Thursday, April 23, 2015

Adoption Part 3 -- The waiting game....and breastfeeding our adoptive baby

This is a combination adoption process and inducing lactation post -- warning, it may get epic.

Once we had finished the home study, we knew it was time to actively look into ways to breastfeed our baby. We know that breast milk is best for our baby, and we also know that it's so much more than just nutrition. Nursing provides comfort, bonding, and many more things for both baby and mom.

We knew that a vast network of milk sharing existed, but we wondered if there was something more. One of Anna’s cousins came to visit and talked to us about how she had induced lactation. We wondered if this was possible, and after talking to her some more, we decided to look into it seriously. 

There are many ways to induce lactation: hormone therapy, natural supplements, or even just frequent nipple stimulation. We decided that because neither of us had previously been pregnant, we would go for the most aggressive method – hormone therapy. While this goes against all of our normal natural way of life, we wanted the greatest possibility of success. We decided if we were going to do this, we were going to commit 110% and really do it. That being said, it totally freaked me out to be taking pills when there was nothing 'wrong' with me. 

The protocol we used is called the Newman-Goldfarb Protocol – as in Jack Newman and Lenore Goldfarb. Knowing that success rates for inducing lactation are highly variable, we decided to both do the protocol with one singular goal – feed our baby. 

Before I get into the nitty-gritty of the protocol, I want to mention that it is absolutely imperative that you work with a health professional if you’re going to go this route. S/he needs to know why you’re doing what you’re doing. We worked with a midwife throughout the entire process, and she prescribed all our medications.

Here’s a quick-ish rundown of how the protocol we used works along with some of our experiences:

First, you have to trick your body into thinking it’s pregnant. To do this, we took a high dose birth control without taking the placebo pill.  In theory, we were never going to get a period during this time. This is how it worked for Anna, but I bled on and off for 3 months…great.

At the same time, we started taking a drug called Domperidone. Domperidone is not approved by the FDA in the US, though they are running trials on it now.  It is approved in Canada and other countries, and it is prescribed for nausea and/or other gastrointestinal problems.  One of the side effects listed on the bottle is “milk may drip out of your nipples.” Domperidone raises your prolactin levels.
So, a quick recap – the birth control raises your progesterone and estrogen levels and the domperidone raises your prolactin levels. All of these combine to “trick” your body into thinking you’re pregnant.
In an ideal situation, we were going to take the birth control for about 6 months, then proceed with the actual milk production part (that’s next). BUT – the trick with adopting is that in most cases, we weren’t going to know exactly when the baby was going to arrive.  

Two days before Thanksgiving, I went to the store to buy all the things we needed for our feast. 

I should mention that since we entered the waiting phase of the adoption process, I never, I mean NEVER, went anywhere without my phone. It was my cell phone that they were going to call when we got matched, and that is NOT a call I wanted to miss.

OK -- back to the grocery. As I was walking into the store, I dropped my phone and the battery fell out. I put it back in and shoved it in my pocket.....but I forgot to turn it back on. In the 30 minutes I was in the store, we got the call. Luckily, she called Anna after I didn't answer. Unluckily, my phone was still off and poor Anna couldn't get a hold of me. The adoption agency still needed to get some more info from the birth mom but promised to call us right after Thanksgiving. Well, Thanksgiving came and went, and we still hadn't heard anything - we were beginning to get nervous. Finally, over a week later (seemed like forever!), they got in touch with us and told us that the birth mom had decided to parent her baby. We were so sad, and we found ourselves back in the waiting game.
On Sunday, January 4, 2015, we got a phone call from the adoption agency at 5:30 pm. When I saw that the adoption agency was calling us on a Sunday evening, I knew it was going to be exciting news. A little boy had been born that morning, and were we interested. 
Are we interested!?!?!?!?!?!  YES!
After some adoption paperwork and red tape, we were finally able to go to the hospital to meet our boy on Tuesday morning. The time in between was torturous. We knew our boy was lying swaddled in a crib in the nursery being taken care of by the nurses. We know they do a wonderful job, but it’s different than the skin to skin we had planned for him, not to mention the breast milk he wasn’t getting.

Back to lactation induction...

Once we got to the hospital, we immediately stopped the birth control but continued the Domperidone. This mimics birth (hormonally, clearly I’m aware there is MUCH more to birth!) -- a sudden drop in your progesterone/estrogen levels with steady and increasing prolactin levels.

Once stopping the birth control the next step is – PUMP PUMP PUMP PUMP PUMP PUMP PUMP. We were so fortunate to meet with some amazing lactation consultants at the Maine Medical Center, and they were more than supportive and helpful. The first time one came to meet with us, I was holding Birch skin to skin, and he was starting to get fussy since he was hungry. Every fiber of my being wanted to put him to my breast but I didn’t know if it was ok since I knew that almost nothing would come out. I didn’t want him getting frustrated at the breast. The lactation consultant encouraged me to do so, and thus began our breast feeding journey.
The first time I pumped, I pumped less than 1 mL of milk, and it was pretty watery. The lactation consultants were so excited about the few drops Anna and I were producing, and they showed us to put those precious drops on our boy's lips so he could lick them. We were breastfeeding our adopted baby!

Here's our sweet boy, Birch, at the hospital. We did skin to skin 24/7. It was winter, so we made a blanket cocoon.

They hooked us up with a hospital grade breast pump, and after one night in the hospital, we brought our boy home. We continued pumping every 3-ish hours, and we always fed him at the breast with the help of a supplemental nursing system (SNS). We sourced donor breast milk from local moms, and we were amazed at people's generosity. While the SNS was critical to getting him to latch, it was a serious pain in the ass. Trying to get a hungry baby to latch to a breast that might not be producing all that much milk while trying to make sure the tube is correctly positioned in his mouth so he can get more milk than we're producing.....you get the idea. Throw in some flailing baby hands, and it'a miracle we ever got him to latch and eat that way.

Maybe his best latch with the SNS. Notice the tape holding the tube onto my skin -- we found tape everywhere in the house. It was all over the place!


By the end of the first week, I was getting close to an ounce (total) with each pump, and when I fed Birch at the breast, he was taking less and less from the SNS. This meant he was getting more and more straight from the tap! Baby's are much more efficient that the pump, so if I was getting an ounce after feeding him, imagine what he was getting on his own!

It was at this point that the unimaginable happened. I was sitting on the couch, nursing our boy when the adoption agency called. The birth mother had changed her mind. We were (are) beyond devastated. We'd had this boy home with us for a week, and he was always in arms, and almost always skin to skin. He taught us about love for a child, and that is a feeling we will never forget.

In Maine, the birth mother can change her mind any time until 3 days after she signs over her parental rights. Our birth mom signed over her parental rights on a Monday -- we had to make it to Thursday. She changed her mind on Wednesday. We find some solace in the fact that we know he was placed with her cousin who was actively involved in the adoption process. They wanted another child, and they had gone through all the same scrutiny we did to adopt. We still miss our boy every day.

The day we dropped him off at the agency, I pumped 3 ounces at once. It was the most I had ever pumped, but it felt like a slap in the face.  Given the nature of the lactation induction protocol, we were at the point of no return. We could either stop pumping and give up the idea of breastfeeding our baby, or we could continue pumping and storing the milk in anticipation of our next match.

At this point, Anna was still producing about 2 mL each pumping session, so after much thinking and debating, she decided to stop the protocol. We started with one goal -- feed our baby. It seemed that I was headed in the direction of being able to produce enough to do that.

So, I continued pumping every 4 hours, and I'm still doing that today. After 3 months of pumping, I produce about 16-20 oz. a day -- about a gallon a week. I've started donating to a local mom in need since we don't have the freezer space to store everything, and we don't have a baby yet. It is worth mentioning again that I am not the norm for lactation induction. Success rates are highly variable -- I'm just a cow, apparently.

On March 18th, the adoption agency called again. A birth mom chose us! She's due July 10th, and she's having a baby girl. This is a completely different situation than before. We get to have a relationship with the birth mom, and we get to know her before the baby is born. She's going to have a relationship with our baby, and she'll be a part of our lives forever.

We've met her a couple times already, and she is simply great. She knows what happened to us, and she goes out of her way to make us feel comfortable and safe in this process. She's excited about us parenting her child, and we're all looking forward to building a relationship over time.

There are days when the pumping starts to wear me down -- especially in the middle of the night. I keep doing it, though, because I know that moment when our girl latches on, it will all be worth it.

I have been able to completely wean myself off the Domperidone with only a small drop in my supply. I know that when we get a baby, her presence will bring it back up. I cannot wait for that day -- July cannot come fast enough.


Here are some resources that we’ve found helpful:
www.asklenore.com – this is Lenore Goldfarb’s website, and it is full of good information
www.breastfeedinginc.ca – this is Jack Newman’s website. He has tons of great info on breastfeeding in general in addition to helpful stuff on inducing lactation. He also has great videos that show good/bad latches (guaranteed to cause a letdown)
Jack Newman’s Guide to Breastfeeding – this book has become our bible. It is so full of good info, and it is great to have a hard copy resource to look through. The revised edition (at the time of writing this) is only available on Canadian Amazon (www.amazon.ca)

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