A Special Gift: Breastfeeding an Adopted Baby

By Julie Bouchet Horwitz
Issue 104, January/February 2001

It was Christmas Eve. The fireplace, ablaze with warmth and light, was hung with four stockings: one for my husband, Bill, one for me, one for our nine-year-old daughter, Margot, and one nameless stocking for the adopted daughter whose arrival our family had been anxiously awaiting for months.

Although Margot was born shortly before our first anniversary, after eight years Bill and I were still longing for another baby. When we made the decision to adopt, we decided to seek a child from China because we were assured we could adopt a young and healthy infant there. I had my heart set on something special: I wanted to breastfeed my adopted child.

I had breastfed Margot and enjoyed the bonding and nurturing so much that I wanted to share this same closeness with our new baby. I had heard of women nursing adopted babies and hoped this would be possible for me. But how, without a pregnancy, was I to do this?

To induce lactation, the milk ducts of the breasts must be stimulated. This is accomplished ordinarily through the baby's sucking. Stimulation releases prolactin, a hormone that relaxes the mother. As the prolactin builds up in the bloodstream, the body begins to produce milk. Most adoptive mothers do not get a full milk supply, but almost all produce some milk. It is more than likely that a mother who chooses to nurse her adopted baby will need to supplement her milk supply.

An adoptive mother may choose to have some breastmilk already established by pumping her breasts before the baby arrives, as I did. I used a double-electric model, pumping every two to three hours on both breasts for ten to fifteen minutes during the day and once during the night, when possible. Within a few weeks, some milk appeared.

It isn't necessary, however, to pump beforehand to induce lactation; simply putting the baby to the breast every two or three hours will achieve the same results. Unless a mother feels strongly about pumping before the baby's arrival, I would not recommend it. I found it time-consuming, exhausting, and, in the end, not very productive.

I had been pumping for two weeks when we received the medical records and a picture of our new daughter, who was three months old and lived in an orphanage in a small city about 400 miles west of Shanghai. It would take at least a month before we were able to make the necessary logistic and legal arrangements to pick her up. This meant that I faced the challenge of breastfeeding a baby who had been institutionalized and bottle-fed for the first four months of her life, but I was not deterred. We named the baby Olivia. She was healthy and beautiful and would soon be in our arms.

After traveling halfway around the world, Bill, Margot, and I arrived at our hotel, ready to meet Olivia. Three days later we received a call saying that our new daughter was, at that very moment, in the conference room on the second floor of our hotel. Rushing downstairs, we first saw little Olivia peeking out from layers of Chinese clothing. She was handed to Margot, whom we had promised would be the first to hold the new baby. We tried to establish eye contact, but Olivia looked away. I stared at her long enough to get a fleeting smile.

We returned to our room to feed our new daughter. In the orphanage she had been fed four times a day, between 6 a.m. and 6 p.m. There were no feedings at night. At four months of age she weighed only 9 pounds. I decided to nurse Olivia immediately to see if she would even accept the breast. Babies have a desire to suck that is just as important as their need for nourishment. To my great relief, when I offered her the breast, she sucked readily.

In most cases, an adoptive mother will not produce enough breastmilk to meet the baby's nutritional needs and will need to supplement her milk supply. To avoid nipple confusion (babies suck differently on a bottle than they do on the breast), the mother can use a breastfeeding aid that provides a supplement while allowing the baby to still suck at the breast. I used a commercial product called the Supplemental Nursing System (SNS). With the SNS, the mother wears a special light plastic bottle around her neck. A thin tube attached to the bottle is taped to the mother's nipple. The baby sucks at the breast and simultaneously receives a supplement from the bottle. The more breastmilk the mother produces, the less supplement the baby takes in from the SNS. An adopted baby will nurse with a SNS even if no breastmilk at all is produced.