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    Jay L. Hoecker, M.D.

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Question

Induced lactation: Can I breast-feed my adopted baby?

I'm adopting a newborn, and I'd like to breast-feed the baby when I bring him home. What can you tell me about induced lactation? Can I produce breast milk if I haven't been pregnant?

Answer

from Jay L. Hoecker, M.D.

With considerable dedication and preparation, induced lactation may be possible.

Normally, lactation is triggered by a complex interaction between the hormones estrogen, progesterone and prolactin during the final months of pregnancy. Upon delivery, levels of estrogen and progesterone fall dramatically — but levels of prolactin remain high. The result is the natural production of breast milk.

Similarly, induced lactation depends on the successful replication of this biological process. You may begin with nipple stimulation — ideally, pumping both breasts with a hospital-grade electric breast pump every three hours around the clock, beginning about two months before you expect to begin breast-feeding. This stimulation encourages the production and release of the hormone prolactin. Your health care provider may also prescribe hormonal therapy, such as supplemental estrogen or progesterone, to mimic the effects of pregnancy. In some cases, other medications may be prescribed as well — although no drugs have been specifically approved to induce lactation, and potential side effects may be a concern.

Typically, hormone therapy is discontinued shortly before breast-feeding begins. At that point, the baby's suckling is thought to stimulate and maintain milk production. Your health care provider may recommend continued pumping to further stimulate milk production.

It's important to note that supplemental feedings with formula or donated breast milk may be needed even if you're able to successfully induce lactation — especially during the initial weeks of breast-feeding, while you're establishing your milk supply. To encourage continued nipple stimulation, you may choose to use a supplemental feeding aide that delivers formula or donated breast milk through a device that attaches to your breast. Supplemental formula feedings can also be given with a traditional bottle.

To learn more about induced lactation and how to increase your chances of successful breast-feeding, contact a lactation consultant at a local hospital or clinic. Counselors from La Leche League or similar organizations may offer help, too.

Next question
Sagging breasts: Inevitable after breast-feeding?
References
  1. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. June 15, 2008.
  2. Wittig SL, et al. Induced lactation: Gaining a better understanding. The American Journal of Maternal/Child Nursing. 2008;33(2):76-81.
  3. Bryant CA. Nursing the adopted infant. Journal of the American Board of Family Medicine. 2006;19(4):374-379.

AN01882

Oct. 29, 2008

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