I'm adopting a newborn, and I'd like to breast-feed the baby when I bring him home. Can I produce breast milk if I haven't been pregnant?

Answers from Elizabeth LaFleur, R.N.

With considerable dedication and preparation, breast-feeding without pregnancy (induced lactation) might be possible.

Normally, the natural production of breast milk (lactation) is triggered by a complex interaction between three hormones — estrogen, progesterone and human placental lactogen — during the final months of pregnancy. At delivery, levels of estrogen and progesterone fall, allowing the hormone prolactin to increase and initiate milk production.

Induced lactation depends on the successful replication of this process. If you have months to prepare, your health care provider might prescribe hormone therapy — such as supplemental estrogen or progesterone — to mimic the effects of pregnancy. Hormone therapy can last six months or more.

About two months before you expect to start breast-feeding, you'll likely stop hormone therapy and begin pumping your breasts with a hospital-grade electric breast pump. This encourages the production and release of prolactin. At first, pump for five minutes three times a day. Work up to pumping for 10 minutes every four hours, including at least once during the night. Then increase pumping time to 15 to 20 minutes every two to three hours. Continue the routine until the baby arrives.

If you have a short time to prepare, hormone therapy might not be an option. Your health care provider might recommend other medications to help induce lactation. Pumping remains important for whatever time you have.

When you begin to breast-feed the baby, your health care provider might recommend continued pumping — including after feedings — to help establish your milk supply. And even if you're able to successfully induce lactation, supplemental feedings with formula or pasteurized donor human milk might be needed — especially during the initial weeks of breast-feeding. To encourage continued nipple and breast stimulation, you might use a supplemental feeding aid that delivers donor breast milk or formula through a device that attaches to your breast. Supplemental feedings can also be given with a bottle. To protect your milk supply, pump each time your baby receives a bottle feeding.

To learn more about induced lactation and how to increase your chances of establishing breast-feeding, contact a lactation consultant at a local hospital or clinic.

With

Elizabeth LaFleur, R.N.

Jan. 20, 2016