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Mother’s Milk

One Woman’s Story of Adoptive Breastfeeding

By Dana Colecchia Getz

"It’s prevalent in the adoption community that some people think that it’s not right to breastfeed another birth mom’s baby.
They think it’s unnatural."

Bethany Schad’s 2-year-old daughter climbs upon her lap, asking in a tiny voice, “Boob?” It is her simple way to request breastfeeding—something that is mostly only for comfort now.

She pulls her daughter in close, replying softly, “Not right now.” Moments later, the child wriggles down, scurrying off to play. This now common, casual exchange resulted from a much more complex journey.

©Dana Getz

After a diagnosis of “unexplained infertility” in 2013, Schad and her husband decided to adopt. They already had a 3-year-old son, to whom Schad had given birth and breastfed. She believed in the health benefits of breastfeeding and enjoyed its intimacy. So, when the couple began the adoption process, Schad researched how she might re-lactate in order to offer those same benefits to her adopted child. After learning in 2015 that they were matched with a health-challenged baby whose symptoms might be lessened by breastfeeding, Schad became more determined to try.

Induced lactation has slowly grown in popularity for adoptive mothers as well as the non-birth mothers of same-sex couples and mothers who have used gestational carriers. Breast milk induction is possible, but not simple. The most common method for non-birthing mothers to produce milk is by following the Newman-Goldfarb protocols. This method, published by a Canadian physician in 2000, involves birth control hormones, frequent breast pumping, and the medication domperidone. Since Schad had breastfed before, she was able to omit the birth control hormones and focus primarily on pumping and domperidone (as well as herbal teas and supplements).

She initially reached out to her doctors, but quickly hit a dead end. Her primary care physician had never heard of lactating without a pregnancy, which is not a particularly uncommon response. In the article “Nursing the Adopted Infant,”  Family Practice specialist Dr. Cathy A. Bryant explained that “Both the American Academy of Family Physicians and the American Academy of Pediatrics have policy statements on breastfeeding that include assisting or encouraging adoptive mothers to induce lactation for adoptive nursing. That said, there is very little in the medical literature on how to help an adoptive mother in her endeavor to induce lactation. Probably, most physicians and adoptive parents are unaware of this potential opportunity.”

Contacting her obstetrician’s office was even less helpful as they refused to give her an appointment to discuss it. The obstetric nurse told her—in what Schad interpreted as a “disgusted” tone—that they “absolutely would not endorse this.” Schad was saddened, but not surprised.

“I knew that was going to be a reaction that we would receive for years to come. It’s prevalent in the adoption community that some people think that it’s not right to breastfeed another birth mom’s baby. They think it’s unnatural. I knew that there would be people that would find it disturbing and not approve of it.”

Beyond this ongoing ethical debate, the use of domperidone—a drug not approved by the FDA—remains controversial. This anti-nausea medication is used off-label to help women produce prolactin, a hormone necessary for breastfeeding. In 2004, the FDA warned against the use of domperidone for lactation induction over concerns of possible cardiac arrhythmias and “unknown risks” to the infant when excreted in breastmilk.

Undeterred, Schad reached out to Magee-Womens Hospital of UPMC’s lactation department. According to Schad, although they were aware of the Newman-Goldfarb protocols, they’d never had a breastfeeding adoptive mother as a patient and had no idea how one would access domperidone.

Schad then connected to online adoptive breastfeeding communities where she learned that domperidone is regularly prescribed in Canada and Europe to induce lactation. She eventually ordered domperidone from overseas. Schad was honest about the weight gain and heart palpitation side effects she experienced, but felt that while pumping alone would have produced some milk, she would not have achieved a full supply without the domperidone. It was an “educated risk” that she was willing to take in order to provide the benefits of breastfeeding for her child.

The American Academy of Pediatrics recommends breastfeeding due to “the unequivocal evidence that breastfeeding protects against a variety of diseases and conditions in the infant.” But with an adopted child, the psychosocial effects of breastfeeding may play an even more beneficial role in their development. Schad explained that for adopted babies who no longer hear the same voices that they heard in the womb, “Their story starts with a loss. That doesn’t go away and that has to be dealt with.”

During their open adoption process, Schad discussed her desire to breastfeed with her daughter’s birth mother whose approval only strengthened her resolve. But when her daughter was born and immediately rushed to the Neonatal Intensive Care Unit (NICU), Schad found that her birth mother’s approval would not be enough.

There is a two-day waiting period after birth before legal guardianship transfers to the adoptive parents. Within that time, regardless of their birth mother’s preference, the hospital would not allow Schad to breastfeed. They considered her a milk “donor,” and donor milk must be pasteurized. Once the couple had legal guardianship, she was finally allowed to give her baby pumped breast milk by bottle.

After five days, Schad and her daughter transferred together to The Children’s Home of Pittsburgh where her baby’s medical needs could be monitored in a more home-like environment. Schad felt supported there as they offered her lactation resources and encouraged her breastfeeding attempts before transitioning home.

Although Schad’s body was producing milk, the first four months included consistent, unsuccessful attempts to get her daughter to latch. In the meantime, Schad continued pumping and bottle-feeding breast milk. She described “dark days” watching her daughter, often inconsolable, struggle through health issues.

Then one morning, after over four months of diligent trying, her daughter suddenly began latching.

“She finally had something that would soothe her,” explained Schad, describing the relief and joy she felt that day. “She never really attached to anything—lovies, pacifiers, nothing to soothe her—except breastfeeding. And when that happened I felt like I gave her something to comfort her.”  

Schad acknowledges that her path is not for every adoptive mother, but she stands by her decisions. She hopes that as more people know about adoptive breastfeeding social acceptance may change and domperidone “will become approved or they will find something better, so it will become accessible and normal.”

For Schad, breastfeeding is only one part of what will be a lifelong attempt to give her daughter every possible opportunity. Over four years after beginning this journey, she still gets emotional reflecting on the awesome responsibility she feels as an adoptive mother.

“(The birth mother) chose me and it could have been anybody. She saw something in me that said she’s going to be a great mom and she’s going to give my daughter more than I ever could.”

Story Credits

Writer & Photographer: Dana Colecchia Getz
Editor & Web Producer: Alyse Horn-Pyatt

Disclaimer: the narrative expressed in the article is solely those of the author(s).
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