Induced Lactation: Breastfeeding an Adopted Baby

Written by dr. Dyah Febriyanti, IBCLC

Sometimes, many couples who can’t get their own children in their marriage decide to adopt babies. Many of them even decide to breastfeed the babies who not only get breastmilk benefits, but also emotional benefits from the bond with the mothers. Induced lactation is the way adoptive breastfeeding can be done.

 

What is induced lactation?
Induced lactation is an effort to do stimulation of lactation without pregnancy (nonpuerperally). This also includes adoptive breastfeeding where a non-breastfeeding mother induces lactation, whether or not she has ever breastfed before. 1
The basic science of induced lactation
Breastmilk production or lactogenesis involves hormonal changes during pregnancy, starting at about 16 weeks.1 When the baby is born and the placenta is expelled, there’s dramatic change in hormones and the milk starts to come in2. It will be better if there is skin-to-skin contact and the baby suckles well.
To mimick the hormonal change during pregnancy and after birth, pills containing synthetic hormones are used.3 Establishing bonding between the mother and the adopted baby, well suckling, and galactogogues are necessary to support milk production.
What are the benefits of induced lactation?
In Islam, ‘mahram’ status can be established if mothers breastfeed their adopted babies. But it can be achieved only in some circumtances and requirements.4
Emotional bonding between the mother and the adopted baby 5
Nutritional fulfillment for the baby 5
The baby gets many breastmilk benefits such as antibody, secreted Immunoglobulin A that prevents allergy, etc 6
Emotional and physical stimulation that support the baby’s growth and development5
How is induced lactation done?
Induced lactation process needs commitment and long term support for both the mother and the adopted baby. The steps of induced lactation are:
Stimulation of breastmilk production
Induced lactation process starts with stimulating breastmilk production by using hormonal therapy. This therapy is done at least 3 weeks by giving the mother pills containing synthetic estrogen and progesterone.1,3 The longer this process is done, the better result will be achieved.
Increasing breastmilk production
Along with the hormonal therapy, the mother takes some drugs to increase breastmilk production.1 The dosage and duration are monitored by lactation consultants.
Skin-to-skin contacts
When the baby arrives, skin-to-skin contact between the mother and the adopted baby is done. 3 Hospitalization is done to support this step. In this step, the adopted baby is focused on building bonding with the mother. The mother offers the breast as frequently as possible while keeping skin-to-skin position day and night.

skin to skin contact

Supplementation for the adopted baby
To fulfill the baby nutritional needs, the baby is given additional milk using suplementation device called ‘suplemental nursing system®’. Artificial nipple is not used. The amount of suplementation will be monitored and reduced gradually by lactation consultant.3 The parents choose between donor milk or formula for the suplementation.

supplementation for the adopted baby

During induced lactation process, the nutritional needs of the baby is monitored.

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When is induced lactation started?
Induced lactation can be started when the baby is not born yet, about 3-6 months pregnancy.3 The process can also be started after the baby is born. The older the baby, the more difficult the process will be.1
How long is induced lactation done?
The production of breastmilk varies among mothers. Usually, the breastmilk comes as early as 4 weeks.3
Sources:
International Lactation Consultant Association. 2013. Core Curriculum for Lactation Consultant 3rd Edition. Jones & Bartlett Learning. p289
Wilson-Clay&Hoover. 2013. The Breastfeeding Atlas. Fifth edition. Texas: Latctnews Press.
Schnell, Alyssa. 2013. Breastfeeding Without Birthing. Amarillo: Praeclarus Press.
Rais, Isnawati. 2015. “Donor ASI dalam perspektif Islam”. Seminar Relaktasi, Induksi Laktasi dan Suplementasi untuk Membantu Bayi menetek. IKMI-Perklini.
Szucs,Kinga A.2010. Induced Lactation and Exclusive Breast Milk Feeding of Adopted Premature Twins. J Hum Lact. 26(3):309-313.
World Health Organization. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals.2009.p 1-9,77

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