003: Meet Hope Lien, adoptive breastfeeding mother and CLC

Breastfeeding Outside the Box

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. SupplementationWhen 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.