I taking a minute to tear myself away from a facinating episode of 8th and Ocean to answer some of the comments about the adoptive breastfeeding thing.  Unless otherwise noted, these are just my own thoughts, not necessarily based on citable research.  I don’t claim to be an expert, but damn I sure am opinionated.

Johnny asks: Can you answer the question about considerations/thoughts about a baby who has never had breastmilk suddenly getting it after 16-18 months? You know me, I’m not being sarcastic.  I wonder if many of the needed, protective enzymes are moot at that point?

In addition to the important nutritional components that are found in breastmilk like fatty acids and super easy to digest proteins that are not found in formula, breastmilk has antibodies that give babies protection against diseases and infections.  When a mother and baby interact, the breastmilk the mother makes is tailor made for the baby and the germs he/she has been exposed to.  I swear I once read that baby’s heads smell so good to encourage mom’s to smell them–which would enable the mom’s body to produce the right antibodies for the baby’s germs.  I can’t find the reference though.

As to the age of the baby, early weaning (before one year old) is a very recent human phenomena.  In the past, children were often breastfed until they were 4-5 years old.  The World Health Organization recommends breastfeeding for at least two years.  This article mentions that 2.5 years- 4.5 years as the "natural time" for human weaning.  If extended breastfeeding creeps you out, remember that is the lens of culture you are looking through.

So I don’t think 18 months old is too old to get some of the benefits (particularly the immunities) from breastmilk.  That being said, I knew all about it but weaned M when she turned one because I was just OVER breastfeeding her.  If I could go back in time, I don’t know if I would change that choice or not.

Barb asks: Has research been done on the possible health risks to the mom or child from the hormone drug taken to induce lactation? If so, what are these risks, if any?

The drugs I am planning to take are birth control pills (Yasmin) and domperidone which is not currently FDA approved (you can find the protocol here).  Dom is an ulcer drug that is widely used in other parts of the world, including Canada.  It is my understanding that it isn’t FDA approved because the process is so expensive and not worth the effort in the US because there are more profitable drugs on the market. Plus, you know, one of the side effects is lactation, so there are not a ton of people (especially MEN!) signing up to take it when they could just take some prevacid.

If you click that dom link up there, you can see the other non-lactation side effects of dom.  Dom does show up in breastmilk, but it is also prescribed for babies with reflux. There is a note about not giving it to people with liver problems, so if the baby comes home as a hep B carrier or hep B infected, I would not give it to the baby via my milk.  I am pretty comfortable with the side effects of the drugs.

I am hoping to wean off the meds pretty quickly.  The fact that I was successful breastfeeding before and still have some drops of milk now (2.5 years after weaning M) is a good indication that my boobs still have milk making capacity.  I always sucked at pumping though so maybe it won’t work at all despite all the effort if the baby doesn’t want to latch.

Marisa says: I just wanted to point out that there are herbal ways of inducing lactation for adoptive breastfeeding too. (Amber: that’s not assvice for you, I’m just saying that there are options for people who are squeamish about drugs).

That isn’t assvice at all.  I will probably suppliment with fenugreek and oatmeal once we get started.

There are several yahoo groups and websites where you can get more info on naturally inducing lactation.  There is a general adoptive breastfeeding group as well as a China specific group.  There are also some message boards. As an aside, Four Friends, the most often referenced one, charges $ to access their message boards.  I find that pretty irritation and haven’t paid for access. 

Lella says: I wonder if an older baby, used to a bottle, will be able to figure out BF. My daughter REFUSED to BF, so I pumped for 9 months. I remember trying to get her to BF throughout her life. My last attempt was at 8 months. She looked at me like I was crazy and proceeded to bite me. Needless to say, that was my last attempt.

Along the same lines, Viv says: The best laid plans…I too had considered doing this and decided against it mainly for logistical reasons. As it turned out, our daughter at 10 mos. had ten big choppers and wasn’t even on formula but regular food.

If I see our baby chewing on it’s bottle nipples, I may be very reluctant to stick my boob in there too.  If the baby seems to have the hang of sucking (sometimes orphanage babies don’t), it might not be too bad.   I think the general idea is to very very gradually work the baby up to trying to latch.  First, get the baby used to eating from a bottle in a position similar to nursing.  Then do it with no shirt.  Then no bra.  Then place the bottle nipple over your own boob (suplimental feeding tube for milk). Then boob with the tube. Then boob only.  This can take weeks or months depending on the baby.

**Obligitory TMI warning.  If you don’t want to hear about my boobs, stop reading now.** The truth of the matter is that I have very small, very flat nipples.  There is no similarity between my nipples and the nipples on a baby bottle. None.  I don’t expect a baby who has been sucking on a bottle nipple for 9-12 months to figure out that my tiny nipples are supposed to serve a similar function.  I will probably need to use nipple shields for this baby.  The very small nipples also make pumping a pain , despite various attachments that are supposed to help.  Once again, not having the boobs of a playboy bunny bites me in the ass.

Also, for the record, breastfeeding hurts sometimes.  When I started nursing M, my nipples were covered with blood blisters because her latch was a little funny.  I never understood the term "toe curling pain" until I tried to breastfeed her.  After a few days work and a lot of consultation with a lactation consultant we worked it out.   M also was know to bite a few times too.  Yes it hurt and yes it was infuriating.  The best thing to do with a biter is counter-intuitively push their face into your breast so they can’t breathe while you are screaming from pain.  They will open up their mouth to breathe.  Also the yelling will startle them and they will learn not to do it.

I know I mentioned it before, but I am mostly concerned about the nutrition.  If I have to only pump and feed with bottles or cups, I think that will be acceptable to me.

Alright, I had planned on writing more, but it is too late and I need some sleep.  I am sure I am jinxing this whole project by talking about it so much.  Just so you know, I am not going to get all psycho about it.  I just figured it was worth a try.