The Truth About Relactation For Adoption — My Story
I breastfed seven children including three of my adopted babies for 11 years total — relactating for two of those adopted babies. Relactation means you have lactated previously after a period of no breastfeeding or very little breastfeeding, as opposed to induced lactation which is defined as breastfeeding without pregnancy. Both are possible, however, this post will focus on relactation.
I have 15+ years of experience in the foster care sector as both a parent and a trainer, and every call, every time you say yes, every “I’m sorry, that’s not a good fit for us” sends you into a myriad of emotions. I didn’t adopt every child I brought in, there were some special considerations and circumstances, I said no more than I said yes, and adoption was the priority. We were part of the foster adoption program in Alaska, meaning our preference was to take in children who would never have to leave as I wanted our home to be the last home these foster kids would live in. We would be their forever home. This meant that parental rights had been or would soon be terminated and a child was considered free for adoption.
The first call that we got for foster care was for a baby boy that was only a few hours old. At the time I was breastfeeding my one-year-old daughter and I asked our social worker if it would be okay if I breastfed the baby. Her response was incredible. She said, “If I don’t know I don’t have to tell you no.” We picked him up at three days old and he latched without any issue and we had a beautiful two-year-long breastfeeding journey.
Breastfeeding is supply and demand and this was a great personal lesson that it truly can be that easy. I did do a couple of things to increase my supply. I drank Mother’s Milk tea, I increased my water consumption and I increased how much food I ate. I wasn’t pumping, so I didn’t specifically notice a change in the composition of my breast milk from what you would consider toddler milk to newborn milk. I’m very aware that as a newborn, he would have been getting colostrum that he wasn’t able to get from me, however, the benefits of breastfeeding an adopted baby with an established milk supply so far outweigh any other option.
Another thing that made it easier to breastfeed him is that he was a newborn. He was three days old when we brought him home and that meant he was eating more frequently but he wasn’t eating high volumes of milk. That meant my milk supply had some time to build up while I progressed in my nursing relationship. It was such an exceptional experience to be able to bring this baby home, have an established supply, and to be able to latch him on, and move forward with life.
If you find yourself in a situation like this, just know that increasing your food and water and some supplements to increase supply are all helpful, but really supply and demand is not only true, but you’ll feel and see it happening in yourself. I got all of the bonding that I would have gotten if I had given birth on my own, which was fantastic.
A couple of years later I adopted a two-year-old son and I called the birth mom to thank her (which I did with every adoptive placement). In that call, she let me know that she was pregnant and was scheduled for an abortion three days later. In that conversation, I told her that I worked alongside CPS and I could have several families that she could interview to adopt the baby if she elected not to get the abortion. After our conversation, she decided not to get the abortion and instead to electively give the baby up for adoption with CPS involved peripherally.
At 27 weeks gestation, she asked me to be this baby’s mom. I was ecstatic. I said yes and asked if I could set up prenatal appointments and she hadn’t been to a doctor outside of having an early initial visit confirming the pregnancy and the gestation.
A week later, she had her first appointment and I was there for every appointment moving forward.
At that point. I had been a breastfeeding counselor for a decade and was also a lactation consultant with the IBCLC. I hadn’t been breastfeeding for several months and felt strongly that getting help was important as I wanted outside perspective and guidance. We were doing a private adoption with social services involvement, and I knew there was a chance that the adoption could fall through so I opted to wait to begin the relactation protocol until after her delivery.
I also went through breast augmentation prior to her birth and although I wasn’t concerned with that interfering, I did want to make sure enough time had passed for me to heal before I began medication and pumping. I connected with Lenore Goldfarb using the Jack Newman/Goldfarb protocol. She is amazing.
I had breastfed five children prior to my daughter’s delivery. I had been pregnant 6 times, had two miscarriages and it had been several months since I stopped breastfeeding. The protocol is designed to mimic what happens during pregnancy, and this works better if a woman is able to get on the protocol during the duration of the pregnancy. I elected to wait until the pregnancy was at the very end to start the protocol including renting a hospital-grade pump and setting up a med protocol with two medications.
The first medication was Diane 35 birth control pills. There has been a concern among some lactation consultants and medical professionals about the use of birth control pills in a lactating woman. We’re told that it’s bad for the milk supply, however, the birth control pill helps to induce lactation by mimicking pregnancy and encouraging breast milk production. It only takes one to two milligrams of oral progesterone to induce lactation. It’s also important to remember that the woman is taking the pill for much less than a year. Each month, I skipped the sugar pills and went straight back to the next month’s “active” pills to simulate pregnancy hormones, and I never had a cycle.
The second medication that I used is Domperidone. It helps you to stop feeling or being sick (nausea or vomiting) and was initially used for people with reflux. It has a side effect that results in lactation which also classifies it as a galactagogue. The baby receives only minute amounts, and the medication does not cross the blood-brain barrier of the infant. It is considered safe for the mother and baby and is given to babies in Canada who are suffering from severe regurgitation.
When my daughter was born, she immediately latched and since I was at the hospital for the delivery, I had access to her quickly and constantly. I was allowed to room in down the hall from the birth mom for the duration of her hospital stay — 3 days due to her being a C-section.
My daughter was born drug positive which was something that we knew about going into the situation. This caused lower birth weight, withdrawals, and difficulty maintaining her body temperature. We did skin-to-skin (kangaroo care) nearly constantly and brought her into a doctor’s office every day after she was released from the hospital to be weighed on a gram scale so we could track that her weight was consistently going up. I feel so strongly that the constant contact she was given did far more than just helped to regulate her body temperature and there is so much science I love on this topic.
Possibly due to the fact that I started the protocol after my daughter was born, I never got a full milk supply. I use a supplemental nursing system, which is a system that has a bottle that hangs around your neck and then a tube that goes from the bottle to the tip of your nipple that you tape down on your breast. When the baby latches they latch to both the breast and the tube and you can adjust the flow of milk from the tube. This allows you to have the baby at the breast for every single feeding and is a great way to supplement a low milk supply.
Eight months later, my son was born, and not only was I in the hospital for the birth his mom asked me to be there for her during labor and delivery. Her labor and delivery were fairly fast, and because we were there we were included in the plans and I was able to cut the cord. This was a private adoption and we were able to make all the decisions about his care. Due to the birth mom’s water breaking early, he was six weeks premature and went to NICU immediately after birth.
One of the best things about this hospital — the Alaska Native Medical Center — is that the staff assumed I was breastfeeding even as the adoptive mom, prior to learning that I was a lactation consultant and they asked me if I wanted an SNS. They had them there in stock and asked me if I needed assistance using it. It would be outstanding if more hospitals followed this incredibly pro-breastfeeding model.
In order to take him home I was trained to place an NG tube as the suck-swallow and breathe reflexes were a struggle for him. He was taken to a doctor’s office every other day to be weighed on a gram scale. I increased his time on the breast as much as possible over a couple of weeks, weaning him off the NG tube to be exclusively breastfed.
When we were asked to adopt our son, I contacted a woman who was donating an oversupply of breast milk and I never needed to supplement with formula. He was exclusively on breast milk until he was a year old and this is also how my daughter who was eight months older, was exclusively on breast milk for a year as well. My experience with re-lactation was specific to adoption and both infants had medical issues we had to work through. Both were given breast milk to supplement my milk supply and I breastfed both of them for about a year.
I had exceptional support from family and friends. I knew people in the industry that were also very supportive. I advocated for myself by finding information online and working with someone who had more experience specifically in this area. I also worked with a local lactation consultant to make sure that I had the correct flange size for the pump. It was important to me to not self-diagnose in this situation, and even with all the book knowledge that I had, I wasn’t missing anything by being my own lactation consultant.
As of this post, I relactated over 21 years ago, and these two babies are now 20 and 21 years old. One thing that was challenging with this protocol in the beginning, is that the medications are not as easily accessible in the United States. At the time, I was able to order everything directly from a pharmacy in Canada.
I never felt disappointed by not having a full milk supply. I knew due to starting the protocol after my daughter’s delivery I didn’t have the time that was ideal to make this work the most beneficially. I was really happy that I had a milk supply at all and breastfeeding has always been so much more than just the food value to me. This was an amazing bonding experience with my babies.