Building Milk Supply in Adoptive Mothers
Karleen Gribble
Niagara Park NSW Australia
From: LEAVEN, Vol. 40 No. 5, October-November 2004, pp. 103-104.
Human milk is the standard
food for babies (Wiessinger 1996) and breastfeeding is part of normal
mothering, promoting child-mother attachment, and providing pleasure
and comfort to the baby (Blass 1994).
The breast is ordinarily
prepared for lactation during pregnancy under the influence of estrogen,
progesterone, prolactin, and other hormones. The ductal system proliferates
and differentiates and the lobes, lobules, and alveoli increase in size
(Riordan 2004). Without pregnancy, the same breast changes can be achieved
through nipple stimulation, which causes the secretion of prolactin
(Kolodny et al.), growth of secretory alveoli, and production of milk
(WHO 1998).
Once milk secretion begins,
removing milk causes more milk to be made (WHO 1998). It is a normal,
natural process for the breast to produce milk in response to a baby
suckling. Thus, weaning need not be permanent and babies unable to be
cared for by their biological mother can be breastfed by their adoptive
mother.
Adoptive Breastfeeding in Developing Countries
The possibility of adoptive
mothers being able to produce sufficient milk for their babies has been
routinely discounted in countries including the US, Canada, and Australia.
Researchers in Western societies have found that women are generally
not successful in providing enough milk to solely nourish their children
(Gribble 2004). However, in developing countries, most adoptive mothers
are successful milk producers (Gribble 2004). Why is this the case?
What can we learn from the experiences of women in developing countries?
What follows is the results of a study (Gribble 2004) of the influence
of context on milk production in adoptive mothers.
An examination of adoptive
breastfeeding in developing countries and in Western countries reveals
differences in breastfeeding practices. Having observed breastfeeding
from a young age, mothers in developing countries are generally knowledgeable
about the process (Jelliffe and Jelliffe 1972). This results in increased
confidence in breastfeeding and fewer breastfeeding problems (Hill and
Aldag 1991; McCarter-Spaulding 2001). Women in developing countries
are also likely to have beliefs about child care that optimize breastfeeding.
They allow unrestricted breastfeeding and keep their babies in close
physical contact, day and night (Quandt 1995; Lozoff and Brittenham
1979). This maximizes prolactin secretion and breast emptying, thus
accelerating breast development (WHO 1998) and increasing milk production
(Daly et al. 1996).
Suggestions for Leaders
Adoptive mothers in Western
countries can be encouraged to maximize their milk supply by educating
themselves about breastfeeding, developing a strong breastfeeding support
network, and emulating the mothering styles of women in developing countries.
Mothers can be encouraged to seek information about breastfeeding, both
of a general nature and that specific to adoptive breastfeeding, as
early as possible in the adoption process. Building a network of knowledgeable
breastfeeding contacts, including other adoptive mothers who can provide
the support and encouragement to persist with breastfeeding is also
helpful (Gribble 2001). In addition, prearrangement of practical support
for the post placement period will help women to concentrate on developing
the mother-child relationship and initiating breastfeeding (Raphael
and Davis 1985).
To emulate the mothering
style of women in developing countries, mothers can be encouraged to
maximize physical contact with their children, breastfeed as frequently
as possible, and use the breast as a source of comfort (Quandt 1986;
Vis and Hennart 1978). Since providing unrestricted breastfeeding and
close contact is contrary to mainstream Western beliefs (Quandt 1986),
it is imperative that women obtain support. This will assist them in
becoming comfortable with this style of parenting and in dealing with
unsupportive contacts (Ladas 1972). Such support, of course, may be
found in La Leche League Groups. Knowledge of and support for breastfeeding
are important factors in maximizing milk production in adoptive mothers.
Leaders can also encourage
women in their ability to lactate with the understanding that while
it is impossible to tell how much milk an individual mother might make,
there is much that can be done to maximize milk production. Mothers
can be told that although they may need to supplement their milk initially,
it may be possible that eventually this will be unnecessary if they
breastfeed for long enough (Riordan 2004). It is important that mothers
also be aided in devising a plan for the transition to breastfeeding,
including making sure the baby is getting enough, safely reducing supplements
and minimizing the likelihood that the baby will become too attached
to the method of supplementation. The support of those knowledgeable
about breastfeeding is vital for adoptive mothers in the West given
the breastfeeding unfriendly culture (Raj and Pilchta 1998).
Some Leaders may feel that
they have inadequate knowledge to assist mothers. However, it is extremely
important to recognize that even without specialized knowledge of adoptive
breastfeeding, Leaders have a vital role to play as supporters for the
adoptive mother, perhaps being the only people in her life who believe
in what she is doing.
Assisting adoptive mothers
to maximize their milk supply does not minimize the emotional impact
of breastfeeding. Many adopted children have histories that leave them
emotionally vulnerable (Drury-Hudson 1994) and the act of breastfeeding
has been observed to assist children in healing past hurts (Gribble
2003). In addition, the promotion of close physical contact between
mother and child will not only benefit the milk supply of an adoptive
mother but will also assist development of a positive attachment relationship
(Anisfeld 1990; Gribble 2003) which will have long-term benefits for
the child (Drury-Hudson 1994; Bowlby 1969).
References
Anisfeld, E. et al. Does
infant carrying promote attachment? An experimental study of the effects
of increased physical contact on the development of attachment. Child
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Blass, E.M. Behavioral and physiological consequences of suckling
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Bowlby, J. Attachment and Loss, Vol 1: Attachment. London,
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Daly, S.E. et al. Frequency and degree of milk removal and the short-term
control of human milk synthesis. Exp Physiol 1996; 81: 861-75.
Drury-Hudson, J. Some effects of attachment disturbance on child behaviour.
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Gribble, K. Mother-to-mother support via the Internet: A new method
for an old model. Breastfeed Rev 2001; 9:13-19.
Gribble, K. Mother comfort: The breastfeeding of older adopted
children. International Lactation Consultants Association Conference
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Gribble, K. The influence of context on the success of adoptive breastfeeding:
Developing countries and the west. Breastfeed Rev 2004; 5-13.
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Karleen Gribble is an
Australian Breastfeeding Association Community Educator and Adjunct
Research Fellow in the School of Nursing, Family and Community Health
at the University of Western Sydney. Her research interests focus
on adoptive breastfeeding (particularly on breastfeeding of older
children and the contribution of breastfeeding to the development
of secure attachment in adopted children) and the non-nutritional
impact of breastfeeding (including breastfeeding of older children).
She is mother to two children, one biological and one adopted from
China, both breastfed. The Contributing Editor for "Keeping Up-to-Date"
is Norma Ritter.
Last updated 12/29/06 by jlm.
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