Thursday, May 27, 2010

Induced Lactation: Protocols for Adoptive Breastfeeding Mothers

Motivation as in anything is extremely important in breastfeeding and even more important is tenacity when inducing lactation.  The success rate for the following protocols according to Nemba in the 1994 Journal of Trop Pediatrics was 89%.  In this study 33 of the 37 women nursed their babies for 9 months or longer.
These mothers began with a 100 mg single priming dose of medrozyprogesterone (Depo Provera).  After 7 days, they began 25 mg of chlorpromazine 4 times daily or 10 mg of metoclopromide (Reglan) 4 times daily until adequate lactation was established.  Frequent pumping before infant's arrival and/or frequent suckling afterward is encouraged.  A Lact-Aid supplemental nutrition system that tapes to the breast is necessary until adequate lactation is established.  Inducing lactation is a gift of time and love!
Breastfeeding an adoptive baby is more than about breastmilk.  It is about bonding.  Skin to skin contact is essential.  Use a lactation aide to feed donor milk or formula at each feeding.  This is essential for stimulation of the milk production, bonding and success.

Monday, May 24, 2010

Engorgement: Bowling Ball Breasts

If you are experiencing difficulty with breast pain or latch-on 3 to 5 days postpartum, it is probably due to engorgement. Your breasts can feel as hard as bowling balls making it difficult for your baby to get a good latch.  Most of the time severe engorgement can be prevented by nursing the baby immediately upon delivery and putting the baby to breast every 2-3 hours.  If your baby is sleepy or there is a delay in breastfeeding, engorment can set in heavily.  Advil is safe for breastfeeding and contains an anti-inflammatory that may reduce some swelling and discomfort. Your best friend during this time is a hot compress. Turn the tap water and let it run until hot. Take two disposable baby diaper and swipe it under the tap three or four times. Mold the diapers around your breast. Repeat this procedure before each feeding. Commercial hot packs are also available, but the diapers work just as well so you may want to save your money for a good breast pump. If the areola is still too hard for the baby to grasp, use a quality breast pump for three to five minutes before latching the baby on. If the baby goes to sleep before emptying the breast, finish pumping afterward. Take heart! Engorgement only lasts for 48-72 hours.