing the milk supply when your baby was carried by someone else?
I’m Rose deVigne – Jackiewicz, a registered nurse, International Board Certified Lactation Consultant in Outpatient Lactation Clinic in San Diego at Kaiser Permanente. Today we’re discussing, “Induced lactation, breastfeeding without giving birth.” This is the Boob Group.
ROBIN KAPLAN: Welcome to The Boob Group broadcasting from the Birth Education Centre of San Diego. I’m your host Robin Kaplan. I’m also a Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre.
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Today, we’re joined by one lovely panellist by phone. Teglene, will you please introduce yourself?
TEGLENE RYAN: Hi, I’m Teglene Ryan. I’m 45 and I have three year children. I have two biological children. My son is 12 and my next son is 11 and then I have an adopted daughter who is three. My profession was a classroom teacher and now I am a full time mom and house schooling my children.
ROBIN KAPLAN: Perfect! Well, welcome to the show Teglene.
TEGLENE RYAN: Glad to be here.
ROBIN KAPLAN: Before we begin today’s show, here’s a question for one of our experts.
MELISSA: Hi, my name is Melissa and I am calling from San Diego, California and I just wanted to find out if there was a recommended milk bank, a local milk bank where moms could donate their milk to and/or moms could request breast milk from. If you could please let me know, I’d gladly appreciate thanks so much. Bye.
VERONICA TINGZON: Hi Boob Group listeners, this is Veronica Tingzon, International Board Certified Lactation Consultant and the owner of the Original Comfort Food Lactation Services in San Diego, California. What is that?
There really isn’t a milk bank here in San Diego, California. The milk banks where they actually pasteurize and dole out the milk are located in different areas. The closest one to San Diego is in San Jose, California. But, we do have a milk depot which is a collection station for the transport to the San Jose Stream and Milk Bank and that’s at Sharp Mary Birch Hospital hospitals here in San Diego, California.
You can always call them and see about getting your milk to the milk banks. However, first you have to contact the Stream and Milk Bank of North America and you can find that www.hmbana.org , HMBANA.ORG and throw out the question there to see if you are a viable candidate for milk donation.
After you fulfil that step and that you know that you are eligible for being a milk donor then you can start transporting your milk through Mary Birch which is then shipped out for processing and pasteurization out to San Jose, California. If you are actually in the need of purchasing the milk, you usually can have prescript for that or an RX from the doctor whether it’s a neo natal doctor or paediatrician.
You’ll need to get that script so that you can start purchasing through the Human Milk Bank Association. Once again, the milk depot; they usually ship that to Mary Birch and start doling out the milk from there. I hope this answers your question. Thank you.
ROBIN KAPLAN: Today on The Boob Group, we’re discussing, “Induced Lactation, breastfeeding without giving birth.” Our returning expert, Rose deVigne – Jackiewicz has been an International Board Certified Lactation Consultant since 1984 and works at the Outpatient Clinic at Outpatient Lactation Clinic I should say at Kaiser Permanente in San Diego. Thanks for joining us Rose and welcome back to the show.
ROSE DEVIGNE-JACKIEWICZ: Thank you and I’m very happy to be here.
ROBIN KAPLAN: So, Rose many people are surprised to hear that a woman can lactate without having birth the baby. How did you first get interested in this topic?
ROSE DEVIGNE-JACKIEWICZ: I first got interested in this topic many years ago. I was at a conference with a nutritionist who was talking about, “How women can bring their milk back after they stopped.” I was fascinated by that.
I had a woman who came to me when I worked at the hospital as a
Lactation Consultant who said, “I’m going to be adopting a baby and I want to breastfeed.” I read that you could breastfeed. I remembered that this nutrition I’ve talked about bringing your milk in and it’s like, “That would be great; I would love to work with you.” That’s how I got started and that’s probably been 25 years.
ROBIN KAPLAN: Can you explain, “What is it mean to induce lactation?”
ROSE DEVIGNE-JACKIEWICZ: Induce lactation historically is been called Adoptive Nursing. But, we now know it’s not just adoptive nursing because as one woman put it, “No, I’m not adopting the baby, I just am having a woman carry it – it’s a surrogate.”
So, it’s not always just because adopting but basically what it means is you are inducing or starting breast milk production without having the nine-month pregnancy. You’re right; there are a lot of people that don’t know. I meet physicians who are quite aware that you can still breastfeed and make milk if you’ve never been pregnant.
ROBIN KAPLAN: What is the difference between Induced Lactation and Re-lactation?
ROSE DEVIGNE-JACKIEWICZ: Technically, Re-lactation is a woman who has breastfeed before. So, that by definition – she’s breastfed before. Induced Lactation is you’ve never breastfed, you’ve never been pregnant; however, those terms are used interchangeably. If you have breastfed 10 years ago and you’ve just adopted a baby – technically, it’s Re-lactation but we still call it Induced Lactation because it’s without the pregnancy.
ROBIN KAPLAN: Teglene, when did you decided that you wanted to breastfeed your adopted baby and have you breastfed before?
TEGLENE RYAN: I have breastfed both my adopted children. I’m sorry both my biological children and when we started looking into the option of adopting, I always had in my mind that I wanted to breastfeed an adopted baby. I have heard about it back probably in the 80’s.
My mom told me about it. Two of my sisters are adopted and she came and told me about a woman she had met at the preschool where she worked who was breastfeeding an adopted baby. She was so excited. She said, “I wish I had known about this when – at least there’s still something available to me when I had your sisters.”
She heard about the supplemental nursing system about the baby getting milk at her breast. So, I kind of always knew that it was possible. But, we were adopting through foster care and didn’t really know what age child was going to be placed with us or when. We were saying that we’re willing to take children between birth and five years old.
ROBIN KAPLAN: So, got it! So, depending on the age of the child would kind of determine whether you were going to breastfeed or not.
TEGLENE RYAN: Exactly!
ROBIN KAPLAN: Rose, do all women’s bodies have the ability to induce lactation and do our chances go down over time?
ROSE DEVIGNE-JACKIEWICZ: Basically, all women do have the ability just like when you get pregnant – all women have the ability to breastfeed. There is a difference in how much milk moms make but as long as they have breast and a functioning pituitary, you can induce lactation.
As far as reducing over time – again, as long as you have breast functioning pituitary – you are able to induce lactation. In fact, in some cultures, grandmothers are known to help. They induced lactation when their daughters are having problems.
ROBIN KAPLAN: Very cool! Rose, can you walk us through the steps. How does a mother induce lactation?
ROSE DEVIGNE-JACKIEWICZ: Probably the first thing is to, “Meet with a lactation consultant” to find out what the different – there’s different protocols for inducing lactation. One of the very first questions I want to know from a mom is, “Tell me what your goals are.” Moms have different goals from, “I just want to have my baby at the breast. It kind of doesn’t matter if I make milk. But, if I do that’s okay” to the extreme of, “I want to make as much milk as possible.”
So, meeting with a lactation consultant who has some experience with these and then it is important to have a primary care physician or an obstetrician involved because there can be some medications involved in the induced lactation process depending on which protocol you choose. So, you do want to have your physician and hopefully he’s a breastfeeding friendly physician.
Because overtime, I’ve had help professionals as well as you know lay people go. You do what? Why would you want to put somebody else’s baby at your breast? I said, “That’s not the point.” It’s not somebody else’s baby.
ROBIN KAPLAN: Yes, exactly!
ROSE DEVIGNE-JACKIEWICZ: It is her baby and she wants to breastfeed. So, the steps can be multiple as far as the first thing is identifying what protocol to go into. For mom says, “I want to just put the baby to breast. It really doesn’t matter if I make that much milk.” There’s really not a lot she needs to do. She just needs to start nursing the baby when the baby arrives. But the mama says, “I want to maximize the milk supply and make as much as possible.”
Then ideally, the longer time you have to prepare – I mean if I could have a mom for four, five months before the birth – because again, what we’re doing is, “We’re kind of tricking the body into thinking it’s pregnant.” When the baby is born, we abruptly stop some of the medications and the herbs with pumping. That kind of tricks the body into thinking – I gave birth, let’s make milk. So, the more time you have – the better are your chances for making more milk.
So, again – if we have all day, we could go through lots of the steps. There are many steps but the first would be to:
• Meet with somebody
• Find out various protocols are
• Discuss what your goals are and then map out that
Okay, we need to do this – this and this. Meet with a physician to say, “Okay, I need an order for this birth control pill.” I need an order for this.
Again, if you are auto-protocol that has a birth control pill involved – the birth control pill is not used for birth control, it’s used for breast stimulations. So you still, if you could get pregnant – you can still potentially get pregnant. You wouldn’t use it as a birth control. Does that answer your question?
ROBIN KAPLAN: Yes and I want to say to for our listeners that, “We will link to some of the websites that have the protocols.” Ask Lenore, it’s one of the ones that I know I used when I’m guiding moms to induce lactation. So, we’ll include those on our website – so that way you can take a look at it.
ROSE DEVIGNE-JACKIEWICZ: That’s what probably the best protocols.
ROBIN KAPLAN: They’ve been used the most that’s for sure. Rose, can this be done without medication and are there certain health conditions that a mom should know about?
So, say, “She’s looking at the Ask Lenore Website and she’s kind of doing it maybe not with a lactation consultant – should she know that if she has a certain medical condition that she should not be, I mean she should work with lactation consultant anyway that she should not be following these protocols if there’s something that’s going on with her own body that could cause a problem.
ROSE DEVIGNE-JACKIEWICZ: Yes. In fact, the protocols do include a section on medical conditions.
ROBIN KAPLAN: Okay.
ROSE DEVIGNE-JACKIEWICZ: So, yes there are some potential conditions and try the first one that, “When moms have had years of infertility and they’ve been on various medications” I’ve had them say to me, “Please don’t tell me, I have to take medicines. I don’t want to take anything if I don’t want to.” Not taking some of the medicines or the herbs, you can still do it. It will take longer – you may not have as much milk supply but it can be done.
Conditions that might interfere:
• A woman has history of blood clots; she may not be a candidate for birth control pills.
• A woman who has a history of hypertension may be not a candidate for the birth control pills.
Although again, in the protocols; it does talk about options. So, it can be done without medications or herbs. There are some herbs that are less, have much less side effects than some of the medications and so it is possible, absolutely.
ROBIN KAPLAN: Teglene, what was your process for inducing lactation? Did you pump? Did you take medication? What did you do?
TEGLENE RYAN: We didn’t know we were getting our daughter until the day we got her because we were adopting on a foster care. It was – we never knew when there was going to be a child who needed a home. Our daughter would to say surrender instant while she was surrendered at birth.
So, we literally found out, “We were getting her and drove to the hospital to get her.” So, there wasn’t any advance preparation on my part because I had no idea that I was going to be coming home the next day with the baby. So, I had researched everything. So, once I got home with her – I knew what I wanted to do. .
I basically ordered the Lactaid which is an At-Breast Supplementer and a friend brought me over a hospital grade pump. I also ordered medication, “Domperidome.” I had previously talked with my doctor about the possibility of me inducing lactation and would that medication be safe for me to take?
So, I had already had the thumbs up from my doctor to take that where the situation to arise. I put her to breast and then it was just the process of being and putting her to the breast and that’s how I started.
ROBIN KAPLAN: Cool, all right when we come back – Rose will discuss how common it is for a mom who has induced lactation to reach a full milk supply as well as tips for starting this process. We’ll be right back.
ROBIN KAPLAN: Well, welcome back to the show. We are here with Rose deVigne – Jackiewicz, an International Board Certified Lactation Consultant and a Consultant at Kaiser Permanente San Diego in their outpatient lactation clinic. We’re also here with Teglene, a mother who has induced lactation for her baby.
So, obviously we’re talking about: “Induced lactation breastfeeding without having given birth.” So, our next question for you Rose is, “How common is it for a mom who induces lactation to achieve a full milk supply and which factors impact her chances?”
ROSE DEVIGNE-JACKIEWICZ: A lot of it, I have found over the years is, “Attitude of the health professionals” because many times moms are told, “That’s a nice thing to do but you won’t make any milk.” So, we set moms up for failure right from the beginning saying, “Well, it’s probably not going to work.” Well, we know it could work.
Historically, in other cultures – it has worked very well. Lenore, she had not been pregnant and she produced a full milk supply for her pre-term baby. So, it absolutely can be done. I think letting moms know, “It is an awesome thing to do.” It is a challenge and it does take time. It’s not something that you can do generally over just a couple of weeks. It does take several months and to maximize a full milk supply – most likely, requires the full protocol.
Although, it has been done if you’ve re-lactated – I had a friend who it had been like four years and technically, she re-lactated. It happened to be not for a baby for a treatment of a family member with cancer – but that’s another topic right there. Within six weeks, she was producing 24 ounces a day.
ROBIN KAPLAN: My goodness.
ROSE DEVIGNE-JACKIEWICZ: That was just with the use of pumping and Domperidome.
ROBIN KAPLAN: I guess just to put that in a frame of reference. So, it’s a whole time baby would be taking somewhere a six month old baby would be taking anywhere between 27 to 35 ounces a day. So, she pretty much was
ROSE DEVIGNE-JACKIEWICZ: She was pumping three ounces eight times a day.
ROBIN KAPLAN: That’s amazing.
ROSE DEVIGNE-JACKIEWICZ: So, it absolutely is possible and I think supporting mom and being very positive – but letting her know that it takes time, “The sooner that you can start the better.” Absolutely
ROBIN KAPLAN: Are there any other factors you would say that would impact her chances?
ROSE DEVIGNE-JACKIEWICZ: Over all, yes for general health. It is just like any woman gives birth. Some women who have a history of infertility or have maybe a history of breast reduction or have situations where maybe their breast is under-developed; even though they give birth, they may make a low milk supply.
So, that wouldn’t be any different than a mother who is inducing lactation for her baby. She may have a potential for a low milk supply depending on.
TEGLENE RYAN: Yes, I was.
ROBIN KAPLAN: That’s awesome. How long did it take you and did it take a while just to bring in those first few drops?
TEGLENE RYAN: It did. I had – when I brought my baby home, she was 18 days old and weighed four pounds, zero ounces. So, she was a pretty tiny little thing. While she latched on great and it seemed like she latch on and suck great. Her suck wasn’t strong enough to draw the milk to the tubing from the lactate from the supplemental nursing.
So, I wasn’t able to get rid of bottles and just nurse her with the supplementer the whole time which was I wanted to do. So, instead I had to keep – we kept practicing nursing while I continued to bottle-feed her. Even feeding from the bottle was difficult for her. Then, I also pumped. I tried to pump just as many times as the day as I could. I kept pumping in the middle of the living room so it was always right there.
It was probably two weeks before I started to see drops of milk. It was about six weeks before I was able to transition her to be fully at the breast and eliminate the bottles. She was nursing well enough that she could draw the milk from the At-Breast Supplementer and I could ditch the bottles.
Once I got to that stage, I decided to stop the pumping and to instead spend that time with her at the breast and fortunately, she loved nursing. She would pretty much latch on a nurse 24/7. So, I had a good partner in bringing in my milk supply. I made the goal of, “Trying to make sure that she was nursing at the breast a good 14 times in 24 hours.”
I had done a lot of the research on what makes women more successful on had read about how women in traditional cultures have a much higher success rate. About one of the theories is that, “In those cultures, baby is physically in contact with mom most of the time.” I’ve read stories about where they would just bring in women and put them in bed with an orphan basically. Within a few days or a few weeks, she would have enough milk for the baby.
So, I basically tried to replicate that with my baby and just have her in physical contact with me as much as the 24-hours as I could and it’s really encourage frequent nursing” both with and without the At-Breast Supplementer.
ROBIN KAPLAN: That is so cool! How long did it take you to clean to get that full milk supply?
TEGLENE RYAN: I was able to stop the last bit of supplemental milk that I was giving when she – shortly after she turned six months old, I was starting to take a few solids. But, even the last month or two, I was only meaning to give her supplements at towards the end like late afternoon and evening. I was able to go most of the day without meaning to give her supplemental milk.
ROBIN KAPLAN: That is so amazing and you hit on some really key points there, “You were willing to keep your baby with you 24/7 and in those early weeks and early months – that is the key.” We fortunately live in the society that was our babies on the schedule and sleeping and that makes it hard for some moms.
But, hearing you say that you’ve read about it and have done it, that’s awesome. That is most likely what really increased your milk supply because you started when the baby was almost three weeks old. You didn’t start two months, three months before the birth. So, that is amazing story.
TEGLENE RYAN: Having the support of my family was really important. My husband was – he would, I think he would go around bragging to people about me that I was nursing our adopted baby. He came back from a conference with health care professionals and he said, “Teglene, there were doctors there who didn’t know that it was possible to nurse an adopted baby – how was that possible? How come that they didn’t know?”
But, he would do things like he would take our older children out for the day and I would tell myself that I am not allowed to do any housework. I would lay down with the baby on my chest and watch movies.
ROSE DEVIGNE-JACKIEWICZ: Way to go.
ROBIN KAPLAN: Did you hear that moms?
TEGLENE RYAN: That was my job for the day. If he took the kids out of the house then I was on the couch with the baby on my chest that’s all I was allowed to do all day.
ROBIN KAPLAN: Well, we talk a lot about Kangaroo Care. We also were talking about how that is one of the ways to bring in the milk supply. So, that’s exactly what you were doing.
ROSE DEVIGNE-JACKIEWICZ: You were also doing what a lot of women do in the latter months of pregnancy where they’re resting and taking it easy because everybody says, “You need to take it easy.” Let me do all of these. You just happen to do it after the birth of the baby so that’s perfect.
TEGLENE RYAN: Right.
ROBIN KAPLAN: Which is often the best time to do it – I mean I always tell my prenatal clients when in my classes, “When else in your life do you have the ability to sit and love on something without really anyone being able to judge you?” She’s sitting there and she’s enjoying her baby. It’s not like you’re being lazy. So, take advantage of it. Partners too, like take advantage of this time.
I love that you did that because I agree with Rose. I think that, that is really insightful. Also, it kind of leads into the other question too because obviously, there are challenges to this process and I think one of the challenge is that, “A lot of us have so much going on and we don’t actually get the time to do what Teglene is explaining that she did to really help bringing her supply.” What other challenges Rose do you see for bringing an amount, inducing lactation?
ROSE DEVIGNE-JACKIEWICZ: Teglene had the baby with her. So, it was easier for her to say, “I’m just going to be nursing.” When a mom is inducing lactation and the baby is not here yet, she may still be working full time. She may still be working 40 hours a week. If she may have kids, she may not but she still has to take that time to pump during the day.
I had one woman who started the process a week before going to vacation in Hawaii. I tried to talk her out of it because it’s like, “You’re going to be at Hawaii for two weeks, you really want to be going and pumping every four hours?” When waiting in two extra weeks isn’t going to make that big of a difference.
True enough, she get on vacation and it was overwhelming. Had she already been in the process? Had she had the baby? You kind of, you just don’t get to set the baby and go, “I’m going to go out to the beach or go out to dinner.” So, it is challenging because you’re doing all of these work as if you had the baby but no baby.
You want to see those milk come in to the bottle. You may only see drops which is why I have moms pumping to tiny bottles not big bottles because you know – very small amounts in the tiny bottle looks like a lot and just having the family support, that is the key. Yes, reminding them, “That it takes time.” You were doing an amazing thing.
Remember we’re kind of tricking mother nature. We’re trying to tell the body, “Yes you’re pregnant.” We want these breast changes. We want to start making milk and trust me, “It’ll be worth it.” But, it can be challenging.
ROBIN KAPLAN: Rose, how can a mother feed her baby while bringing in her own milk supply? Would you say: “A supplemental nursing system as the best case scenario as possible?”
ROSE DEVIGNE-JACKIEWICZ: I would say the supplemental nursing system is ideal because it keeps the baby at the breast. The best stimulation for the breast is a good nursing baby. A hospital grade pump would be the next choice but a good nursing baby is the best – and that’s where the supplemental nursing system keeps the baby at the breast.
As far as what she’s going to feed the baby, there’s option of donor milk from the milk bank which can be kind of expensive. But, we have friends that have donated milk and/or appropriate formula for the baby.
ROBIN KAPLAN: Teglene, how challenging was this process for you and what kept you going?
TEGLENE RYAN: One of the things that really kept me going was, “My baby.” I knew she didn’t have a very good experience. Before she was born, there was no prenatal care and there was drugs and alcohol exposure. I knew that she was very much at risk for long-term problems. I knew that this baby is really needed just the physical contact of breast feeding, the nutrition and the oral development. She had so many strikes against her. I felt like it was my job to give her every strike in the other direction. So, that something that motivated me.
It was – the hardest thing was, “Not knowing how much milk I would get and the progress feeling swell at the time.” I did think about giving up a lot. I did questioned – another comment that I have in those time to do this. At the time, I didn’t always feel like I had enough time to do it. I was home schooling a seven and nine year old. My seven year old has some special needs. My husband’s a fire fighter who’s gone for days at the time.
I was spending half of the time as a single mom home schooling, trying to induce lactation. So, I had to – I had a friend who was particularly supportive and she told me that, “It was important to everybody that I continue to breastfeed the baby not just for the baby. That it was important for the whole family and that was okay to let some things slide.” Maybe the home schooling lessons weren’t going to be great and perfect for a few months.
I’ve really had to make peace with that and choose to let things go for a period of time. My older kids are fine; they’re not behind in school now. Even though, I did – I had to let things go to make time for it. Looking back on it, it’s so easy that it was worth it – but in the moment, it was much harder to see.
ROBIN KAPLAN: I think that’s great advice for any breastfeeding mom.
ROSE DEVIGNE-JACKIEWICZ: Absolutely and if you think about it, “You wore your baby.” You use these supplemental nursing system had you not done that, you would have been mixing bottles eight, ten times a day washing bottles – sitting down to feed the baby. That may have actually take more time than what you actually did.
TEGLENE RYAN: The hard part was, “I was doing that.” There were a couple of months there where I was spending a lot of time mixing up the supplemental milk, washing out the tubing, putting together the supplementers. It probably took an hour a day just to prepare all of the supplements and wash the tubing and all of that.
So, there was a time period where I was doing the work of full-time breastfeeding and full-time bottle-feeding even though I had it bags and tubes.
ROBIN KAPLAN: Absolutely! You’re right.
ROSE DEVIGNE-JACKIEWICZ: Absolutely!
TEGLENE RYAN: That was the hump that I had to get over. As I was able to delay, the women who her husband created the lactate for her, unfortunately she passed away a couple of years ago. But, at that time – she was available. You can call her on the phone and she will help you. She had used the Lactaid with adopted babies’ years ago. She’s the one who told me to start delaying the first supplement of the day.
So, I played the role game of “Okay, I didn’t give any supplements until 9:00 in the morning. I didn’t give any supplements until 10:00 in the morning.” I gradually kept pushing it back. So, I didn’t have to give any supplements until 4:00.
ROBIN KAPLAN: Awesome!
TEGLENE RYAN: So, I’m out for the day and feel like an exclusively breastfeeding mom.
ROBIN KAPLAN: That is awesome!
TEGLENE RYAN: It kind of helped me have that little mental game. When I got to the point where I didn’t need to give the supplement until late in the afternoon – then I was like, “This is okay. I could keep doing this.”
ROBIN KAPLAN: Yes, absolutely!
TEGLENE RYAN: I was still spending some time preparing the supplements and washing tubing but it wasn’t as intense.
ROBIN KAPLAN: Well, thank you so much Rose and Teglene for your insight into inducing lactation. This is truly one of my favorite topics, I love it. For our Boob Group Club members, our conversation will continue after the end of the show – as Rose and Teglene will discuss tips for starting the process of inducing lactation as well as for those that are in the thick of it. For more information about Boob Group Club, please visit our website at www.newmommymedia.com .
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ROBIN KAPLAN: Thank you so much to our expert, panelist and to all of our listeners and be sure to check in our sister show Preggie Pals for all of your pregnancy needs and Parent Savers, our show for parents who have zero to three year olds.
Next week coming up or coming up next week we have Anney, Cherri and Jennifer back on the show to talk about what life has been like while they’ve been nursing their nine old babies in our series breastfeeding expectations. Thanks for listening to the Boob Group, your judgment-free breastfeeding resource.
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