Blog: Adoptive breastfeeding and inducing lactation

Nature is amazing, isn’t it? Can you imagine the heartache of knowing you can’t conceive your own children, but the elation of being able to bond with your new baby by breastfeeding them as though you’d birthed them yourself?  

In my job as a lactation consultant, I was lucky enough to work with a Melbourne mum called Amy, who was able to experience breastfeeding with her adopted son. By the time her son came to live with her and her husband, he was 12 weeks old and had only ever been fed from a bottle. As she’d read a lot about breastfeeding an adopted child, Amy was keen to start right away. When I visited her at home, I helped her start with some skin-to-skin and we were then able to latch her son with a nipple shield and a supply line (sometimes known as a supplemental nursing system or SNS) containing formula on her very first try! To Amy’s surprise, ‘he showed immediate interest in latching’ and ‘caught onto the idea really quickly’. Amy expected the process to take a long time, however she was amazed, ‘how natural it became almost instantaneously’.

Building up a milk supply without the hormones that are released when the placenta is expelled is time consuming and takes a lot of dedication and persistence, but it is definitely possible. With Amy, she had also undertaken the ‘Newman-Goldfarb protocol’ for a period of time preceding her son’s adoption. This is a sequence of medications the mum-to-be takes to mimic pregnancy and birth. First, she takes the contraceptive pill for 9 months. She then commences a drug called domperidone (which incidentally is an anti-nausea medication) to increase the levels of the milk-making hormone, prolactin, and starts expressing regularly. The idea of this is to stimulate the breast to grow breast tissue as it does in pregnancy and then subsequently start to produce milk as it is stimulated by a breast pump, and then, hopefully, a baby sucking.  

At first, it’s best to express as frequently as a newborn usually feeds, which can be up to 8 to 14 times in a 24-hour period. Once milk starts to come out, that’s the exciting part, and something to build on. By the time Amy started breastfeeding, she had already been able to pump 10 mL per feed. That quickly escalated to be able to pump up to 60 mL and, together with offering the breast, she was able to mix feed for around 4 months. Some feeds she didn’t need to top up with the supply line at all, sometimes she did. Amy’s son thrived on breastmilk, and Amy sourced some donor milk to replace his formula top-ups, so that he was exclusively breastmilk-fed for a number of months. He only weaned from the breast when he became too distracted, which ‘made feeding him with the SNS a very messy and difficult task to manage’, said Amy. When Amy started using the bottle more often for his top-ups, her son started to refuse the breast, as he preferred the easier flow. ‘I was sad that it ended’, reminisces Amy, ‘but also overwhelmingly satisfied at what I had achieved’.

Rather than a hush-hush, little-known activity, inducing lactation (once only really known about in some cultures where a grandmother was able to feed her grandbaby after losing her daughter in childbirth) is now becoming more popular due to women sharing their lactation journeys on social media. I’ve been fascinated to follow Allie and Sam, from Nova Scotia, Canada, on TikTok and Instagram, and there are many others from all over the world sharing their induced lactation successes. Allie birthed the couple’s twin boys (from Sam’s eggs) and her wife Sam, who had never been pregnant, induced lactation and was able to produce a full supply and exclusively breastfeed the boys for four months. As I write this, she is still mix-feeding the pair of 7-month-olds. ‘I’m so thrilled’, she said recently on her TikTok account, ‘I’d like to continue breastfeeding for at least a year’.  Such a motivating and inspiring act that will hopefully fill many more women with hope to be able to experience something they never would have known they could!