Friday, July 10, 2015

The Whole Inducing Lactation Thing

When I was first researching infertility treatments, the second book that I read (and in my opinion the best, most comprehensive, most layperson-friendly) was The Infertility Survival Handbook: Everything You Never Thought You'd Need to Know by Elizabeth Swire Falker. I read it once when I was getting my feet wet with all the different terms, before I knew that we would be going deep, deep, deep into IVF, and that none of it would work. Then I read it probably at least four more times, and used it like a targeted resource every time we did something new. My copy looks well-worn and well-loved.

One of the things I found interesting about the book was that ultimately, IVF didn't work for the author, either. She also went down the adoption pathway, and for her it was fairly twisty (not unlike her IVF journey). However, she said something interesting in the Telling My Story chapter:

"While I'm thrilled to be a mother and even had the unique experience of inducing lactation and breast-feeding our adopted child (I induced lactation and pumped [and froze] breast milk for months for David and then relactated for the little boy we named Theo, and then successfully breastfed him for three days), I will never entirely heal from my miscarriages." 

Did you catch that? She said that she was able to breastfeed babies that she did not give birth to. 

That blew my mind. I didn't think such a thing was possible. And then I filed it away, thinking it wouldn't ever apply to me.

As Bryce and I made our decision to end infertility treatments and pursue adoption, that possibility lingered in the back of my mind. As I added adoption-related pins to my Pinterest board "One Day Our Dream Will Come," I started to add pins on inducing lactation, articles from women who did it successfully, ways to do it without medication, adding SNS systems to supplement nursing at the breast with breastmilk or formula. I started researching the Newman-Goldfarb protocol to increase milk supply. Because apparently, a strange fact that I did not know, just pumping every 2-3 hours will actually cause you to start producing milk. It just may not (probably won't) be enough to breastfeed exclusively. The Newman-Goldfarb protocol involves taking a progesterone-only pill such as Provera (or an estrogen-progesterone combo birth control pill, if you are under 35, so no go on that one for me) in combination with a drug called domperidone, which is actually meant for GI stuff but has the side effect of creating lactation and increasing supply. There's also all these herbs that can help, like Fenugreek, and Blessed Thistle, and Goat's Rue, all things that are in these handy dandy Nursing Teas you can buy from Amazon.

Honestly, it was all a little overwhelming, but then there was also a short article in our Adoptive Parent Education Manual from our agency where a client successfully breastfed and thought it was an amazing experience. And I have friends who are lactation consultants, and they were thrilled to see these pins show up on my boards, and were all gung-ho about sharing their resources with me and encouraging me to do this amazing thing for my hazy-on-the-horizon FutureBaby. The LaLecheLeague also has a lot of resources, but sometimes I find them a little strong in their opinions and persuasive approach.

So initially I was really, really excited about this. Sure, I wouldn't get to be pregnant or give birth. But this experience didn't have to exclude me... I could nurse our baby and gain back a biological function of my body that my infertility had managed not to destroy.


I am kind of torn. Because this could be either a really great way for my body to redeem itself, to show its use in supporting tiny life, just in a different way than I'd envisioned... or it could be one more way that it fails me.

Because... get this... I also came across research that PCOS can make it really hard for women to breastfeed, in some cases pretty much impossible to have more than the frustratingly tiniest of supplies. It could be just fine, or it could be an awful no-go. And my PCOS has not been particularly friendly to me so far (because PCOS doesn't have to mean hideous infertility issues, but it can also be one nasty nail in your conception coffin). So I'm not all that optimistic that it would go the friendly way in this arena, either.

And, this is a lot, I mean A LOT of time-consuming, strangely-fertility-treatment-esque work to get that supply to do its magic. Pumping 2-3 times a day is no joke. I am pretty sure that I can't do that and teach at the same time, considering that I usually have time to PEE maybe once in a 6-hour period and am often still eating my lunch when I start one of my classes. I can make an educated guess that it would be fairly traumatizing to pump under a hooter-hider while setting priorities for the day and checking agendas. I don't think that would go over well, with anyone involved. Plus all the drugs...while both the progesterone and the domperidone are pills, not injections, it's still putting things into my body that are foreign and have side effects. And all the herbs and teas and restrictions on my diet... I don't mean to sound selfish here, but I feel like I've put my body through a lot, a LOT, and been on restriction after restriction without much any success, and so my faith in my body pulling through on this one is pretty damn low.  I could do all of this, I could pump and pump and pump and take all the drugs and buy all the gadgets necessary to freeze my milk (a part of that story I'd forgotten) in preparation for a baby to come sometime, and it could not come to fruition. The subject of donor milk has come up and I am just not that dedicated. I have very close friends who formula-fed and their children are just as healthy and just as smart as any breast-fed baby I've seen. I know breast is supposed to be best and formula companies are supposed to be evil, but it's amazing how they can mimic breastmilk to an extent, and how my friends' babies aren't allergy-ridden, ADHD-dizzy, delayed-development specimens. Also somewhat selfishly, I have heard all about how formula-fed babies sleep longer and deeper and the poop is not quite so runny.

I know that the whole breastfeeding versus formula feeding issue is incredibly polarizing. I am not saying one is better than the other, but I also need to look at our personal situation carefully, weighing all the options and their associated benefits and detriments.

Such as, when would I start all this pumping nonsense? Randomly, before we are matched? Wait until we are matched and then pump away and hope that the situation gives me enough time to produce the milk necessary? What if the match falls through? Then I am left with no baby and leaky breasts, which would seem to magnify the loss. Do I wait until after things are final? What about this "nipple confusion" thing I hear about? Will it be for nothing if I start with formula first and THEN supplement with breastmilk? What about if I do start ahead of time? Do I take time off from teaching to make this work? When would I decide to do this? I need my FMLA for the actual maternity leave, since (other post in the works) I do not get paid maternity leave beyond 5 days plus any of my 3 personal days that I haven't used up on adoption-related trips or business... so how would we afford that?

And really, how am I going to feel if my body fails me ONE MORE TIME? Will I be able to concentrate on bonding with my baby if I'm sitting there, rocking on the glider, talking to my breast and willing it to lactate more, begging this beautiful new baby to latch on to a boob that doesn't emanate the hormones of a momma who just gave birth? Will the focus be on my baby and the bonding experience, or on the breastfeeding experience and everything I need to do to get there? Will it be like focusing on the wedding instead of the marriage, everything about the dress and the flowers and the music and getting everything perfect but not thinking about the actual relationship that's going to be solidified and celebrated? Kind of seems that way to me.

It would be wonderful, WONDERFUL if I could get this to work. If it could all come together smoothly without causing a nervous breakdown. I would love to breastfeed our baby. I would love to sit on that glider, like any other new mom, and nurse our precious new infant. But at what cost?

I think I will run all this by my OB/GYN, see what their experience has been with all this. Also look into maybe having some sort of imaging of my boobles, because apparently PCOS people with poor supply have very little glandular tissue in their breasts. They can be generous, as mine are, but mostly fatty tissue with very little milk production gland structure to be seen. Maybe that would help make things a little more clear-cut. Of course, I don't even know if they would do such a thing.

It's a tricky balance, to "give the precious gift of breastmilk" to my baby, as one website so persuasively put it, without also receiving the gift of frustration, anger at my already abused body, and desperation to make something happen that just may not be possible for me. Is it better to try, or to just make peace with bottle feeding formula and enjoying a bonding moment that both Bryce and I can have, equally? One person has brought up donor milk, which is interesting and also has that whole both-of-us-bottle-feeding aspect, but I just don't think that that is right for us. Which is hilarious, because donor gametes were just fine, but there's a lot of careful regulation with sperm and eggs, at least in our experience, whereas the donor milk thing can get sketchy if it's not coming from a known source close to you. THERE IS JUST SO MUCH TO THINK ABOUT.

If you considered or attempted induced lactation, how'd it go for you? What went into your decision-making? When did you decide to stop if it wasn't successful, and what did it take to have it be successful if you were? 

Also, as I already referred to this as a polarizing topic, I would appreciate comments that do not judge me for my choices (or inability to choose), but rather give information and are helpful or supportive, in either direction. Just don't be a doodyhead, pretty please and thank you. 


  1. I find it very interesting that lactation can be induced, too. It's awesome that it could be an option, but all the concerns you bring up are valid, too. Breastfeeding can be bumpy even for women who do give birth. I have to say I don't think exclusive breastfeeding sounds very feasible for women who are going back to work after a few weeks, whether lactation induced or not. Some people certainly make things work with the pump, and cheers to them. However I agree with you: as a teacher especially, pumping at work does not appeal, at all. (But I have never tried, so I'm not going to say it's impossible!). There certainly has been a huge movement toward breastmilk instead of formula, which as far as I can tell is a correction over the past where formula was pushed in hospitals etc. But babies fed either will most likely do just fine. I hope you get some of answers you want, and some of them you unfortunately won't know unless you try. But if you go with formula it will be fine, just fine.

    1. Isn't that amazing?

      I realized as I was writing this post that while still on the fence, I'm leaning towards not doing it, until there's more evidence that I won't be banging my head against a wall in trying to get my body to play nice (again). It's true, some people do make pumping seem completely doable, but all the prep work for this is just so daunting. I am actually hoping to be able to take 6 months off, so I wouldn't be returning to work with a pump for a while, but I would be pumping to just GET the milk to start flowing, so it's like a reverse issue.

      Thank you so much for your thoughts and reassurance that no matter which way it goes, it will be fine. :) I appreciate it!

  2. I am also a PCOS sufferer. I wasn't able to breastfeed my son because we couldn't figure out getting him to latch and so we decided to just formula feed him. With my daughter we were able to get her to latch and so far we have been at this breastfeeding journey for 16 months now. It took us 2 years to get pregnant with our son, so while we haven't been through all you have, we weren't the regular "Let's get pregnant, BAM, Pregnant" type of people that it seems like regular people are. Having done both, I know from experience that both work. Both methods will allow your kids to be well nourished, happy, and healthy. There are perks on either side. Formula feeding you can divvy up the night with your husband and take turns feeding baby. But then you have to have bottles, formula, and water with you wherever you go. And you get to wash lots of bottles. Breastfeeding you don't have to worry about if you get sidetracked while you are out and baby suddenly wants to feed again. You also don't have to worry about the expense of formula (all formulas are governed and need to meet the same safety standards). But with breastfeeding you are the one who will need to get up with baby all the time when they are hungry. You would need to pump while at work too. The bond with baby is really awesome. All the extra snuggles and cuddles. :) I am sure no matter what you decide to do, it will be the best option for you. And you will be great at it. :)

    1. You bring up some excellent points! There is no one amazing way to go with all perks and no drawbacks, right? Thank you so much for sharing your personal experiences with both feeding methods, and for your vote of confidence! Helps tremendously. :)

  3. I tried to breastfeed our twins (DE IVF) but was not successful. They are 4 years old now and thriving like crazy and healthy to boot. I am breastfeeding our 9 month old son (FET) and while I do like not having to remember to pack formula, bottles, etc. I do wonder if my husband is missing out on the bonding of feeding our son with a bottle (he is a boob snob and refuses bottles) and sometimes I resent that he gets to sleep or do other things while I take care of every feeding. I think formula is great in that you both get to be involved and support the other and bond with baby. I think breast is great too and has benefits but it's not without challenges. Either route you chose will be healthy for baby and their development. I think it's amazing the option is there but I understand you being hesitant as well. You and Bryce are in charge and never let anyone second guess your ability to make decisions and parent. You're going to be amazing.

  4. I think the biggest thing to remember when it comes to these sorts of decisions is that you will be a great mom no matter which way you wind up going. Talking to your doctor seems like a very sensible starting point.

    While I haven't induced lactation in preparation for adoption, I did exclusively pump (preemie unable to breastfeed) and have PCOS. In my experience it is a huge effort - though this is not the case for every woman. When I was really working at it, I was pumping every 2-3 hours, including at night. It typically took me around 15-25 minutes actually hooked up to the pump and about 10-15 minutes of prep-work (washing the pump parts, setting everything up, and so forth) for each pump. I had to maintain a very rigid schedule to get myself to lactate with any volume at all, which meant everything had to revolve around that schedule and fit into the 1-1.5 hours between finishing one pump and starting setting up for the next one - though I did make sure I got at least 2-2.5 hours of sleep between pumps at night after a certain point. I just couldn't function otherwise.

    If you do decide to go for it, I'd highly recommend having a lactation consultant help you get a good pump and - very important - help fit the right flanges/shields. I had a lot of problems with really, really painful (read: bleeding) nipples and tried about 4-5 different sets of flanges before the lactation consultant finally pulled out the "last resort": a set of soft silicone flanges that had been discontinued by the manufacturer. The pair she gave me were some of the last they had in their stock, and they were the only thing that made pumping bearable. I wound up purchasing a couple more sets at a rather exorbitant price online, but worth it.

    It also might be worth clarifying what you want from breastfeeding. Do you want to exclusively breastfeed? 1/2 supply? Able to feed during the evenings/nights, but use formula at other times? There's a surprising amount of gray area between exclusive breastfeeding and all formula feeding.

    Certainly, considering how you would feel if your body just won't play ball on this issue is definitely important. One other random thing you might consider is how you might feel if you adopt a baby who can't or won't breastfeed for whatever reason. I was truly surprised at how incredibly upset I was when my daughter couldn't latch and suck properly. It just wasn't an issue I'd considered - I figured I'd be able to quit pumping, start breastfeeding and because babies are more efficient than pumps, my supply would magically go up and things would be awesome. Didn't happen, and it was probably the most frustrating/upsetting part of the experience. I'm getting to the point where I'm proud of what I managed and happy with the decision I eventually made to stop - I just couldn't keep up, go to work, and actually be present with the baby. Every woman is different on the breastfeeding/lactating/formula thing, and as long as baby is fed and loved, that's what's important.

    In the end, it's what works best for you. And you'll do great no matter what you wind up doing :).

  5. In my moms groups, there are women who are formula-feeding exclusively for various reasons, and from what they say, it seems that they are totally okay with it.
    I'm an exclusively formula-feeding mama for lots of reasons (late-diagnosed tongue-tie, C-section infection + meds + severe pain, and so on) and now, my baby is eight months and wants to breastfeed! He has shown a little bit of interest when we were being particularly intimate throughout the months, but nothing significant, and would always happily latch onto his bottle, his head on my breast...
    I am, unfortunately, not one of those moms who has been totally fine with formula-feeding---not because I think it is not right, but just for my own personal, emotional, psychological reasons. I don't judge anyone who chooses that route because a) I would never assume I know what's best for every single woman-and-child dyad on earth, and b) I know first-hand the crazy difficulties one can encounter during a particularly fragile time.
    But now that my son is becoming more and more a person with agency, with will, he is rooting for my breast. He has 6 teeth, and it can hurt, and of course he has no experience, so he bites. I have been completely surprised by this. We've never successfully breastfed! But for the past week or two, he latches on right away, especially when he wants comfort at night.
    I'm going to consult a lactation specialist and I've already ordered an SNS starter device---it's a bottle-and-tube contraption, fifteen bucks, whereby you give the baby formula via a tiny tube that is taped to your breast---so essentially the baby gets formula while sucking on your nipple. The nipple stimulation could stimulate lactation...
    In my case, I think I am just going to try this SNS for those moments before bed when my son is craving intimacy and comfort---so I doubt I will relactate, and I don't ahve the goal of breastfeeding exclusively at this late stage. Still, it is a totally unexpected thing that's happening and I'm just going to follow it and see where things end up!
    I tell you all this because I thought you might find it interesting and to sort of get to see it from one baby's point of view. (: He is leading this, at the ripe old age of 8 months, and I'm responding to him.
    Of course a big part of this is that I mourned the breastfeeding connection and have yearned for it, even while I accepted our situation. And all along, S and I have had LOTS of skin-to-skin contact, which may have something to do with this change.
    In any case, no matter what, the kid will feel nourished and loved by you, so just follow your gut, your path, and see where it takes you.