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Breastfeeding My Adopted Daughter

Julia Ball
London, England
From New Beginnings, Vol. 25 No. 5, 2008, pp. 22-24

When my partner and I decided to begin the process of adopting, I was very surprised to read in the book, First Steps in Parenting the Child who Hurts, that it is possible, and indeed very valuable, to suckle an adopted infant. I discovered that I could get information about adoptive breastfeeding from La Leche League.

I assumed, no doubt like many people, that breastfeeding wasn't possible in adoption, and that this bonding experience would be one of the losses of not having given birth to my child. It felt very interesting and exciting to me that breastfeeding our child was feasible. I had researched the importance of touch for a dissertation, and knew how valuable, indeed critical, touch is for infants and how positive breastfeeding is, not just initially but for a person's ability to form relationships later on in life.

My future child would most likely have missed out on a close one-to-one relationship, and would have had the trauma of losing her birth mother. Breastfeeding could be a way of allowing her to catch up with some of what she had missed out on. Perhaps it could also be a way of beginning to work toward healing her early trauma and losses.

I contacted a woman from La Leche League who had breastfed her adopted daughter. She was immensely supportive and encouraging and gave me a lot of time to talk through all sorts of questions and concerns.

We were adopting a child from China, very likely a girl, anywhere between nine months and two years old. She would have been in an orphanage or fostered by a family, possibly with one-to-one care, for all of her life.

Adopting an older baby or toddler and attempting to teach her to breastfeed is quite a different task from initiating breastfeeding with a newborn or young baby. For a start, she wouldn't need milk so often, as she would be eating other things; yet it is the frequency of feeding that helps the mother to make milk. Another issue, common to many adoptions, was that we didn't know when it would happen, so I wasn't sure when I should start attempting to build up a milk supply. I knew this could take a couple of months.

On the Internet I was fortunate to discover a group of adopters of Chinese children, who were breastfeeding or hoped to do so. This had a wealth of information, from trying to establish a milk supply to encouraging your child to latch on. I also came across the work of Karleen Gribble, who has written extensively about adoptive breastfeeding.

Around Christmas 2005, we were anticipating receiving our referral (details of the child we had been matched with) and by February going to China to meet and adopt our child. The bureaucracy makes it impossible to get there any sooner.

I started pumping with an electric pump about four times a day from December. I had thought it might feel quite clinical and unpleasant to be attached to a plastic pump, and I imagine it might well do if you are pumping after having given birth and had already nursed a baby at your breast. But without this contrast, I was actually pleasantly surprised that it felt quite relaxing. I looked on this as a time to lie down and think about our future baby. This was a positive experience, which enabled me to connect with my imminent motherhood and focus on this little being who was somewhere out there in the world and would be coming our way soon. Since children and our relationship with them are so physical, it felt good to be preparing my body in a physical way. I was quite surprised on day two of pumping to find little beads of milk.

It was quite a commitment to pump as often as possible. I was out and about quite a bit and I could only do it at home. I produced nothing more than beads, so it wasn't very satisfying and I wasn't able to collect milk and freeze it as some women do. I took herbs to help with milk production but, at this point, since I didn't know whether or not my child would be interested in breastfeeding, I didn't want to take other medication to boost lactation.

By March we had not received our referral and it looked as though, because of delays in China, it might take two or more months. I decided to stop pumping because I thought I might get fed up with it. At the end of June, we were delighted to learn we'd be adopting a 10-month-old girl. She had been fostered since she was a month old, with one-to-one care. Having had this early attachment could make bonding a little easier.

I began pumping again and taking herbs. I wasn't producing anything significant, but it felt like a positive thing to be doing. I knew that our daughter would have been bottle-fed, so I was finding out possible ways of weaning her off the bottle and onto my breast. I knew this could very likely take months.

Like the arrival of any baby, it was a very emotional experience for all of us when we adopted her. I was conscious of the huge trauma she was going through in losing her foster parents and being handed over to complete strangers. The system in China at the moment provides no period for getting to know your child prior to adoption.

The first few hours were spent calming her enough to take her bottle. Over the next few days we were reassuring her, beginning to get to know her and help her to start to see that we would look after her needs and keep her safe. I didn't attempt to breastfeed her while we were in China, so as not to make too many changes early on, but I did hold her next to my skin when bottle feeding, as plenty of skin-to-skin contact was recommended to help her to bond.

I bought a supplementary nursing system: a bottle with thin tubes that attach to the nipple. When the baby sucks at both the breast and the tube, she gets milk from the bottle and stimulates the mother's breast.

Weaning my daughter off the bottle and onto the breast wasn't merely a practical exercise; it would be about allowing her to develop trust and be intimate with me. After several huge losses and difficult transitions, she had good reason not to trust her new mother immediately. We started with an ordinary bottle teat over my nipple, with the tube coming out of that. She was happy within a few days to go with that rather than the bottle. Already this felt a lot closer. We switched to a wide-mouthed teat, which worked even better.

In some ways it was a bit of a palaver. I needed to make up her formula, then with a clean needle thread the tube through the teat end, put the needle away in a safe place, and hope she would feel like feeding. Sometimes the tube came out of the nipple and then I needed to thread it again. Sometimes she wasn't in the mood for feeding. The next step was moving to the nipple shield, which is much less thick and closer to the breast than the bottle teat. This took a couple of months. If she was ill or unsettled in any way I didn't like to make any changes, so sometimes I just let things be for a while rather than risk rushing anything.

The nipple shield was harder for her to get a hold of because it is soft plastic, and she didn't like that but she did get used to it. I would have a teat on one nipple and a shield on the other: she could try out the shield and if she didn't like it she could go over to the teat. I felt quite strongly that she had to do it in her own time and that trying to get her to do something more quickly would just be counterproductive. I was pretty keen, however, to get rid of the shield and no more threading would have been such a treat!

It was winter and she had coughs and colds. It was hard for her to feed with a blocked nose. I started offering the bare breast (plus tube) on one nipple and the shield on the other. Sometimes I felt quite discouraged because she always went for the shield and sometimes didn't have her milk at all. Although sometimes the rejection was quite hard, this whole process meant that I was picking up on her communication in a way I don't think I would have if I had not been breastfeeding her. Sometimes if she rejected the milk altogether I would think about our day, what we had been doing, how I had been with her. Sometimes I would realize we had been too busy or I had been distracted from being emotionally available to her, and if we slowed down and I gave my focus more to her, she would come back. In her own way she was also testing the waters and showing interest in breastfeeding. She could be quite playful -- sometimes she would give the breast a very small suck just to try it out, and then giggle a bit!

Shortly after Christmas she had a proper bit of milk from the bare breast. It was amazing! All this hard work seemed to be going somewhere. Then she went back to the shield for a little while, and then she stopped feeding altogether for a couple of weeks. Although I missed the intimacy, and even felt rejected, I decided that I would always be there to offer milk; it was up to her whether she took it or not. Sometimes it really did feel like an effort. To avoid feeling discouraged I reminded myself that whatever happened -- whether or not she decided to feed -- the effort I was putting in to offer her breastfeeding was valuable in itself and helpful to our bonding.

When she did come back after the two-week break she very quickly wanted the bare breast -- in fact, to the extent that she pulled the shield off the other breast and latched on to the bare breast for a whole feed. And that was how it went on. She continued to feed regularly twice a day before sleeping. Occasionally she would have an extra feed mid-morning.

This has continued for the last 17 months, although in the last five months she has been having three to four feeds a day. Although I wasn't producing much milk, it felt like a hugely important part of our developing relationship. Positive changes continue to surprise me.

A number of months ago I decided to try taking an anti-nausea medication that has a side effect of increasing prolactin levels and stimulating lactation. I went to a doctor armed with information and was very pleasantly surprised how interested and supportive she was, and she gave me a prescription.

This medication is sometimes given to mothers with newborns to help with lactation. As an adoptive mother, I needed to take a higher dose. It did work, which slightly surprised me. I pumped about 100ml a day. I was hoping to boost my milk supply and then be able to gradually come off the medication while keeping up my supply through breastfeeding and pumping if necessary. Unfortunately, I didn't manage to because I didn't want to continue taking the drug after three months. It was satisfying being able to produce more milk and would have made feeding easier. Of course there are the nutritional benefits as well. However, my daughter still gets some of my milk when she feeds, and she had the benefit of more while I was taking the medication. The main benefit of breastfeeding for us, though, is the attachment.

Sometimes I wonder if I'm a bit kooky, and why I do this rather complicated thing. But the benefits are so obvious if I stop to think about them. It's a lovely, enjoyable thing for us to share that I never thought I would be able to do with an adopted child. I see her becoming more attached and feeling more safe and secure and I know that breastfeeding is a big part of that. I have been lucky having a supportive partner who is as convinced of the benefits as I am.

I'm not always sure what other people think, and I'm careful whom I talk to about it. However, I feel increasingly inclined to talk about it in regard to the benefits for adopted children. I have heard an adopted adult say that one of the things she felt sad about was that she wasn't breastfed. It seems a shame that there isn't more information readily available about the benefits, and more support for mothers who are interested. However, personally, I have had some wonderful support and I am hopeful that things will change.

Reprinted with permission from LLL Great Britain's magazine, Breastfeeding Matters.

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