Induced Lactation/Adoptive Breastfeeding

When we made the decision to pursue adoption I knew I wanted to learn more about induced lactation, maybe try it, and hopefully be successful at it. There's not an overwhelming amount of information out there. As far as info from people who actually know what they are talking about, the best resource I found was Ask Lenore - the website content and message boards were great and Lenore even answered emails when I had a few questions to ask.

As far as people who don't know what they're talking about, well that would be me. But I'm going to write it all down anyway. What I wanted most when first starting was to read other people's real life experiences. So, for my own posterity and for anyone out there who's wondering what it might be like, here's what I did/am doing:

Prep work: or what I did to get ready

• Read everything I could get my hands on and decide on the accelerated protocol
  
• Tried unsuccessfully to get an Rx for birth control from my primary care doctor, subsequently met with an awesome midwife, and went home with all the free birth control pill (bcp) samples in the office
  
• Ordered a sh-t ton of domperidone from overseas
  

Deciding when to start the protocol (and a bonus TMI fact!)

I wasn't sure when to start the protocol. I was tempted to start the day our profile went live, but held back. The standard protocol takes about 6 months and the accelerated protocol takes about 2 months. But we had no idea when we'd be matched or when our peanut would be coming home.

Also, I had the fun biological quirk that my bre.asts have always leaked. Yup. For as long as I can remember, if I messed with them enough (or even just a little) a few drops of something milk-ish would emerge. There were times in my life when I found this embarrassing and times when I worried it meant something horrible. But now, now it felt like my body was made to do this! Of course I immediately emailed Lenore and asked, as the valedictorian of milk production, did I even need to follow the protocol? Um, yes. She reminded me that it takes the body a very long time to build up the necessary milk supply to feed an entire human being.

After lots of hemming and hawing I decided to wait until we were contacted by a birth mother to start the protocol.

Actually starting the protocol (and a second bonus TMI fact!)
In October 2011 we were contacted by a birth mother. She was due in 9 weeks. I took this as my cue and started the accelerated protocol by popping my first bcp. I had only been on birth control once before (thanks adult acne!) and it made me so nauseous I had to stop. No difference this time. I vomited the entire first night. I have no idea why my body reacts this way. Just lucky I guess. I toughed it out though and eventually the nausea wore off.

I was an idiot and spent a few weeks on birth control alone before I realized that I was supposed to be taking the domperidone too. Oops. Seemed to still work though as I quickly experienced the required bre.ast changes*.

*hello big bazookas.

But then the birth mother disappeared and our match was off. I emailed Lenore again and asked what to do. She suggested staying with the protocol as many women find their second match comes sooner than expected and they appreciate the benefit of the extra time on protocol. I wasn't feeling as optimistic as Lenore and I was a little worried about the effects of the long-term use of bcp and domperidone (I had been spotting/bleeding nonstop for weeks). I ultimately decided to keep up with the protocol until the birth mother's due date (which was only a few weeks away) on the slim chance that birth mother reappeared. I dropped the bcp* and kept up with the domperidone alone (per protocol) but did not start pumping (which was against protocol). It was my internal compromise with myself...keep up with the pills but don't go all out and start the pumping.

*and bled and bled and bled and bled. Longest. Period. Ever.

Pumping (yes, it hurts. don't believe them when they tell you it doesn't)
Birth mother reappeared. We were ecstatic. And I was stressed about having enough time to start pumping. She was due in 6 days!! I started pumping that night. It felt like my nipples were on fire. Quite a few drops came out, but they were pale and watery looking. And yes, I will admit it, we tasted it. Just dipped our pinkies in and each tried a drop. And thank goodness we did as it was S-A-L-T-Y. Tasted like tears. After much googling I figured out that this was the equivalent of "weaning milk", although for me it was more like just-getting-started milk. (however, note that infection can also be a cause of salty milk)

I pumped every 3 hours except during the night. I didn't collect much at first. Not even an ounce a day. I sort of roller coastered between omg-my-body-is-producing-milk-this-is-so-awesome and this-is-no-where-near-enough-to-feed-a-baby-bring-on-the-depression. At each pumping session my milk became, well, milkier and there was more of it. I dumped the first 3 days worth of "salty  milk" as that seemed like a cruel trick to play on a new little peanut. But once it was sweet (like melted ice cream - yes, I kept trying it to be sure), I started stock piling it in the freezer. My supply increased about a tablespoon a day, but oh how that helped with my commitment and stamina. Each night, as I put the day's bag into the freezer* I would look back at the other bags and be reminded that this was working. That each day meant a little more and that was a success.

*after each pumping session I would pour what I had collected into a single bottle that I kept in the fridge all day. After my last session, I would transfer the day's collection into a sterilized bag and put it into the freezer.

In all honesty, it was really hard. Pumping was not a nice feeling for me. It brought up crazy emotions. The first 5 minutes of every session were always the hardest for me. I'd get this angry/rageful thing going where my body just vibrated with yuckyness. And then there was the pain from the pumping. And the constant washing/sterilizing of pump parts and collection bottles. It was a never ending cycle that left me exhausted and overwhelmed. The things I did to try to make it better:

• Upped my dose of domperidone - I was taking 20 mg (2 tablets) 4 times a day. After lots of reading I decided to up my dose to 30 mg (3 tablets) 4 times a day. This gave me a bump in my supply and that was a huge encouragement
• Ate oatmeal for breakfast as often as possible - I believe this helped my supply as well
• Pumped more frequently and for a longer period of time - I upped my sessions to every 2.5 hours. Everything I read recommended at least 1 night session, but I just couldn't bring myself to do it. So my personal compromise was to try to squeeze in more sessions during the day. I also went from 15-20 minutes per session to 25-30 minutes per session. I think this helped with my supply as well
• Asked for help - I asked my wife to pitch in with the cleaning/sterilizing duties. Having her take over that part of the process in the evenings (when she was home from work) was a huge relief and helped give me the stamina to keep going
• Got better equipment - my pump came with 2 bre.ast shields, neither of which were a perfect fit. I ordered the correct size online. I also ordered a pumping bra that made the whole process "hands-free" which allowed me to entertain myself with internet blog stalking. And I went to Tar.get and got 2 bras that actually fit my new (read: bigger) milkmaids. Being comfortable made such a difference
• Applied lanolin to my nip.ples - feels great - but will also stain your shirt!
• Thought about why I was doing this - remembering my end goal, and how very much I wanted to be able to share this with my one-day-peanut kept me going

With all those adjustments, my supply continued to increase and sometimes I would even get a spray of milk and then, once in awhile, the ever elusive (and holy grail) stream of milk. Looking back, I was pretty down on myself the whole time, focusing on how I was not producing enough to exclusively bre.astfeed a baby (which all the websites/articles tell you from the beginning may not be possible and should probably not even be the main goal). But, that all of this happened over the course of 9 days* is pretty damn amazing. 

*versus the 6 weeks of pumping the protocol recommends.

And then what happened?

In just over a week I was pumping 3 oz a day. I knew this wasn't enough but I was hoping once the baby came home my supply would increase at an even more rapid pace (based on what I read that 1) babies are more efficient at sucking than bre,ast pumps and 2) the more a baby is at the bre,ast the more milk is produced). I looked into supplemental systems (like this one) but ultimately decided to hold off. 

Then our birth mother changed her mind. And we were devastated. And I was so upset that I stopped pumping cold turkey. BIG MISTAKE. Apparently, even if you are only pumping 3 oz a day, you can still get engorged. PAINFUL. So very, very painful. I have a freakishly high tolerance for pain but I was in so much agony that I even woke S up in the middle of the night. I tried to pump multiple times that night but it was hard to get my bre.asts into the shields or to even get any milk out because everything was so swollen and hard (and  painful! did I say painful?). Eventually, after some hand expression and repeated attempts at pumping, I got some relief. I pumped a few times a day (for only about 5 minutes per session) over the next few days (which, I have to say, was one of the most difficult parts of this failed match). Eventually,  my supply tapered off, my bre.asts when back to their normal size, and my hormones stabilized*.

*I think - although S might say differently.

I still have a (small) stash of milk in the freezer. It makes me proud (and a little sad) each time I see it. My plan is to start the standard protocol on the 5th day* of my next period.

*seems to be somewhat of an old wives tale going around the internet that if you start the bcp's on the 5th day of your period you're less likely to experience the mid-cycle spotting/bleeding. I figure it's worth a try.

My bre.asts still leak some and I'm scared that my response this second time around will be less than the first*. But I also really, really want this, so I'm going to give it a go. I figure I'll stick with the bcp/dom protocol  for as many months as I can and just keep hoping that we're connected with the right birth mother for the right match.

*I'm also scared we'll never get matched again. Clearly I should add some anti-anxiety meds to my personal protocol.