A Journey Through Adoption and Induced Lactation

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By: Melissa Portunato MPH, IBCLC, RLC

Recently, we had the opportunity to chat with Kristina, a loving mother and wife, nurse, and International Board Certified Lactation Consultant (IBCLC). Kristina opens up about her longing to be a mother, her desire to breastfeed and the adversity she has faced with adopting. Join us on this intimate journey as she candidly shares her heart including her personal commitment to provide breast milk for her adopted baby by inducing lactation. 

Kristina grew up with both an adopted sister and brother, so adoption was never off her radar. She always wanted to have a family and embraced the idea of adopting but she planned on having biological children first. In 2006, she got married and began nursing school where she quickly became fascinated with lactation and pursued the gold standard of lactation care, IBCLC. She worked alongside mothers and babies in labor and delivery for several years. Her desire to have a baby of her own to breastfeed became more intense. When she was unable to get pregnant after several years, Kristina and her husband felt it was God’s plan to adopt a baby. In 2013, that thought became a reality when she connected with the biological mother of her son who was 9 weeks pregnant at the time. Kristina felt extremely fortunate and blessed to be able to meet her baby’s biological mother so early in her pregnancy. This woman was incredibly open and welcoming in allowing Kristina be part of her life. 

Immediately, Kristina knew that she wanted to induce lactation and thought that she would simply start pumping several months before the baby arrived. However, after speaking to an endocrinologist 4 months before the baby’s due date, she decided to follow a protocol that includes taking birth control pills and domperidone, a medicinal drug that is proven to increase the “milk making hormone” prolactin. She was told that she should have taken both medications for about 6 months, but at that point did not have that much time. She started both medications and after 6 weeks stopped taking the birth control pills and the next day started pumping. For 8 weeks (until the birth of her son) Kristina pumped around the clock – 8 times a day every 24 hours. At first, she only saw droplets but at the end of her first week, she had collected a daily total of 2 ½ ounces! She was committed to her pumping schedule and her milk volume steadily increased. By week 3, she was pumping 3 ½ ounces per day and the day before delivery she was pumping 15 ounces per day! 

Kristina and her baby’s biological mother had a tight-knit relationship the entire pregnancy. Together they attended prenatal visits and she was even asked to be at the birth. This came completely unexpected but Kristina and her husband were thrilled and immediately said yes. Kristina had always felt the time in the hospital was reserved for the baby and the birth mother. Kristina felt her baby’s birth mom needed to “say Hello to say Goodbye.” She wanted to give them privacy and space during their short hospital-stay. 

The most anticipated day had finally arrived and Kristina got to witness the birth of her firstborn son. Little did she know, the birth mom would ask her if she wanted to do skin to skin! Kristina quickly said yes without any hesitation. And what do you know? While doing skin to skin, her baby latched to her breast! Kristina said it was simply magical. Her heart leaped for joy and her dreams came true at that very moment. Kristina was finally a mother and was breastfeeding her baby! 

Kristina says at first the driver for her to breastfeed was to provide the superior form of infant nutrition, but eventually, the driver would become the unbreakable bond she had formed with her baby. Her breastfeeding journey continued for 2 years, even after returning to work. She exclusively breastfed her baby, never needing to supplement with formula. How amazing right?!

In 2015, she embarked on her second adoption journey and induced lactation once again. This time, the story ended with heartbreak when the biological mother wanted her baby back days after the birth (before signing the final relinquishment). This was devastating for Kristina and her family, including her son. But with immeasurable love and grace, she gave back the baby to the mother that had birthed him. She walked away from this journey once again incredibly empowered by the ability to induce and sustain lactation. 

Kristina voiced several struggles she encountered as she (and the birth mother) wanted to provide her breast milk to the newborn in the hospital. With her first-born son the hospital was incredibly supportive, offering to let her use one of their in-house pumps, storing the milk in the hospital refrigerator, and rejoicing in the birth mother’s choice to have them both breastfeed the baby in the hospital. However, the second experience was quite the opposite. The hospital and staff were not supportive and did not allow Kristina to breastfeed or offer pumped milk to the baby despite the request of the birth mother (who did not herself want to breastfeed but wanted the baby to get Kristina’s breastmilk.) The hospital stated that if the birth mother did not want to breastfeed the only other option was formula, even after Kristina offered to show proof of testing and screening. She says that she would like to see more awareness brought to the topics of inducing lactation and adoptive breastfeeding. Unfortunately, the medical community is not well enough informed to develop hospital policies and practices that safeguard adopted babies’ right to breastmilk. We need to do better, we owe it to our babies! 

Today, Kristina is a passionate breastfeeding advocate in Guatemala where she provides no-cost lactation care and support to breastfeeding mothers in impoverished areas throughout the region. Kristina’s dedication to the lactation community began even before the birth of her baby but her own personal journey has fueled her passion to help mothers achieve their breastfeeding goals. 

Kristina’s advice for a new mom inducing lactation and adopting a baby: “Don’t focus on how much milk you are making, but go for it and see what happens. Get ready to experience an amazing connection with your little one!” 

Follow Kristina on IG @leche.with.love
www.lechewithlove.com

Photo Credit: www.room212photography.com

Can Breastfeeding Be Used As Birth Control?

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By Danielle Lasher, Spectra Baby USA Pumping Mom and Blogger 

Just breastfeed! It’s that simple, right? Nurse your baby and you’ll have no concerns about accidentally finding yourself expecting another one? That’s the idea, and it actually works quite well for most.

Traditionally, women who breastfeed on demand can keep their menstrual cycle suppressed and thus, are said to be protected from pregnancy at a rate of 98% through the first six months of their baby’s life. This is known as the Lactational Amenorrhea Method. Should mothers be able to trust that their bodies are capable and biology has accounted for keeping fertility at bay and milk flowing when they have a new baby? Of course, but breastfeeding isn’t just reliable birth control because it’s idyllic; it is strongly supported by repeated peer-reviewed studies. 

What Is The Lactational Amenorrhea Method?

The Lactational Amenorrhea Method utilizes a few ground rules to keep it in check. First, a woman whose period has returned cannot use this method reliably. 

Second, the baby must be exclusively breastfed. What does that mean exactly? It means you are only breastfeeding. No bottles, cups or spoon-feeding. No SNS. No supplementing with formula, donor milk or even your own pumped breastmilk in any form. Why not? Because it would mean baby is being fed via means that don’t fully stimulate your breasts to produce milk. That’s the root system of LAM. That constant stimulation is needed to keep those hormones in check and fertility at bay.

Last but not least, the baby must be six months old or younger. So, if your period is still MIA, you aren’t supplementing or giving solids, and baby is younger than six months, LAM is a fantastic birth control option for you with a 98 percent efficacy rate.

Does It Really Work?

Truth be told, a lot of women have doubts. It seems too good to be true, right? Many choose to use backup barrier methods because they’re heard those “I breastfed and ended up pregnant” stories. The science is pretty firm on LAM though. Yes, it works, but it has to be implemented correctly. Some women worry about that first cycle returning and possibly getting pregnant when they ovulate the first time, not knowing their first period is on the way. Still, there are fairly simple measures that can be taken to nearly foolproof your LAM plan, and they don’t need to include birth control that can hinder your supply.

So Just Breastfeed And That’s It?

Mostly. We also have to consider how women are approaching their bodies. Most of us learned about the birds and the bees and becoming a woman under similar circumstances. A lot of women aren’t aware that the way they’ve been taught to track their cycle by charting their period isn’t actually accurate.

Yes, there is a right way, and many of those “breastfeeding for birth control failed us” babies happen because moms haven’t been shown how to correctly monitor their cycle. The crux of many natural birth control options, such as Fertility Awareness Methods, starts with being aware of ovulation, not tracking the period as most women are taught. 

What Is Fertility Awareness?

Fertility Awareness is an umbrella term for different methods of natural birth control practices that rely on tracking the cycle in some manner and using back-up methods of protection or abstinence during the fertile period. 

While popular, period apps are only as good as the information you’re putting into them. It’s not magic. Predicted fertility estimates given by such apps are based on averages of your cycle and other users’. If you want solid predictions for fertile days and when to expect Aunt Flo, you’ll need to input data for the app to make those estimations, such as the consistency of your cervical mucus, the position of your cervix, and your basal body temperature each day.  

Being an active participant in the health of your body and womb is pretty empowering, and once you learn how to do it, it all becomes second nature. There are modern-day tools to help make things easier on you, too. Products like the Caya diaphragm and many tech-friendly temping devices have taken breastfeeding and birth control to a whole new level. Gone are the days of having to wake up at the same time every day to temp, or worrying your temp is inaccurate because you’re nursing all night.

Can Breastfeeding Be Used As Birth Control?

So, can you use breastfeeding as a form of birth control? Absolutely! It really is that easy!

If you find yourself wanting the extra reassurance that you’ll catch that return in fertility, tracking ovulation and following the Seven Standards of Ecological Breastfeeding—a core tenet of Natural Family Planning—takes the Lactational Amenorrhea Method one step further. These steps include:

 

  • Exclusive breastfeeding for the first six months with no solids, formula or water
  • No pacifiers, instead giving baby unlimited access to the breast 
  • Not introducing any bottles
  • Co-sleeping in the room with your little one for both daytime naps and through the night
  • Nursing often and on-demand—not on a schedule
  • Avoiding leaving baby or engaging in anything that limits the ability to nurse

These steps make the guidelines a woman must follow to stay in line with LAM a little clearer. Remember, the more baby nurses, the more prolactin mom produces. When this hormone is high, it keeps estrogen and progesterone (the hormones primarily responsible for inducing ovulation and menses) low. Thus, lots of nursing means a lesser chance of fertility returning.

Ultimately, some women will see their cycle return within six to eight weeks after birth (even while following all the “rules”) while others won’t until they’ve weaned from nursing completely—often, well into the toddler years.

Sources: WABA, Market Watch, NFP and More, MEL Magazine

Traveling While Exclusively Pumping

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By Jenn Foster MA, IBCLC

Trying to pack for a trip is always stressful. One of the hardest parts of traveling away from your little one, especially when exclusively pumping, is planning ahead to ensure you have everything you need.  We are here to help you be prepared for your travels and melt away some stress for traveling away from home while pumping exclusively.

A checklist can help you make sure that you have everything you need when you leave the house. But even with a system, there’s a good chance that one day you’re going to be in a hurry and forget something crucial, like breast shields or collection bottles to pump into.

Here are five quick tips to make pumping on your trip easier.

  1. Bring extra sets of pump parts with you on your journey.

Ensuring that you have everything you need and more can help you when traveling. Pack extra breastshields (flanges), collection bottles, duckbill valves and backflow protectors.  Just in case you misplaced some pump parts, you will be prepared by having extra sets of everything you need to pump.

  1. Tricks of the trade when on your journey.

One trick of the trade can be to pack two storage bags and breast pads in zip lock bags for each pumping session you will do while on your trip. Keeping breastmilk storage bags and breast pads in ziplock bags help you plan ahead for every pumping session.  You will be able to have everything together and stress less about not having enough. For example, you pump 8 times per 24 hours and will be gone for 5 days.  Plan ahead by packing 45-50 ziplock bags. Extra sets of these items help you not only plan for what you need; but, will also help you keep them together in one safe place. 

  1. Get a hands-free pumping bra so that you can do other things while you pump.

With pumping so many times while away, getting a hands-free bra can be a game changer. This way, while you pump, you can work on a laptop, take notes while you’re on a conference call, or take a break and read a book or magazine. Instead of holding your breast shields during the time you spend pumping can be very liberating!

  1. Ensure to prepare to wash your breast pump parts daily.

CDC recently issued guidelines stating that pump parts should be washed as soon as possible after each use. (More about the new guidelines here.). To avoid spending a lot of time washing pump parts – and deal with getting access to a sink, bring enough sets of pump parts to get you through a day. Then you can wash them all in one batch at the end of the day.

  1. Make friends with the other pumping moms.

Having a relationship in place can be really helpful when your planning a trip away from your normal comfy pumping environment. However, it can be very helpful by having the support of other moms who have been in your shoes. Look for moms who have also pumped away from baby. Look for a support group online for moms who exclusively pump.Spectra Baby USA  has an amazing of group exclusively pumping moms.

Preparing To Join The Work Force Again

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By: Mirine Dye, MPH, IBCLC

Going back to work and breastfeeding is very much a normal part of a woman’s life, but careful planning still needs to be done.  Although pregnancy is a time to plan for birth and think about how your new family is going to work, it is also the time to start planning on how you will transition back to work.

Ideally, you have a supportive work environment and start envisioning your plan before you even take leave.  Find out what your employers policy is on breastfeeding or pumping and use this to start your plan. For instance, do they have a private lactation room or does one need to be identified? How does the flow of your day fit in to the need to spend 2-3 breaks pumping, each break being 20-30 minutes long. How and where will you store your milk? How will you clean your hands before pumping and how will you clean your pump parts after pumping? 

If none of this is obvious before you take leave consider writing down exactly what you think you will need and start speaking to your supervisor or human resource office. Thankfully there are legal protections in place should you need them, but if you are a valued employee you should be able to explore solutions with conversation and maybe a little education.

Also, the Affordable Care Act says you should have a private space, not a bathroom, where you can pump milk for your baby.  A chair, an outlet, a door for privacy and a sink nearby provides for the bare minimum. A fridge for storage would be great, or take your own cooler with cooler packs if needed. Milk ejection or “let-down” happens best when mom is comfortable and not distracted! Carry a picture or video of your baby and watch the video during pumping. Don’t rush, take this time to think about how much working women can accomplish and how amazing you are for taking on this effort!

It may also be helpful to have a letter of support from your pediatrician, obstetrician, midwife or lactation consultant. What would it say? Here are some bullet points for some of the wording:

  1. Part of the mother’s care plan is to continue to provide only breastmilk for her baby until at least 6 months of age. 
  2. In order to provide her infant with the correct amount of milk for the infant’s growth and brain development, she must feed the baby when together, and use breast pump when separated, mimicking the eating pattern of the infant. This means that mother must pump no less than every 2-3 hours while separated from her baby.
  3. Please allow the mother to stay on the recommended pumping schedule for her breast health and the nutrition of her baby. 

So what will it look like when you return? You may have some options depending on your workplace and your baby! When returning to work mothers may:

    • Have infant brought to worksite, these are very lucky babies and mothers!
    • Pump exclusively during the week and breastfeed on days off
    • Pump at work and feed baby bottles while away
    • Reverse cycle ( some babies prefer no bottles, and will only breastfeed and wait all day for mom to return and make up for their milk needs all evening and night!) Mom should still express milk when separated from baby to keep comfortable and to keep up supply

Mothers should try to simulate their schedule at home before returning to work, 2 weeks before returning to work is a good time to start.