The word is getting out!  Non-gestational parents – whether by adoption, surrogacy, foster care, or their partner is birthing – can provide their own milk to their babies by inducing lactation.  Inducing lactation is a unique lactation circumstance that deserves the skilled support of a lactation professional. As a lactation consultant who has worked with hundreds of parents to induce lactation and trained numerous lactation professionals to do the same, some common obstacles have emerged.  This presentation identifies common obstacles faced by lactation professionals supporting inducing lactation and proposes several solutions for each.  Case studies are included as appropriate.

Have an inclusive lactation practice?  Co-nursing — also called co-breastfeeding or co-lactation — involves sharing lactation and/or the breastfeeding relationship between two (or more) queer parents.  Usually one parent births their baby and the other induces lactation, but both parents may induce lactation if the baby arrives via adoption or surrogacy.   When research and general knowledge about breastfeeding revolve around one person breastfeeding a baby,  it can be difficult to know how to navigate a shared breastfeeding relationship.  How to establish sufficient lactation between two  parents?  How to balance parental roles when they both breastfeed?  Will baby develop a preference for breastfeeding with one parent over another?  This presentation draws on the experiences of many co-nursing couples to serve as a guide for successful co-nursing for queer families.

Exclusive feeding directly from the breast or chest is not always available.  Common reasons for this include a baby who is unable to effectively remove milk from the breast/chest or a parent who is not producing enough milk to meet baby’s needs.  A nursing supplementer – or supplemental feeding tube device as it is often referred to in journals – can serve as an “external milk duct” providing plenty of extra flow when baby needs an easier flow or parents need an increased flow.  A nursing supplementer can help preserve the breastfeeding relationship and increase milk production.  So why isn’t it used more often?  It can be challenging to use, especially at first.  As a lactation consultant who specializes in working with parents inducing lactation, Alyssa has seen the struggles and successes using a nursing supplementer first-hand.  In this presentation she shares her professional experience and the wisdom of the research to help other lactation professionals support clients with this incredible tool for supporting long-term breastfeeding outcomes.

Too much supplementation means baby is getting less of the parent’s own milk, and eventually less milk production for the parent.  Too little supplementation means baby is not fed enough.  So how to find that juuuuust right amount?  Or even to determine whether supplementation is really necessary?   And, when necessary, how to supplement in a way that preserves long-term breast/chestfeeding outcomes?  This presentation can serve a guide for if, when, how and how much to supplement direct breast/chestfeeding with additional human milk or infant formula.

Whether a parent or parent-to-be is growing their family by adoption, surrogacy, foster care or their partner is birthing, they may choose to induce lactation.  Inducing lactation allows a non-gestational parent to provide their milk for their baby and aids parent and baby in having a nursing relationship.  But how can a parent bring in milk without the hormones of pregnancy, birth, and postpartum?  When a parent is birthing, lactation is a process:  her body and breasts prepare for lactation during pregnancy, the delivery of the placenta triggers the initiation of mature milk, and continued removal of milk maintains milk production.   Without pregnancy, the parent can lactate by simulating this process using three basic steps (or less!).  Methods used in each of the steps for inducing lactation is customized to the unique circumstances, health and fertility profile, and preferences of each parent.

Every parent deserves the opportunity to breastfeed – even if that parent did not birth their baby.  And as professionals, it is important to recognize that these parents will come to us with some unique needs and circumstances.  They are likely to have health histories that are different than gestational parents.  They may have difficult feelings about their path to parenthood or a non-conforming gender identity. The timing of their baby’s arrival may be unknown until weeks or days beforehand.  They may be sharing the breastfeeding/chestfeeding relationship with a partner.  They can expect to need to supplement their milk production.  And of course, they won’t have the hormones of pregnancy to initiate lactation.  Understanding as best we can the unique needs of these extraordinary parents can go a long way towards being an inclusive lactation practice.

Many lactating parents rely on a breast pump to help provide milk for their babies when they are separated or not feeding directly from the breast/chest for other reasons. Some of these parents may find pumping uncomfortable. Many others have difficulty expressing enough milk to meet their babies’ needs. There are also those who produce an overabundance of milk while pumping. This session addresses all of these parents by providing ideas for making pumping as effective, efficient, and comfortable as possible.

When is it too late to breastfeed a baby? Sometimes parents regret the decision not to breastfeed. Sometimes they discontinue breastfeeding and feel it was too soon. For various reasons, parents may wish to resume lactation.  Although it isn’t as easy to make milk without the hormones of pregnancy kicking things off, it is very possible for parents who haven’t lactated for days, weeks, or months to begin to produce milk once again.  This presentation was developed to help the listener understand when and why a parent may wish to relactate, what to expect, and the specific tools and techniques to resume milk production.

Newborn babies are hardwired for breastfeeding:  their newborn instincts direct them to latching at the breast/chest.  But what about older babies who are currently exclusively bottle-feeding – can they learn to breastfeed too?  A birthing parent may wish to initiate or resume breastfeeding after choosing not to breastfeed or discontinuing breastfeeding.  An adoptive or foster parent may be placed with an older baby or toddler whom they wish to nurse.  With patience, persistence, support, and some tools and tricks, it can be possible.  This presentation discusses how to know if baby is ready to breastfeed, setting the stage for success, and the process of gentle transitioning from bottle to breast/chest.

When a parent is unable to meet her baby’s needs with her own milk, milk donated by another nursing parent may be an option. Parents have always quietly, informally received donated milk from family members and friends. Recently, parents are connecting via the internet with nursing parents they have never met who are willing to donate their surplus milk to another baby in need. Milk donors are not screened, the milk is not pasteurized, and the handling and storage of the milk is not monitored. As a result, it is essential that parents take precautions whenever accepting donated milk. This session takes a close look at the concerns regarding milk sharing and how parents can minimize the risks involved.

According to research collected by the U.S. Surgeon General, the support of the breastfeeding partner is one of the most important factors for breastfeeding success. Dads and other breastfeeding partners can support breastfeeding success by providing emotional support, gathering resources, helping mother get comfortable, nurturing her, and more.  This session also suggests ways the partner can bond with the baby without bottle-feeding, so that mother can more successfully breastfeed without feeling that she must allow her partner to sometimes feed the baby.