Another Protocol for Inducing Lactation
In Breastfeeding Without Birthing, I present several excellent approaches, or protocols, for inducing lactation. I encourage my readers, with the help of an International Board Certified Lactation Consultant (IBCLC), to mix-and-match them if desired to suit their individual needs. In working clients in my private practice, I find myself coming back to one combination that seems to fit especially well for mothers for whom the Newman-Goldfarb Protocol may not fit: either the mother cannot or chooses not to take the birth control pill, or she has a short lead time before baby arrives. (Dr. Newman does not recommend using the birth control pill if a mother has less than 3.5 months lead time before her baby is expected to arrive.)
Step 1: Preparing Your Breasts for Making Milk
Up to about 3 months before baby arrives, start manually stimulating the breasts. Breasts can be manually stimulated using breast massage, nipple manipulation, partner suckling, and/or hand expression. Work up to doing some combination of these manual breast stimulation techniques 8 times per day. Since little to no milk is expected during this time, a mother can manually stimulate the breasts (except for partner suckling) in the bathroom whenever she uses the toilet or takes a shower. Also, begin taking the herb goat's rue according to package directions. During this time, a mother is likely to observe changes in her breasts: heaviness, tenderness, enlargement, and/or increased nipple elasticity.
Step 2: Starting to Make Milk Before Baby Arrives
Then about 6 weeks before baby is expected to arrive, add pumping to the routine. Gradually transition from just manual stimulation of the breasts to pumping with manual stimulation. Pumping with manual stimulation is known as "hands-on pumping". Hands-on pump 8 times per day, including once during the middle of the night. Also, add in either domperidone or an herbal combination appropriate for adoptive mothers. Herbal combinations designed for adoptive mothers already contain goat's rue as well as several other herbs that promote milk production, so mothers using an herbal approach can discontinue the goat's rue on its own at this point. For mothers choosing to use domperidone, goat's rue can be continued as long as it continues to be helpful.
Step 3: Breastfeeding and Continuing to Make More Milk
Begin nursing your beautiful baby! Supplement using an at-breast supplementer such as the Lact-Aid or SNS. Alternatively, supplement using bottle-feeding and continue hands-on pumping if desired. Continue taking domperidone for as long as needed/desired.
Breastfeeding Without Birthing contains detailed information on the manual stimulation and pumping techniques described in this protocol, domperidone, herbal combinations for adoptive mothers, at-breast supplementation, and bottle-feeding techniques that support breastfeeding.
Why do I like this protocol?
- I especially like its emphasis on manually stimulating the breasts and then gradually adding in pumping. Many mothers inducing lactation (including myself!) have found pumping very uncomfortable at first. Much more so than for mothers who have just given birth. I suspect that this is due to increased elasticity of the nipples that occurs during pregnancy. Manually "waking up" the breasts and stretching nipples is a more gentle approach than the pump and may result in less soreness from pumping.
- On the same note, manually stimulating the breasts can help mothers to become more comfortable handling their breasts and to start seeing them as means for feeding and comforting a baby. Studies have shown that mothers who hand express have better long term breastfeeding outcomes and I believe this is why.
- Hands-on pumping has been shown to significantly increase the amount of output from pumping.
- This approach does not involve artificial hormones. Domperidone is not an artificial hormone, but a gastrointestinal medication that as a side effect causes the body to release its own natural prolactin, the hormone responsible for milk production.
- More specifically, it helps to prepare the breasts for lactation without the need to take a birth control pill which, for some mothers, is undesirable.
- It provides the option to use domperidone or just herbs without any pharmaceutical medications.
- It works for mothers with a medium or short lead time. If the mother has less than 6 weeks before baby is expected to arrive, steps 1 and 2 can be started together.